Access To Firearms Research Articles

Confronting the Global Crisis of Youth and Firearms in the Wake of Serbia’s First School Shooting

Abstract Issue School shootings reflect crucial systemic flaws, notably the ease of firearm access and training for children, despite rigorous firearm regulations. Description In May 2023, Serbia was rocked by its first school shooting in Belgrade, where a 13-year-old boy, armed with guns and Molotov cocktails, killed 9 and injured 6.His actions were amplified by his proficiency with firearms, a skill honed under his father’s guidance at shooting ranges. This tragic event ignited a nationwide debate on gun control. Our study seeks to attain an in-depth analysis on regulations on minimum age for firearm training in context of school shootings in Serbia and USA as countries with highest rates of civilian gun ownership globally. Results Serbian regulations lack a definitive minimum age for firearm training at shooting ranges, mirroring a situation in the USA, where 17 states do not have child access prevention laws, and 43 states lack mandated safe storage requirements. A worrying trend is the escalation in mass shootings by individuals aged 21 or younger, deviating from the earlier trend of middle-aged perpetrators. This younger demographic often seeks fame, inspired by previous mass shooters, contributing to the rise in both deliberate and accidental shootings by young people. Lessons We need to consider the implementation of regulations on minimum age for children firearm training at shooting ranges, as well as stricter control of the ranges. This problem extends beyond national boundaries, reflecting a global issue. The accessibility of firearms to youth, coupled with their developmental susceptibility to impulsive and aggressive behavior, raises significant concerns. Key messages • To increase global awareness and stricter regulations on youth firearm access, emphasizing the stricter regulations on shooting ranges and the integration of firearm safety education into curricula. • Firearm control and children safety is a collective international duty, crucial for addressing a concern that impacts public safety and youth welfare.

Whether and how to store firearms in the home: Qualitative insights from care partner experiences in the Safety in Dementia Trial.

Most people with dementia (PWD) in the United States live in community settings supported by family and/or unpaid care partners. Firearms access is one of many decisions care partners navigate alongside PWD in efforts to prevent injuries and deaths. Conversations about firearms access are socially challenging, although specific challenges to be overcome have not been described. As part of the larger Safety in Dementia Trial, we interviewed care partners about their views and experiences regarding firearms access in the home where the PWD resides. Interviewees were English-speaking adults (≥18 years) in the United States who are unpaid care partners of community-dwelling PWD. Responses to interview discussions related to (1) a desire for safety, and (2) fear of firearm violence was analyzed using a focusing process to categorize views into essential themes. Fifty care partners, who were primarily female (58%), White (66%), adult children (56%), and living in the same household (64%), participated in interviews between February 2023-February 2024. Dominant themes emerging from the focusing technique included (1) firearms as a necessary component of home safety; (2) fear of accidental/impulsive firearm violence; (3) observed risk and "near misses"; and (4) differing views on home firearms as a source of conflict. Thematic descriptions did not differ according to care partner's relationship to the PWD (adult child, spouse, other). Considering whether and how to alter access to firearms where PWD reside can be difficult for care partners to navigate. Care partners expressed a desire to limit firearms access, but worried both about creating conflict with the PWD and the self-defense implications of making firearms inaccessible. Findings were similar across subsets of care partners indicating that standardized tools and messaging to care partners may be effective in promoting safety in homes with PWD.

Development, dissemination and survey evaluation of layered education for healthcare professionals to support implementation of firearm injury and mortality prevention strategies in emergency care settings, New York, USA

BackgroundThere is consensus on the need and ability to address firearm injury risk in healthcare settings; however, the lack of education for healthcare professionals hinders the implementation of evidence-based firearm...

Firearm screening and intervention beliefs and practices among U.S. Air Force (USAF) mental health providers and behavioral health technicians.

