INTRODUCTION: The majority of homicides (79%) and suicides (53%) in the United States involved a firearm in 2020. High firearm homicide and suicide rates and corresponding inequities by race and ethnicity and poverty level represent important public health concerns. This study examined changes in firearm homicide and firearm suicide rates coinciding with the emergence of the COVID-19 pandemic in 2020. METHODS: National vital statistics and population data were integrated with urbanization and poverty measures at the county level. Population-based firearm homicide and suicide rates were examined by age, sex, race and ethnicity, geographic area, level of urbanization, and level of poverty. RESULTS: From 2019 to 2020, the overall firearm homicide rate increased 34.6%, from 4.6 to 6.1 per 100,000 persons. The largest increases occurred among non-Hispanic Black or African American males aged 10-44 years and non-Hispanic American Indian or Alaska Native (AI/AN) males aged 25-44 years. Rates of firearm homicide were lowest and increased least at the lowest poverty level and were higher and showed larger increases at higher poverty levels. The overall firearm suicide rate remained relatively unchanged from 2019 to 2020 (7.9 to 8.1); however, in some populations, including AI/AN males aged 10-44 years, rates did increase. CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: During the COVID-19 pandemic, the firearm homicide rate in the United States reached its highest level since 1994, with substantial increases among several population subgroups. These increases have widened disparities in rates by race and ethnicity and poverty level. Several increases in firearm suicide rates were also observed. Implementation of comprehensive strategies employing proven approaches that address underlying economic, physical, and social conditions contributing to the risks for violence and suicide is urgently needed to reduce these rates and disparities.

Sexual violence is prevalent and, for many victims, begins early in life (1). In the United States, one in five women and one in 38 men report completed or attempted rape victimization during their lifetime, with 43.2% of female and 51.3% of male victims reporting that their first rape victimization occurred before age 18 years (1). Media have been shown to act as a socializing agent for a range of health and social behaviors (2). Media portrayals might influence, reinforce, or modify how the public responds to incidents of sexual violence and their support for prevention efforts and media might construct a lens through which the public can understand who is affected by sexual violence, what forms it takes, why it happens, and who is responsible for addressing it (3). Media portrayals of sexual violence were assessed using a systematic random sample of newspaper articles from 48 of the top 50 distributed traditional print media outlets that were examined for sexual violence content and potential differences by geographic region and year of publication. Differences by year and region in type of sexual violence covered, media language used, and outcomes reported were identified, highlighting an opportunity for public health officials, practitioners, and journalists to frame sexual violence as a preventable public health issue and to incorporate best practices from CDC and the National Sexual Violence Resource Center's Sexual Violence Media Guide (4).

The Centers for Disease Control and Prevention's (CDC's) Domestic Violence Prevention Enhancements and Leadership Through Alliances, Focusing on Outcomes for Communities United with States (DELTA FOCUS) program is a 5-year cooperative agreement (2013-2018) funding 10 state domestic violence coalitions and local coordinated community response teams to engage in primary prevention of intimate partner violence. Grantees' prevention strategies were often developmental and emergent; therefore, CDC's approach to program oversight, administration, and support to grantees required a flexible approach. CDC staff adopted a Data-to-Action Framework for the DELTA FOCUS program evaluation that supported a culture of learning to meet dynamic and unexpected information needs. Briefly, a Data-to-Action Framework involves the collection and use of information in real time for program improvement. Utilizing this framework, the DELTA FOCUS data-to-action process yielded important insights into CDC's ongoing technical assistance, improved program accountability by providing useful materials, and information for internal agency leadership, and helped build a learning community among grantees. CDC and other funders, as decision makers, can promote program improvements that are data-informed by incorporating internal processes supportive of ongoing data collection and review.

According to 2011 data, nearly one in four women and one in seven men in the United States experience severe physical violence by an intimate partner, creating a public health burden requiring population-level solutions. To prevent intimate partner violence (IPV) before it occurs, the CDC developed Domestic Violence Prevention Enhancements and Leadership Through Alliances, Focusing on Outcomes for Communities United with States to identify promising community- and societal-level prevention strategies to prevent IPV. The program funds 10 state domestic violence coalitions for 5 years to implement and evaluate programs and policies to prevent IPV by influencing the environments and conditions in which people live, work, and play. The program evaluation goals are to promote IPV prevention by identifying promising prevention strategies and describing those strategies using case studies, thereby creating a foundation for building practice-based evidence with a health equity approach.

Woodsmoke contains harmful components - such as fine particulate matter (PM2.5) and polycyclic aromatic hydrocarbons (PAHs) - and impacts more than half of the global population. We investigated urinary hydroxylated PAH metabolites (OH-PAHs) as woodsmoke exposure biomarkers in nine non-smoking volunteers experimentally exposed to a wood fire. Individual urine samples were collected from 24-h before to 48-h after the exposure and personal PM2.5 samples were collected during the 2-h woodsmoke exposure. Concentrations of nine OH-PAHs increased by 1.8-7.2 times within 2.3-19.3 h, and returned to baseline approximately 24 h after the exposure. 2-Naphthol (2-NAP) had the largest post-exposure increase and exhibited a clear excretion pattern in all participants. The level of urinary OH-PAHs, except 1-hydroxypyrene (1-PYR), correlated with those of PM2.5, levoglucosan and PAHs in personal PM2.5 samples. This finding suggests that several urinary OH-PAHs, especially 2-NAP, are potential exposure biomarkers to woodsmoke; by contrast, 1-PYR may not be a suitable biomarker. Compared with levoglucosan and methoxyphenols - two other urinary woodsmoke biomarkers that were measured in the same study and reported previously - OH-PAHs might be better biomarkers based on sensitivity, robustness and stability, particularly under suboptimal sampling and storage conditions, like in epidemiological studies carried out in less developed areas.