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Every day of the year, 688 people around the world die from firearm-related injuries. The vast majority are homicides, but in some countries and regions, suicide is more common.

A new study estimates that 251,000 people died from firearm-related injuries in 2016. Half of those deaths occurred in just six countries: Brazil, the United States, Mexico, Colombia, Venezuela and Guatemala. All told, 64% of all firearm-related deaths were homicides, 27% were suicides and 9% were accidental. Homicides were the primary cause of death in 113 of the countries, and suicides represented the largest fraction in 67 countries.

The study, published Tuesday in the Journal of the American Medical Association (JAMA), reviewed data from 195 countries between the years 1990 and 2016 and is the most extensive study ever conducted on firearm-related deaths. Law enforcement shootings, executions and deaths from conflicts and terrorism were not included in the estimates. Global firearm-related deaths exceeded global conflict and terrorism deaths every year from 1990 to 2016, except 1994, when the Rwandan genocide occurred.

The study’s first author, Dr. Mohsen Naghavi, professor of global health at the Seattle-based Institute for Health Metrics and Evaluation (IMHE) said:

This study confirms what many have been claiming for years – that gun violence is one of the greatest public health crises of our time. There are no simple antidotes to address this health problem. The tragedy of each firearm-related death will continue until reasonable and reasoned leaders come together to address the issue.

A key finding reveals that 87% (218,900) of global firearm-related deaths occurred among men, and more than 34,700 occurred among men between the ages of 20 and 24.

The 10 countries with the most firearm-related deaths (all ages, both sexes) in 2016 were:

1. Brazil: 43,000 deaths
2. United States: 37,200
3. India: 26,000
4. Mexico: 15,400
5. Colombia: 13,300
6. Venezuela: 12,800
7. Philippines: 8,020
8. Guatemala: 5,090
9. Russia: 4,380
10. Afghanistan: 4,050

Ranked by the number of deaths per 100,000 people, the 10 countries with the highest homicide rates are:

1. El Salvador: 38.9 deaths per 100,000 people
2. Venezuela: 32.9
3. Guatemala: 28.0
4. Colombia: 24.3
5. Honduras: 21.6
6. U.S. Virgin Islands (territory): 19.0
7. Brazil: 18.2
8. Jamaica: 16.0
9. Puerto Rico (territory): 15.5
10. The Bahamas: 13.1

The 10 countries posting the highest suicide rates were:

1. Greenland (territory): 22 deaths per 100,000 people
2. United States: 6.4
3. Uruguay: 4.2
4. Zimbabwe: 3.1
5. Argentina: 2.7
6. Switzerland: 2.5
7. Montenegro: 2.5
8. Finland: 2.4
9. Serbia: 2.4

The full report along with supplemental and methodological information is available at the JAMA website. The following graphic was produced by IMHE.

Source: Institute for Health Metrics and Evaluation (IMHE)