Of the 15 leading causes of death, firearm-related harms receive the third lowest amount of federal research funding. This is despite the fact that firearms are the number one killer of children and teens in the United States.


Gun violence impacts people living in America every single day. Each year, gun violence kills over 44,000 people. For every one person who is killed by gunshot wounds, more than two people survive.

Injury by firearm is life altering — financially, mentally, and physically — for those personally injured, their families, and their communities.

Those who personally sustain nonfatal firearm injuries are at an increased risk for chronic pain, limitations in body function, poorer health, psychiatric disorders, and substance abuse disorders. Treatment for these conditions come with a significant financial cost for the individual who sustained firearm injuries and their families. Initial medical treatment for an individual treated for a firearm injury costs on average $5,254 for an emergency department visit and $95,887 for an inpatient stay, which results in an annual cost of $2.8 billion in medical spending for firearm-related injuries annually. However, the cost of gun violence goes far beyond the lofty medical expenses among those who receive treatment.

Beyond direct medical spending, firearm violence has a significant societal cost. These costs include expenses related to a new quality of life, revenue and productivity losses, depreciating real estate values, and an increasing financial burden placed on U.S. companies.

Each year, gun violence costs the U.S. economy $557 billion, equivalent to 2.6% of the country’s Gross Domestic Product. That’s over twice what the Department of Education spent to educate U.S. children in FY 2022.

For example, firearm violence depreciates home values and reduces retail and service industry growth. In fact, a single additional firearm homicide added to the census tract in Minneapolis is associated with a $22,000 decrease in housing values. Furthermore, a 2017 study found that six U.S. cities that experienced surges in gun violence experienced a 4% decrease in new retail and service industry establishments.

The economic impacts of gun violence detrimentally harm the communities most impacted by gun violence. Depreciating home values and limited access to retail stores for goods and employment perpetuates the systemic factors that elevate individuals’ risks for engaging in gun violence.

At Brady, we know the best way to treat the 320 people each day who are shot or killed by firearm injuries is through prevention.

To prevent gun violence, we must understand the underlying risks associated with higher rates of gun violence and identify the evidence-based solutions to address firearm violence. We must use a public health approach.

The field of public health focuses on the well being of entire populations, rather than the individual. Public health is a science that relies on evidence-based strategies to prevent disease and foster healthy populations. Because of public health’s emphasis on prevention and creating healthy communities, public health experts focus on addressing the root causes of diseases and health disparities, such as social determinants of health. This scope includes public safety, exposure to crime, and socioeconomic conditions.


Gun violence is a leading cause of premature death in the United States (U.S.) and, since 2020, is the leading cause of death among children and teens (aged 1-19). However, gun violence impacts communities across the country differently depending on those communities’ exposure to root causes.

For just one example, consider that gun homicide's diverse and complex root causes include — but are not limited to — poverty, trauma, and ineffective public safety policies, all of which, due to systemic racism, disproportionately impact Black and Latino communities. As a result, gun homicide disproportionately harms Black and Latino communities — and Black and Latino children.

For yet another example of the interplay between root causes and firearm violence, including both homicide and suicide, consider that areas with high levels of poverty are associated with higher rates of firearm deaths. In 2020, for example, counties with the highest poverty levels had firearm homicide rates 4.5 times as high and firearm suicide rates 1.3 times as high as counties with the lowest poverty levels.

As a final example, consider the link between trauma and gun violence, both homicide and suicide. Depending on racial/ethnic background, 62-80% of youth in high-poverty households in high-disadvantaged neighborhoods were exposed to firearm homicides. Youth are more likely to carry a firearm when exposed to gun violence in their communities.

Concentrated gun violence in communities perpetuates cycles of poverty, structural disadvantage, and health inequality, which are not only problems in their own right but also root causes of yet more gun violence, while also suffocating the community’s growth.

