Firearm-related injuries are among the five leading causes of death for people aged 1–44 years in the U.S. The immediate and long-term harms of firearm injuries pose an economic burden on society. Fatal and nonfatal firearm injury costs in the U.S. were estimated providing up-to-date economic burden estimates.

Counts of nonfatal firearm injuries were obtained from the 2019–2020 Healthcare Cost and Utilization Project Nationwide Emergency Department Sample. Data on nonfatal injury intent were obtained from the National Electronic Injury Surveillance System – Firearm Injury Surveillance System. Counts of deaths (firearm as underlying cause) were obtained from the 2019–2020 multiple cause-of-death mortality data from the National Vital Statistics System. Analyses were conducted in 2023.

The total cost of firearm related injuries and deaths in the U.S. for 2020 was $493.2 billion, a 16 percent increase compared with 2019. There are significant disparities in the cost of firearm deaths in 2019–2020, with non-Hispanic Black people, males, and young and middle-aged groups being the most affected.

Most of the nonfatal firearm injury–related costs are attributed to hospitalization. These findings highlight the racial/ethnic differences in fatal firearm injuries and the disproportionate cost burden to urban areas. Addressing this important public health problem can help ameliorate the costs to our society from the rising rates of firearm injuries.