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Background: After numerous recent mass casualty events, civilian hemorrhage control has taken a militaristic approach with aggressive and early use of tourniquets. While military literature has demonstrated the utility of tourniquets in preventing battlefield deaths from extremity injuries, there is limited understanding of their role in civilian penetrating trauma deaths. The purpose of this study is to review medical examiner (ME) autopsy records in a defined population to determine the incidence of preventable deaths from extremity wounds amenable to tourniquet placement. Methods: This is a retrospective review of ME cases from one urban county with a descriptive analysis of the demographics, mechanisms of injuries, and causes of death of homicide cases from 2003 to 2017. Mechanism of injury and wound patterns were reviewed to determine the overall occurrence of extremity injuries and amenability of tourniquet placement. Results: A total of 1,804 homicide cases were reviewed with 1,521 (84.3%) resulting from penetrating trauma. Isolated extremity injuries were present in 22 (1.45%) of the penetrating cases, all of which were amenable to tourniquet placement. There were 409 (26.9%) concurrent extremity and central penetrating injuries. The vast majority of extremity wounds were amenable to tourniquet placement (92.1%). Extrapolating nationally to 16,187 annual penetrating injury related homicides in 2016, an estimated 235 (1.45%) isolated extremity injury related deaths could be prevented and an additional estimated 4,354 (26.9%) concurrent extremity and central injury related deaths could potentially receive enhanced care with early tourniquet placement. Conclusion: Among urban ME cases, both isolated extremity cases and concurrent extremity-central injuries exist that may be amenable to life-saving tourniquet use. Extrapolating our findings nationwide suggests that many lives could be saved with early tourniquet use. Considering these findings, tourniquet availability and early placement may have a prominent role in reducing injury deaths from penetrating trauma. [ABSTRACT FROM AUTHOR]

Reports on the establishment of the firearm-related injury surveillance systems in Wisconsin funded by the Centers for Disease Control and Prevention. Requirement on all Wisconsin hospitals to report external cause of injury codes (E-codes); Assessment of firearm-related injuries; Procedure for the injury surveillance; Advantages of the systems.

Patients who schedule an office visit before a foreign trip expect to get vaccinations--and maybe something for traveler's diarrhea. Yet these are only two of many ways you can promote happier, healthier travel. [ABSTRACT FROM AUTHOR]

Ballistic gelatin has been extensively used in ballistics research for decades, but calibration standards were established on limited datasets, and only few studies have attempted to recreate these experiments with biological tissues. Recent studies have demonstrated better biofidelity with 20% ordnance ballistic gelatin, but researchers have discredited the use of synthetic gelatin claiming different behavior than ordnance gelatin. To investigate the use of synthetic clear gelatin as an acceptable surrogate of biological tissue, depth of penetration was compared between low-velocity impacts of various projectiles into porcine tissue (n = 192), post-mortem human subjects (n = 29), and Clear Ballistics synthetic gelatin (n = 39). The predicted depth of penetration of the 0.177" steel BB (38.1 mm) was consistent with the manufacturer's calibration standard (31.75-44.45 mm) and within calibration bounds of recently proposed empirical equations. Compared to impacts in biological tissue, synthetic gelatin demonstrated the least variability in depth of penetration (R 2  = 0.96). Using ANCOVA, velocity was a significant covariate (p < 0.001), and there were no significant differences in normalized depth of penetration over density between porcine tissue, post-mortem human subjects, and 20% synthetic gelatin (p = 0.22). Ultimately, this study confirmed the use of 20% synthetic gelatin as an acceptable tissue simulant using standard calibration methods for use in future ballistic studies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Published by Elsevier Ltd.)

Objective: Suicide among farmers has, over the past 20 years, garnered attention from scholars around the world. The purpose of this paper is twofold. First, this paper will present a framework for considering farmer suicide that builds upon the Interpersonal-Psychological Theory of Suicidal Behavior and extends our current explanations of suicide to include a multilevel, multifactorial focus on individual, interpersonal, community and systemic factors at the root of stressors contributing to suicide among farmers. Secondly, a blueprint for farmer suicide prevention, leveraging the Water of Systems Change Model, is proposed., Method: In the spirit of conveying multi-layered influence on farmer suicide while highlighting relevant levels for prevention a parsimonious, prevention-based model of farmer suicide is presented., Results: The Water of Systems Change (WSC) model incorporates research to bring attention to the community, organizational, and societal conditions that keep a problem, such as farmer suicide, from being eradicated., Conclusion: Suicide is a societal issue that requires a multi-level response. Farmer suicide is a particular concern, as farmers provide for and support all of us. It is incumbent upon public health and the community-at-large to improve our policies, systems, and contexts to create an environment in which farmers are also provided for and supported.

