Access To Guns Research Articles

Youth firearm suicide: Precipitating/risk factors and gun access

Using 2005–2014 National Violent Death Reporting System data, we examined firearm suicides among youth (age<21years; N=3116). Rates of firearm versus other suicide means were consistent during the study period. Young firearm suicide decedents were less likely than those who used other means to have been identified as having mental health problems, and in the case of males, to have had a history of suicide attempt or suicide intent disclosure. The odds of firearm use versus other means were higher in the Midwest, South, and West than in the Northeast Census region. Firearm ownership information was missing for two-thirds of the cases. Among those cases with ownership information, nearly two-thirds used guns that belonged to parents or other family members. Coroner/medical examiner or law enforcement reports described how easily these victims accessed the gun used.

Optimal Design of Panel Reinforcements With Ribs Made of Plates

The stiffness of plate structures can be significantly improved by adding reinforcing ribs. In this paper, we are concerned with the stiffening of panels using ribs made of constant-thickness plates. These ribs are common in, for example, the reinforcement of ship hulls, aircraft wings, pressure vessels, and storage tanks. Here, we present a method for optimally designing the locations and dimensions of rectangular ribs to reinforce a panel. The work presented here is an extension to our previous work to design structures made solely of discrete plate elements. The most important feature of our method is that the explicit geometry representation provides a direct translation to a computer-aided design (CAD) model, thereby producing reinforcement designs that conform to available plate cutting and joining processes. The main contributions of this paper are the introduction of two important design and manufacturing constraints for the optimal rib layout problem. One is a constraint on the minimum separation between any two ribs to guarantee adequate weld gun access. The other is a constraint that guarantees that ribs do not interfere with holes in the panel. These holes may be needed to, for example, route components or provide access, such as a manhole. We present numerical examples of our method under different types of loadings to demonstrate its applicability.

Access to a Loaded Gun Without Adult Permission and School-Based Bullying

PurposeGun access and bullying are risk factors for sustaining or perpetrating violence among adolescents. Our knowledge of gun access among bullied students is limited. MethodsWe used data on students, aged 12–18 years, from the 2011 and 2013 School Crime Supplement to the National Crime Victimization Survey to assess the association between self-reported bullying victimization (traditional and cyber) and access to a loaded gun without adult permission. Prevalence ratios (PRs) and confidence intervals (CIs) were obtained from multivariable Poisson regression using the Taylor series after controlling for student age, sex, family income, public/private school, and race. ResultsOf 10,704 participants, 4.2% (95% CI: 3.8%–4.6%) reported gun access. Compared with nonbullied students, those who reported traditional bullying (PR = 2.2; 95% CI: 1.7–2.4), cyberbullying (PR = 2.8; 95% CI: 1.6–4.9), and both (PR = 5.9; 95% CI: 4.6–7.7) were more likely to also report gun access. ConclusionsAdolescents who experience bullying, particularly those who report both traditional bullying and cyberbullying, are more likely to report access to a loaded gun without adult permission. These findings highlight the importance of developing interventions focused on these modifiable risk factors for preventing self-directed or interpersonal violence among youth.

Suicide Ideation among Adolescent American Indians: An Application of General Strain Theory

ABSTRACTThe objective of this study is to compare suicidal thoughts among American Indian/Alaskan Natives (AI/AN) to a series of non-AI/AN comparison groups, using data from the National Longitudinal Study of Adolescent to Adult Health. This study uses general strain theory as the guiding framework for understanding differences between racial groups in their suicidal ideation. A statistically significant difference is present between AI/AN and comparisons in suicidal ideation. The factors that may explain these differences addressed in this study include: alcohol abuse, exposure to suicidal behavior of friends and family, depression, and gun access. Implications for prevention and treatment are discussed.

Deploying an Ecological Model to Stem the Rising Tide of Firearm Suicide in Older Age

ABSTRACTA central objective of the Surgeon General’s National Strategy for Suicide Prevention is to focus on older adults. We review individual risk-factors for suicide in late life and then introduce an ecological model to expand conceptualization of elder suicide. We first look at the role of firearms, providing evidence that firearm availability increases the means of elder suicide and gun access policies can contribute to reducing risk. Next, we focus on primary care providers, documenting how older adults often come into contact with these professionals before ending their lives and how these providers could take a more active role in mediating individual-level risk factors. We then turn our attention to the intersection between gun access and primary care and consider how advancing standards of care concerning gun access and suicide risk might be an effective policy alternative for blocking the pathway to suicide among older adults.

