Top 5 Takeaways

  1. Higher social vulnerability linked to increased firearm injury ED visits: Counties with higher overall social vulnerability experienced higher rates of emergency department (ED) visits for firearm injuries.
  2. Impact of socioeconomic status and housing: The study observed significant patterns related to socioeconomic status and housing type and transportation, highlighting how these factors contribute to social vulnerability and firearm injury rates.
  3. Varied patterns across different indicators: While some social vulnerability indicators like household composition and disability status, and racial and ethnic minority status and language proficiency, did not show a clear pattern, specific indicators like poverty and lack of vehicle access were notably associated with higher firearm injury rates.
  4. Role of FASTER program in data collection: The CDC’s Firearm Injury Surveillance Through Emergency Rooms (FASTER) program played a crucial role in providing timely and comprehensive data on firearm injuries, which facilitated this analysis.
  5. Need for tailored prevention efforts: Monitoring ED visits for firearm injuries by county-level social vulnerability can guide tailored prevention strategies that address social and structural conditions contributing to violence risk.

Original Article Author and Citation

Corresponding Author

Miriam E. Van Dyke,

Suggested Citation

Van Dyke ME, Chen MS, Sheppard M, et al. County-Level Social Vulnerability and Emergency Department Visits for Firearm Injuries — 10 U.S. Jurisdictions, January 1, 2018–December 31, 2021. MMWR Morb Mortal Wkly Rep 2022;71:873–877. DOI:


The report highlights that during 2018–2021, in 10 jurisdictions participating in the CDC’s Firearm Injury Surveillance Through Emergency Rooms (FASTER) program, there was a significant correlation between county-level social vulnerability and emergency department visits for firearm injuries. Counties with higher overall social vulnerability saw higher proportions of these visits.


The study analyzed data from 647 counties across 10 FASTER-funded jurisdictions, using data shared with CDC’s National Syndromic Surveillance Program from 2018–2021. Social vulnerability was assessed using the 2018 Social Vulnerability Index (SVI), and rates of ED visits for firearm injuries were calculated across tertile levels of social vulnerability.


This analysis underscores the relationship between social vulnerability and firearm injury rates in the United States, with significant implications for public health. The patterns observed across different social vulnerability indicators and themes suggest that more nuanced factors, beyond just poverty or unemployment, contribute to these disparities.


Monitoring and analyzing firearm injury rates by county-level social vulnerability are critical for guiding prevention efforts. By focusing on communities disproportionately affected by firearm injuries, public health initiatives can address the underlying social and structural inequities that contribute to violence, thereby reducing firearm-related harms.


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