Firearm injury hospitalizations and handgun purchaser licensing laws: longitudinal evaluation of state-level purchaser licensure requirements on firearm violence, 2000–2016
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SUBMITTER: Doucette M
PROVIDER: S-EPMC11342609 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:ObjectivesStricter firearm policies correlate with lower suicides by firearm in the US. However, much work examines policies in isolation and does not investigate firearm policies as they relate to US pro-gun culture. We examine the relation between permissiveness of state firearm laws, gun culture, and suicides by firearm.Study designPanel longitudinal study.MethodsThe count of suicides by firearm for 50 US states from 2000 to 2016 served as the outcome. Permissiveness of multiple state firearm laws, based on ratings from the Traveler's Guide to the Firearm Laws of the Fifty States, served as the exposure. These ratings, measured at the state-year, capture not only the overall policy environment but also the extent to which the state exhibits a pro-gun culture. We applied a fixed effects negative binomial count model, which controls for the population-at-risk, to examine suicides overall and by race/ethnicity and gender.ResultsA 10-unit increase in permissiveness of state firearm laws corresponds with 2% greater suicides by firearm overall (Incidence rate ratio [IRR] = 1.02; 95% CI: 1.01-1.03) and among non-Hispanic white males ([IRR] = 1.02, 95% CI: 1.01-1.02).ConclusionsFindings, if replicated, indicate that states enacting more restrictive firearm policies, and lessening a pro-gun culture, may lead to reductions in suicide by firearm.
| S-EPMC9461642 | biostudies-literature
Project description:BackgroundFirearm homicides occur less frequently in US states with more firearm control laws. However, firearms are easily transported across state lines, and laws in one location may affect firearm violence in another. This study examined associations between within-state firearm laws and firearm homicide while accounting for interference from laws in other nearby states.MethodsThe units of analysis were 3,107 counties in the 48 contiguous US states, arrayed in 15 yearly panels for 2000 to 2014 (n = 46,605). The dependent measure was firearm homicides accessed from the Centers for Disease Control and Prevention (CDC) Compressed Mortality Data. The main independent measures were counts of firearm laws and the proportion of laws within categories (e.g., background checks, child access prevention laws). We calculated these measures for interstate laws using a geographic gravity function between county centroids. Bayesian conditional autoregressive Poisson models related within-state firearm laws and interstate firearm laws to firearm homicides.ResultsThere were 172,726 firearm homicides in the included counties over the 15 years. States had between 3 and 100 firearm laws. Within-state firearm laws (incidence rate ratio [IRR] = 0.995, 95% confidence interval [CI] = 0.992, 0.997) and interstate firearm laws (IRR = 0.993, 95% CI = 0.990, 0.996) were independently associated with fewer firearm homicides, and associations for within-state laws were strongest where interstate laws were weakest.ConclusionsAdditional firearm laws are associated with fewer firearm homicides both within the states where the laws are enacted and elsewhere in the United States. Interference from interstate firearm laws may bias associations for studies of within-state laws and firearm homicide.
| S-EPMC7708450 | biostudies-literature
Project description:ImportanceFirearms caused more than 500 pediatric fatalities in 2017-a 50% increase from 2009. Laws regulating firearms are one approach to reducing pediatric firearm fatalities.ObjectiveTo evaluate the association between state child access prevention (CAP) firearm laws and pediatric firearm fatalities.Design, setting, and participantsA state-level, cross-sectional study of CAP firearm laws throughout the United States, 1991-2016, was conducted using negative binomial regression to analyze differences in state fatality rates in children aged 0 to 14 years. Data analysis was performed from November 21, 2018, to October 18, 2019.ExposuresImplementation of 2 categories of state CAP firearm laws: recklessness laws, which pertain to providing a firearm to a child, and negligence laws, which pertain to accessibility of a firearm within the home.Main outcomes and measuresRates of firearm fatalities across all intents and by specific intent (homicide, suicide, and unintentional) per 100 000 children aged 0 to 14 years.ResultsTwenty-five states passed CAP laws between 1989 and 2000. Between 1991 and 2016, 13 697 firearm fatalities occurred in children aged 0 to 14 years. Recklessness laws were not associated with changes in pediatric firearm fatality rates. Negligence laws overall were associated with significant reductions in firearm fatalities in children aged 0 to 14 years, with a 13% relative reduction in all firearm fatalities (95% CI, -18% to -7%), a 15% relative reduction in firearm homicides (95% CI, -22% to -7%), a 12% relative reduction in firearm suicides (95% CI, -20% to -2%), and a 13% relative reduction in unintentional firearm fatalities (95% CI, -24% to -1%). The most stringent negligence laws were associated with unintentional firearm fatality reductions of 59% (95% CI, -68% to -49%). A total of 3929 deaths (29% of all firearm deaths) were associated with states not having passed the most stringent form of negligence CAP laws.Conclusions and relevanceIn this study, negligence laws were associated with relative reductions in firearm fatality rates in children aged 0 to 14 years. The most stringent negligence laws were associated with the largest reductions in unintentional firearm fatalities. Recklessness laws were not associated with reduced firearm fatality rates. The passage of negligence CAP laws may have the potential to reduce firearm fatalities in children.