We examined beliefs and practices regarding firearm assessment and lethal means safety counseling (LMSC) among U.S. Air Force (USAF) mental health providers (MHPs) and behavioral health technicians (BHTs). Data were collected from 204 USAF MHPs (74.0%; n = 151) and BHTs (26.0%; n = 53) via an anonymous, voluntary survey. A modest proportion indicated they strongly/extremely believe that firearm ownership (42.2%) and storage practices (58.3%) are related to suicide risk. A minority indicated they "strongly"/"extremely" believe that LMSC will yield changes in storage practices (30.9%) and decreases in suicide risk (29.9%). Across patient scenarios, most indicated that "most of the time"/"always" they assess for firearm access (74.5%-99.5%) and provide LMSC (57.8%-95.6%). About half (52.5%) reported having distributed cable locks. Most (59.3%) indicated they are somewhat interested/very interested in receiving additional training on LMSC. MHPs, compared with BHTs, were significantly more likely to report believing a link between firearm ownership and storage practices and suicide risk, believing LMSC is effective at reducing suicide risk, providing LMSC to female patients and patients with current suicidal ideation, and having distributed cable locks. Findings suggest that there is not widespread agreement among USAF MHPs and BHTs that personal firearm ownership and nonsecure storage practices are associated with elevated suicide risk, and there were low levels of confidence in the effectiveness of LMSC. Yet, most USAF MHPs and BHTs reported they integrate firearm access assessment and LMSC as part of their routine clinical care, particularly for patients with identified suicide risk. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Preinjury and Event-Related Characteristics of Pediatric Firearm Injuries: The American College of Surgeons Firearm Study, United States, March 2021‒February 2022.

Objectives. To assess differences in contextual factors by intent among pediatric firearm injury patients and determine factors associated with data missingness. Methods. We retrospectively queried the American College of Surgeons Firearm Study database (March 1, 2021-February 28, 2022) for patients aged 18 years or younger. We stratified preinjury, firearm-related, and event-related factors by intent and compared them by using Fisher exact, χ2, or 1-way analysis of variance testing. Secondary analysis estimated the adjusted odds of missingness by using generalized linear modeling with binominal logit link. Results. Among 17 395 patients, 2974 (17.1%) were aged 18 years or younger; 1966 (66.1%) were injured by assault, 579 (19.5%) unintentionally, and 76 (2.6%) by self-inflicted means. Most contextual factors differed by intent, including proportion of youths with previous adverse childhood experiences, mental illness, and violent assaults or injury, firearm type and access, perpetrator relationship, and injury location. In adjusted analyses, age, trauma center designation, intent, and admission status were associated with missingness. Conclusions. Contextual factors related to pediatric firearm injury vary by intent. Specific predictors associated with missingness may inform improved future data collection. Public Health Implications. Contextual factors related to pediatric firearm injury can be obtained in a systematic manner nationally to inform targeted interventions. (Am J Public Health. 2024;114(10):1097-1109. https://doi.org/10.2105/AJPH.2024.307754).

The State of Firearm Policy Research in the United States.

Firearm-related deaths lead to the most person-years of life lost in the US. There were 48,830 deaths from homicides and suicides in 2021 alone. Firearm access remains at an all-time high in most states - indicated by record manufacturing, sales, employment in firearm industry, taxes collected from sales, and the number of federal background check applications in 2020 and 2021. Yet, firearm injury is a politically contentious topic to the point of stalling progress on an important public health topic. This politicization led to nearly three decades of federal disinvestment in firearm research; reduced surveillance of firearm-related crime, injury, and death; and degraded data quality. This left generations of researchers with limited epidemiologic tools to conduct firearm policy research, jeopardizing the amount and quality of research conducted. Despite these limitations, research has persisted and promising approaches to reduce firearm morbidity and mortality have been identified. Yet the field has struggled to keep pace with methodological advancements and conceptualizations of racial and ethnic disparities as products of systemic racism. In this commentary, we highlight some existing evidence-informed policies, explicate some limitations in the field, and identify opportunities to address the limitations of prior work to strengthen future capacity for evidence-informed prevention.

The Role of Firearm and Police Violence Exposure in Youth Firearm Beliefs and Access

Rates of youth firearm exposure and carriage are well-established, but less work has examined how exposure to police violence and firearm violence, as victim or witness, may be associated with beliefs in gun ownership for society or access to guns. This study used survey data from a multiracial sample of 276 youth living in New Orleans, Louisiana ( M age = 17.76) to examine these associations. Results from binary logistic regressions confirmed a significant association between higher belief in gun ownership for safety and all violence exposures, directly and indirectly. We did not find support for an association between gun access and any violence exposures. The findings shed light on pathways to firearm violence risk and provide critical information on youth firearm attitudes.