US government backs biometric tech to secure gun access

US government backs biometric tech to secure gun access

Gun Access and Safety Practices among Older Adults.

Background. Given high rates of gun ownership among older adults, geriatric providers can assess firearm safety practices using a “5 Ls” approach: Locked; Loaded; Little children; feeling Low; and Learned owner. This study describes gun access and the “5 Ls” among US older adults. Methods. Data on the “5 Ls” from the Second Injury Control and Risk Survey (ICARIS-2), a national telephone survey conducted by the Centers for Disease Control and Prevention, were analyzed. Weighted variables were used to generate national estimates regarding prevalence of gun ownership and associated gun safety among older adults (≥55 years). Results. Of 2939 older adults, 39% (95% CI 37%–42%) reported ≥1 gun stored at home. Among those with guns at home, 21% (95% CI 18–24%) stored guns loaded and unlocked; 9.2% (95% CI 6.6–12%) had ≥1 child in household; 5.1% (95% CI 3.5–6.8%) reported past-year suicidal ideation and 3.6% (95% CI 2.1–5.2%) reported history of a suicide attempt; and 55% (95% CI 51–59%) stated that ≥1 adult had attended firearm safety workshop. Conclusion. Some older adults may be at elevated risk of firearm injury because of storage practices, suicidal thoughts, or limited safety training. Future work should assess effective approaches to reduce the risk of gun-related injuries among older adults.

The Role of Gun Supply in 1980s and 1990s Urban Violence

It is reasonably well-established that gun homicides in urban areas, particularly among young black males, increased radically in the late 1980s and early 1990s and then began to fall. The standard explanation for this has been the expansion of crack markets in the 1980s; to the degree that increased gun access among young black males was believed to play a role, the implicit assumption was there was a demand shock in gun markets. We examine the gun homicide rate increase/decrease among urban young black males of this period using the NBER vital statistics datasets, indices of crack use, data on arrests and incarceration and a novel data set looking at gun prices and quantities sold during this period. We find four facts that complicate the standard model: First, the prices of cheaper entry-level guns fall during the late 1980s and 1990s, even as quantities sold increase, fitting the MICRO 101 signature of a positive supply shock in the market for guns; second, gun violence falls rapidly after 1993, while all measures of crack use show stable or increasing patterns; third, local measures of crack use generally have a 25-50% lower correlation with local gun homicides then a global measure of crack use, suggesting a spurious relationship; fourth, gun homicides stay very closely correlated with gun suicides, a standard proxy for gun ownership, suggesting that conditional on gun ownership, violence levels remained fairly constant. We argue that improvements in manufacturing technology and changes in the regulatory posture of the BATF played a substantial role in increasing availability of guns, in particular low cost 25 ACP, 380 ACP and 9mm autoloaders in the late 1980s and early 1990s.

Guns, Impulsive Angry Behavior, and Mental Disorders: Results from the National Comorbidity Survey Replication (NCS-R).

Analyses from the National Comorbidity Study Replication provide the first nationally representative estimates of the co-occurrence of impulsive angry behavior and possessing or carrying a gun among adults with and without certain mental disorders and demographic characteristics. The study found that a large number of individuals in the United States self-report patterns of impulsive angry behavior and also possess firearms at home (8.9%) or carry guns outside the home (1.5%). These data document associations of numerous common mental disorders and combinations of angry behavior with gun access. Because only a small proportion of persons with this risky combination have ever been involuntarily hospitalized for a mental health problem, most will not be subject to existing mental health-related legal restrictions on firearms resulting from a history of involuntary commitment. Excluding a large proportion of the general population from gun possession is also not likely to be feasible. Behavioral risk-based approaches to firearms restriction, such as expanding the definition of gun-prohibited persons to include those with violent misdemeanor convictions and multiple DUI convictions, could be a more effective public health policy to prevent gun violence in the population.

