Household Firearm Research Articles

Suicide Mortality in the United States: The Importance of Attending to Method in Understanding Population-Level Disparities in the Burden of Suicide

Suicide mortality varies widely across age, sex, race, and geography, far more than does mortality from the leading causes of natural death. Unlike the tight correlation between cancer mortality and the incidence of cancer, suicide mortality is only modestly correlated with the incidence of suicidal acts and other established risk factors for suicidal behavior, such as major psychiatric disorders. An implication of this modest correlation is that the proportion of all suicidal acts that prove fatal (the case fatality ratio) must account for a substantial portion of the (nonrandom) variation observed in suicide mortality. In the United States, the case fatality ratio is strongly related to the availability of household firearms. Findings from ecologic and individual-level studies conducted over the past two decades illustrate the importance of accounting for the availability of highly lethal suicide methods in efforts to understand (and ultimately reduce) disparities in suicide mortality across populations.

Law & Psychiatry: Gun Laws and Mental Illness: How Sensible Are the Current Restrictions?

This column describes federal and state laws to restrict access to firearms among people with mental illness. The contribution to public safety of these laws is likely to be small because only 3%-5% of violent acts are attributable to serious mental illness, and most do not involve guns. The categories of persons with mental illnesses targeted by the laws may not be at higher risk of violence than other subgroups in this population. The laws may deter people from seeking treatment for fear of losing the right to possess firearms and may reinforce stereotypes of persons with mental illnesses as dangerous.

Recent psychopathology, suicidal thoughts and suicide attempts in households with and without firearms: findings from the National Comorbidity Study Replication

Objective:To assess the relationship between firearm ownership and possible psychiatric confounders of the firearm–suicide relationship.Methods:Multivariate logistic regression was used to estimate the association between living in a home with firearms...

Reporting Error in Household Gun Ownership in the 2000 General Social Survey

The use of surveys is one of the few ways to determine the extent and character of firearms ownership in the United States. The findings from such surveys have implications for both firearms research and firearms policy. Using data from the 2000 General Social Survey, the author examines the possibility of error in the reporting of household firearm ownership. Strong and significant differences in ownership reporting are found between married men and women, especially for those who were not socialized in part of a traditional “gun culture.”

“WE'VE GOT A GUN?”: comparing reports of adolescents and their parents about household firearms

AbstractFirearms are a leading cause of mortality among adolescents, and the guns that adolescents use to harm themselves or others often come from their own homes. In this statewide, multilanguage, community‐based survey of 5,704 coresiding pairs of adolescents and their parents, we asked about guns in the home and compared their responses. The proportions of parents and adolescents responding affirmatively were similar: 25.7% and 26.8%, respectively, for any guns; 15.0% and 13.2%, respectively, for handguns. A paired analysis documented substantial agreement for whether there was any gun in the home and less agreement about whether there was a handgun in the home. The amount of agreement and disagreement was related to household composition and gender of the respondents. The disagreement was substantial for some groups (e.g., when boys residing in households containing a single mother and no other adults reported that there was a gun in the home, 64.8% of their mothers said that there was not a gun in the home). Implications for research and intervention are discussed. © 2007 Wiley Periodicals, Inc.

Storage of household firearms: an examination of the attitudes and beliefs of married women with children

Although safe firearm storage is a promising injury prevention strategy, many parents do not keep their firearms unloaded and locked up. Using the theory of planned behavior as a guiding conceptual framework, this study examines factors associated with safe storage among married women with children and who have firearms in their homes. Data come from a national telephone survey (n=185). We examined beliefs about defensive firearm use, subjective norms, perceived behavioral control and firearm storage practices. A Wilcoxon-Mann-Whitney test was conducted to assess associations between psychosocial factors and firearm storage practices. Women were highly motivated to keep firearms stored safely. Those reporting safe storage practices had more favorable attitudes, more supportive subjective norms and higher perceptions of behavioral control than those without safe storage. One-fourth believed a firearm would prevent a family member from being hurt in case of a break-in, 58% believed a firearm could scare off a burglar. Some 63% said they leave decisions about firearm storage to their husbands. Women were highly motivated to store firearms safely as evidenced by favorable attitudes, supportive subjective norms and high perceptions of behavioral control. This was especially true for those reporting safer storage practices.

