Statement of Purpose This study aims to identify the characteristics and better understand the circumstances surrounding firearm injuries occurring among Veterans living in Oregon and compare types and outcomes of firearm injuries by Veteran rural and urban status. A detailed understanding of the patterns and contexts of rural and urban Veterans’ firearm injuries is needed to inform VA risk reduction programs.

Methods/Approach VA administrative data was used to identify Veterans with firearm injury related healthcare visits at a VA facility in Oregon between January 1st, 2010 and December 31st, 2019. In-depth chart reviews were conducted to extract information on demographics, context of injury, treatment, and interventions received.

Results A total of 164 firearm injuries were identified among eligible Oregon Veterans. About half (51.8%) of the injuries occurred among rural Veterans. The two largest categories of firearm injuries among rural and urban Veterans were unintentional (62.8%) and intentional (8.9%). In 75.6% of all injuries the cases, the patient shot themselves. Many unintentional injuries occurred while a Veteran was cleaning their gun (35.9%). Most injuries (75.6%) were first treated in non-VA emergency departments or local trauma centers. Approximately 17.1% of records described referral to mental healthcare. Few VA records described risk reduction efforts. Only 11.0% documented firearm safety follow-up (e.g., safe handling and storage).

Conclusion Firearm injury circumstances were similar between rural and urban Veterans in Oregon. Standardized, consistent risk reduction efforts may help reduce risk of subsequent harm among Veterans treated for firearm injuries.

Significance Examining characteristics and circumstances of firearm injuries by urban and rural status among Veterans can inform tailored and effective firearm safety counseling to Veterans who seek VA health care, potentially reducing rates of firearm-related injuries and deaths among Veterans.