Firearm Research Research Articles

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.

Toward a Standard Measure of Gun Ownership: A Methodological and Theoretical Quandary in Firearm Research

One limitation of the literature on gun ownership is a lack of consensus regarding how to operationalize the dependent variable. Consequently, gun measures vary widely across studies, and findings about the prevalence and predictors of gun ownership are inconsistent. In the current study, we endeavor to develop an empirically supported, standard measure of gun ownership. First, utilizing data from a national sample of the U.S. population, we analyze the relative validity of household versus personal measures of gun ownership and critically appraise the value of accounting for gun quantity and the purpose of ownership. Second, per our findings, we recommend a short set of survey questions as the standard measure of gun ownership. These questions (1) differentiate non-owners, personal gun owners, and household gun owners; (2) account for the number of firearms owned; and (3) categorize owners by motivation (protective vs. non-protective).

Shirtsleeves to shirtsleeves in three research generations. A project on the science of science and the exceedingly rare circumstances that sustain research legacies from a mentor to mentee and to theirs: A case study on firearm research.

In the 50 years since public health firearm research began, the decades have witnessed several pioneering investigators, followed by NRA backlash and a CDC funding moratorium, then increasing firearm mortality punctuated by mass shootings, and finally an unprecedented release of funding dedicated for research and to support trainees. Motivated by my own efforts to stay productive in firearm research, by the shirtsleeves-to-shirtsleeves cautionary lesson that wealth - for us this a researcher's funding, infrastructure, and capacity - amassed by one generation will soon diminish, and by my worry that we are not adequately dedicated to growing new investigators, I set out to document researcher lineages in this field. I created a multigenerational lineage map to find authors using "gun" or "firearm" in the title/abstract as a way to find peer-reviewed publications on firearms as a public health issue. I designated the first author as Gen1 if the manuscript was sole authored or the senior author had never been first author on a firearm publication. I plotted each Gen1 author at the year of their first first-authored publication, and pointed from them to subsequent "first-time first-author investigators" (Gen2) for whom they were senior author, and so on for a Gen2 serving as senior author for a Gen3, and so on in that lineage. Gen1 authors numbered 91 by 2023, the first being Rushforth in 1974.3 Rushforth, 14 years later, produced the first and his only Gen2 author, Paulson,4 who produced no Gen3 authors. The field had produced 6 Gen2 authors when the first Gen3 author appeared in 1993, who produced the first Gen4 author in 1998, 14 years after Kraus5 that initiated that lineage in 1984. To date, only 5 lineages have produced a Gen4 author and among those only one lineage, from Schwab in 2002,6 has produced a Gen5. Twenty-four Gen3 authors have emerged. Only 35% of Gen2 authors produced a Gen3. I hope this motivates years-long strategies to help trainees become established, informed by modeling quantitative and qualitative data to identify characteristics underlying the investigator network related to productivity and shortcomings alike. Without dedication to understand the science of science, shirtsleeves-to-shirtsleeves in three generations may be the fate of firearm research.

Association of State Firearm Laws With Firearm Ownership and Mortality

IntroductionFirearm injury is a leading cause of death among Americans. As the right to bear arms is protected by the Second Amendment, policy-makers must consider the impact of legislation on both firearm ownership and firearm harms. 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 MethodsWe 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. We employ transfer entropy, an information-theoretic method that relies on Granger causality, to infer relationships from time series. Specifically, we examine transfer entropy from firearm restrictiveness to deaths per firearm owner, firearm ownership, and firearm deaths, independently ResultsOn a national level, we 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, we 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 ConclusionsWe present an information-theoretic approach to study relationships in firearm research. Our method provides preliminary evidence for the role of restrictive legislation in promoting safe firearm ownership. We find that firearm acquisition considerably increases following the implementation of restrictive firearm laws and, simultaneously, firearm deaths decrease. These effects vary with respect to death by intent and the geographical region laws were implemented in.

Strategies for recruiting adolescents in rural areas in firearm injury research

BackgroundParticipant recruitment is a central aspect of human sciences research. Barriers to participant recruitment can be categorised into participant, recruiter and institutional factors. Firearm injury research poses unique barriers to...