SIZE OF HOUSEHOLD FIREARM COLLECTIONS: IMPLICATIONS FOR SUBCULTURES AND GENDER*

Recent work (Cook and Ludwig, 2003) has linked local firearm density to increased burglary victimization risk. The current work investigates within‐household gun density or household firearm collection size. Previous work has suggested two subcultures of gun owners: protection‐minded and sport‐ or hunting‐minded. It also has identified gender gaps in reporting any household guns and in the number reported. None of the earlier work, however, has controlled for selection into gun‐owning household status. This limitation raises potential questions about earlier findings. The current research controls for selection. If the two subcultures thesis is correct, protection‐minded owners should report smaller household firearm collections. The expected impact is observed in one national survey and is partially replicated in a second. Gender gaps seemed more independent than previously suggested. This study is the first to provide evidence of two partially overlapping subcultures of gun owners even after controlling for selection into gun‐owning household status. Practical implications for burglary risk may exist.

Household Firearm Ownership and Rates of Suicide Across the 50 United States

The current investigation explores the association between rates of household firearm ownership and suicide across the 50 states. Prior ecologic research on the relationship between firearm prevalence and suicide has been criticized for using problematic proxy-based, rather than survey-based, estimates of firearm prevalence and for failing to control for potential psychological risk factors for suicide. We address these two criticisms by using recently available state-level survey-based estimates of household firearm ownership, serious mental illness, and alcohol/illicit substance use and dependence. Negative binomial regression was used to assess the relationship between household firearm ownership rates and rates of firearm, nonfirearm, and overall suicide for both sexes and for four age groups. Analyses controlled for rates of poverty, urbanization, unemployment, mental illness, and drug and alcohol dependence and abuse. US residents of all ages and both sexes are more likely to die from suicide when they live in areas where more households contain firearms. A positive and significant association exists between levels of household firearm ownership and rates of firearm and overall suicide; rates of nonfirearm suicide were not associated with levels of household firearm ownership. Household firearm ownership levels are strongly associated with higher rates of suicide, consistent with the hypothesis that the availability of lethal means increases the rate of completed suicide.

Storage of household firearms: an examination of the attitudes and beliefs of married women with children

Storage of household firearms: an examination of the attitudes and beliefs of married women with children

State-level homicide victimization rates in the US in relation to survey measures of household firearm ownership, 2001–2003

Two of every three American homicide victims are killed with firearms, yet little is known about the role played by household firearms in homicide victimization. The present study is the first to examine the cross sectional association between household firearm ownership and homicide victimization across the 50 US states, by age and gender, using nationally representative state-level survey-based estimates of household firearm ownership. Household firearm prevalence for each of the 50 states was obtained from the 2001 Behavioral Risk Factor Surveillance System. Homicide mortality data for each state were aggregated over the three-year study period, 2001–2003. Analyses controlled for state-level rates of aggravated assault, robbery, unemployment, urbanization, per capita alcohol consumption, and a resource deprivation index (a construct that includes median family income, the percentage of families living beneath the poverty line, the Gini index of family income inequality, the percentage of the population that is black and the percentage of families headed by a single female parent). Multivariate analyses found that states with higher rates of household firearm ownership had significantly higher homicide victimization rates of men, women and children. The association between firearm prevalence and homicide victimization in our study was driven by gun-related homicide victimization rates; non-gun-related victimization rates were not significantly associated with rates of firearm ownership. Although causal inference is not warranted on the basis of the present study alone, our findings suggest that the household may be an important source of firearms used to kill men, women and children in the United States.

Changing times: a longitudinal analysis of international firearm suicide data.

We investigated changes in the proportion of firearm suicides in Western countries since the 1980s and the relation of these changes to the change in the proportion of households owning firearms. Several countries had an obvious decline in firearm suicides: Norway, United Kingdom, Canada, Australia, and New Zealand. Multilevel modeling of longitudinal data confirmed the effect of the proportion of households owning firearms. Legislation and regulatory measures reducing the availability of firearms in private households can distinctly strengthen the prevention of firearm suicides.

Are Household Firearms Stored Less Safely in Homes With Adolescents?