Violence across Latin America is an increasingly important factor influencing migration to the US. A particular form of violence that is experienced by many Latinx migrants is extortion. This research analyzes the extortion experiences of Latinx immigrant adults arriving at the US southern border and the impact these experiences have on mental health. We find that on average, participants paid $804 in extortion during their migration. The most common perpetrators of extortion in our study were police followed by immigration officials throughout Latin America. Pregnant participants were less likely to experience extortion and adults traveling with children were more likely to be extorted. Participants who were extorted for money reported significantly greater severity of post-traumatic stress disorder (PTSD) symptoms compared to those who were not extorted. This research is the first of its kind to analyze extortion experiences among Latinx immigrants to the US, quantifying the prevalence, amounts paid, countries where extortion occurs, and perpetrators of extortion. In addition, extortion experiences are associated with negative effects on the mental health of newly arrived Latinx immigrants to the US. Based upon these findings, we recommend that extortion should be considered a significant stressor in the migrant experience, particularly for those adults traveling with children., (© 2024. The Author(s).)

Background: Globally, Mexico is one of six countries with the highest level of firearm mortality. While previous studies have examined firearm mortality in Mexico before 2015, increases in violence since then highlight the need for an updated analysis. In this study, we examined changes in firearm-related deaths in Mexico from 2015 to 2022 and described these deaths by key demographic groups, incident location, and state of occurrence. Data came from Mexico's Instituto Nacional de Estadistica y Geografia (INEGI), a federal agency that collects and reports national population data. We used descriptive statistics to analyze rates, proportions, and percentage changes in firearm mortality, and we displayed temporal trends using time plots and special trends using maps., Results: Firearm deaths increased in Mexico from 2015 to 2018 but slightly decreased from 2018 to 2022. Homicides presented the highest increase and the highest proportion of firearm-related deaths from 2015 to 2022. Victims were primarily males but rates among women increased at a higher proportion (99.5% vs 53.5%). One third of victims were 20-29y but rates among children and adolescents (10-9y) increased at a higher proportion. Most firearm-related deaths occurred in streets or public spaces but the percentage of incidents occurring in households have increased. State-level rates and percentage changes varied significantly. States with higher rates of firearm mortality coincide with those involving conflict among organized criminal organizations., Conclusion: Firearm mortality in Mexico is a major public health burden. The epidemiology of firearm-related deaths in Mexico varies by intent, demographics, location, and states. To mitigate this challenge, multiple solutions are required., (© 2024. The Author(s).)

Importance: Suicide is a leading cause of death among US youths, and mental health disorders are a known factor associated with increased suicide risk. Knowledge about potential sociodemographic differences in documented mental health diagnoses may guide prevention efforts., Objective: To examine the association of documented mental health diagnosis with (1) sociodemographic and clinical characteristics, (2) precipitating circumstances, and (3) mechanism among youth suicide decedents., Design, Setting, and Participants: This retrospective, cross-sectional study of youth suicide decedents aged 10 to 24 years used data from the Centers for Disease Control and Prevention National Violent Death Reporting System from 2010 to 2021. Data analysis was conducted from January to November 2023., Exposures: Sociodemographic characteristics, clinical characteristics, precipitating circumstances, and suicide mechanism., Main Outcomes and Measures: The primary outcome was previously documented presence of a mental health diagnosis. Associations were evaluated by multivariable logistic regression., Results: Among 40 618 youth suicide decedents (23 602 aged 20 to 24 years [58.1%]; 32 167 male [79.2%]; 1190 American Indian or Alaska Native [2.9%]; 1680 Asian, Native Hawaiian, or Other Pacific Islander [4.2%]; 5118 Black [12.7%]; 5334 Hispanic [13.2%]; 35 034 non-Hispanic; 30 756 White [76.1%]), 16 426 (40.4%) had a documented mental health diagnosis and 19 027 (46.8%) died by firearms. The adjusted odds of having a mental health diagnosis were lower among youths who were American Indian or Alaska Native (adjusted odds ratio [aOR], 0.45; 95% CI, 0.39-0.51); Asian, Native Hawaiian, or Other Pacific Islander (aOR, 0.58; 95% CI, 0.52-0.64); and Black (aOR, 0.62; 95% CI, 0.58-0.66) compared with White youths; lower among Hispanic youths (aOR, 0.76; 95% CI, 0.72-0.82) compared with non-Hispanic youths; lower among youths aged 10 to 14 years (aOR, 0.70; 95% CI, 0.65-0.76) compared with youths aged 20 to 24 years; and higher for females (aOR, 1.64; 95% CI, 1.56-1.73) than males. A mental health diagnosis was documented for 6308 of 19 027 youths who died by firearms (33.2%); 1691 of 2743 youths who died by poisonings (61.6%); 7017 of 15 331 youths who died by hanging, strangulation, or suffocation (45.8%); and 1407 of 3181 youths who died by other mechanisms (44.2%). Compared with firearm suicides, the adjusted odds of having a documented mental health diagnosis were higher for suicides by poisoning (aOR, 1.70; 95% CI, 1.62-1.78); hanging, strangulation, and suffocation (aOR, 2.78; 95% CI, 2.55-3.03); and other mechanisms (aOR, 1.59; 95% CI, 1.47-1.72)., Conclusions and Relevance: In this cross-sectional study, 3 of 5 youth suicide decedents did not have a documented preceding mental health diagnosis; the odds of having a mental health diagnosis were lower among racially and ethnically minoritized youths than White youths and among firearm suicides compared with other mechanisms. These findings underscore the need for equitable identification of mental health needs and universal lethal means counseling as strategies to prevent youth suicide.