Social Media Data for Firearms Research: Promise and Perils

Firearms research has been hindered by a persistent lack of high-quality, reliable, and timely data. Using social media data in firearms research is, therefore, appealing: these data are large in scale, continuously provided, passively obtained, inexpensive in some cases, and easily combined with data from traditional sources. We consider how social media data have been used in firearms research to date and how they can be best used moving forward. Despite the many advantages of using social media data, there are key analytical and ethical considerations associated with their use, including understanding the underlying population, constructing valid and reliable measures from shared content, the possibility of false data and misinformation through fake accounts, and concerns having to do with the privacy and consent of social media users. Notwithstanding these drawbacks, we show that there is a compelling case for the continued development of these data for firearms research and suggest principles for their responsible use in this context.

Assessing Social Media Data as a Resource for Firearm Research: Analysis of Tweets Pertaining to Firearm Deaths.

BackgroundHistoric constraints on research dollars and reliable information have limited firearm research. At the same time, interest in the power and potential of social media analytics, particularly in health contexts, has surged.ObjectiveThe aim of this study is to contribute toward the goal of establishing a foundation for how social media data may best be used, alone or in conjunction with other data resources, to improve the information base for firearm research.MethodsWe examined the value of social media data for estimating a firearm outcome for which robust benchmark data exist—specifically, firearm mortality, which is captured in the National Vital Statistics System (NVSS). We hand curated tweet data from the Twitter application programming interface spanning January 1, 2017, to December 31, 2018. We developed machine learning classifiers to identify tweets that pertain to firearm deaths and develop estimates of the volume of Twitter firearm discussion by month. We compared within-state variation over time in the volume of tweets pertaining to firearm deaths with within-state trends in NVSS-based estimates of firearm fatalities using Pearson linear correlations.ResultsThe correlation between the monthly number of firearm fatalities measured by the NVSS and the monthly volume of tweets pertaining to firearm deaths was weak (median 0.081) and highly dispersed across states (range –0.31 to 0.535). The median correlation between month-to-month changes in firearm fatalities in the NVSS and firearm deaths discussed in tweets was moderate (median 0.30) and exhibited less dispersion among states (range –0.06 to 0.69).ConclusionsOur findings suggest that Twitter data may hold value for tracking dynamics in firearm-related outcomes, particularly for relatively populous cities that are identifiable through location mentions in tweet content. The data are likely to be particularly valuable for understanding firearm outcomes not currently measured, not measured well, or not measurable through other available means. This research provides an important building block for future work that continues to develop the usefulness of social media data for firearm research.

Addressing the void: firearm injury prevention in the USA

Addressing the void: firearm injury prevention in the USA

Proxies for legal firearm prevalence

Product acquisition policies define legal markets. Policy evaluations require data but prevalence data are not always available. We introduce Legal Firearm Prevalence (LFP), a direct behavioral measure based on the population of firearm licensees in Massachusetts, and argue that it can help evaluate firearm sales and usage restrictions. LFP is not directly measurable in most firearm markets, so we test candidate proxies for LFP in several common research designs, finding that firearm acquisitions are the best proxy in every research design tested. We update the classic study of guns and crime by Cook and Ludwig (2006), finding that choosing an invalid proxy can lead to false research conclusions. We recommend systematic collection and reporting of firearm acquisition data to improve firearm research and inform firearm policy.

Policy pathways to address American youth firearm injury and death.