Gun Culture: Mapping a Peculiar Preference for Firearms in the Commission of Suicide

Research has shown how honor cultures promote aggression against others (e.g., homicide) and the self (e.g., suicide). Two studies examine the connection between honor and a predilection for guns in the commission of suicide. Study 1 shows that Whites living in honor states are especially likely to use guns to commit suicide, controlling for gun accessibility. Study 2 reveals that a “gun access gap” in honor states—a positive difference between the proportion of all suicides that involve a gun and the gun ownership rate—predicts outcomes linked previously to honor cultures: homicides and accidental deaths.

Firearms: Ownership, Laws &amp; and The Case for Community Mobilization

&lt;p&gt;The United States (U.S.) currently ranks number one in the world in both the quantity of privately owned guns and the rate of private gun ownership. These privately owned firearms, which include rifles, shotguns and handguns, are predominantly owned by middle-aged, 35-54, white men, but the gaps have been steadily closing over the years, especially depending on the type of firearm, in all areas including gender, age, race, education level, political affiliation and geographic location. Gun violence is a leading cause of injury death in the U.S. In examining gun violence and potentially reducing its incidence, this article reviews gun ownership, access and utilization in the U.S., outcomes of gun violence, and the impact of community involvement in reducing gun violence. Specific areas of focus include the current state of background checks, with a focus on mental illness, and the role of medical professionals in guiding gun policy development. Gun violence continues to negatively impact the safety of individuals, families and communities. This article will emphasize the importance of social mobilization in enacting meaningful changes in gun policy and the development of relationships among healthcare professionals, social workers, and community members so as to further reduce and/or prevent gun violence.&lt;/p&gt;

Firearms: Ownership, Laws &amp; and The Case for Community Mobilization

&lt;p&gt;The United States (U.S.) currently ranks number one in the world in both the quantity of privately owned guns and the rate of private gun ownership. These privately owned firearms, which include rifles, shotguns and handguns, are predominantly owned by middle-aged, 35-54, white men, but the gaps have been steadily closing over the years, especially depending on the type of firearm, in all areas including gender, age, race, education level, political affiliation and geographic location. Gun violence is a leading cause of injury death in the U.S. In examining gun violence and potentially reducing its incidence, this article reviews gun ownership, access and utilization in the U.S., outcomes of gun violence, and the impact of community involvement in reducing gun violence. Specific areas of focus include the current state of background checks, with a focus on mental illness, and the role of medical professionals in guiding gun policy development. Gun violence continues to negatively impact the safety of individuals, families and communities. This article will emphasize the importance of social mobilization in enacting meaningful changes in gun policy and the development of relationships among healthcare professionals, social workers, and community members so as to further reduce and/or prevent gun violence.&lt;/p&gt;

Repeal of the concealed weapons law and its impact on gun-related injuries and deaths

Senate Bill 1108 (SB-1108) allows adult citizens to carry concealed weapons without a permit and without completion of a training course. It is unclear whether the law creates a "deterrent factor" to criminals or whether it escalates gun-related violence. We hypothesized that the enactment of SB-1108 resulted in an increase in gun-related injuries and deaths (GRIDs) in southern Arizona. We performed a retrospective cohort study spanning 24 months before (prelaw) and after (postlaw) SB-1108. We collected injury and death data and overall crime and accident trends. Injured patients were dichotomized based on whether their injuries were intentional (iGRIDs) or accidental (aGRIDs). The primary outcome was any GRID. To determine proportional differences in GRIDs between the two periods, we performed χ analyses. For each subgroup, we calculated relative risk (RR). The number of national and state background checks for firearms purchases increased in the postlaw period (national and state p < 0.001); that increase was proportionately reflected in a relative increase in state firearm purchase in the postlaw period (1.50% prelaw vs. 1.59% postlaw, p < 0.001). Overall, victims of events potentially involving guns had an 11% increased risk of being injured or killed by a firearm (p = 0.036) The proportion of iGRIDs to overall city violent crime remained the same during the two periods (9.74% prelaw vs. 10.36% postlaw; RR, 1.06; 95% confidence interval, 0.96-1.17). However, in the postlaw period, the proportion of gun-related homicides increased by 27% after SB-1108 (RR, 1.27; 95% confidence interval, 1.02-1.58). Both nationally and statewide, firearm purchases increased after the passage of SB-1108. Although the proportion of iGRIDs to overall city violent crime remained the same, the proportion of gun-related homicides increased. Liberalization of gun access is associated with an increase in fatalities from guns. Epidemiologic study, level III.