Prevalence and correlates of handgun carrying and perceived ease of access among adolescents in Florida

ObjectiveAdolescent firearm violence poses a serious public health concern. The aim of this study is to explore correlates of access to firearms and firearm carrying patterns among adolescents in 2022....

Perpetrator characteristics and firearm use in pediatric homicides: Supplementary Homicide Reports - United States, 1976 to 2020

BackgroundDescribe trends in perpetrator characteristics and firearm use in pediatric homicides across the United States.MethodsMultiply-imputed data from the Federal Bureau of Investigation’s 1976–2020 Supplementary Homicide Reports were used to estimate perpetrator characteristics (sex, age, and relationship to victim) and firearm use in pediatric homicides. Descriptive analyses were stratified by victim age group, sex, race, and five-year time periods.ResultsFamily members were the most common perpetrator of infant and toddler (ages 0–4) and child (ages 5–12) homicides, whereas acquaintances accounted for the majority of adolescent (ages 13–19) homicides. Perpetrator characteristics vary across victim sex and race, particularly among adolescents. Despite overall stability, there were changes in perpetrator characteristics from 1976 to 2020. There was a sustained increase in the proportion of homicides committed with a firearm. In 2016–2020, the proportion of firearm-involved homicides was an all-time high for infant and toddler (14.8%), child (53.1%), and adolescent victims (88.5%).ConclusionsPolicy interventions that improve family stability and well-being may be most effective at preventing infant, toddler, and child homicides, whereas programs that target peer and community relationships, as well as policies that focus on firearm access, may be more crucial for preventing adolescent homicides.

Youth Suicide, Mental Health, and Firearm Access—Time to Focus on Upstream Prevention

Youth Suicide, Mental Health, and Firearm Access—Time to Focus on Upstream Prevention

Substitution of Methods in Suicide Deaths - Firearm Injury and Hanging.

Background: Prevention strategies for suicide emphasize restrictions on firearm access. These restrictions may lose efficacy if individuals substitute other lethal suicide methods. Aims: The objective of this study is to determine the extent to which individuals who die by suicide in the United States substitute hanging for firearm injury. Methods: This study is a repeated cross-sectional analysis of suicide deaths in the United States from 2003 to 2021. Multiple regression was used to estimate the effect of firearm access proxies on individual suicide methods (hanging vs. firearm injury). Results: The probability of death by hanging was significantly and negatively associated with proxies of firearm access. Limitations: This study does not compare crude rates of suicide by state, which rise on average with rates of firearm ownership. The National Violent Death Reporting System expanded over the sample period, so early years have incomplete ascertainment. Rates of gun ownership and gun safety law scales are measured as proxies. Conclusions: Although means restriction around firearm access is a critical tool for suicide prevention, complementary strategies for prevention around hanging merit further study.

Acceptability and feasibility of video-based firearm safety education in a Colorado emergency department for caregivers of adolescents in firearm-owning households

BackgroundEasy firearm access increases injury risk among adolescents. We evaluated the acceptability and feasibility of improving knowledge of a 3 min safe firearm storage education video in the paediatric emergency...

Confounder selection in firearm policy research: A scoping review.

Legislative firearm policies are often proposed as a way of preventing firearm-related harm. Confounding is a substantial threat to accurately estimating the causal effects of firearm policies. This scoping review characterizes selection of potential confounders in US firearm policy evaluations in the health sciences literature. We identified empirical research articles indexed in PubMed from 1/1/2000-9/1/2021 that examined any of 18 pre-specified firearm policies and extracted key study elements, including the exposure (firearm policy), outcomes, potential confounders adjusted for in analyses, and study approach (i.e., static, uncontrolled pre-post, and controlled pre-post). There was wide variation in potential confounders within study approach-policy-outcome combinations. The most common potential confounders included sociodemographic and economic variables, rurality/urbanicity, violent crime, law enforcement-related variables, alcohol use, and firearm access (mostly measured via proxies for firearm ownership). Firearm policies other than the policy being evaluated were included in the adjustment set in 23-44% of studies, depending on the study approach. Confounder selection was most often said to be based on prior research (n=49, 40%) or not explicitly stated (n=48, 39%). This scoping review provides a comprehensive resource for critically appraising the firearm policy literature and offers considerations to support more rigorous confounding control in future firearm policy research.

