Published

February 11, 2026

Introduction

This report highlights key trends in firearm injury-related deaths and emergency department visits by Snohomish County residents to Washington state hospitals. This information is presented to support program planning and public health intervention implementation by the Snohomish County Health Department.

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Key Takeaways

  1. Firearm injury burden peaked in 2023 and has declined since. Both emergency department (ED) visits and firearm-related deaths reached their highest levels in 2023, followed by steady declines through 2024 and into 2025; by 2025, ED visits had fallen to their lowest level since consistent reporting began in 2019.

  2. Young adults consistently experience the highest risk of firearm injury. Across historical and recent data, adults ages 18–24 had the highest population rates of firearm-related ED visits and deaths, underscoring a sustained concentration of harm during early adulthood.

  3. Older adults face fewer injuries but substantially higher fatality risk. Residents aged 60 and older accounted for a small share of nonfatal ED visits but represented the largest proportion of firearm-related deaths.

  4. Firearm harm is overwhelmingly concentrated among males. Males accounted for roughly 90% of both nonfatal and fatal firearm injuries, higher than those observed among females.

  5. Black, non-Hispanic residents consistently experienced the highest population rates of firearm-related ED visits and deaths despite representing a smaller share of total visits, indicating a disproportionate burden relative to population size that persists in both historical and recent data.

Historical Data

Date Ranges:

January 01, 2019 to December 31, 2024

Firearm Injury ED Visits

723

Firearm Injury Deaths

489

Age Group

Interpretation

• Across all years, firearm harm was concentrated among younger adults. Residents aged 18–24 accounted for the largest share of firearm-related ED visits (172 visits, 24%), followed by those aged 30–39 (160 visits, 22%) and 40–49 (97 visits, 13%).

• Young adults aged 18–24 had the highest ED visit rate at 43 per 100,000—higher than any other age group. Adults aged 25–29 reported the second-highest rate at 26 per 100,000, and teenagers aged 13–17 followed closely at 23 per 100,000 despite representing only 10% of total visits (74 visits).

• Mortality patterns mostly mirrored the nonfatal trends among young adults. Both 18–24-year-olds and 25–29-year-olds reported firearm injury death rates of 14 per 100,000 residents, the highest among all age groups.

• Those aged 60 and older accounted for only 8% of nonfatal visits but they represented a disproportionately high share of firearm-related deaths (26%), the highest across all age groups. This contrast could suggest differing patterns of firearm harm across the lifespan.

  • * refers to estimates with small counts (1 to 9) that have been suppressed to preserve privacy. See the Data Notes section for more information.
  • ! represents population rates that have been suppressed due to not meeting statistical precision thresholds.
  • * refers to estimates with small counts (1 to 9) that have been suppressed to preserve privacy. See the Data Notes section for more information.
  • ! represents population rates that have been suppressed due to not meeting statistical precision thresholds.

Sex

Interpretation

• Across all years, males consistently carried an overwhelming burden of firearm injury. They accounted for 644 firearm-related ED visits (89%), translating to a rate of 26 visits per 100,000 residents—nearly ten times higher than the rate among females (79 visits, 3 per 100,000).

• This disparity extended to fatal injuries as well. Males had the highest firearm death rate at 16 per 100,000 residents, representing 407 deaths (83%). Female residents experienced a much lower rate of 3 per 100,000 (82 deaths, 17%). The persistent contrast in both nonfatal and fatal outcomes highlights a long-standing, disproportionate impact among male residents.

  • * refers to estimates with small counts (1 to 9) that have been suppressed to preserve privacy. See the Data Notes section for more information.
  • ! represents population rates that have been suppressed due to not meeting statistical precision thresholds.
  • * refers to estimates with small counts (1 to 9) that have been suppressed to preserve privacy. See the Data Notes section for more information.
  • ! represents population rates that have been suppressed due to not meeting statistical precision thresholds.

Race Ethnicity

Interpretation

• White, non-Hispanic residents represented the largest share of firearm-related ED visits (402 visits, 56%). Given their larger share of the county’s adult population, this proportion is expected. Their population rate, however, was the second lowest of the four reported groups at 13 visits per 100,000 residents.

• Black, non-Hispanic residents faced the most substantial impact of firearm harm across both nonfatal and fatal outcomes. Although they accounted for only 14% of firearm-related ED visits (98 visits), their visit rate was the highest of any group at 54 per 100,000 residents—more than twice the rate observed among Hispanic or Latino residents.

• This elevated burden carried through to mortality as well: Black, non-Hispanic residents had the highest firearm death rate at 14 per 100,000, surpassing the rate among White, non-Hispanic residents (11 per 100,000) and doubling the rate observed among Hispanic/Latino and Multiracial, non-Hispanic residents (7 per 100,000). Taken together, the nonfatal and fatal patterns demonstrate a consistent and disproportionate risk of firearm injury for Black, non-Hispanic residents in Snohomish County.

