Household Firearm Research Articles

Firearm assaults against US law enforcement officers in the line-of-duty: Associations with firearm ownership and state firearm laws

Law enforcement officers are disproportionately affected by occupational injury. Firearm violence is the second leading cause of occupational mortality for this group behind motor vehicle crashes. In the general population, greater firearm ownership and weaker firearm laws are associated with increased firearm violence incidence. It is plausible that a high prevalence of firearms could also be associated with a greater incidence of LEO assault with a firearm. Using data from the Federal Bureau of Investigation’s, Uniform Crime Reporting, Police Employee Data for 2006–2016, we conducted a panel analysis to estimate the association between state-level estimates of household firearm ownership and LEO assault with a firearm. We additionally examined if effect modification by universal background check law status was present. Higher state-level firearm ownership was associated with an increased odds of LEO assault with a firearm in multi-level models. This association was modified by universal background check law status. In states without a universal background check law, for every 1% increase in state-level firearm ownership per agency-year, there was a 12.4% increase in the odds of an LEO assault with a firearm when adjusting for confounders (OR:1.124; 95% CI:1.018,1.240). In states with a universal background check law, there was no association. Findings, though small in magnitude, suggest aggregate firearm ownership may contribute to LEO assault with a firearm in states without a universal background check law. Future research to prevent LEO assault with a firearm should combine measures to address high rates of firearm ownership with other evidence-based prevention strategies.

Type of household firearm ownership and firearm suicide among adolescents, 1976–2018

After declining steadily for almost two decades, the rate of firearm suicide among adolescents (aged 15–19 years) has increased nearly every year since 2007. At the same time, overall levels of household firearm ownership have been declining. In this paper, we examined whether and how types of firearms in the homes of adolescents have changed over time, and the extent to which such changes are associated with trends in firearm suicides among adolescents. Our analyses focused on understanding these trends among Black and White male and female adolescents to better understand longstanding race-gender differences in firearm ownership and firearm suicide. With combined data from the General Social Survey (GSS) and the National Center for Health Statistics (NCHS), the findings show that handgun ownership in Black and White households increased over the last four decades, while overall levels of firearm ownership declined. Increases in handgun ownership were predictive of increased firearm suicide rates among White adolescents, especially among males. We found no significant relationship between firearm suicide among Black adolescents and firearm ownership among Black households, regardless of gun type, which is potentially unsurprising given that firearm ownership is substantially lower in Black households compared to White households. Possibly reflecting race and gender differences in household gun ownership, our findings also show that rates of firearm suicide were lower for Black and female adolescents and highest for White male adolescents. Taken together, these findings provide new evidence on the relationship between trends in firearm ownership and adolescent firearm suicide and address important questions about the influence of race and gender for understanding firearm suicide among adolescents.

Prevalence and Correlates of Firearm Access Among Post-9/11 US Women Veterans Using Reproductive Healthcare: a Cross-Sectional Survey

BackgroundSuicide rates have increased among women Veterans, with increased use of firearms as the method. Addressing suicide risk in this population requires understanding the prevalence and correlates of firearm access in healthcare settings frequented by women Veterans.ObjectivesCharacterize the prevalence and correlates of firearm ownership and storage practices among women Veterans using Department of Veterans Affairs (VA) reproductive healthcare (RHC) services.DesignCross-sectional national survey conducted in 2018–2019 (17.9% response rate).ParticipantsPost-9/11 women Veterans using RHC (n=350).Main MeasuresVA Military Sexual Trauma Screen, PTSD Checklist for DSM-5, Hurt/Insult/Threaten/Scream, Columbia-Suicide Severity Rating Scale screener, self-reported firearm access.Key Results38.0% (95% confidence interval [95% CI]: 32.9, 43.3) of participants reported personally owning firearms, and 38.9% (95% CI: 33.7, 44.2) reported other household members owned firearms. Among those with firearms in or around their homes, 17.8% (95% CI: 12.3, 24.4) and 21.9% (95% CI: 15.9, 28.9) reported all were unsafely stored (loaded or unlocked, respectively). Women who experienced recent intimate partner violence were less likely to report personally owning firearms (adjusted prevalence ratio [APR]=0.75; 95% CI: 0.57, 0.996). Those who experienced military sexual harassment (APR=1.46; 95% CI=1.09, 1.96), were married (APR=1.74; 95% CI: 1.33, 2.27), or lived with other adult(s) (APR=6.26; 95% CI: 2.87, 13.63) were more likely to report having household firearms owned by someone else. Storing firearms loaded was more prevalent among women with lifetime (APR=1.47; 95% CI=1.03, 2.08) or past-month (APR=1.69; 95% CI=1.15, 2.48) suicidal ideation and less likely among those with other adult(s) in the home (unadjusted PR=0.62; 95% CI=0.43, 0.91). Those with parenting responsibilities (APR=0.61; 95% CI=0.38, 0.97) were less likely to store firearms unlocked.ConclusionsFirearm access is prevalent among post-9/11 women Veterans using VA RHC. Interpersonal factors may be important determinants of firearm access in this population. Safe firearm storage initiatives are needed among women Veterans using RHC, particularly for those with suicidal ideation.

