Statement of purpose Veterans are more likely to own firearms and have a higher risk of fatal firearm injury than non-Veterans. The patterns of Veterans’ fatal and nonfatal firearm injury may vary by region and by rural versus non-rural residence. Research is needed to inform the development of culturally-appropriate firearm risk reduction programs for Veterans who use Department of Veterans Affairs (VA) healthcare.
Methods/Approach Using VA administrative data, we examined firearm injury rates among VA healthcare- using Veterans from 2010–2019, comparing Veterans by state and by rural/non-rural residence (a single state, Oregon, is presented here). Firearm injuries were identified and categorized by intent using International Classification of Diseases diagnosis codes. We examined injury circumstances by conducting electronic health record chart reviews.
Results Among a national cohort of 9.8 million Veterans, 11,380 received care for firearm injuries, with 207 occurring among Veterans in Oregon. Rural Veterans had a higher rate of firearm injuries than non-rural Veterans in Oregon (30.2 versus 22.4 per 100,000 Veteran-years, respectively), but not nationally (24.0 versus 24.5). Unintentional firearm injuries were treated more frequently than intentional injuries. In Oregon, rates of unintentional injury were higher among rural than among urban Veterans (23.7 and 15.6); nationally, rates were similar (16.4 and 15.5). Preliminary review of twenty-eight Oregon Veterans’ (n=15 rural; n=13 non-rural) charts revealed that most of these injuries were caused by the patient unintentionally pulling the trigger or dropping their own handgun during cleaning/routine firearm maintenance.
Conclusion Patterns of firearm injury treated in the VA healthcare system vary by region and rurality. Understanding these differences can aid prevention efforts.
Significance Analyses of rates, patterns, risk factors for, and circumstances surrounding firearm injuries among VA healthcare-using Veterans by region and rurality can help reduce knowledge gaps and inform risk reduction efforts by the VA and other healthcare and public health systems.
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