Implementing a Public Health Approach to Gun Violence Prevention: The Importance of Physician Engagement

Evidence-based, well-implemented, and enforced gun policies can reduce gun violence, and this vision can be realized with the help of physicians. As the details of policy proposals unfold and the p...

Feasibility and acceptability of interventions to delay gun access in VA mental health settings

ObjectivesThe majority of VA patient suicides are completed with firearms. Interventions that delay patients’ gun access during high-risk periods may reduce suicide, but may not be acceptable to VA stakeholders or may be challenging to implement. Using qualitative methods, stakeholders’ perceptions about gun safety and interventions to delay gun access during high-risk periods were explored. MethodsTen focus groups and four individual interviews were conducted with key stakeholders, including VA mental health patients, mental health clinicians, family members and VA facility leaders (N=60). Transcripts were consensus-coded by two independent coders, and structured summaries were developed and reviewed using a consensus process. ResultsAll stakeholder groups indicated that VA health system providers had a role in increasing patient safety and emphasized the need for providers to address gun access with their at-risk patients. However, VA mental health patients and clinicians reported limited discussion regarding gun access in VA mental health settings during routine care. Most, although not all, patients and clinicians indicated that routine screening for gun access was acceptable, with several noting that it was more acceptable for mental health patients. Most participants suggested that family and friends be involved in reducing gun access, but expressed concerns about potential family member safety. Participants generally found distribution of trigger locks acceptable, but were skeptical about its effectiveness. Involving Veteran Service Organizations or other individuals in temporarily holding guns during high-risk periods was acceptable to many participants but only with numerous caveats. ConclusionsPatients, clinicians and family members consider the VA health system to have a legitimate role in addressing gun safety. Several measures to delay gun access during high-risk periods for suicide were seen as acceptable and feasible if implemented thoughtfully.

Risk Factors for Gun-Related Behaviors Among Urban Out-of-treatment Substance Using Women

We examine the prevalence and factors associated with lifetime gun-carrying among 858 urban out-of-treatment substance using women using data collected between 2000 and 2004 in a large Midwestern city. Instruments assessed gun ownership, carrying and access, psychopathology and personal lifestyle risk factors. Analyses were conducted using logistic regression. Illegal activities for income and lifetime violent victimization were the most significant predictors of gun carrying. The implications for practice and future research are discussed along with the study's limitations. The work was supported by grants from the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism.

Predictors of suicide in patients with dementia.

Assessing predictors of suicide and means of completion in patients with dementia may aid the development of interventions to reduce risk of suicide among the growing population of individuals with dementia. This national, retrospective, cohort study used data from the Department of Veterans Affairs (fiscal years 2001-2005). The sample included patients ≥60 years old diagnosed with dementia (N = 294,952), of which 241 committed suicide. Potential predictors of suicide were identified using logistic regression. Suicide methods are also reported. Increased risk of suicide was associated with white race (OR: 2.4, 95% CI: 1.2, 4.8), depression (OR: 2.0, 95% CI: 1.5, 2.9), a history of inpatient psychiatric hospitalizations (OR: 2.3, 95% CI: 1.5, 3.5), and prescription fills of antidepressants (OR: 2.1, 95% CI: 1.6, 2.8) or anxiolytics (OR: 2.0, 95% CI: 1.5, 2.7). Nursing home admission was associated with lower suicide risk (OR: 0.3, 95% CI: 0.1, 0.8). Severity of medical comorbidity did not affect risk of suicide. Sensitivity analysis indicated that the majority of suicides occurred in those who were newly diagnosed with dementia. Firearms were the most common method of suicide (73%) used. Given the higher rate of suicide in those receiving treatment for psychiatric symptoms and the high proportion that died using firearms, closer monitoring and assessment of gun access may be an important part of initial treatment planning for older male patients with dementia, particularly those with symptoms of depression or anxiety.

Does Household Gun Access Increase the Risk of Attempted Suicide?