Teen firearm access during COVID: a repeated cross-sectional analysis of Pennsylvania families

PurposeThis study aims to investigate patterns in adolescent gun access and household gun storage in 2021 and 2022.Design/methodology/approachData were collected from two cross-sectional surveys of Pennsylvania parents with a teenage child at home.FindingsThe results indicated that about 20% of gun owners in each survey stored their guns loaded; a similar percentage stored their guns unlocked. Very few gun owners reported that their children could access their guns without adult supervision. This study found no change in gun storage practices between 2021 and 2022, but higher rates of gun ownership in 2022. The factors associated with gun storage behaviors did change between the two time points. COVID-related uncertainties and transitions in the household were linked to gun ownership and less safe storage practices in 2021, but not in 2022.Originality/valueThis study identified factors associated with teen gun access at distinct points during the pandemic. This study found little evidence of any association between child mental health and household firearm storage.

Firearms, Physicians, Families, and Kids: Finding Words that Work

Firearms, Physicians, Families, and Kids: Finding Words that Work

Youth gun carrying and household firearm ownership in 22 US states.

Youth gun carrying is associated with a range of adverse outcomes, including increased risks for homicide, suicide, school disciplinary problems, and criminal legal involvement. In this study we examined the association between state-level household firearm ownership rates and the odds of past-year gun carrying among high-school-aged youth. Using survey-weighted multivariable logistic regression models, results showed that each 1% point increase in state-level gun ownership was associated with a 2.7% (95% confidence interval [CI] = [1.1%, 4.2%], p = 0.001) increased odds of youth gun carrying, controlling for histories of school-based victimization, physical fighting, and substance use. Among a subset of weapon-carrying youth, state-level firearm availability was a significant factor in determining whether the weapon carried was a gun or a less lethal (i.e., nonfirearm) weapon (odds ratio = 1.021, 95% CI = [1.005, 1.038], p = 0.01). These findings show that firearm availability confers additional risk for youth gun carrying beyond the psychosocial risks emphasized in prior research and efforts to restrict youth access to firearms might be particularly important, especially in communities with high levels of household gun ownership.

Firearm Injury and Mortality Prevention in Pediatric Health-care Settings.

Firearm Injury and Mortality Prevention in Pediatric Health-care Settings.

Firearm ownership and access to healthcare in the U.S.: A cross-sectional analysis of six states

Provider-led firearm storage counseling is a form of firearm suicide prevention intervention. Little research examines whether barriers to healthcare access for at-risk individuals limit this intervention's impact. This study explores the relationship between household firearm presence/storage practices and healthcare access/utilization using a cross-sectional analysis of the 2017 Behavioral Risk Factor Surveillance System (BRFSS), which included state-representative data from six states that completed the Firearm Safety and Healthcare Access Modules: California, Idaho, Kansas, Oregon, Texas, and Utah. Exposures were household firearm presence and firearm storage practices. Outcomes were lacking health insurance, not having a healthcare provider, inability to afford care, and no recent routine checkup. Logistic regression models adjusted for age, sex, education, employment, children in the household, and state of residency. Our analysis included 31,888 individuals; 31.1% reported a household firearm. Compared to those in firearm-owning households, those in non-firearm-owning households had higher odds of being uninsured (aOR 1.99, 95%CI 1.60–2.48), not having a provider (aOR 1.40, 95%CI 1.18–1.67), and reporting cost as a barrier to care (aOR 1.37, 95%CI 1.13–1.67). Among firearm-owning households, those with firearms stored loaded and unlocked had higher odds of lacking a personal healthcare provider (aOR 1.52, 95%CI 1.07–2.15) compared to individuals in homes where firearms were stored unloaded. Results indicate that while individuals in firearm-owning households are more likely than non-firearm owning households to have healthcare access, those in homes with the riskiest firearm storage practices had less access. Provider-led counseling may have limited reach for individuals in homes with risky firearm storage practices.