Introduction: This study sought to evaluate injury frequency of penetrative trauma before and after stay-at-home orders were implemented due to COVID-19 in Wisconsin., Methods: Patients who presented to a level I trauma center from January 2018 through December 2021 with a mechanism of injury of firearm or stab wound were included. The study was split into pre-COVID (January 2018-February 2020) and COVID (March 2020-December 2021) periods. Statistical analysis included chi-square tests and interrupted time series analysis., Results: A total of 1702 patients met inclusion criteria. The COVID group had a statistically significantly higher proportion of firearm injuries (83.2%) and a significantly lower proportion of stab injuries (16.8%) compared to the pre-COVID period group (70% and 30%, respectively, P  < 0.001). There was no change from pre-COVID to COVID periods in in-hospital mortality or length of hospital stays. There was an increase in firearm incidents in the COVID period in 72% of Milwaukee County ZIP codes and a decrease in stab incidents in 48% of ZIP codes. Interrupted time series analysis indicated a significant increase from the pre-COVID to COVID periods in monthly firearm and stab injuries. Firearm injury significantly increased from pre-COVID to COVID for Black or African American patients but no other racial group., Conclusions: These findings are consistent with other state and national trends suggesting increasing penetrative injury during the COVID-19 pandemic. The intersection of the COVID-19 pandemic and violence pandemic may yield a "syndemic," imposing a significant burden on trauma systems. Evidenced-based public health interventions are needed to mitigate the surge of firearm injuries., (Copyright© Board of Regents of the University of Wisconsin System and The Medical College of Wisconsin, Inc.)

