Characterising fire or burn-related fatalities in the USA using the National Violent Death Reporting System, 2003-2020

Objectives Intentional fire or burn-related deaths are rare in the USA compared with some countries, but do occur, and our knowledge of their epidemiology is limited. The objective of this study is to epidemiologically describe fire or burn-related deaths resulting from violence, including victim and suspected perpetrator characteristics and incident circumstances. Methods This cross-sectional study uses National Violent Death Reporting System data from 2003 to 2020 to examine violent fire or burn-related deaths among individuals of all ages. Analyses include the following case types: (1) fire or burn-related injuries were immediate, underlying or antecedent cause of death; (2) death resulted from arson; or (3) weapon used was categorised as 'fire or burns'. Precipitating circumstances were examined by manner of death (ie, suicide, homicide or undetermined intent) using chi(2) tests, with p values of <0.05 indicating statistical significance. Results Among 4395 victims, most were male (64.6%), non-Hispanic white (60.8%) and 20-64 years (72.7%). Deaths by suicide were most common (38.9%), followed by homicides (32.6%) and undetermined deaths (28.5%). Current mental health (53.4%) and substance use problems (15.0%) were common among suicide deaths. One-half (49.8%) of homicide deaths were precipitated by another crime and 19.5% were related to intimate partner violence. Conclusions The prevalence of mental health and substance use problems among suicide victims underscores the urgency for targeted prevention strategies and timely interventions. Stressors, such as interpersonal conflicts and financial problems, may contribute to fire or burn-related violent deaths.