Role of Firearm Ownership on 2001–2016 Trends in U.S. Firearm Suicide Rates

In the U.S., state-level household firearm ownership is strongly associated with firearm suicide mortality rates. Whether the recent increases in firearm suicide are explained by state-level household firearm ownership rates and trends remains unknown. Mortality data from the U.S. National Vital Statistics System and an estimate of state-level household firearm ownership rate were used to conduct hierarchical age-period-cohort (random-effects) modeling of firearm suicide mortality between 2001 and 2016. Models were adjusted for individual-level race and sex and for state-level poverty rate, unemployment rate, median household income in U.S. dollars, population density, and elevation. Between 2001 and 2016, the crude national firearm suicide mortality rate increased from 6.8 to 8.0 per 100,000, and household firearm ownership rate remained relatively stable, at around 40%. Both variables were markedly heterogeneous and correlated at the state level. Age-period-cohort models revealed period effects (affecting people across ages) and cohort effects (affecting specific birth cohorts) underlying the recent increases in firearm suicide. Individuals born after 2000 had higher firearm suicide rates than most cohorts born before. A 2001-2006 decreasing period effect was followed, after 2009, by an increasing period effect that peaked in 2015. State-level household firearm ownership rates and trends did not explain cohort effects and only minimally explained period effects. State-level firearm ownership rates largely explain the state-level differences in firearm suicide but only marginally explain recent increases in firearm suicide. Although firearms in the home increase firearm suicide risk, the recent national rise in firearm suicide might be the result of broader, more distal causes of suicide risk.

This Is Very Much Our Lane: Childhood Firearm Exposure and Adult Outcomes.

The recent spate of mass shootings across the United States has led the president to declare gun violence a public health epidemic.1 Among adolescents and young adults, suicide and homicide are the second- and third-leading causes of death, with approximately half of suicides and nearly 90% of homicides in this age group related to firearms.2–4 In this issue of Pediatrics , Copeland et al5 present the first published prospective study in which the impact of childhood firearm exposure on adult outcomes is examined. This study can be used to inform interventions at the pediatric practice and public policy level. Copeland et al5 test associations of childhood domestic gun access with subsequent adult criminality and suicidality. In this ≥20-year prospective, community-representative study conducted in North Carolina, researchers repeatedly measured household firearm exposure for children. These youth were managed into adulthood with multiple periodic assessments for suicidality and criminality. The proportion of … Address correspondence to Asad Bandealy, MD, MPH, Division of General and Community Pediatrics, Children’s National Hospital, 3336 14th St NW, Washington, DC 20009. E-mail: abandeal{at}childrensnational.org

Associations Between Gun Storage Practices and Parenting Practices: A Pennsylvania Study

This study examines how parenting practices might relate to home gun storage practices, even after accounting for sociodemographic correlates found in past research. First, parenting practices of personal gun owners, household gun owners, and nonowners are compared. Second, the study identifies associations among parenting practices, household gun storage, and juvenile access to household firearms. Data were obtained in October 2019 through an online survey of 525 Pennsylvania parents of youth ages 12–17. Respondents were selected to mirror Pennsylvania demographics. Results indicated no differences in parenting practices based on household gun ownership. Yet, personal gun ownership was associated with more inconsistency in discipline and poor monitoring and supervision. Poor supervision and monitoring were not associated with firearm storage practices. Parents who reported poorer supervision and monitoring were more likely to allow their child gun access. There was no link between parental involvement and household firearm practices. Parents who used inconsistent discipline also had inconsistent firearm storage practices. Positive discipline and communication were associated with storing guns locked.