Exposure to gun violence, weak gun laws, and access to firearms significantly increases the risk of firearm suicide. In fact, research shows that access to a gun in the home increases the risk of suicide death by 300%. Although firearms are only used in 5% of suicide attempts, they account for over half of all suicide deaths. This is because 90% of those who attempt suicide with a firearm will not survive. In contrast, the odds of survival are substantially higher for those who attempt suicide by other methods. A “second chance” is a critical factor in suicide prevention efforts, as the vast majority — 9 in 10 — of individuals who survive an attempt will not die by suicide. Furthermore, states with weaker gun laws have firearm suicide rates two times higher than states with stronger gun laws.

These are just a few examples of societal conditions and exposures to violence translate to an increased risk of gun violence. In order to address gun violence in a holistic and comprehensive way, there must be more research and data surrounding the policies, programs, and strategies to prevent it.

In response to increasing rates of firearm mortality across the U.S., the purpose of our analysis is to examine the economic impact of evidence-based firearm regulations. Further, we aim to understand how federal funding for firearm-related harms research compares to the federal funding of other leading causes of death in the U.S. This is because the funding provided by the federal government is used to help identify and test the regulations and strategies that are effective in saving lives.


To identify the economic burden placed on U.S. residents associated with gun violence, we utilized existing research examining the financial cost placed on taxpayers per firearm death in each state. Then, using the average number of firearm deaths in the five states with the highest and the five states with the lowest rates of firearm mortality, we calculated a per capita rate of the financial burden placed on taxpayers.

In order to demonstrate the relative lack of federal gun violence research funding, we analyzed how much federal funding each leading cause of death receives per death. We then identified the 15 leading causes of death in the U.S. from the Centers for Disease Control and Prevention (CDC) that receive federal research funding through the National Institute of Health (NIH). To gather the number of annual deaths in 2020, we used the CDC’s WONDER database.

To quantify funding, we used data made available by the National Institute of Health (NIH), which listed funding each topic received from Congress in FY 2020, the most recent year of available data on funding for firearm injury research. Then, we measured how much funding each category received per annual death in order to compare funding more equitably.

Each firearm death across the country directly costs the American taxpayer an average of $273,904, and each non-fatal firearm injury costs $25,150.

The financial burden placed upon taxpayers by the epidemic of gun violence is not equally distributed across the country. Residents of states with higher rates of gun deaths and firearm injuries each year – which tend to be states with weaker gun laws – face higher costs associated with gun violence. 

Figure 3
Figure 3

Firearm death costs taxpayers living in the five states with the weakest gun laws nearly 4 times as much as it costs taxpayers living in the five states with the strongest gun laws per 100,000 persons.

Residents living in states with stronger gun laws, like California or New Jersey, face a less of an economic burden than those living in states with weak gun laws, like Wyoming or Arkansas. The per capita cost of gun violence placed on taxpayers in Mississippi is over 6 times greater than the cost taxpayers in Massachusetts face. Common-sense gun laws save lives and taxpayer dollars.

Across the 15 leading causes of death in the U.S., gun violence receives the third lowest amount of federal funding for research conducted by the NIH at only $309.58 of funding per firearm death.

The stark divide in research funding highlights the limited resources available to those investigating ways to prevent gun deaths and injuries across the country compared to other leading causes of death.

Alzheimer’s Disease, chronic liver disease, and cancer received the most federal funding allocated to the NIH in FY2020 – at a rate over 13,000%, 7,000%, and 6,000% higher than the funding allocated to firearm injuries, respectively. Additionally, the previous leading cause of death among children and adolescents, motor vehicle crashes, receives 566.7% more federal funding through the NIH per death than firearm injury research.

The only causes of death included in our analysis that garner less federal funding through the NIH are poisonings and falls.

Our analysis demonstrates that the implementation of evidence-based policies, proven to reduce rates of gun violence and save lives, is critical in reducing the impact gun violence has on people across the U.S.

