Social and Economic Factors

Gun violence continues to be a significant public health

issue in the U.S.²⁰ In 2023, firearms were responsible for more than half

(55%) of all suicide deaths nationally.²¹ Furthermore, the U.S. has a significantly higher rate

of firearm deaths than 30 other populous high-income countries as defined by the Organization for Economic Co-operation and Development.²² In 2023, firearm deaths accounted for more than 1.1 million years

of potential life lost before age 65.²³

Changes over time. Nationally, the firearm death rate decreased 3% from 14.5 to 14.0 deaths due to firearm injury of any intent (unintentional, suicide, homicide or undetermined) per 100,000 population between 2022 and 2023. The current rate does not meet the Healthy People 2030 target to reduce firearm-related deaths to 10.7 per 100,000 population

and is 16% higher than it was in 2019 (12.1).²⁴ In 2023, there were 46,700 deaths by firearm. Homicides by firearm decreased 8% nationally from 5.9 to 5.4 between 2022 and 2023. The firearm suicide rate (8.2) did not significantly change.

Between 2022 and 2023, the firearm death rate decreased:

During the same time, the firearm death rate decreased 11% in Missouri (24.1 to 21.4 deaths per 100,000 population) and 8% in California (8.9 to 8.2). However, the rate increased 45% in the District of Columbia (22.9 to 33.1).

Differences. The firearm death rate varied by race/ethnicity, geography, gender and age in 2023. It was:

In 2023, there were 22,830

homicides committed in the U.S., of which nearly 18,000 — or almost 80% —

involved a firearm.^25,26

Changes over time. Nationally, the homicide rate decreased 13% between 2020-2021 and 2022-2023 from 7.7 to 6.7 deaths due to injuries inflicted by another person with intent to injure or kill per 100,000 population. In 2022-2023, nearly 44,900 homicides occurred, a decrease of more than 5,700 deaths compared with 2020-2021. The current rate does not meet the Healthy People 2030 target to reduce homicides to 5.5 deaths per 100,000 population

.²⁷  

Between 2020-2021 and 2022-2023, the homicide rate significantly decreased:

During the same period, the homicide rate significantly decreased in 19 states, led by: 44% in Delaware (9.5 to 5.3 deaths per 100,000 population), 32% in Utah (2.8 to 1.9) and 26% in New Jersey (4.2 to 3.1).

Differences. Homicide varied significantly by race/ethnicity, geography, age and gender in 2022-2023. The rate was:

Unemployment can lead to

lower self-esteem, higher levels of depression

and strained or lost personal relationships, and it is associated with a higher risk of all-cause mortality

.^28–30 Meanwhile, a stable, safe and well-paying job makes it easier for people to live in healthier neighborhoods, access health insurance benefits, and afford quality child care, education and nutritious food — all critical factors

to maintaining good health that are jeopardized by unemployment

.^31,32  

Changes over time. Nationally, the percentage of the civilian workforce that is unemployed increased 7% from 4.3% to 4.6% of workers ages 16-64 between 2023 and 2024. In 2024, more than 8.1 million civilians in the workforce were unemployed, 720,000 more than in 2023. 

Between 2023 and 2024, unemployment significantly increased 8% among both Black (7.4% to 8.0%) and Hispanic (5.3% to 5.7%) civilian workers, and 6% among white (3.5% to 3.7%) civilian workers. The rate also increased in 11 states, with the largest increases being 46% in Delaware (3.5% to 5.1%), 37% in Nevada (4.6% to 6.3%) and 23% in Minnesota (3.0% to 3.7%).

Differences. Unemployment varied significantly by geography and race/ethnicity in 2024. The rate was:

Volunteering

is a form of civic participation that can improve individual

, community and societal health.^33,34

Changes over time. Nationally, the percentage of the population age 16 and older that reported volunteering increased 22% from 23.2% to 28.3% between 2021 and 2023. 

Between 2021 and 2023, volunteerism increased:

Volunteerism significantly increased in 10 states during this period, led by Hawaii, Massachusetts, Tennessee and Vermont.

Differences. Volunteerism varied significantly by geography, income, educational attainment, race/ethnicity and gender in 2023. The prevalence was:

Voting is a form of active civic engagement

, which is associated with better health

, reduced violence and lower unemployment rates.^35,36

Changes over time. Nationally, the percentage of U.S. citizens age 18 and older who voted in the last presidential election decreased 2% from 66.8% to 65.3% between 2020 and 2024.

During the same period, voter participation significantly decreased 14% in Arizona (71.9% to 61.7%), and 9% in both New York (64.7% to 59.2%) and Texas (63.9% to 57.9%).

Differences. Voter participation varied significantly by geography in 2024, with participation 1.4 times higher in Minnesota (75.9%) than in Arkansas (52.8%).