Context: The burden of firearm violence and death are uniquely American problems. Over 90% of firearm deaths among children and adolescents in high income countries occur in the United States. Despite similar overall crime rates, the gun homicide rate is about 25 times higher in the U.S. than other Western democracies, and 49 times higher for those aged 15-24 years. Firearm-related injuries are a leading cause of child and adolescent deaths, second only to motor vehicle crashes. Approximately 4.6 million children are living in U.S. homes with at least one loaded, unlocked firearm. Reducing gun violence injuries and deaths is imperative and requires a multifaceted approach. Objectives: Review the impact of gun violence on youth across the U.S.; articulate the evidence base for gun safety policies; describe the current landscape of federal and state firearm laws. Study Design: Policy analysis and literature review. Results: The history of U.S. firearm policy demonstrates laws in evolution from 1791-2021, regulating both gun owner rights and restrictions. These firearm policies, existing in a variety of forms in states and nationally, reveal evidence that gun safety legislation saves lives: Child Access Prevention; Safe Storage; Universal Background Checks; Permit to Purchase; Extended Waiting Periods; Extreme Risk Protection Orders; Assault Weapon and High Capacity Magazine Ban. The dearth of federal law has resulted in more extensive state legislation but with variability and inconsistencies. No single law or policy reduces all forms of gun violence, but states with a variety of firearm policies have a cumulative impact on reducing injuries and death. Conclusions: We aim to promote education, physical safety, and behavioral health so that children can achieve their highest potential. Decreasing firearm injury and death is achievable with education, collaboration, research, and policies. To protect children and youth from firearm injury and death, we must: strengthen federal laws building on evidence from state policies; protect current evidence-based state laws from dismantling efforts; invest in public health firearms research; overcome the inequities suffered by disproportionately affected populations.

Reported firearm access among patients admitted to a dual diagnosis medically-assisted withdrawal unit over five years

BackgroundUp to one-third of firearm-related suicides were carried out by individuals who had consumed alcohol shortly before their death. Despite the critical role of firearm access screening in suicide risk assessment, few studies have examined firearm access among patients with substance use disorders. This study examines the rates of firearm access among those admitted to a co-occurring diagnosis unit over a five year period. MethodsAll patients admitted to a co-occurring disorders inpatient unit from 2014 to mid-2020 were included. An analysis contrasting the differences among patients reporting firearms was performed. A multivariable logistic regression model using factors from initial admission were chosen based on clinical relevance, past firearms research, and statistical significance on bivariate analysis was used. ResultsOver the study period there were 7332 admissions representing 4055 patients. Documentation of firearm access was completed in 83.6% of admissions. Firearm access was reported in 9.4% of admissions. Patients reporting firearm access were more likely to report never having suicidal ideation (p = 0.001), be married (p = <0.001), and report no past history of suicide attempts (p = <0.001). The full logistic regression model revealed that being married (OR: 2.29 and p < 0.0001) and employed (OR: 1.51 and p = 0.024) were factors associated with firearms access. ConclusionsThis is one of the largest reports assessing factors associated with firearm access among those admitted to a co-occurring disorders unit. Firearm access rates in this population appear lower than rates in the general population. The roles employment and marital status play in firearm access deserve future attention.

A Scoping Review of Current Social Emergency Medicine Research.

IntroductionSocial emergency medicine (EM) is an emerging field that examines the intersection of emergency care and social factors that influence health outcomes. We conducted a scoping review to explore the breadth and content of existing research pertaining to social EM to identify potential areas where future social EM research efforts should be directed.MethodsWe conducted a comprehensive PubMed search using Medical Subject Heading terms and phrases pertaining to social EM topic areas (e.g., “homelessness,” “housing instability”) based on previously published expert consensus. For searches that yielded fewer than 100 total publications, we used the PubMed “similar publications” tool to expand the search and ensure no relevant publications were missed. Studies were independently abstracted by two investigators and classified as relevant if they were conducted in US or Canadian emergency departments (ED). We classified relevant publications by study design type (observational or interventional research, systematic review, or commentary), publication site, and year. Discrepancies in relevant publications or classification were reviewed by a third investigator.ResultsOur search strategy yielded 1,571 publications, of which 590 (38%) were relevant to social EM; among relevant publications, 58 (10%) were interventional studies, 410 (69%) were observational studies, 26 (4%) were systematic reviews, and 96 (16%) were commentaries. The majority (68%) of studies were published between 2010–2020. Firearm research and lesbian, gay, bisexual, transgender, and queer (LGBTQ) health research in particular grew rapidly over the last five years. The human trafficking topic area had the highest percentage (21%) of interventional studies. A significant portion of publications -- as high as 42% in the firearm violence topic area – included observational data or interventions related to children or the pediatric ED. Areas with more search results often included many publications describing disparities known to predispose ED patients to adverse outcomes (e.g., socioeconomic or racial disparities), or the influence of social determinants on ED utilization.ConclusionSocial emergency medicine research has been growing over the past 10 years, although areas such as firearm violence and LGBTQ health have had more research activity than other topics. The field would benefit from a consensus-driven research agenda.

