In a Canada analysis, suicide was the most common cause of death from firearms at 68 percent, and older men in rural areas were impacted most.

To better understand injuries and deaths from firearms, researchers looked at data on all residents of Ontario with a valid OHIP number who were injured or died of gun injuries between 2002 and 2016. They used hospital discharge and provincial death records to categorize injuries as assault, unintentional, self-harm and undetermined intent.  The data are readily available because outside criminals, most firearms in Canada are registered with the government. Canada has had various bans and restrictions on firearm ownership by the public since 1885, when indigenous people tried to rebel against the federal government. 

There were 2009 injuries not self-harm over the study period, about one firearm-related injury every 3 days, and 92 percent of those were also fatal.  



They found:

Injuries related to assault accounted for 40 percent of non-fatal injuries and 25 percent of deaths. Rather than older men in rural areas, this was dominated by young men in cities. Fifty percent of the highest assault rates were the Greater Toronto Area and Hamilton.

Firearms injuries among younger people were most often related to crime while suicide was most common among those aged 45 or older. 

Firearms for suicide were higher in rural areas, which caused injuries and death rates for rural areas to seem higher.

There were changes during years, which could be normal variation. The high during the period was 4.71 per 100 000 in 2005/06 and then rates declined, with an uptick in the last 2 years of the study (3.51 per 100 000 in 2015/16). Both peaks were related to injuries from crime. Suicide showed less variability. 

"This urban-rural divide highlights the need for tailored interventions to address these 2 contrasting injury patterns," write the authors. "Our findings highlight the need for suicide-prevention strategies in rural Ontario targeted at men aged 45 or older. Restricting access to lethal methods by such means as safe-storage campaigns and reduction in firearm ownership must go hand in hand with depression screening and treatment."