To examine whether firearms are more frequently stored loaded, unlocked, or both in households with adolescents only (aged 13-17 years) compared with households with younger children only (aged 0-12 years). Random-digit-dial survey on firearms (n = 2770). We computed bivariate associations between the presence of adolescents and firearm storage practices. Statistical significance was assessed using prevalence ratios with 95% confidence intervals. United States. Survey respondents with children (aged <18 years) who reported the presence of a household firearm. Prevalence of firearms in the home stored loaded and/or unlocked. Of the 392 respondents, 22% had a loaded firearm, 32% had an unlocked firearm, and 8% had a firearm stored loaded and unlocked. Compared with households with younger children, households with adolescents only were somewhat more likely to store a firearm unlocked (42% vs 29%; prevalence ratio, 1.48; 95% confidence interval, 1.04-2.02), loaded (26% vs 20%; prevalence ratio, 1.25; 95% confidence interval, 0.82-1.91), or both (10% vs 8%; prevalence ratio, 1.43; 95% confidence interval, 0.64-3.19). Parents of adolescents appear to be more likely to keep household firearms stored unsafely, especially with regard to keeping firearms unlocked. This is of concern because most youth firearm injuries happen to adolescents. Firearm injury prevention programs should directly target parents of adolescents to promote safe firearm storage.

Adolescent and Young Adult Suicide: A 10‐Year Retrospective Review of Kentucky Medical Examiner Cases

The compilation of all suicidal causes of death attained the third highest ranking of mortality between the ages of 15 and 24 following unintentional deaths and homicide in the United States, accounting for approximately 4000 deaths in 2002. A variety of biopsychosocial factors may contribute to adolescent suicidal behavior, including psychiatric disorders, risk-taking behaviors, and lack of a cohesive family unit. The authors conducted a 10-year (1993-2002) retrospective review of 108 Medical Examiner cases of suicide ages 11-17 and 358 cases ages 18-24 in Kentucky, which represents two thirds of the Coroner cases in the state. The majority of victims were male and Caucasian. The major causes of death were the same for the two age groups, specifically, firearm injury (72.2% and 70.7%), hanging (22.2% and 18.7%), and drug intoxication (2.8% and 5.3%). An integrated Coroner-Medical Examiner system profits in the public health arena by providing collaborative research data for policy decisions. The prevalence of youth suicide by firearm should prompt further discussion regarding ways to better identify high-risk adolescents and young adults and restrict pediatric access to unsecured household firearms.

The association between changes in household firearm ownership and rates of suicide in the United States, 1981–2002

Objective: To explore whether recent declines in household firearm prevalence in the United States were associated with changes in rates of suicide for men, women, and children. Methods: This time...

Parental Misperceptions About Children and Firearms

To assess the accuracy of parental predictions about their children's self-reported behavior around household guns. Survey. Family practice clinic in rural Alabama. Convenience sample of parents and their children aged 5 to 14 years. Questionnaires about firearms administered separately to children and their parents. Rates of concordance and discordance between parents and their children living in homes with guns about whether the children knew the storage location of household firearms and had ever handled firearms in the home. Of 420 parent-child dyads, 314 agreed to participate; 201 of the 314 homes contained guns. Children younger than 10 years were as likely as older children to report knowing the storage location (73% vs 79%, respectively) and to report having handled a household gun (36% vs 36%, respectively). Thirty-nine percent of parents who reported that their children did not know the storage location of household guns and 22% of parents who reported that their children had never handled a household gun were contradicted by their children's reports. Such discordance between parent and child reports was unrelated to whether parents stored their firearms locked away or had ever discussed firearm safety with their children. Many parents who were living in homes with firearms and who reported that their children had never handled firearms in their homes were contradicted by their children's self-reports. Parents who locked their guns away and discussed gun safety with their children were as likely to be contradicted as parents who did not take such safety measures.