Each of the five states with the strongest gun laws in our analysis have laws proven to lower rates of firearm violence. Among these laws are regulations that strengthen Brady Background Checks – through universal background checks, permit-to-purchase laws, or waiting periods on firearm purchases; safe storage or child access prevention laws; and extreme risk laws. Meanwhile, the five states with the weakest gun laws in our analysis do not have any of such laws in place.

When strong gun laws proven to reduce gun violence are in place, there is less of an economic burden on American taxpayers. However, there is a large gap in the existing research on which policies, community-based programs, and enforcement practices are most effective in ending the epidemic of gun violence. As research on firearm-related harms and prevention progresses, there will be more strategies and tools community leaders, medical professionals, parents, and policymakers can employ to mitigate risk factors through programs and regulations.

The stark divide in federal research funding between firearm injuries and other leading causes of death showcases how much more can, and should, be done to further investigate the solutions that can alleviate the high rates of firearm mortality across the U.S.

For many causes of death, a substantial investment in research is proven to reduce mortality rates. After years of adequate funding and implementation of research-based solutions, the motor vehicle crashes mortality rate decreased by 10.3% between 2001 and 2021. Over the same time period, the firearm mortality rate increased by 41.2%.

Over the past two decades, the major difference between motor vehicle crashes and gun violence is a consistent investment in research on the best practices to prevent them. Between FY1997 and FY2020, the federal government was prohibited from allocating research funding to firearm-related harms because of the Dickey Amendment. The Amendment stalled progress in the field of firearm-related harm research by more than twenty years, leaving the epidemic to grow significantly without the ability to identify risk factors, understand the impact of policies, and evaluate community-based solutions to reduce harm.

Conversely, the NIH was allocated an average of $88 million annually between 2008-2017 to research motor vehicle crashes. In turn, the nation learned more about vehicle safety, the efficacy of campaigns intended to stop drunk driving, and the efficacy of improving road conditions – leading to a widespread adoption of the practices and laws proven to reduce fatalities.

The funding Congress has allocated for firearm-related harm research since FY 2020 has been instrumental in creating a solid foundation of research, but there is so much more to be done to begin to understand such a complex issue.

More federal funding would create a better opportunity for researchers to investigate strategies and policies intended to prevent firearm violence will continue to create effective strategies and programs to reduce gun violence across the country. In doing so, we can improve the overall health and well-being of people all across the U.S.

For over 50 years, Brady has worked alongside policymakers, gun violence survivors, and community leaders to enact life-saving legislation and programs to end gun violence across the country.

Since the Sandy Hook Elementary School massacre, Brady has been instrumental in passing about 600 gun safety laws. These laws have saved countless lives and we remain committed to passing evidence-based legislation and programs at the state and federal level.

While we know the policies we have passed and are working to pass across the country are effective in saving lives, there is much more research to be done in order to have a chance at understanding the root causes of gun violence. As research develops with the new wave of federal funding, which began in FY 2020, we will be able to approach reducing firearm injuries through a holistic, public health approach.

This is our lanex2
Dr. Joseph V. Sakran, Founder of This Is Our Lane.

We're committed to working with public health and medical experts to address gun violence as the public health crisis it is.

This is our lanex2
Dr. Joseph V. Sakran, Founder of This Is Our Lane.
Learn More About This Is Our Lane

In 2018, Brady’s Chief Medical Officer, trauma surgeon, public health expert, and gun violence survivor Joseph V. Sakran, MD, MPH, MPA, FACS launched @ThisIsOurLane, a coalition of doctors and healthcare professionals dedicated to reducing firearm injuries and deaths while recognizing the environmental circumstances that lead to increased levels of firearm violence. For the first time, the public was able to hear and see what those on the frontlines of America’s gun violence epidemic experience every day while treating gunshot victims in trauma centers and emergency rooms across the country.

Our partnership with @ThisIsOurLane has sparked action, with doctors and other healthcare professionals testifying before Congress and state legislatures, helping win historic gun violence prevention research funding, inspiring the American College of Surgeons to host the first of its kind medical summit on firearm injury prevention that brought together organizations across the house of medicine, and more.

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