  • * refers to estimates with small counts (1 to 9) that have been suppressed to preserve privacy. See the Data Notes section for more information.
  • ! represents population rates that have been suppressed due to not meeting statistical precision thresholds.
  • * refers to estimates with small counts (1 to 9) that have been suppressed to preserve privacy. See the Data Notes section for more information.
  • ! represents population rates that have been suppressed due to not meeting statistical precision thresholds.

Recent Data

Date Ranges:

January 01, 2025 to December 31, 2025

Firearm Injury ED Visits

77

Age Group

Interpretation

• Adults, 30 – 39, experienced the largest share of firearm-related ED visits (20 visits, 26%), followed by those aged 40 - 49 (14 visits, 18%), 18 - 24 (11 visits, 14%) and 60+ (11 visits, 14%).

• Population rates show the impact on younger adults becomes even more pronounced. Residents aged 18–24 had the highest rate- notably higher than any other age group. Adults aged 30–39 followed with a rate of 15 per 100,000. These elevated rates among younger adults underscore the importance of early, developmentally appropriate firearm-safety education and prevention efforts.

  • * refers to estimates with small counts (1 to 9) that have been suppressed to preserve privacy. See the Data Notes section for more information.
  • ! represents population rates that have been suppressed due to not meeting statistical precision thresholds.
  • * refers to estimates with small counts (1 to 9) that have been suppressed to preserve privacy. See the Data Notes section for more information.
  • ! represents population rates that have been suppressed due to not meeting statistical precision thresholds.

Sex

Interpretation

• Males accounted for the majority of firearm-related emergency department visits, with 71 visits (92%). This translated to a rate of 16 visits per 100,000 residents. Female-specific rates could not be calculated because their counts were suppressed, however the available data indicate that males carried a substantially higher burden of firearm injury.

  • * refers to estimates with small counts (1 to 9) that have been suppressed to preserve privacy. See the Data Notes section for more information.
  • ! represents population rates that have been suppressed due to not meeting statistical precision thresholds.
  • * refers to estimates with small counts (1 to 9) that have been suppressed to preserve privacy. See the Data Notes section for more information.
  • ! represents population rates that have been suppressed due to not meeting statistical precision thresholds.

Race Ethnicity

Interpretation

• White, non-Hispanic residents made up the largest share of emergency department visits (41 visits, 53%). This aligns with their larger share of the county’s adult population. Even so, their population rate was the lowest among the three reported groups—8 visits per 100,000 residents.

• Black, non-Hispanic residents experienced a disproportionate impact. They accounted for only 13 visits (17%) but had the highest population rate of firearm injury at 40 per 100,000—more than double the rate observed among Hispanic or Latino residents (14 per 100,000). Although fewer in number, the increased rate highlights a concerning risk of firearm injury relative to population size.

  • * refers to estimates with small counts (1 to 9) that have been suppressed to preserve privacy. See the Data Notes section for more information.
  • ! represents population rates that have been suppressed due to not meeting statistical precision thresholds.
  • * refers to estimates with small counts (1 to 9) that have been suppressed to preserve privacy. See the Data Notes section for more information.
  • ! represents population rates that have been suppressed due to not meeting statistical precision thresholds.

Public Health Resources

Preventing firearm injuries and deaths starts with awareness, action, and community collaboration. Safe storage is a crucial step—this means locking firearms, storing ammunition separately, and using trigger locks to prevent unauthorized access. If you or a loved one is experiencing a mental health crisis, call 988—the free, confidential Suicide & Crisis Lifeline, available 24/7 in over 240 languages.

In times of crisis, especially when someone is experiencing depression, suicidal thoughts, or substance use issues, consider removing firearms from the home temporarily. The University of Washington’s Firearm Injury & Policy Research Program offers a map of safe storage sites across Washington. Legal tools like Voluntary Do-Not-Sell agreements or Extreme Risk Protection Orders can also temporarily restrict firearm access for those at high risk of harm.

Snohomish County Lock It Up is dedicated to building safer communities by promoting the secure storage of firearms. Safe firearm storage saves lives. We provide free lock boxes, trigger locks, and cable locks, along with tips and tools to help you store firearms securely. Through community events and partnerships with local law enforcement, we’re working to make our homes and neighborhoods safer—one lock at a time.