Prevalence of Household Firearms and Firearm-Storage Practices in the 50 States and the District of Columbia: Findings From the Behavioral Risk Factor Surveillance System, 2002

To examine the prevalence of household firearms and firearm-storage practices in the 50 states and the District of Columbia and estimate the number of children exposed to unsafe storage practices. We analyzed data from the 2002 cross-sectional Behavioral Risk Factor Surveillance System survey of 240735 adults from randomly selected households with telephones in the 50 states and the District of Columbia. Nationally, 32.6% of adults reported that firearms were kept in or around their home. The prevalence of adults with household firearms ranged from 5.2% in the District of Columbia to 62.8% in Wyoming (median: 40.8%). The prevalence of adults with loaded household firearms ranged from 1.6% in Hawaii, Massachusetts, and New Jersey to 19.2% in Alabama (median: 7.0%), and the prevalence of adults with loaded and unlocked household firearms ranged from 0.4% in Massachusetts to 12.7% in Alabama (median: 4.2%). Among adults with children and youth <18 years old, the prevalence of loaded household firearms ranged from 1.0% to 13.4% (median: 5.3%), and the prevalence of loaded and unlocked household firearms ranged from 0.3% to 7.3% (median: 2.3%); in each instance, Massachusetts had the lowest prevalence and Alabama had the highest. Findings indicate that approximately 1.69 million (95% confidence interval: 1.57-1.82 million) children and youth in the United States <18 years old are living with loaded and unlocked household firearms. Substantial state variations exist in the prevalence of household firearms and firearm-storage practices. It is vital that surveillance systems such as the Behavioral Risk Factor Surveillance System continue to monitor the prevalence of household firearms and firearm-storage practices so that future interventions to promote safe storage of firearms can be evaluated and more widely implemented based on their efficacy.

Do Partners With Children Know About Firearms in Their Home? Evidence of a Gender Gap and Implications for Practitioners

The gender gap describing the apparent differences in male and female reports of firearm-ownership and -storage habits has never been evaluated among individuals who live in the same household. Thus, the objective of this study was to examine the level of agreement on household firearms and storage practices among cohabiting partners. Data for this investigation came from follow-up telephone interviews of participants who underwent a randomized, controlled trial to test the effect of home-safety counseling, including firearm safety, on behavior change. Baseline interviews were conducted at a level 1 pediatric emergency department in North Carolina with adults who took a child or adolescent who was under his or her care to a pediatric emergency department. Follow-up interviews were conducted via telephone at 18 months after intervention with participants who reported household firearms at baseline. Participants then were asked whether their partners could be contacted for a separate telephone interview. The measured outcomes were number and type of household firearms and firearm-storage practices. The strength of agreement between partners' reported firearm-ownership and -storage practices was measured with the kappa statistic. Seventy-six partner-respondent pairs completed the study (62% response rate). Most initial respondents were white (89%), female (76%), and college graduates (52%); the median age was 37. There were no same-gender partners, and 91% reported that they were spouses. There was not perfect agreement among male and female partners with regard to the presence of household firearms. More men (80%) reported the presence of household firearms than did women (72%; kappa = .64). The discordance between partner pairs regarding the number of household firearms and type was poor to fair (kappa = .35 and .34, respectively). Although similar proportions of men and women reported storing any household firearms loaded (10%) and storing all household firearms locked up (63% men and 62% women), the kappa values demonstrated only moderate agreement (kappa = .56-.60). Most men (88%) and women (83%) reported that firearm storage was the husband's responsibility; 82% of men compared with 17% of women reported that they personally owned all of the firearms. A gender gap does exist in the reporting of firearm ownership with regard to the number and type of firearms owned. There are also differences in reported firearm-storage practices, which are likely related to the finding that men were reported to be the primary owner of firearms in most households as well as the person more commonly responsible for firearm storage. Firearm-safety counseling should include male partners in the history-taking process to improve knowledge about the presence and storage patterns of household firearms.

Firearm storage practices and rates of unintentional firearm deaths in the United States

Background: The American Academy of Pediatrics and the American Medical Association recommend storing firearms unloaded and locked up to minimize the chance of injury. Although these recommendations appeal to common sense, no study has yet addressed whether firearm storage practices influence the risk of unintentional firearm injury. Methods: Negative binomial regression analyses were used to assess the cross sectional relation between firearm storage practices and rates of unintentional firearm death in the United States, controlling for rates of firearm prevalence, poverty and urbanization. Recently available state-level measures of household firearm prevalence and firearm storage practices were obtained from the 2002 Behavioral Risk Factor Surveillance System. Unintentional firearm death counts and population data came from the National Center for Health Statistics. Results: Independent of firearm prevalence, urbanization, and poverty, a disproportionately large share of unintentional firearm fatalities occurred in states where gun owners were more likely to store their firearms loaded, the greatest risk occurring in states where loaded firearms were more likely to be stored unlocked. Conclusion: Our findings provide empirical support for recommendations issued by the AMA and the AAP that firearms should be stored unloaded and locked, and suggest that promoting safer storage practices could save many lives.

