Out of the world’s 251,000 gun deaths every year, there’s a group of six countries that make up more than half of those deaths — and the United States is in it, according to a new study published in JAMA.

The five other countries are Brazil, Mexico, Colombia, Venezuela, and Guatemala, which have differing problems, but generally have much weaker economies and institutions — particularly criminal justice systems — than America. No other developed nation comes close to the death toll these other countries face to gun violence, which, for the purposes of this study, excludes deaths from war, terrorism, executions, and police.

The top six’s gun death tolls for 2016: Brazil was 43,200, the US 37,200, Mexico 15,400, Colombia 13,300, Venezuela 12,800, and Guatemala 5,090. Collectively, these countries made up less than 10 percent of the global population but 50.5 percent of the world’s gun deaths, the study found.

One reason America ranks so high is its large population: A country with more people is, all other things held equal, generally going to have more gun deaths.

To that end, the US’s rate of gun deaths is a bit lower than the other countries on this list; it was at 10.6 per 100,000 people, while Mexico was at 11.8, Brazil 19.4, Colombia 25.9, Guatemala 32.3, and Venezuela 38.7. El Salvador, which was not on the top six list for overall deaths, had the highest gun death rate in the world at 39.2 per 100,000 people. The global rate of gun deaths was 3.4 per 100,000 people.

Globally, most gun deaths were homicides. But in the US, most were suicides.

The US was one of 17 countries (out of 195) in which both the firearm homicide rate and firearm suicide rate were higher than the global median.

This chart looks at the rate of gun deaths worldwide, broken out by suicide and homicide.
This chart looks at the rate of gun deaths worldwide, broken out by suicide and homicide.

America was also the odd country out among wealthier nations when it comes to gun deaths. For comparison, the US’s rate of 10.6 gun deaths per 100,000 people was much higher than Switzerland’s rate of 2.8, Canada’s 2.1, Germany’s 0.9, the United Kingdom’s 0.3, and Japan’s 0.2.

It is expected that as countries become wealthier and build stronger government institutions, they will see fewer gun deaths (since systemic poverty and weak criminal justice systems, for example, can contribute to more violence). While the rate of US gun deaths is lower than that of many less developed countries, America is still an outlier when compared to nations in similar socioeconomic circumstances.

The study’s estimates are not perfect, as some countries do a poor job tracking gun deaths and proxy measures that are used to gauge gun deaths. But the study gives us the best look yet into gun deaths worldwide — and it’s not good for America.

A major reason is the US’s tremendous number of guns and weak gun laws. Time and time again, researchers have linked these factors to America’s high rates of gun violence, making it the most violent developed country in the world when it comes to guns.

America’s unique gun violence problem

The US is unique in two key — and related — ways when it comes to guns: It has way more gun deaths than other developed nations, and it has far higher levels of gun ownership than any other country in the world.

The US has nearly six times the gun homicide rate of Canada, more than seven times that of Sweden, and nearly 16 times that of Germany, according to United Nations data for 2012 compiled by the Guardian. (These gun deaths are a big reason America has a much higher overall homicide rate, which includes non-gun deaths, than other developed nations.)

A chart shows America’s disproportionate levels of gun violence. Javier Zarracina/Vox

Mass shootings actually make up a small fraction of America’s gun deaths, constituting less than 2 percent of such deaths in 2016. But America does see a lot of these horrific events: According to CNN, “The US makes up less than 5% of the world’s population, but holds 31% of global mass shooters.”

The US also has by far the highest number of privately owned guns in the world. Estimated for 2017, the number of civilian-owned firearms in the US was 120.5 guns per 100 residents, meaning there were more firearms than people. The world’s second-ranked country was Yemen, a quasi-failed state torn by civil war, where there were 52.8 guns per 100 residents, according to an analysis from the Small Arms Survey.

A chart showing civilian gun ownership rates by country. Small Arms Survey

Another way of looking at that: Americans make up less than 5 percent of the world’s population, yet they own roughly 45 percent of all the world’s privately held firearms.

These two facts — on gun deaths and firearm ownership — are related. The research, compiled by the Harvard School of Public Health’s Injury Control Research Center, is pretty clear: After controlling for variables such as socioeconomic factors and other crime, places with more guns have more gun deaths. Researchers have found this to be true not just with homicides, but also with suicides (which in recent years were around 60 percent of US gun deaths), domestic violence, and even violence against police.

As a breakthrough analysis by UC Berkeley’s Franklin Zimring and Gordon Hawkins in the 1990s found, it’s not even that the US has more crime than other developed countries. This chart, based on data from Jeffrey Swanson at Duke University, shows that the US is not an outlier when it comes to overall crime:

A chart showing crime rates among wealthy nations.

Instead, the US appears to have more lethal violence — and that’s driven in large part by the prevalence of guns.

”A series of specific comparisons of the death rates from property crime and assault in New York City and London show how enormous differences in death risk can be explained even while general patterns are similar,” Zimring and Hawkins wrote. “A preference for crimes of personal force and the willingness and ability to use guns in robbery make similar levels of property crime 54 times as deadly in New York City as in London.”

A chart showing homicides among wealthy nations.

This is in many ways intuitive: People of every country get into arguments and fights with friends, family, and peers. But in the US, it’s much more likely that someone will get angry at an argument and be able to pull out a gun and kill someone.

Guns are not the only contributor to violence. (Other factors include, for example, poverty, urbanization, alcohol consumption, and strength of criminal justice systems.) But when researchers control for other confounding variables, they have found time and time again that America’s high levels of gun ownership are a major reason the US is so much worse in terms of gun violence than its developed peers.

Stronger gun laws could help address the problem. A 2016 review of 130 studies in 10 countries, published in Epidemiologic Reviews, found that new legal restrictions on owning and purchasing guns tended to be followed by a drop in gun violence — a strong indicator that restricting access to guns can save lives. A review of the US evidence by RAND also linked some gun control measures, including background checks, to reduced injuries and deaths.

But America maintains some of the weakest gun laws in the developed world, effectively allowing civilians to own firearms at much greater levels than anywhere else. Until the US confronts that issue, it will continue seeing more gun deaths than the rest of the developed world.

For more on America’s gun problem, read Vox’s explainer.