Highlights
- •What is currently known about this topic?
The US firearm-related mortality rate exceeds that of other nations, with guns now
the leading cause of death among US children. While gun ownership and regulations
have been shown to be associated with reduced firearm-related mortality, their impact
on firearm-related suicides, especially in children, has not been explored fully.
- •What new information is contained within this article?
This article explores the association of gun ownership and gun regulations on the
rate of firearm-related suicide in both the adult and pediatric populations. Further,
the potential reasons behind these findings are discussed. With this evidence-based
study, this research seeks to encourage policymakers to enact more restrictive gun
regulations.
Summary
Background
Few studies have investigated the relationship between specific gun regulations and
gun ownership with the firearm-related suicide rate among juveniles and adults across
U.S. states. Therefore, this study seeks to determine if gun ownership rates and gun
restrictions are related to the firearm-related suicide rate in both the pediatric
and adult populations.
Methods
Fourteen measures of state gun law restrictions and gun ownership were collected.
These included Giffords Center ranking, gun ownership percentages, and 12 specific
firearm laws. Unadjusted linear regressions modeled the relationship between each
individual variable and the rate of firearm-related suicides for adults and children
across states. This was repeated using a multivariable linear regression adjusting
for poverty, poor mental health, race, gun ownership, and divorce rates by state.
P values of <0.004 were considered significant.
Results
In the unadjusted linear regression, 9 of 14 firearm-related measures were statistically
associated with fewer firearm-related suicides in adults. Similarly, 9 of 14 measures
were found to be associated with fewer firearm-related suicides in the pediatric population.
In the multivariable regression, 6 of 14 vs. 5 of 14 measures were statistically associated
with fewer firearm-related suicides in the adult and pediatric populations, respectively.
Conclusions
Ultimately, this study found that increased state gun restrictions and lower gun ownership
rates were associated with fewer firearm related suicides among juveniles and adults
in the US. This paper provides objective data to help lawmakers as they create gun
control legislation that can potentially decrease the rate of fire-arm related suicide.
Keywords
Abbreviations:
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References
- Global Mortality From Firearms, 1990-2016.Jama. 2018; 320: 792-814
- International comparison of civilian violent deaths: a public health approach to reduce gun-related deaths in US youth.Public Health. 2020; 180: 109-113
- Violent death rates in the US compared to those of the other high-income countries, 2015.Prev Med. 2019; 123: 20-26
- Violence and Public and Personal Health: Gun Violence.FP Essent. 2019; 480: 16-21
- Current Causes of Death in Children and Adolescents in the United States.N Engl J Med. 2022; 386: 1955-1956
BBC News US & Canada. America's Gun Culture in Charts, https://www.bbc.com/news/world-us-canada-41488081; 2021. [Accessed 4 December 2021]
- Changes in Suicide Rates - United States, 2018-2019.MMWR Morb Mortal Wkly Rep. 2021; 70: 261-268
Mental Health America. The State of Mental Health in America, https://mhanational.org/issues/state-mental-health-america; 2021. [Accessed 4 December 2021].
- Association of Changes in Missouri Firearm Laws With Adolescent and Young Adult Suicides by Firearms.JAMA Netw Open. 2020; 3e2024303
- Firearm Laws and Firearm Homicides: A Systematic Review.JAMA Intern Med. 2017; 177: 106-119
- State Gun Laws and Pediatric Firearm-Related Mortality.Pediatrics. 2019; 144
- State gun laws, gun ownership, and mass shootings in the US: cross sectional time series.Bmj. 2019; 364: l542
- Adolescent Suicide, Household Firearm Ownership, and the Effects of Child Access Prevention Laws.J Am Acad Child Adolesc Psychiatry. 2021; 60: 1096-1104
Kaiser Family Foundaiton. States with Firearm Laws Designed to Protect Children, https://www.kff.org/other/state-indicator/firearms-and-children-legislation/; 2019. [Accessed 6 May 2022].
Giffords Law Center to Prevent Gun Violence. Large Capacity Magazines, https://giffords.org/lawcenter/gun-laws/policy-areas/hardware-ammunition/large-capacity-magazines/; 2019. [Accessed 4 December 2021].
Giffords Law Center to Prevent Gun Violence. Annual Gun Law Scorecard, https://giffords.org/lawcenter/resources/scorecard/; 2021. [Accessed 4 December 2021].
