Project description:IntroductionFirearm injury is a leading cause of death among Americans. Because the right to bear arms is protected by the Second Amendment, policymakers must consider the impact of legislation on both firearm ownership and firearm harms. The current state of knowledge in firearm research majorly examines the impact of firearm legislation on firearm injuries and fatalities alone, and it relies on correlational analyses. The few studies that consider causal effects employ counterfactual-based inference. This study introduces information-theoretic tools to explore the role of firearm laws in mitigating firearm harms while maintaining citizens' right to bear arms.MethodsThe authors study monthly time series from January 2000 to October 2019 for the implementation of firearm laws from RAND's State Firearm Law Database, firearm deaths by intent from the Centers for Disease Control and Prevention databases, and firearm ownership from an econometric model. The authors employ transfer entropy, an information-theoretic method that relies on Granger causality, to infer relationships from time series. Specifically, the authors examine transfer entropy from firearm restrictiveness to deaths per firearm owner, firearm ownership, and firearm deaths, independently.ResultsOn a national level, the authors uncover a negative association from firearm restrictiveness to deaths per firearm owner and a positive association from firearm restrictiveness to firearm ownership. On a regional level, the authors identify a negative association from firearm restrictiveness to deaths per firearm owner in the Northeast, a negative association from firearm restrictiveness to firearm ownership in the Midwest, and a negative association from firearm restrictiveness to firearm suicides in the South.ConclusionsThe authors present an information-theoretic approach to study relationships in firearm research. This method provides preliminary evidence for the role of restrictive legislation in promoting safe firearm ownership. The authors find that firearm acquisition considerably increases after the implementation of restrictive firearm laws, and simultaneously, firearm deaths decrease. These effects vary with respect to death by intent and the geographic region the laws were implemented in.

Project description:ImportanceBoth major depression and firearm ownership are associated with an increased risk for death by suicide in the United States, but the extent of overlap among these major risk factors is not well characterized.ObjectiveTo assess the prevalence of current and planned firearm ownership among individuals with depression.Design, setting, and participantsCross-sectional survey study using data pooled from 2 waves of a 50-state nonprobability internet survey conducted between May and July 7, 2021. Internet survey respondents were 18 years of age or older and were sampled from all 50 US states and the District of Columbia.Main outcomes and measuresSelf-reported firearm ownership; depressive symptoms as measured by the 9-item Patient Health Questionnaire.ResultsOf 24 770 survey respondents (64.6% women and 35.4% men; 5.0% Asian, 10.8% Black, 7.5% Hispanic, and 74.0% White; mean [SD] age 45.8 [17.5]), 6929 (28.0%) reported moderate or greater depressive symptoms; this group had mean (SD) age of 38.18 (15.19) years, 4587 were female (66.2%), and 406 were Asian (5.9%), 725 were Black (10.5%), 652 were Hispanic (6.8%), and 4902 were White (70.7%). Of those with depression, 31.3% reported firearm ownership (n = 2167), of whom 35.9% (n = 777) reported purchasing a firearm within the past year. In regression models, the presence of moderate or greater depressive symptoms was not significantly associated with firearm ownership (adjusted odds ratio [OR], 1.07; 95% CI, 0.98-1.17) but was associated with greater likelihood of a first-time firearm purchase during the COVID-19 pandemic (adjusted OR, 1.77; 95% CI, 1.56-2.02) and greater likelihood of considering a future firearm purchase (adjusted OR, 1.53; 95% CI, 1.23-1.90).Conclusions and relevanceIn this study, current and planned firearm ownership was common among individuals with major depressive symptoms, suggesting a public health opportunity to address this conjunction of suicide risk factors.