Background: Combined ED and police department (PD) data have improved violence surveillance in the UK, enabling significantly improved prevention. We sought to determine if the addition of emergency medical service (EMS) data to ED data would contribute meaningful information on violence-related paediatric injuries beyond PD record data in a US city., Methods: Cross-sectional data on self-reported violence-related injuries of youth treated in the ED between January 2015 and September 2016 were combined with incidents classified by EMS as intentional interpersonal violence and incidents in which the PD responded to a youth injury from a simple or aggravated assault, robbery or sexual offence. Nearest neighbour hierarchical spatial clustering detected areas in which 10 or more incidents occurred during this period (hotspots), with the radii of the area being 1000, 1500, 2000 and 3000 ft. Overlap of PD incidents within ED&EMS hotspots (and vice versa) was calculated and Spearman's r tested statistical associations between the data sets, or ED&EMS contribution to PD violence information., Results: There were 935 unique ED&EMS records (ED=381; EMS=554). Of these, 877 (94%) were not in PD records. In large hotspots >2000 ft, ED&EMS records identified one additional incident for every three in the PD database. ED and EMS provided significant numbers of incidents not reported to PD. Significant correlations of ED&EMS incidents in PD hotspots imply that the ED&EMS incidents are as pervasive across the city as that reported by PD. In addition, ED and EMS provided unique violence information, as ED&EMS hotspots never included a majority (>50%) of PD records. Most (676/877; 77%) incidents unique to ED&EMS records were within 1000 ft of a school or park., Conclusions: Many violence locations in ED and EMS data were not present in PD records. A combined PD, ED and EMS database resulted in new knowledge of the geospatial distribution of violence-related paediatric injuries and can be used for data-informed and targeted prevention of violence in which children are injured-especially in and around schools and parks., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: To examine how timing of the first outpatient mental health (MH) visit after a pediatric firearm injury varies by sociodemographic and clinical characteristics., Methods: We retrospectively studied children aged 5 to 17 years with a nonfatal firearm injury from 2010 to 2018 using the IBM Watson MarketScan Medicaid database. Logistic regression estimated the odds of MH service use in the 6 months after injury, adjusted for sociodemographic and clinical characteristics. Cox proportional hazard models, stratified by previous MH service use, evaluated variation in timing of the first outpatient MH visit by sociodemographic and clinical characteristics., Results: After a firearm injury, 958 of 2613 (36.7%) children used MH services within 6 months; of these, 378 of 958 (39.5%) had no previous MH service use. The adjusted odds of MH service use after injury were higher among children with previous MH service use (adjusted odds ratio, 10.41; 95% confidence interval [CI], 8.45-12.82) and among non-Hispanic white compared with non-Hispanic Black children (adjusted odds ratio, 1.29; 95% CI, 1.02-1.63). The first outpatient MH visit after injury occurred sooner among children with previous MH service use (adjusted hazard ratio, 6.32; 95% CI, 5.45-7.32). For children without previous MH service use, the first MH outpatient visit occurred sooner among children with an MH diagnosis made during the injury encounter (adjusted hazard ratio, 2.72; 95% CI, 2.04-3.65)., Conclusions: More than 3 in 5 children do not receive MH services after firearm injury. Previous engagement with MH services and new detection of MH diagnoses during firearm injury encounters may facilitate timelier connection to MH services after injury., (Copyright © 2023 by the American Academy of Pediatrics.)

Importance: Firearm violence is a public health crisis placing significant burden on individuals, communities, and health care systems. After firearm injury, there is increased risk of poor health, disability, and psychopathology. The newest 2022 guidelines from the American College of Surgeons Committee on Trauma require that all trauma centers screen for risk of psychopathology and provide referral to intervention. Yet, implementing these guidelines in ways that are responsive to the unique needs of communities and specific patient populations, such as after firearm violence, is challenging., Observations: The current review highlights important considerations and presents a model for trauma centers to provide comprehensive care to survivors of firearm injury. This model highlights the need to enhance standard practice to provide patient-centered, trauma-informed care, as well as integrate inpatient and outpatient psychological services to address psychosocial needs. Further, incorporation of violence prevention programming better addresses firearm injury as a public health concern., Conclusions and Relevance: Using research to guide a framework for trauma centers in comprehensive care after firearm violence, we can prevent complications to physical and psychological recovery for this population. Health systems must acknowledge the socioecological context of firearm violence and provide more comprehensive care in the hospital and after discharge, to improve long-term recovery and serve as a means of tertiary prevention of firearm violence.