Firearm Access and Safe Storage

Firearm Access and Safe Storage

Which Types of Providers Have Firearm Discussions in a Pediatric Primary Care Clinic?

ObjectiveSafe firearm storage decreases self-inflicted and unintentional firearm injury in youth. Medical providers are well-positioned to discuss safe firearm storage with families. The primary objective of this study was to determine which providers are most likely to discuss firearms with their patients. Our secondary objective was to determine whether providers were more likely to discuss firearms with patients at elevated suicide risk. MethodsThis was a retrospective chart review of primary care well-child visits occurring January to December 2019 in a large, urban academic clinic. We documented provider type and training level (exposure); any documentation of firearms in the chart (counseling, screening) was considered as having a firearm discussion (outcome). We also collected demographics, patient mental health history, and Patient Health Questionnaire-9 scores and assessed suicide risk. ResultsOf the 743 charts reviewed, firearms were discussed in 9% (n = 66). Medical students were most likely to discuss firearms (15%), and attending physicians were least likely (1%, P < 0.001). Providers did not discuss firearms more frequently among youth at elevated suicide risk. ConclusionsThough providers do not frequently discuss and document firearm discussions overall, the higher rates among medical students are promising. Given the lethality of firearms in a suicide attempt, the lack of firearm safety discussions with those at elevated suicide risk was concerning. Further study should evaluate factors that facilitate discussions in this cohort and identify strategies to improve counseling among more senior providers.

Neighborhood disorder as a predictor of perceptions of firearm access: Examining peers effects

ObjectiveThis study sought to examine the relationship between neighborhood disorder and perceptions of gun access. Further, this study focused on determining whether or not antisocial peer affiliation mediates this relationship. MethodsThe Pathways to Desistance data were analyzed. This is an 11-wave longitudinal study following 1,354 justice-involved youth across seven years post-adjudication. Generalized structural equation modeling was used to assess direct and indirect relationships of interest. ResultsGreater levels of neighborhood disorder were associated with increased perceptions of access to guns in the community. Affiliation with antisocial peers significantly mediated this relationship, accounting for about 15 % of this relationship. ConclusionsAffiliation with antisocial peers may be greater in disordered neighborhoods and they may facilitate access to guns for adolescents living in such communities. Mentoring programs for adolescents living in disordered communities may have some capacity for attenuating this relationship.

Fighting behavior, conflict perceptions, and firearm access among U.S. adolescents in a pediatric emergency department

ObjectivePrior evidence demonstrates that both firearm access and fighting can predict future violence and injury in adolescents. We aimed to examine associations between firearm access with fighting behavior and conflict perception in a sample of adolescents in an urban emergency department (ED) setting. MethodsIn 2023, we conducted a secondary analysis of 13,610 adolescent encounters in the ED of a U.S. children's hospital from 2013 to 2020, using a universally applied, self-administered computerized behavioral health survey. We compared patient characteristics by reported firearm access and fighting behavior using chi-squared tests. Generalized estimating equations (GEE) were used to investigate associations between 1) fighting behavior and firearm access, and 2) between fighting behavior and respondent preference to and reporting of fighting incident to law enforcement after adjusting for race and ethnicity, age, and gender. ResultsApproximately one-quarter of the sample reported past year fighting. Youth who reported fighting were more likely to report firearm access (AOR = 1.66, 95%CI = [1.49–1.86]). This association strengthened among youth who perceived continued conflict after a fight (AOR = 2.05, 95%CI = [1.73–2.43]). Youth who perceived continued conflict following a fight were more likely to report (AOR = 1.97, 95%CI = [1.65–2.36]) or want to report (AOR = 2.63, 95%CI = [1.81–3.81]) the fight to law enforcement. ConclusionsThose perceiving continued conflict after a fight were more likely to report access to firearms and endorse retaliation; however, they were more likely to want to report the fight to law enforcement. These findings highlight the potential for more comprehensive ED risk assessment to reduce retaliation and reinjury for adolescents reporting fighting behavior.

