Racial and ethnic patterns in firearms deaths.

In the United States, there is currently an epidemic of firearms violence. Among victims of this violence, there are striking racial and ethnic patterns in the manners and circumstances of death. This study was conducted to explore and quantitate some of these differences. Autopsy and investigation reports of 554 consecutive firearms deaths in Dallas County, Texas, from March 1992 to February 1993 were reviewed. Overall suicide rates by race for 1970 and 1990 were calculated. Suicide rates for blacks have increased while overall rates (all races) have decreased slightly. Large racial and ethnic differences in the homicide-suicide ratio (H:S) were found (0.42 in non-Hispanic whites; 7.44 in others) (p < 0.001). Non-Hispanic whites who committed suicide with a firearm were less likely than other groups to do so with another person present (12% non-Hispanic whites; 49% others) (p < 0.001). Blacks and Asians who committed suicide with a firearm killed another person in 67% of witnessed cases (those with another person present during the incident). Whites (Hispanics and non-Hispanics) killed another person in only 12% of witnessed firearm suicides. The data suggest that the subtypes, psychodynamics, and causes of suicide may currently differ among racial and ethnic groups. These differences should be considered in order to formulate adequate prevention strategies and to assess the suicide and homicide risk in depressed individuals. The difficulty of accurate death certification in some cases is also discussed.