Study finds gunfire as leading cause of death for Tennessee youth

Staff photo by Matt Hamilton / Supporters listen as Dylan Kussman speaks during the Wear Orange event held by the Chattanooga chapter of Moms Demand Action in Miller Park on Sunday, June 4, 2023. The event was held to honor the lives of those lost to gun violence.

NASHVILLE — Gunfire was the 10th leading cause of death among Tennesseans in 2021 and reached "record highs," according to a report released Monday by the Sycamore Institute, a nonpartisan think tank.

But for those ages 1 to 18, gunfire was the leading cause of death, the report found.

Sycamore said that in 2021 guns were responsible for the deaths of 1,569 residents or about 22 of every 100,000 people. That was enough to make Tennessee's firearm death rate the 11th highest in the U.S.

Just over half of firearms deaths, 52%, were suicides. Most of the remainder involved homicides.

Sycamore officials say they prepared the report in advance of Republican Gov. Bill Lee's expected Aug. 21 special legislative session focusing on firearms, public safety and mental health.

Lee, who has yet to formally issue the call for the special session, wants his fellow Republicans who comprise a supermajority in both the House and Senate to act following the mass shooting in March at a private Christian elementary school in Nashville.

The governor wants lawmakers to look at issues such as judicial orders of protection to remove firearms from mentally ill or unstable people through a legal process that allows the gun owner to participate with a lawyer. Critics say it is a red flag law impairing the rights of gun owners.

The shooting left three children and three adults dead. Police shot and killed the 28-year-old assailant, Audrey Hale, a former student at The Covenant School, who was armed with two semi-automatic weapons.

Lee's expected special session is seen as facing a difficult path with many of his fellow Republicans opposed.

Rep. Yusuf Hakeem, D-Chattanooga, said he hasn't yet seen the Sycamore report but that he understands death by gun violence is a leading cause of death for young people.

"The status quo is not in the interest of our citizens, and we need to look at potential changes in our gun laws," Hakeem said. "To my knowledge what average citizens want is common sense gun laws."

He said there is a "lot of fear-mongering between gun lobbyists and gun manufacturers, and it's very unfortunate to make another $100 million, they'll go to any extremes, and that's unfortunate because we're talking about the lives of our citizens."

State Senate Judiciary Committee Chair Todd Gardenhire, R-Chattanooga, who is skeptical about Lee's effort on orders of protection, said by phone Monday that he read the report and intends to study it further as well as seek additional information.

The report says firearms deaths are less frequent among children than any other age group because childhood deaths in general are rare.

"However, gunfire was the leading cause of death for Tennessee children ages 1 to 18 in 2021," the report says.

Children are defined as being under age 19, and they accounted for 8% of gun-related deaths.

Gardenhire said he wants to see more information on that.

"I think that's vitally important on the breakdowns," he said.

Gardenhire noted the under-19-year-old category includes teens ages 15 through 18 who may be more susceptible to involvement in criminal gang activity.

"I think that may skew the numbers quite a bit in that age group — from 15, 16 years old to 18 — might skew those numbers a bit," he said.

Gardenhire said such information could be helpful — that is, "if we get into the gun part, which I doubt we will," he said.

"I can't imagine the governor giving us anything except mental health issues, and I don't think he wants to get into anything that opens up Title 39," which addresses firearms, Gardenhire said.

According to Sycamore, of all gun deaths in 2021, 42% were among those ages 35-64, and 37% were 19 to 34-year-olds. When adjusted for population size, young adults ages 19 to 34 had the highest rate of gun-related deaths at 39.1 per 100,000 people.

Shooting deaths in the state have been rising for about a decade — largely driven by spikes in homicides. Children and Black Tennesseans had the fastest growth in firearm death rates, according to Sycamore's examination, which relied at least in part on U.S. Centers for Disease Control and Prevention data.

Over the same period, according to Sycamore, state crime data showed a rise in offenses involving firearms — both fatal and non-fatal — while all other crime rates declined.

From the 2000s to the 2010s, firearm death rates rose in about three-quarters of the 80 counties with available data. The counties with the highest rates are mostly in West Tennessee.

Most firearm deaths occur in Tennessee's most populous counties, according to Sycamore, but the counties with the highest rates are largely concentrated in West Tennessee. Because of low numbers, Sycamore combined data across multiple years for each of the 80 counties with counts high enough to be reported.

In the decade spanning 2012-2021, 43% of the state's nearly 12,000 shooting deaths occurred in the four largest counties — Shelby, Davidson, Knox and Hamilton, which together accounted for about 36% of the state's population during that period, according to Sycamore. Of these, only Shelby County was also among the counties with the highest rates of death from gunfire. Other counties with the highest rates tended to concentrate in West Tennessee.

Between the 2000s and the 2010s, gun death rates rose in about three-quarters of the 80 Tennessee counties with available data.

Between the 2002-2011 and 2012-2021 periods, the firearm death rate in Tennessee increased by about 19% or 2.9 deaths per 100,000 people. Across the 80 counties with complete data, that change ranged from an increase of 12.2 deaths (131%) in Overton County to a decrease of 16.4 deaths (-52%) in DeKalb County.

Contact Andy Sher at or 615-285-9480.