Dispositional characteristics in firearm ownership and purchasing behavior during the 2020 purchasing surge

RationaleIn 2020 the U.S. saw a firearm purchasing surge that was synchronous with the onset of the SARS-CoV-2 (COVID-19) pandemic and notable community unrest. Extant literature has highlighted a potential cohort effect among 2020 firearm purchasers and the importance of characterizing these individuals to inform policy and interventions. Dispositional traits have received minimal attention in the firearm literature overall, despite research that indicates dispositional traits impact intervention interest, access, and effectiveness. ObjectiveThe current study examined two dispositional traits indicated as important in firearm research – threat sensitivity (THT) and disinhibition (DIS). We hypothesized that 1) firearm owners overall would have lower THT and higher DIS relative to non-firearm owners, 2) mean levels of DIS (but not THT) would be higher among firearm owners who purchased during the 2020 purchasing surge relative to firearm owners who did not and non-firearm owners, and 3) DIS (but not THT) would be related to future plans for purchasing such that mean levels of DIS would be highest amongst those who have plans. MethodsThis study used an online-recruited sample (N = 3500) matched to 2010 US Census data. ResultsFirearm owners demonstrated lower THT and higher DIS than non-firearm owners. 2020 firearm purchasers had higher DIS compared to non-firearm owners and non-purchasing firearm owners, while firearm owners who did not purchase had lower THT compared to non-owners and 2020 purchasers. Plans to purchase in the next 12 months was associated with higher DIS relative to those undecided or without plans. ConclusionsIn combination with prior research, findings suggest elevated DIS may drive purchasing as a danger and distress management strategy, while low THT may protect against emotion-based firearm purchasing. Further research is needed to clarify the directionality of these relationships and to identify other dispositional characteristics of those purchasing firearms in 2020.

Extreme School Violence and Students with Emotional and Behavioral Disorders: (How) Do They Intersect?

Mass school shootings in America are undoubtedly among the most unsettling and tragic events that have occurred in modern history. Following such an event, questions often arise about characteristics of the perpetrator. Assertions and speculation regarding the mental health status or special education disability status, specifically related to emotional and behavioral disorders (EBD), flood media outlets and popular news sources. However, there are no data to suggest that children or youth with EBD pose a greater risk of committing a mass school shooting than do others. In this paper, we discuss assumptions related to mass school shootings and students with EBD and consider efforts for prevention and intervention. We discuss detrimental effects of a zero-tolerance approach, especially for students with EBD, and the use of threat assessment as a more effective, research-based model of prevention. We highlight in particular the potential benefits of a threat assessment model for students with or at risk for EBD. Finally, we discuss the need for future research to critically examine the effectiveness and potential side effects of lockdown drills and limitations on federally funded firearm research.

Domestic Violence and Safe Storage of Firearms in the COVID-19 Era.

Domestic Violence and Safe Storage of Firearms in the COVID-19 Era.

A National Research Strategy to Reduce Firearm-Related Injury and Death: Recommendations from the Health Policy Research Subcommittee of the Society of General Internal Medicine (SGIM).

Injury due to firearms is a serious health issue in the USA, leading to nearly 40,000 deaths annually and many more non-fatal injuries. Despite the significant impact on morbidity and mortality, relatively little research funding is dedicated to understanding the impact of firearm-related injury and to developing strategies to mitigate harm. In part, research has been stymied by decades-old language in federal legislation that was interpreted as prohibiting federal funding for firearm injury-related research. This paper, prepared by members of the Society of General Internal Medicine (SGIM), calls for support for research that seeks to understand the nature of firearm-related injury and resources to develop effective approaches to prevent it. We outline recommendations to develop evidence to inform policymakers and the medical and public health communities. These recommendations include (1) development of a shared national research agenda to address firearm-related injury and death; (2) allocation of federal funds specifically for research related to firearm injury; (3) support for the career development of researchers studying firearm-related injury; and (4) facilitating access to comprehensive data sources needed for developing evidence.