| S-EPMC7052788 | biostudies-literature
Project description:BACKGROUND:Older adults complete suicide at a disproportionately higher rate compared to the general population, with firearms the most common means of suicide. State gun laws may be a policy remedy. Less is known about Gun Violence Restricting Order (GVRO) laws, which allow for removal of firearms from people deemed to be a danger to themselves or others, and their effects on suicide rates among older adults. The purpose of this study was to examine the association of state firearm laws with the incidence of firearm, non-firearm-related, and total suicide among older adults, with a focus on GVRO laws. METHODS:This is a longitudinal study of US states using data from 2012 to 2016. The outcome variables were firearm, non-firearm and total suicide rates among older adults. Predictor variables were [1] total number of gun laws to assess for impact of overall firearm legislation at the state level, and [2] GVRO laws. RESULTS:The total number of firearm laws, as well as GVRO laws, were negatively associated with firearm-related suicide rate among older adults ages 55-64 and > 65 years-old (p < 0.001). There was a small but significant positive association of total number of firearm laws to non-firearm-related suicide rates and a negative association with total suicide rate. GVRO laws were not significantly associated with non-firearm-related suicide and were negatively associated with total suicide rate. CONCLUSION:Stricter firearm legislation, as well as GVRO laws, are protective against firearm-relate suicides among older adults.
| S-EPMC7137454 | biostudies-literature
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.
| S-EPMC11301056 | biostudies-literature
Project description:BackgroundThe movement of firearm across state lines may decrease the effectiveness of state-level firearm laws. Yet, how state-level firearm policies affect cross-state movement have not yet been widely explored. This study aims to characterize the interstate movement of firearms and its relationship with state-level firearm policies.MethodsWe analyzed the network of interstate firearm movement using Bureau of Alcohol, Tobacco, Firearms, and Explosives firearm trace data (2010-2017). We constructed the network of firearm movement between 50 states. We used zero-inflated negative binomial regression to estimate the relationship between the number of a state's firearm laws and number of states for which it was the source of 100 or more firearms, adjusting for state characteristics. We used a similar model to examine the relationship between firearm laws and the number of states for which a given state was the destination of 100 or more firearms.ResultsOver the 8-year period, states had an average of 26 (Standard Deviation [SD] 25.2) firearm laws. On average, a state was the source of 100 or more crime-related firearms for 2.2 (SD 2.7) states and was the destination of 100 or more crime-related firearms for 2.2 (SD 3.4) states. Greater number of firearm laws was associated with states being the source of 100 or more firearms to fewer states (Incidence Rate Ratio [IRR] 0.58 per SD, p < 0.001) and being the destination of 100 or more firearms from more states (IRR1.73 per SD, p < 0.001).ConclusionsRestrictive state-level firearm policies are associated with less movement of firearms to other states, but with more movement of firearms from outside states. The effectiveness of state-level firearm-restricting laws is complicated by a network of interstate firearm movement.
| S-EPMC8499462 | biostudies-literature
Project description:ImportanceEvidence suggests that limiting access to firearms among individuals at high risk of suicide can be an effective means of suicide prevention, yet accurately identifying those at risk to intervene remains a key challenge. Firearm purchasing records may offer a large-scale and objective data source for the development of tools to predict firearm suicide risk.ObjectiveTo test whether a statewide database of handgun transaction records, coupled with machine learning techniques, can be used to forecast firearm suicide risk.Design, setting, and participantsThis prognostic study used the California database of 4 976 391 handgun transaction records from 1 951 006 individuals from January 1, 1996, to October 6, 2015. Transaction-level random forest classification was implemented to predict firearm suicide risk, and the relative predictive power of features in the algorithm was estimated via permutation importance. Analyses were performed from December 1, 2020, to May 19, 2022.Main outcomes and measuresThe main outcome was firearm suicide within 1 year of a firearm transaction, derived from California death records (1996-2016). With the use of California's Dealer's Records of Sale (1996-2015), 41 handgun, transaction, purchaser, and community-level predictor variables were generated.ResultsThere are a total of 4 976 391 transactions in the California's Dealer's Record of Sale database representing 1 951 006 individuals (1 525 754 men [78.2% of individuals]; mean [SD] age, 43.4 [13.9] years). Firearm suicide within 1 year occurred in 0.07% of handgun transactions (3278 transactions among 2614 individuals). A total of 38.6% of observed firearm suicides were among transactions classified in the highest-risk ventile (379 of 983 transactions), with 95% specificity. Among the small number of transactions with a random forest score above 0.95, more than two-thirds (24 of 35 [68.6%]) were associated with a purchaser who died by firearm suicide within 1 year. Important features included known risk factors, such as older age at first purchase, and previously unreported predictors, including distance to firearms dealer and month of purchase.Conclusions and relevanceThis prognostic study presented the first large-scale machine learning analysis of individual-level handgun transaction records. The results suggested the potential utility of such records in identifying high-risk individuals to aid suicide prevention efforts. It also identified handgun, individual, and community characteristics that have strong predictive relationships with firearm suicide and may warrant further study.