Washington’s Suicide Prevention Plan emphasizes the shared role we all play in promoting behavioral health and reducing suicide risk. Key strategies include limiting access to lethal means and training healthcare professionals to talk about suicide risk and safe firearm storage. Since 2014, Washington has led efforts to require suicide prevention training for health professionals and has passed laws to improve firearm safety. These efforts are strengthened by partnerships with organizations like the Safer Homes Coalition, Seattle Children’s Hospital, and Harborview Injury Prevention and Research Center—all working together to educate the public and promote responsible firearm practices.

The Snohomish County Children’s Wellness Coalition Suicide Prevention Task Force is collaborative effort dedicated to reducing youth suicide, ideation, planning, and attempts across the county. This working group aims to strengthen and support suicide prevention, intervention, and postvention strategies while fostering a more connected and responsive network of care for youth.

Through partnerships with the Washington State Department of Health, Forefront Suicide Prevention at the University of Washington, the American Foundation for Suicide Prevention, Riverside Trauma Center, and other leading organizations, the Task Force works to coordinate regional efforts, provide targeted support beyond school hours, and address critical gaps in policy and practice. We offer technical assistance, training, and opportunities for youth voice to ensure communities are equipped with the tools and understanding needed to reduce risk factors and promote protective ones. Join us in building a future where every young person feels seen, supported, and safe. To learn more about our work, please visit us at General 4 — Snohomish County Children’s Wellness Coalition.

To access more Snohomish County specific health data, please visit the Snohomish County Health Department Data & Reports webpage.

Data Notes

This report uses three main types of measures:

  1. Counts – The total number of times the event occurred (such as emergency department visits or deaths) related to the specific condition of interest being monitored.

Example: Patients 17 and under had 100 ED visits and patients 18 and older had 300 ED visits for the condition of interest.

  1. Percentages – The portion of all events that occurred within a specific group of people. This helps show how different groups are affected relative to the whole.

Example: Patients 17 and under had 100 ED visits (25%) and patients 18 and older had 300 ED visits (75%) for the condition of interest. How it’s calculated: (Number of events in a group ÷ Total number of events) × 100

  1. Population Rates – A way to compare how often events happen in different groups, taking into account the population or size of each group. This helps identify whether the condition of interest is more or less common in one group compared to another.

How it’s calculated: (Number of events in a group ÷ Number of people in that group) × 100,000

Emergency Department Data

  • Emergency Department data presented within this report is from the Rapid Health Information NetwOrk (RHINO) program at the Washington State Department of Health, which is responsible for the collection, analysis, and dissemination of syndromic surveillance data, also known as healthcare encounter data, for the state of Washington.
  • This data represents the number of emergency department visits related to the condition of interest for people living in Snohomish County and sought care at a non-federal emergency department in Washington state.
  • Emergency Department data is available in near-real time.

Death Data

  • Death data presented within this report is from Washington resident death certificates. Specifically, the data was accessed via the Washington State Department of Health Center for Health Statistics (CHS) Annual Death Data Files.
  • This data represents the number of deaths of Snohomish County residents both inside and outside of Washington state due to the condition of interest.
  • The death data presented in this report reflect records that have complete data elements. These counts are considered the most accurate available at the time of reporting. However, totals may change as additional information is completed and validated.
  • Finalized death data is released annually for population health analysis, typically ~9 months after the end of the calendar year.

Population Data

  • Population data presented within this report is from official population estimates (derived from US Census Data) from the Washington Office of Financial Management (OFM). Specifically, the data was accessed via the Washington State Department of Health Community Health Assessment Tool’s (CHAT) Population module.
  • This data represents the number of people living within Snohomish County.
  • If population estimates are not available for a time period in the report, the most recent available population estimate will be utilized.

Emergency Department Data

  • Firearm injury ED visits are identified by the CDC Firearm Injury v2 Chief Complaint-Discharge Diagnosis (CCDD) category which searches for the presence of 1) firearm injury-related free-text (examples: gunshot, GSW, I was shot) and ICD-10-CM diagnosis codes (examples: W32-W34, X72-X74, X93-X95, Y22-Y24, Y35, Y38) in the Chief Complaint and Discharge Diagnosis fields of the ED visit record.
  • The data may not reflect the exact number of ED visits attributed to firearm injuries due to 1) differences in coding or reporting over time or between hospitals or 2) patients having symptoms that are non-specific or do not match search criteria.

Death Data

  • Deaths are classified using the underlying cause of death ICD-10 codes on death certificates. The underlying cause of death is defined as “(a) the disease or injury which initiated the train of morbid events leading directly to death, or (b) the circumstances of the accident or violence which produced the fatal injury.”
  • Firearm injury deaths are identified by the presence of firearm injury-related ICD-10 mortality codes on death certificates (W32-W34, X72-X74, X93-X95, Y22-Y24, Y35.0) as specified by the International Collaborative Effort (ICE) on Injury Statistics injury classification matrix.