- Gun ownership and social gun culture.Inj Prev. 2016; 22: 216-220
Centers for Disease Control and Prevention. Fatal Injury Reports, National, Regional and State, 1981 - 2019, https://wisqars.cdc.gov/fatal-reports.
United States Census Bureau. Historical Poverty Tables: People and Families - 1959 to 2020, www.census.gov/programs-surveys/saipe.html; 2021. [Accessed 4 December 2021].
United States Census Bureau. Population, Population Change, and Estimated Components of Population Change, www.census.gov/data/tables/time-series/demo/popest/2010s-state-total.html; 2021. [Accessed 4 December 2021].
United States Census Bureau. Marriage and Divorce, https://www.census.gov/topics/families/marriage-and-divorce.html; 2021.[Accessed 4 December 2021].
□□□■
Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System, https://www.cdc.gov/brfss/brfssprevalence/index.html; 2021. [Accessed 4 December 2021].
- Mental Health Problems and Cancer Risk Factors Among Young Adults.Am J Prev Med. 2017; 53: S30-S39
- Poor Mental Health and Reduced Decline in Smoking Prevalence.Am J Prev Med. 2015; 49: 362-369
- Firearm legislation and firearm-related fatalities in the United States.JAMA Intern Med. 2013; 173: 732-740
- The effect of child access prevention laws on unintentional child firearm fatalities, 1979-2000.J Trauma. 2006; 61: 423-428
- Weaker gun state laws are associated with higher rates of suicide secondary to firearms.J Surg Res. 2018; 221: 135-142
- The Association Between State Laws Regulating Handgun Ownership and Statewide Suicide Rates.Am J Public Health. 2015; 105: 2059-2067
- Association Between State Minimum Wages and Suicide Rates in the U.S.Am J Prev Med. 2019; 56: 648-654
- Suicide, guns, and public policy.Am J Public Health. 2013; 103: 27-31
- State handgun purchase age minimums in the US and adolescent suicide rates: regression discontinuity and difference-in-differences analyses.Bmj. 2020; 370: m2436
- The association of firearm laws with firearm outcomes among children and adolescents: a scoping review.J Behav Med. 2019; 42: 741-762
- Funding and Publication of Research on Gun Violence and Other Leading Causes of Death.Jama. 2017; 317: 84-85
- Silencing the science on gun research.Jama. 2013; 309: 549-550
- What Do We Know About the Association Between Firearm Legislation and Firearm-Related Injuries?.Epidemiol Rev. 2016; 38: 140-157
- Homicide and suicide rates associated with implementation of the Brady Handgun Violence Prevention Act.Jama. 2000; 284: 585-591
- Epidemiologic Evidence to Guide the Understanding and Prevention of Gun Violence.Epidemiol Rev. 2016; 38: 1-4
- Gun policy and serious mental illness: priorities for future research and policy.Psychiatr Serv. 2014; 65: 50-58
- Associations Between Firearm and Suicide Rates: A Replication of Kleck (2021).Arch Suicide Res. 2022; : 1-16
- Lethality of firearms relative to other suicide methods: a population based study.J Epidemiol Community Health. 2003; 57: 120-124
- Self-inflicted and unintentional firearm injuries among children and adolescents: the source of the firearm.Arch Pediatr Adolesc Med. 1999; 153: 875-878
- Pediatric Firearm-Related Injuries in the United States.Hosp Pediatr. 2017; 7: 303-312
- Children and Adolescents Mental Health: A Systematic Review of Interaction-Based Interventions in Schools and Communities.Front Psychol. 2019; 10: 918
- Trends in Firearm Injuries Among Children and Teenagers in the United States.J Surg Res. 2020; 245: 529-536
- Handgun Legislation and Changes in Statewide Overall Suicide Rates.Am J Public Health. 2017; 107: 579-581
- A comparison and analysis of seven gun law permissiveness scales.Inj Epidemiol. 2021; 8: 2
- Does the level of education influence completed suicide? A nationwide register study.J Affect Disord. 2013; 147: 437-440
- Impact of Mental Health Treatment on Suicide Attempts.J Behav Health Serv Res. 2021; 48: 4-14
- Substance use and suicide.Curr Opin Psychiatry. 2011; 24: 197-202
Article info
Publication history
Accepted:
January 9,
2023
Received in revised form:
December 27,
2022
Received:
November 14,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