Assessment of county-level proxy variables for household firearm ownership

Our objective in this study was to evaluate how well proxy variables for firearm ownership used in county-level studies measure firearm ownership. We applied Bayesian spatial smoothing methods to calculate county-level estimates of household firearm ownership using Behavioral Risk Factor Surveillance System (BRFSS) data (2013–2018). We compared these estimates to four proxies for county-level firearm ownership: the proportion of suicides that were firearm suicides, the average of the proportion of suicides that were firearm suicides and the proportion of homicides that were firearm homicides, gun shops per capita, and federal firearm licenses per capita. U.S. counties for which BRFSS data on household firearm ownership were collected and available for release (n = 304) were included. The median (interquartile range) prevalence of household firearm ownership was 46.6% (37.2%, 56.4%). The per capita rate of federal firearm licenses was most strongly correlated with household firearm ownership (r = 0.70; 95% CI: 0.63, 0.75) followed by the proportion of suicides that were firearm suicides (r = 0.45; 95% CI: 0.36, 0.54). These correlations were stronger among counties with populations of ≥250,000 people. The per capita rate of federal firearm licenses was the best proxy variable for firearm ownership at the county level, however, a better proxy should be identified.

Parent and Adolescent Reports of Adolescent Access to Household Firearms in the United States

Adolescent access to firearms increases their risk of firearm injury. To examine adolescent firearm access in homes with guns, how storage may modify access, and discordance between parent and adolescent report of access. This survey study used data on parents and their adolescent children from a nationally representative online survey of adults in gun-owning households, conducted from June 30 to August 11, 2019. Individuals who owned firearms and parents of adolescents were oversampled. All parents living with a child aged 13 to 17 years were invited to have their child participate in a separate survey. Respondents with more than 1 adolescent living with them were asked to choose the child with the most recent birthday. Analyses were conducted from June 1, 2020, to January 4, 2021. Firearm access was assessed by asking adolescents how long it would take to access a loaded gun in their home. Parents were asked whether their child could independently access a household firearm. Individuals who owned guns reported firearm storage practices. Study-specific poststratification weights adjusted for survey nonresponse and undercoverage or overcoverage resulting from the study-specific sample design and for benchmark demographic distributions. Of 6721 adults invited to participate, 4030 completed the survey. Of these, 280 had a firearm in their homes and had a child aged 13 to 17 years who participated in the survey. The mean (SD) age of parents was 45.2 (7.2) years; of children, 15.0 (1.4) years. The sample included 159 male adolescents (weighted percentage, 60.8%; 95% CI, 53.8%-67.8%) and 129 male adults (weighted percentage, 48.3%; 95% CI, 40.9%-55.6%). In 33.9% (95% CI, 26.7%-41.2%) of households, an adolescent reported that they could access a loaded firearm in less than 5 minutes. In homes where all guns were locked, 23.7% (95% CI, 12.3%-35.1%) of adolescents reported that they could access a loaded firearm in less than 5 minutes. Overall, 70.4% (95% CI, 63.7%-77.1%) of parents reported that their child could not access a household firearm. In households where parents said their child could not access a firearm, 21.8% (95% CI 13.8%-29.7%) of their children indicated that they could access a firearm within 5 minutes and 14.9% (95% CI, 8.9%-20.9%) indicated that they could access a firearm in more than 5 minutes but less than 1 hour. In this study, many adolescents reported having ready access to loaded guns in their homes, even when all household firearms were locked. Many adolescents who reported having access to household firearms lived with parents who knew their children had access, but others lived with parents who did not know. These finding should inform prevention efforts aimed at reducing adolescent access to household firearms.

A multi-state evaluation of the association between mental health and firearm storage practices