Gun Storage Practices and Risk of Youth Suicide and Unintentional Firearm Injuries

Household firearms are associated with an elevated risk of firearm death to occupants in the home. Many organizations and health authorities advocate locking firearms and ammunition to prevent access to guns by children and adolescents. The association of these firearm storage practices with the reduction of firearm injury risk is unclear. To measure the association of specific household firearm storage practices (locking guns, locking ammunition, keeping guns unloaded) and the risk of unintentional and self-inflicted firearm injuries. Case-control study of firearms in events identified by medical examiner and coroner offices from 37 counties in Washington, Oregon, and Missouri, and 5 trauma centers in Seattle, Spokane, and Tacoma, Wash, and Kansas City, Mo. CASES AND CONTROLS: Case firearms were identified by involvement in an incident in which a child or adolescent younger than 20 years gained access to a firearm and shot himself/herself intentionally or unintentionally or shot another individual unintentionally. Firearm assaults and homicides were excluded. We used records from hospitals and medical examiners to ascertain these incidents. Using random-digit dial telephone sampling, control firearms were identified by identification of eligible households with at least 1 firearm and children living or visiting in the home. Controls were frequency matched by age group and county. The key exposures of interest in this study were: (1) whether the subject firearm was stored in a locked location or with an extrinsic lock; (2) whether the firearm was stored unloaded; (3) whether the firearm was stored both unloaded in a locked location; (4) whether the ammunition for the firearm was stored separately; and (5) whether the ammunition was stored in a locked location. Data regarding the storage status of case and control guns were collected by interview with respondents from the households of case and control firearms. We interviewed 106 respondents with case firearms and 480 with control firearms. Of the shootings associated with the case firearms, 81 were suicide attempts (95% fatal) and 25 were unintentional injuries (52% fatal). After adjustment for potentially confounding variables, guns from case households were less likely to be stored unloaded than control guns (odds ratio [OR], 0.30; 95% confidence interval [CI], 0.16-0.56). Similarly, case guns were less likely to be stored locked (OR, 0.27; 95% CI, 0.17-0.45), stored separately from ammunition (OR, 0.45; 95% CI, 0.34-0.93), or to have ammunition that was locked (OR, 0.39; 95% CI, 0.23-0.66) than were control guns. These findings were consistent for both handguns and long guns and were also similar for both suicide attempts and unintentional injuries. The 4 practices of keeping a gun locked, unloaded, storing ammunition locked, and in a separate location are each associated with a protective effect and suggest a feasible strategy to reduce these types of injuries in homes with children and teenagers where guns are stored.

One third of households in the USA own firearms which are often stored unsafely

Question What is the prevalence of firearms and how are they stored in households in the USA? Study Design Systematic review. Main results Forty-two articles met inclusion criteria. All studies had cross-sectional designs (and included 7 national prevalence studies, 5 state prevalence studies, 14 clinic-based convenience samples and 10 were samples of professionals). Studies published between 1992 and 2002 estimated that firearms were present in a third of households in the USA. More than 25% of household firearms were kept loaded, but only half of these were kept locked. More than 50% of households with firearms had handguns. The proportion of handguns in households with children was the same as those without children. However, firearm storage practices were slightly more secure in households with children. Medical professionals had a similar rate of handgun ownership to the general population. There was little information about the use of gunlocks, trigger locks, gun safes, gun cabinets and lock boxes. There was also little information about the storage of firearm ammunition. Authors’ conclusions Firearms can be found in about a third of households in the USA. Medical professionals and people with children have a similar rate of firearm ownership to the general population. A significant number of households store guns and firearms unsafely, which is a serious cause for concern.