Recent studies have suggested that individuals working in certain occupations may be at increased risk for suicide. While occupation is an individual-level factor, one's work is situated in organizations, communities, and societies that are impacted by policies and systems. Analysis of existing data has identified that farmers are among those with elevated rates of suicide. This qualitative study reports themes that capture the experience of farmers prior to their death by suicide in Wisconsin. This retrospective qualitative study analyzed data from the Wisconsin Violent Death Reporting System. Data on farmer suicides that occurred in Wisconsin between 2004 and 2018 were accessed. Qualitative analyses followed an inductive thematic analysis approach. All study activities were approved by the institutional review board at the Medical College of Wisconsin. Between 2004 and 2018, 190 farmers died by suicide in Wisconsin. Five themes were identified in the qualitative analysis: "rugged individualism" clashes with a need to rely on others, interpersonal loss causes intense emotional pain and suffering, financial stress and strain overwhelm Wisconsin farmers, farmers are providers for families and communities, and alcohol and firearms are a lethal combination. Farmers who died by suicide in Wisconsin were facing significant stressors at the time of their death, many of which were not directly related to verifiable diagnosed mental illness. These circumstances varied, from physical health issues to financial stressors, to emotional pain from interpersonal conflict, and to access to lethal means. This study provides evidence calling for a public health solution to this issue, through changes at the policy, systems, and cultural levels. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Purpose: There is a need to address suicide among farmers in the United States and understand what contributes to suicide among American farmers. The purpose of this qualitative study is to analyze narrative data to uncover circumstances that were present in the lives of farmers who died by suicide., Methods: This study leverages data available in the National Violent Death Reporting System. For this study, we examined all suicides that occurred in Wisconsin between the years 2012 and 2016 and were extracted from the Wisconsin Violent Death Reporting System. Decedents were manually sorted by the "usual occupation" variable in order to identify farmers., Findings: During the study period, 73 farmers died, most of whom were White, non-Hispanic males. Four themes were identified in the thematic analysis: stymied by physical health issues, grief from loss of relationships, ready access to firearms in rural Wisconsin, and the burden of farming and the farm., Conclusions: The findings from this study demonstrate how unique contextual factors lead to suicide among farmers. This study has implications for suicide prevention among farmers. Primarily, there is a need to address the accessibility of firearms, as their availability in a time of crisis has lethal consequences. However, suicide prevention programming that addresses access to lethal means must take the sociocultural context of rural America into consideration. These findings should also be considered as applied to health care providers that serve rural communities. Suicide risk assessment and management should consider stressors unique to farmers., (© 2021 National Rural Health Association.)

Issue: Gun violence is a major public health burden, adversely affecting patients, families, and communities across the United States (U.S.) and the world. To manage the burden of injury from gun violence and identify primary, secondary, and tertiary prevention strategies, physician leaders must understand the biological and psychosocial aspects of this complex problem. However, gun violence and its complexities are not widely taught in medical schools. This Observation article details why gun violence education is not being included in medical education, offers an informed, science-based model for the disease of gun violence, and suggests methods to integrate gun violence education into medical school curricula., Evidence: We surveyed the literature for articles addressing this topic and for studies on medical school education and curriculum changes. We also examined some of the resources commonly used in medical school for mention of gun violence. Finally, we conducted a query of the AAMC Curriculum Inventory to further see if gun violence is currently incorporated into participating U.S. medical schools' curricula and found that gun violence is not a topic discussed in any significant capacity at most U.S. medical schools. Only 13-18% of schools that participated in the AAMC Curriculum Inventory during the years 2015-2018 documented gun and firearm content in their curriculum. Any other disease with similar number of deaths and injuries would be considered worthy of inclusion into medical education curricula., Implications: Medical school curricula commonly adjust with the ebb and flow of disease. Although gun violence meets the classic definition of a disease and is a major cause of harm and death, it is not taught to medical students. We assert that gun violence should be taught and framed as a biopsychosocial disease, highlighting many opportunities for interventions across a team of health care providers and physician leaders. We strongly urge medical schools to evaluate their curricula, address this teaching gap, and train the next generation of physician leaders to address all aspects of gun violence.