Project description:ImportanceLittle is known about support for and willingness to engage in political violence in the United States. Such violence would likely involve firearms.ObjectiveTo evaluate whether firearm owners' and nonowners' support for political violence differs and whether support among owners varies by type of firearms owned, recency of purchase, and frequency of carrying a loaded firearm in public.Design, setting, and participantsThis cross-sectional nationally representative survey study was conducted from May 13 to June 2, 2022, among US adult members of the Ipsos KnowledgePanel, including an oversample of firearm owners.ExposureFirearm ownership vs nonownership.Main outcomes and measuresMain outcomes concern (1) support for political violence, in general and to advance specific political objectives; (2) personal willingness to engage in political violence, by severity of violence and target population; and (3) perceived likelihood of firearm use in political violence. Outcomes are expressed as weighted proportions and adjusted prevalence differences, with P values adjusted for the false-discovery rate and reported as q values.ResultsThe analytic sample comprised 12 851 respondents: 5820 (45.3%) firearm owners, 6132 (47.7%) nonowners without firearms at home, and 899 (7.0%) nonowners with firearms at home. After weighting, 51.0% (95% CI, 49.9%-52.1%) were female, 8.5% (95% CI, 7.5%-9.5%) Hispanic, 9.1% (95% CI, 8.1%-10.2%) non-Hispanic Black, and 62.6% (95% CI, 61.5%-63.8%) non-Hispanic White; the mean (SD) age was 48.5 (18.0) years. Owners were more likely than nonowners without firearms at home to consider violence usually or always justified to advance at least 1 of 17 specific political objectives (owners: 38.8%; 95% CI, 37.3%-40.4%; nonowners: 29.8%; 95% CI, 28.5%-31.2%; adjusted difference, 6.5 percentage points; 95% CI, 4.5-9.3 percentage points; q < .001) but were not more willing to engage in political violence. Recent purchasers, owners who always or nearly always carry loaded firearms in public, and to a lesser extent, owners of assault-type rifles were more supportive of and willing to engage in political violence than other subgroups of firearm owners.Conclusions and relevanceIn this study of support for political violence in the United States, differences between firearm owners and nonowners without firearms at home were small to moderate when present. Differences were greater among subsets of owners than between owners and nonowners. These findings can guide risk-based prevention efforts.

Project description:ImportanceYoung adults in their 20s are at high relative risk for self- and other-directed firearm injury, but little is known about gun access patterns for this group.ObjectiveTo describe the longitudinal patterns of firearm access from childhood to young adulthood and to estimate whether violence experienced as a child or as an adult is associated with gun ownership in young adulthood.Design, setting, and participantsThe Great Smoky Mountains Study included participants from 11 contiguous, mostly rural counties in the Southeastern US. The first wave was completed in 1993 and the most recent in 2019. Periodic survey data were gathered in adolescence through participants' late 20s. In 2023, adjusted Poisson regression with incident rate ratios (IRRs) and 95% CIs were used to estimate associations between violence and gun ownership in young adulthood in 3 age cohorts from the original sample.ExposuresViolent experiences in childhood (bullying, sexual and physical abuse, violent events, witnessing trauma, physical violence between parents, and school/neighborhood dangerousness) or adulthood (physical and sexual assault).Main outcomes and measuresInitiating gun ownership was defined as no gun access or ownership in childhood followed by gun ownership at age 25 or 30 years. Maintaining gun ownership was defined as reporting gun access or ownership in at least 1 survey in childhood and ownership at age 25 or 30 years.ResultsAmong 1260 participants (679 [54%] male; ages 9, 11, and 13 years), gun access or ownership was more common in childhood (women: 366 [63%]; men: 517 [76%]) than in adulthood (women: 207 [36%]; men: 370 [54%]). The most common longitudinal pattern was consistent access or ownership from childhood to adulthood (373 [35%]) followed by having access or ownership in childhood only (408 [32%]). Most of the violent exposures evaluated were not significantly associated with the outcomes. Being bullied at school was common and was associated with reduced ownership initiation (IRR, 0.76; 95% CI, 0.61-0.94). Witnessing a violent event was significantly associated with increased probability of becoming a gun owner in adulthood (IRR, 1.24; 95% CI, 1.03-1.49).Conclusions and relevanceIn this cohort study, gun ownership and access were transitory, even in a geographic area where gun culture is strong. Early adulthood-when the prevalence of gun ownership was relatively low-may represent an opportune time for clinicians and communities to provide education on the risks associated with firearm access, as well as strategies for risk mitigation.