| S-EPMC9274320 | biostudies-literature
Project description:BackgroundResearch has documented sharp and short-lived increases in firearm acquisitions immediately following high-profile mass shootings and specific elections, increasing exposure to firearms at the community level. We exploit cross-city variation in the estimated number of excess handgun acquisitions in California following the 2012 presidential election and the Sandy Hook school shooting 5 weeks later to assess whether the additional handguns were associated with increases in the rate of firearm-related harms at the city level.MethodsWe use a two-stage modeling approach. First, we estimate excess handguns as the difference between actual handgun acquisitions, as recorded in California's Dealer Record of Sales, and expected acquisitions, as predicted by a seasonal autoregressive integrated moving-average (SARIMA) time series model. We use Poisson regression models to estimate the effect of city-level excess handgun purchasing on city-level changes in rates of firearm mortality and injury.ResultsWe estimate there were 36,142 excess handguns acquired in California in the 11 weeks following the election (95% prediction interval: 22,780 to 49,505); the Sandy Hook shooting occurred in week 6. We find city-level purchasing spikes were associated with higher rates of firearm injury in the 52 weeks post-election: a relative rate of 1.044 firearm injuries for each excess handgun per 1,000 people (95% CI: 1.000 to 1.089). This amounts to approximately 290 (95% CI: 0 to 616) additional firearm injuries (roughly a 4% increase) in California over the year. We do not detect statistically significant associations for shorter time windows or for firearm mortality.ConclusionThis study provides evidence for an association between excess handgun acquisitions following high-profile events and firearm injury at the community level. This suggests that even marginal increases in handgun prevalence may be impactful.
| S-EPMC6709554 | biostudies-literature
Project description:OBJECTIVE:To examine firearm dealer willingness to sell when a handgun is being purchased for another person. US law requires a background check of the purchaser but not the end user of a firearm. SUBJECTS AND METHODS:A total of 120 handgun dealers (six from each of the 20 largest US cities with 10 or more dealers) participated in telephone interviews. Dealers within each city were randomly assigned to a male or female interviewer and then randomly assigned to one of three purchase conditions-when the consumer said that the handgun was for him/herself, a gift for a girl/boyfriend, or for a girl/boyfriend "because s/he needs it". RESULTS:Most dealers were willing to sell a handgun regardless of the end user (self: 87.5%; gift: 70.8%; "need": 52.5%). Multivariate analyses indicate that dealers in the Midwest, South, and West were more willing to sell than those in the Northeast (adjusted odds ratio (AOR) = 21.30, 18.74, and 8.93, respectively) and that willingness to sell is lower when the sale would be illegal, that is, under the "need" condition (AOR = 0.20). CONCLUSIONS:and implications: Dealers are in a position to exercise judgment when a customer is explicit about buying a firearm for someone else. Some appeared willing to ignore or sidestep relevant information even when told that the end user was prohibited from purchasing a firearm him/herself. In the absence of federal handgun registration, which would track ownership changes, resources with which to conduct compliance checks (for example, as are conducted to identify retailers who sell tobacco or alcohol to under-age persons) seem warranted.
| S-EPMC1730960 | biostudies-literature
Project description:In the USA, homicide is a leading cause of death for young males and a major cause of racial disparities in life expectancy for men. There are intense debate and little rigorous research on the effects of firearm sales regulation on homicides. This study estimates the impact of Missouri's 2007 repeal of its permit-to-purchase (PTP) handgun law on states' homicide rates and controls for changes in poverty, unemployment, crime, incarceration, policing levels, and other policies that could potentially affect homicides. Using death certificate data available through 2010, the repeal of Missouri's PTP law was associated with an increase in annual firearm homicides rates of 1.09 per 100,000 (+23%) but was unrelated to changes in non-firearm homicide rates. Using Uniform Crime Reporting data from police through 2012, the law's repeal was associated with increased annual murders rates of 0.93 per 100,000 (+16%). These estimated effects translate to increases of between 55 and 63 homicides per year in Missouri.
| S-EPMC3978146 | biostudies-literature