INTRODUCTION: A complex and ongoing issue in firearm violence prevention research is correctly classifying injury intent (e.g., homicide, suicide, or unintentional). Emerging rule-based approaches to improve classification use the number of bullet wounds to infer intent of the injury when additional information is not available. Using the Centers for Disease Control and Prevention's National Violent Death Reporting System (NVDRS), which captures detailed information on intent of firearm injuries from coroner/medical examiner reports, law enforcement reports, and death certificates, this study examined potential evidence to support intent determination based on the number of bullet wounds. METHODS: 2003-2021 NVDRS data on fatal firearm injuries was analyzed in 2023. ANOVA was used to test statistical significance of differences in average number of bullet wounds by intent, and Tukey's Honest Significant Difference Test was used to determine specific differences by intent. RESULTS: A total of 299,362 fatal firearm injury decedents were identified. The average number of bullet wounds significantly differed by intent: suicide, 1.02; homicide, 2.72; and unintentional injury, 1.01 (P<.001). Homicide decedents had a significantly higher average number of wounds than unintentional injury decedents and suicide decedents (ΔM homicide-unintentional injury [1.71; 95% CI: 1.62 - 1.79; P<.001] and ΔM homicide-suicide [1.70; 95% CI: 1.68 - 1.72; P<.001]). CONCLUSIONS: The number of bullet wounds may be a useful indicator for classifying intent of firearm injuries, particularly for interpersonal assault, and when other supporting information is not available for medical coding. Accurate counts of firearm injuries by intent are critical for public health surveillance and prevention planning.

During the last four years, xenophobic rhetoric directed toward Latino immigrants in U.S. media outlets and political forums has greatly increased. Using a general inductive approach, this qualitative study examined the forms of cultural stress, with a focus on discrimination and xenophobia, experienced by Latino adolescents in urban U.S. settings in 2018 and 2019. Six focus groups were conducted in Miami and Los Angeles (three groups per city) with first- and second-generation tenth-grade Latino students (n = 34). The following four themes emerged from the data: perceived discrimination from other Latino subgroups (in-group discrimination), perceived discrimination from non-Latino groups (out-group discrimination), internalization of stressors and discrimination experienced by participants' parents, and the current U.S. political rhetoric surrounding immigration. Understanding cultural stress among Latino adolescents provides valuable insight for future interventions to offset negative health outcomes associated with cultural stress.