The aim of this research is to assess if home firearm access increases the risk of nonfatal suicidal attempts among adolescents. Such a gun focus has largely been limited to case-control studies on completed suicides. This line of research has found that household gun access increases the risk of suicide due to features of available firearms (e.g., provide little time for rescue). We extend this “risk factor” perspective to the study of nonfatal suicide attempts among a national sample of adolescents. Current findings reveal that home handgun access, but not long gun only access, is associated with an increased risk of attempted suicide in cross-sectional models. In panel models, however, we find no significant association between home firearm access (of any gun type) and risk of attempted suicide. The implications of these findings for research on suicidal behavior among adolescents are discussed.

The Missing Piece: A Sociological Autopsy of Firearm Suicide in the United States

Social, economic, violence, political, and gun access predictors of suicide and gun suicide were examined via sociological autopsy. The model predicting suicide rates overall had the best results, χ(2) (9, N=50)=5.279 (CMIN, the goodness of fit statistic that represents the minimum discrepancy between the unrestricted sample covariance matrix and the restricted covariance matrix) p=.809, [the goodness of fit statistic that represents the minimum discrepancy between the unrestricted sample covariance matrix and the restricted covariance matrix] indicating an excellent fit of the data and theoretical model. The model explained 76% of the variance in state suicide rates and was a significantly better predictor than one could expect by chance, F(6,43)=22.889, p<.001). All path coefficients were significant predictors of suicide with the exception of violence climate, which was not included. This study contributes to the theoretical knowledge by adding a comprehensive framework of analysis and model useful for prevention.

AMA Condemns Florida Gun Law as Intrusion Into Medical Care

Back to table of contents Previous article Next article Professional NewsFull AccessAMA Condemns Florida Gun Law as Intrusion Into Medical CareMark MoranMark MoranSearch for more papers by this authorPublished Online:15 Jul 2011https://doi.org/10.1176/pn.46.14.psychnews_46_14_10_3AbstractThe AMA House of Delegates at its June meeting affirmed that the AMA vigorously defends the physician-patient-family relationship and actively opposes state or federal efforts to interfere in the content of communication in medical care between physicians and their patients. And, the delegates said, the AMA will support litigation that may be necessary to block the implementation of newly enacted state or federal laws that restrict the privacy of physician-patient-family relationships or that violate the First Amendment rights of physicians in their practice of medicine. Presiding over a debate of the House of Delegates at the AMA's annual meeting are Jeremy Lazarus, M.D. (right), then speaker of the house, and Andrew Gurman, M.D., then vice speaker. Lazarus is now president-elect of the AMA, and Gurman is speaker.Credit: Mark MoranThe house approved, with widespread support and little opposition, a resolution titled "Government Interference in Patient Counseling" that is a strident defense of physicians' right to discuss issues that they regard as important to patient care. The resolution is in response to a controversial new Florida law that restricts what physicians are allowed to discuss with patients about gun ownership. That law is a toned-down version of an earlier proposal that would have permitted both criminal penalties and multimillion-dollar fines to be imposed on physicians who ask patients or patients' family members about gun possession or the presence of guns in the home. Florida psychiatrists and other physicians have voiced strong concerns about how this would interfere with an important element of the doctor-patient relationship, since this type of knowledge can be crucial in preventing accidental, or even deliberate, injuries or deaths (Psychiatric News, March 4). Child psychiatrist and APA treasurer David Fassler, M.D., testifying during AMA reference committee hearings on the resolution, called restrictions on physicians' ability to ask about access to firearms an "outrageous intrusion" into the practice of medicine. "Physicians must be able to ask any clinically relevant question in the evaluation and treatment of patients," Fassler said. "As a child and adolescent psychiatrist, I have an obligation to assess potential safety issues in the home, which often includes discussion of gun ownership, access, and storage. It's troubling that proposals that would limit my ability to ask such questions and document the answers are receiving serious consideration—and, in the case of Florida, favorable legislative action. "If and when enacted, such initiatives would have a chilling effect on the doctor-patient relationship," Fassler said.Information about the resolution approved by the House is posted at <www.ama-assn.org/assets/meeting/2011a/b-annotated-a-11.pdf>. ISSUES NewArchived