Project description:BackgroundThe literature on gun violence is broad and variable, describing multiple legislation types and outcomes in observational studies. Our objective was to document the extent and nature of evidence on the impact of firearm legislation on mortality from firearm violence.MethodsA scoping review was conducted under PRISMA-ScR guidance. A comprehensive peer-reviewed search strategy was executed in several electronic databases from inception to March 2024. Grey literature was searched for unpublished sources. Data were extracted on study design, country, population, type of legislation, and overall study conclusions on legislation impact on mortality from suicide, homicide, femicide, and domestic violence. Critical appraisal for a sample of articles with the same study design (ecological studies) was conducted for quality assessment.Findings5057 titles and abstracts and 651 full-text articles were reviewed. Following full-text review and grey literature search, 202 articles satisfied our eligibility criteria. Federal legislation was identified from all included countries, while state-specific laws were only reported in studies from the U.S. Numerous legislative approaches were identified including preventative, prohibitive, and more tailored strategies focused on identifying high risk individuals. Law types had various effects on rates of firearm homicide, suicide, and femicide. Lack of robust design, uneven implementation, and poor evaluation of legislation may contribute to these differences.InterpretationWe found that national, restrictive laws reduce population-level firearm mortality. These findings can inform policy makers, public health researchers, and governments when designing and implementing legislation to reduce injury and death from firearms.FundingFunding is provided by the Strategy for Patient-Oriented Research (SPOR) Evidence Alliance and in part by St. Michael's Hospital, University of Toronto.Scoping review registrationOpen Science Framework (OSF): https://osf.io/sf38n.

Project description:ImportanceFirearm injury is the second leading cause of death in the United States for children and young adults. The risk of unintentional and self-inflicted firearm injury is lower when all household firearms are stored locked.ObjectiveTo estimate the reduction in youth firearm suicide and unintentional firearm mortality that would result if more adults in households with youth stored household guns locked.Design, setting, and participantsA modeling study using Monte Carlo simulation of youth firearm suicide and unintentional firearm mortality in 2015. A simulated US national sample of firearm-owning households where youth reside was derived using nationally representative rates of firearm ownership and storage and population data from the US Census to test a hypothetical intervention, safe storage of firearms in the home, on youth accidental death and suicide. Data analyses were performed from August 3, 2017, to January 9, 2018.ExposuresObserved and counterfactual household-level safe firearm storage (ie, storing all firearms locked), the latter estimated by varying the probability that a hypothetical intervention increased safe firearm storage beyond that observed in 2015.Main outcomes and measuresObserved and counterfactual counts of firearm suicide and unintentional firearm mortality among youth aged 0 to 19 years, the latter estimated by incorporating an empirically based estimate of the mortality benefit expected from additional safe storage (beyond that observed in 2015).ResultsA hypothetical intervention among firearm owners residing with children with a 20% probability of motivating these owners to lock all household firearms was significantly associated with a projected reduction in youth firearm mortality (median incidence rate ratio = 0.90; interquartile range, 0.87-0.93). In the overall model, 6% to 32% of deaths were estimated to be preventable depending on the probability of motivating safer storage.Conclusions and relevanceResults of this modeling study suggest that a relatively modest uptake of a straightforward safe storage recommendation-lock all household firearms-could result in meaningful reductions in firearm suicide and unintentional firearm fatalities among youth. Approaches that will motivate additional parents to store firearms safely are needed.

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Household Firearm Ownership and Firearm Mortality

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