Abstract
BackgroundFirearm dealer density is correlated with firearm interpersonal violence, but no quasi-experimental studies have assessed whether changes in dealer density lead to changes in firearm self-harm injuries and deaths. We assessed whether openings of firearm dealers are associated with short-term changes in local firearm self-harm injury rates.MethodsWe identified 718 openings of firearm dealers in California using licensing data, 2014–2016. We defined exposure regions based on aggregations of zip codes defined by proximity to firearm dealer openings and matched each opening to four control regions on time and determinants of firearm injury. We applied a differences-in-differences approach to compare rates of firearm self-harm, in the month before and after each opening, in places with and without openings.ResultsFirearm dealer openings were not associated with acute, local changes in firearm self-harm relative to places without openings (ratio of rate ratio: 0.90 [95% CI:0.68–1.19]). Results were robust to numerous sensitivity and secondary analyses.ConclusionWe found no associations of firearm dealer openings with acute, localized firearm self-harm deaths and injuries. Our focus on acute, local effects; broad availability of dealers and firearms; durability of firearms; or strong confounding-control may explain these null findings.
Highlights
Firearms are a major means of self-harm and the most common method of suicide in the United States, accounting for approximately 25,000 suicides and 4,000 intentional self-harm injuries in in 2018 [1]
Firearm dealer openings were not associated with acute, local changes in firearm self-harm relative to places without openings
We found no associations of firearm dealer openings with acute, localized firearm self-harm deaths and injuries
Summary
Firearms are a major means of self-harm and the most common method of suicide in the United States, accounting for approximately 25,000 suicides and 4,000 intentional self-harm injuries in in 2018 [1]. Proximity to firearm dealers may imply greater access to firearms, ammunition, and related equipment, or greater exposure to firearm-related advertising, sales, discounts, or events Each of these may promote firearm ownership among new or current gun owners or change firearm-related behavior—for example, by increasing the frequency with which firearms are used or how they are stored. Suicides are sensitive to firearm availability: greater firearm availability in the household or community, regardless of individual ownership, is associated with substantially increased risk of completed firearm suicide [4, 11, 15, 16] Taken together, this evidence suggests that, across communities, within-community increases in firearm dealer density may lead to new firearm purchases and higher levels of firearm ownership, which in turn may imply greater availability of firearms for suicide completions in moments of crisis. We assessed whether openings of firearm dealers are associated with short-term changes in local firearm self-harm injury rates
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