County Characteristics and Veteran Suicide in the United States, 2011–2018

IntroductionFew studies have examined county-level hotspots of veteran suicide and associated place-based contributors, limiting development of targeted community-level prevention strategies. The objectives of this national spatial analysis of all veteran suicides were to identify areas of the United States (U.S.) with higher-than-expected veteran suicide rates and determine county-level social and economic characteristics associated with areas of higher risk. MethodsUsing Bayesian hierarchical modeling, county-level standardized mortality ratios for veteran suicide deaths were estimated for time periods 2011-2018, 2011-2014, and 2015-2018. Adjusted relative risk, accounting for community characteristics, for each county was then estimated and associations between community characteristics and veteran suicide risk were examined. Analyses were conducted in 2023-2024. ResultsRisk of veteran suicide is predominantly concentrated in the Mountain West and West. Significant predictors of risk across all time periods were per capita number of firearm retailers (2011-2018 RR=1.065 [95%CI 1.030-1.102]), the proportion of residents who moved in the past year (2011-2018 RR=1.060 [95%CI 1.039-1.081]), the proportion of residents who live alone (2011-2018 RR=1.067 [95%CI 1.046-1.089]), the proportion of residents in rental housing (2011-2018 RR=1.041 [95%CI 1.018-1.065]), and the proportion of married residents (2011-2018 RR=0.915 [95%CI 0.890-0.941]). ConclusionsThis study contributes to a comprehensive public health approach to veteran suicide prevention by identifying where resources are needed most, and which place-based intervention targets have the largest potential for impact. Findings suggest that public health efforts to address suicide among veterans should address community level firearm access and identify ways to alleviate deleterious effects of social fragmentation.

“Spouses have a huge role” in preventing firearm suicide among women veterans: Partners' perspectives, experiences, and needs

Many women Veterans have access to firearms owned by their partners; therefore, understanding partners' perspectives, experiences, and needs regarding firearm lethal means safety (LMS) is essential. Twenty-five partners of women Veterans with a history of household firearm access participated in this mixed methods study. Nearly all participants expressed that if their partner was suicidal, they would be willing to take steps to reduce their partner's firearm access and to participate in firearm LMS discussions with their partner's healthcare provider. However, only a subset reported engaging in such behaviors. Participants reported needing information and guidance regarding actionable firearm LMS strategies (e.g., safe storage locations). Firearm LMS can be facilitated by supporting women Veterans' partners in recognizing and responding to suicide risk and providing them with guidance and tools to support reducing firearm access when suicide risk is elevated.

Firearm Access and Socio-Structural Factors Related to Suicidality Among Youth With Diverse Sexual, Gender, and Racial Identities

Objective Elevated rates of suicidal ideation (SI) and suicide attempts (SA) among youth, particularly multiply marginalized youth, are occurring in the context of youths’ access to household firearms. Research examining how perceived access to firearms is related to SI and SA among youth with marginalized identities is limited and often neglects to consider intersectionality. This study explored how intersecting social identities and positions, access to firearms, and socio-structural factors were associated with SI and SA for youth. Method The analytic sample (N = 17,794) included 7-12th grade students who participated in the 2021 Dane County Youth Assessment. Exhaustive CHAID – a decision tree matrix approach – examined all possible combinations of self-reported sociodemographic characteristics (gender identity, sexual identity, racial identity, grade, and firearm access) and socio-structural variables (bias-based bullying, school belongingness, and social pressure) to predict mutually exclusive groups of youth based on past-year SI and SA. Results SI and SA was most prevalent among intersectional groups with multiply marginalized identities and access to firearms. Socio-structural factors, including bias-based bullying victimization, lack of school belongingness, and social pressure, were characteristic of groups with higher prevalence of SI and SA. Conclusions While the marginalized youth in this sample have lower access to firearms, the prevalence of SI and SA was highest among multiply marginalized youth who reported access to firearms in the context of bias-based bullying, social pressure, and a lack of school belongingness. Youth suicide prevention efforts would be strengthened by policies that address firearm access and improve the school environment.