Objective: Interpersonal violence is an ongoing, vexing public health issue. Communities require comprehensive timely data on violence to plan and implement effective violence prevention strategies. Emergency departments (EDs) can play an important role in violence prevention. EDs treat injuries associated with violent crime, and they are well-positioned to systematically collect information about these injuries, including the location where the injury occurred. The Cardiff Model for Violence Prevention (The Cardiff Model) provides a framework for interdisciplinary data collection and sharing., Methods: This paper uses the Diffusion of Innovation Theory as a framework to present our experiences of implementing the Cardiff Model in several EDs that serve the Milwaukee area, and to detail the processes of data collection, linking and presentation across four different hospital systems., Results: Implementing a city-wide data collection effort that involves multiple hospital systems is challenging. Viewing our findings through the lens of the Diffusion of Innovations theory provides a way to anticipate facilitators and challenges to Cardiff Model implementation in a hospital setting., Conclusions: Facilitators and barriers to Cardiff Model adoption in the ED setting can be understood using the Diffusion of Innovation theory, and barriers can be interrupted through careful planning and continuous communication between partners., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Injury is a major public health issue in the USA. In 2017, unintentional injury was the leading cause of death for ages 1 through 44. Unfortunately, there is evidence that the sciences of injury prevention and control may not fully and widely integrated into medical school curriculum. This paper describes a novel injury prevention and control summer programme that was implemented in 2002 and is ongoing., Methods: The main component of the Series includes at least seven injury-related lectures and discussions designed to provoke students' interest and understanding of injury as a biopsychosocial disease. These lectures are organised in a seminar fashion and are 2-4 hours in duration. Kirkpatrick's four-part model guides evaluation specific to our four programme objectives. Trainee satisfaction with the programme, knowledge and outcome (specific to career goals) is evaluated using several mixed-methods tools., Results: A total of 318 students have participated in the Series. Evaluation findings show an increase in knowledge of injury-related concepts as well as an increase in interest in pursuing injury-related research topics in the future., Implications: The Series is a novel and innovative programme that provides training in injury and injury prevention and control-related topics to medical students, as well as undergraduate, graduate and pharmacy students. We hope that by increasing students' knowledge and understanding of injury prevention and control we are contributing to a physician workforce that understands the importance of a public health approach to injury prevention, that implements public health principles in practice and that advocates for policies and practices that positively impact injury prevention and control to help make our communities healthier and safer., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Suicide is the tenth leading cause of death in Wisconsin. Between the years 2012 and 2016, rural counties in Wisconsin had statistically significantly higher rates of suicide than urban counties. Counties in northern and western Wisconsin have some of the highest rates of suicide, with several counties having rates nearly double the state suicide rate for the same time period., Study Aim: This study investigates the utility of a systems-level, primary prevention suicide prevention strategy in reducing suicide in a rural Wisconsin county. This project focuses upstream to promote behavioural health resiliency and decrease risk factors for suicide., Results: County-level suicide rates decreased over time. Youth Risk Behaviour Survey results demonstrate that the percentage of students in the high school who report that they have an adult in the school to turn to for support increased by 11%. In addition, the number of students reporting a suicide attempt over the past 12 months decreased from 8.4% to 7.2%. Trust among project partners remained above 75% across the three survey timepoints, and the results demonstrated that power became more equally dispersed over time. There was an increase in community knowledge in where to go for help in an emotional crisis., Discussion: Systems change to prevent suicide is a complex undertaking but can affect change at the county level. In our study county, we learnt that a strong implementation body (our Partnership Council) and buy-in from key partners is essential in creating change at the systems level., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Importance: Wisconsin has the second-highest Black homicide rate in the country, reporting a rate of 37.57 deaths per 100,000 Black non-Hispanic Wisconsinites. Meanwhile, White non-Hispanics experience a homicide rate of 2.0 deaths per 100,000., Objective: This data identifies a public health disparity that deserves further investigation. This study seeks to detail the mortality rate of all-cause homicide, firearm-related homicide, non-firearm-related homicide, and legal intervention firearm-related homicide; leading causes of death; average age of death; and years of potential life lost (YPLL) between White non-Hispanics and Black non-Hispanics in Wisconsin during 2000-2017., Design: Wisconsin homicide rates, ranked leading causes of death, and average age of death were obtained through the Wisconsin Department of Health Services via the Wisconsin Interactive Statistics on Health (WISH) Query System. National data were obtained through the Centers for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System (WISQARS). Homicide rates, ranked leading causes of death, average age of death, and YPLL were compared by mechanism of injury, county of residence, and race and ethnicity., Participants and Exposures: The entire population of Black non-Hispanic Americans and White non-Hispanic Americans during 2000-2017 was included. For comparison, this was narrowed to the population of Black non-Hispanic Wisconsinites and White non-Hispanic Wisconsinites during 2000-2017. Exposure groups include all homicide victims during 2000-2017., Main Outcomes and Measures: We hypothesized that Black non-Hispanic Wisconsinites would have a significantly worse burden of disease compared to White non-Hispanic Wisconsinites, as well as Black non-Hispanic Americans., Results: This study found that firearm-related homicide rates for Black non-Hispanics compared to White non-Hispanics were 14.6 times greater in Milwaukee, 29.9 times greater in Wisconsin, and 13.0 times greater in urban counties of the United States. Firearm-related homicide is the second-leading cause of death for Black non-Hispanics in Milwaukee and the fourth-leading cause of death in Wisconsin. YPLL per person for Black non-Hispanic victims of firearm-related homicide are 36.83 years in Milwaukee and 37.04 years in Wisconsin., Conclusion and Relevance: Our findings strongly suggest that Black non-Hispanic Wisconsinites endure a significantly worse burden of firearm-related homicide compared to White non-Hispanic Wisconsinites and Black non-Hispanic Americans. This study demonstrates a significant disparity in firearm-related homicide that should inspire policy discussion., (Copyright© Board of Regents of the University of Wisconsin System and The Medical College of Wisconsin, Inc.)