Understanding female veterans' experiences and perspectives of firearms.

Although firearms are the leading suicide means among female veterans, firearm research in this population remains limited. This study explored female veterans' firearm-related experiences and perspectives. Sixteen cisgender female veterans (ages 27-69) participated in qualitative interviews. Participants gained initial firearm knowledge and exposure in childhood and adolescence through older male family members. Military service led to broader exposure to firearms, which were perceived as important for survival and protection in a male-dominated environment, predominantly due to the risk for sexual violence. Following military service, the desire for self-protection motivated firearm ownership and storage practices. Participants perceived trust as essential to firearm discussions, preferring for family members to initiate such conversations. This study provides insight into the context in which female veterans' firearm-related beliefs and practices develop. Interpersonal factors and various lifespan experiences appear to play a vital role in female veterans' firearm access, ownership, and storage practices.

Burn Chamber Test of Ex Situ Thermal Impulse Sensors.

Recently, we reported on a novel ex situ thermal impulse sensing technique (based on lanthanide-doped oxide precursor nanoparticles) for use in structural fire forensics and demonstrated its functionality in small-scale lab-based tests. As a next step we have now performed a large-scale lab test at the US Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF) Fire Research Laboratory using a burn chamber with three sand burners. In this test we demonstrate our technique's ability to determine the average temperature experienced by surfaces during the fire. While we successfully demonstrate our techniques accuracy, we also discover several previously unknown vulnerabilities. Namely, we find that: (1) our current method of embedding sensors in paint results in our sensor particles being difficult to recover (due to a large quantity of debris), (2) the current test panels have poor survivability, (3) debris from the fire tests interferes with excitation of dopant Dy ions (limiting our sensors' functionality), and (4) dispersal in paint results in suppression of the (metastable)tetragonal-to-monoclinic phase transition of ZrO2. To overcome these vulnerabilities we are evaluating new panel materials, paints, and lanthanide-dopants.

Disparities in Firearm Injury: Consequences of Structural Violence

This review focuses on disparities in firearm injuries and deaths in the United States (US), specifically looking at imbalances between different races/ethnicities, socioeconomic statuses, genders, sexual orientations, geographic locations, firearm ownership, laws, and intents. There are regional differences within the US between firearm deaths, firearm legislation, gun ownership rates, and Black-White disparities. Firearm injury intent varies by race/ethnicity, age, and gender. Data remain limited due to continued restrictions on funding for firearm research. The studies highlighted in this review show that firearm injuries and deaths remain a public health crisis in the US, and that certain populations are affected more than others. By identifying and targeting these inequities with specific interventions, we can work toward lessening preventable firearm deaths and disabilities.

Standards in Biologic Lesions: Cutaneous Thermal Injury and Inhalation Injury Working Group 2018 Meeting Proceedings.

On August 27 and 28, 2018, the American Burn Association, in conjunction with Underwriters Laboratories, convened a group of experts on burn and inhalation injury in Washington, DC. The goal of the meeting was to identify and discuss the existing knowledge, data, and modeling gaps related to understanding cutaneous thermal injury and inhalation injury due to exposure from a fire environment, and in addition, address two more areas proposed by the American Burn Association Research Committee that are critical to burn care but may have current translational research gaps (inflammatory response and hypermetabolic response). Representatives from the Underwriters Laboratories Firefighter Safety Research Institute and the Bureau of Alcohol, Tobacco, Firearms and Explosives Fire Research Laboratory presented the state of the science in their fields, highlighting areas that required further investigation and guidance from the burn community. Four areas were discussed by the full 24 participant group and in smaller groups: Basic and Translational Understanding of Inhalation Injury, Thermal Contact and Resulting Injury, Systemic Inflammatory Response and Resuscitation, and Hypermetabolic Response and Healing. A primary finding was the need for validating historic models to develop a set of reliable data on contact time and temperature and resulting injury. The working groups identified common areas of focus across each subtopic, including gaining an understanding of individual response to injury that would allow for precision medicine approaches. Predisposed phenotype in response to insult, the effects of age and sex, and the role of microbiomes could all be studied by employing multi-omic (systems biology) approaches.