# Spatial co-occurrence of firearm homicides and opioid overdose deaths in Chicago by level of COVID-19 mortality, 2017–2021

## TL;DR

This study examines how firearm homicides and opioid deaths overlap with high COVID-19 mortality in Chicago communities from 2017 to 2021.

## Contribution

The study highlights the spatial co-occurrence of firearm homicides, opioid deaths, and high COVID-19 mortality in marginalized communities.

## Key findings

- Firearm homicide and opioid overdose rates were highest in zip codes with the highest COVID-19 mortality.
- Increases in firearm homicides and opioid deaths were observed across all levels of COVID-19 mortality.
- The findings suggest the need to address systemic factors that make communities vulnerable to multiple public health crises.

## Abstract

Firearm homicide and opioid overdoses were already leading causes of death in the U.S. before both problems surged during the COVID-19 pandemic. Firearm violence, overdoses, and COVID-19 have all disproportionately harmed communities that are socially and economically marginalized, but the co-occurrence of these problems in the same communities has received little attention. To describe the co-occurrence of firearm homicides and opioid overdose deaths with COVID-19 mortality we used 2017–2021 medical examiner’s data from Chicago, IL. Deaths were assigned to zip codes based on decedents’ residence. We stratified zip codes into quartiles by COVID-19 mortality rate, then compared firearm homicide and fatal opioid overdose rates by COVID-19 quartile.

Throughout the study period, firearm homicide and opioid overdose rates were highest in the highest COVID-19 mortality quartile and lowest in the lowest COVID-19 mortality quartile. Increases in firearm homicide and opioid overdose were observed across all COVID-19 mortality quartiles.

High co-occurrence of these deaths at the community level call for addressing the systemic forces which made them most vulnerable before the pandemic. Such strategies should consider the environments where people reside, not only where fatal injuries occur.