Nearly 40,000 people were shot to death in the U.S. in 2017, a record number of annual firearm-related fatalities and a return to a gun death rate not seen in more than 20 years, according to the Centers for Disease Control and Prevention.

The year’s 39,773 gunshot deaths equated to nearly 109 deaths each day, according to a data from CDC’s WONDER database and first reported by the gun-focused news site The Trace.

Gun deaths have now risen for a third straight year, after more than a decade with little statistical fluctuation. The 2017 numbers increased 2.8 percent from 2016, and topped the previous yearly peak of 39,595 set in 1993 at the height of a U.S. epidemic of firearm-related murder and suicide. The 2017 rate of 12.2 firearm deaths per 100,000 people was the highest since 1996, when it was 12.8 per 100,000.

The 2017 increase in gun deaths was driven largely by rising suicides, which reached a total of 23,854, or around 60 percent of all gun deaths. Following years of relative stability, the rate of firearm suicides has grown steadily since 2007, especially among men ― predominantly white men.

Although gun homicides have fluctuated somewhat in recent years, firearm-related slayings rose slightly last year, reaching 14,542 ― also the highest annual total since the 1990s.

The numbers came amid a year of bloody massacres, including the deadliest mass shooting in modern U.S. history at a country music festival in Las Vegas. But the majority of the year’s firearm deaths reflect a more routine form of gun violence, which has taken a disproportionate toll on poorer neighborhoods and communities of color.

Black men accounted for more than half of gun homicide victims in 2017, despite making up less than 7 percent of the population, according to an analysis by the Giffords Law Center to Prevent Gun Violence, a gun safety organization founded by former Rep. Gabrielle Giffords (D).

The new data also shows that 2017 was the third straight year in which gun deaths outpaced traffic fatalities. It was also the first year that firearm-related deaths surpassed car crash deaths by more than 1,000, according to Giffords.

Troubling as the CDC report is, it says nothing of the tens of thousands of people who each year survive gunshots. CDC data has been less reliable on nonfatal gunshot injuries, and recent reporting has called into question government estimates of a precipitous rise in nonfatal wounds in recent years.

Still, the new CDC figures show why so many Americans are rallying around the cause of gun violence prevention, as demonstrated by midterm election victories by candidates favoring gun reform, Giffords said.

“It’s unacceptable that the number of deaths from shootings keeps escalating while Washington D.C. refuses to even debate policies we know would help save lives,” Giffords said in a statement. “But activism leads to change and come January, more gun safety champions will be joining Congress and making this public health problem a priority.”