Firearm storage method is a potentially modifiable risk factor for suicide. Using data from a large, multi-state survey, we sought to determine whether there is an association between mental health and household firearm storage practices, and characterize that association by state of residence. Participants who endorsed the presence of a household firearm and answered the mental health questions in the 2016–2017 Behavioral Risk Factor Surveillance System from eight states were included (n=26,949). Exposures were recent poor mental health (≥14 vs. 0–13 days/past month), and diagnosis of depression. Outcomes were household firearm storage practices (loaded, and both loaded and unlocked). Using Poisson regression, we calculated adjusted prevalence ratios (aPR) overall and stratified by state of residence. Of adults endorsing a household firearm, 35.1% reported storing a firearm loaded, and of those, 53.4% reported that the firearm was both loaded and unlocked. Neither recent poor mental health nor depression was associated with loaded (aPR 1.14 [95% CI: 0.95–1.37] and aPR 0.94 [95% CI 0.80–1.09], respectively) or loaded and unlocked (aPR 1.08 [95% CI 0.88–1.42] and aPR 1.04 [95% CI 0.88–1.22], respectively) firearm storage. In the setting of highly prevalent loaded firearm storage, no differences in storage practices by mental health indicators were observed across eight states despite disparate firearm policies and local culture. The lack of difference in storage practices by mental health indicators across several states highlights an opportunity to improve means safety counseling practices, and the need for dedicated evaluation of state-level firearm storage policies.

Adolescent Suicide, Household Firearm Ownership, and the Effects of Child Access Prevention Laws

This study has 3 objectives: to examine the association between state-level firearm ownership and suicide among adolescents of high school age; to compare the strength of the firearm ownership-suicide association among adolescents relative to adults; and to evaluate the relationship between 11 child access prevention (CAP) laws and suicide. Using an ecological time series cross-sectional design, we modeled suicide rates from January 1, 1991, to December 31, 2017, as a function of household firearm ownership and states' implementation of CAP provisions using fixed effect negative binomial models. There were 37,652 suicides among adolescents between the ages of 14 and 18 years during the study period, and more than half of all suicides (51.5%, n= 19,402) involved firearms. Each 10 percentage-point increase in states' firearm ownership was associated with a 39.3% (35.1%-43.5%) increase in firearm suicide, which in turn contributed a 6.8% (2.5%-11.1%) increase in all-cause suicide. The association between firearm ownership and suicide was approximately 2 times stronger among adolescents relative to adults. Policies mandating locks and safe storage were associated with a 13.1% (2.7%-22.3%) reduction in adolescent firearm suicide and an unexplained 8.7% (1.2%-15.7%) reduction in non-firearm suicide. CAP provisions were associated with reduced firearm suicide across the lifespan, but effects were stronger among adolescents. There is an increased risk of adolescent suicide associated with household firearm ownership, and safe storage provisions are associated with decreased adolescent firearm suicide.

Investigating the association between household firearm ownership and suicide rates in the United States using spatial regression models

Past studies have rather consistently shown a significant positive association between firearm ownership and suicide rates (particularly firearm-related) in the United States. However, the impact of spatial dependence of suicide rates has not been considered in the existing research that took an ecological studies approach. To bridge this gap in the literature, we estimated and compared the association using Ordinary Least Square (OLS), spatial autoregressive (SAR), and hierarchical spatial autoregressive (HSAR) regression models. The outcome variable was the average age-adjusted and smoothed suicide rate (all, firearm, and non-firearm) at the county level in the United States between 2008 and 2014. The covariates included the state-level firearm ownership and several key demographic, geographic, religious, psychopathological, and suicide-related variables at both the state and county levels. Our main findings were: 1) the spatially-informed models (SAR and HSAR) were significantly outperformed the OLS model. The SARlag model was a better choice than the SARerr model in fitting our data. However, the HSAR model was not statistically better than the SAR model; 2) based on the results from the three final SARlag models, firearm ownership was significantly associated with firearm suicide rates, but not with all or non-firearm suicide rates, and such relationships were also observed in the SARlag models using contiguity-based spatial weight matrix; and 3) The final SARlag models explained 82.6%, 84.9%, and 76.1% of the total variance in all, firearm, and non-firearm suicide rates, respectively. In conclusion, the SARlag model provided more robust evidence supporting the positive relationship between firearm suicide rate and firearm ownership. Results from this study confirmed that access to household firearms was a significant risk factor of firearm suicide in the United States and hence means reduction should be included in the suicide prevention strategy in the United States. In the future, the effect of state firearm laws and regulations on suicide rate should also be investigated using spatially informed models to gain insights on the connection among firearm ownership, firearm laws and regulations, and population-based suicide rates.

Patterns of gun owner beliefs about firearm risk in relation to firearm storage: a latent class analysis using the 2019 National Firearms Survey

BackgroundResearch on gun owners’ risk-related beliefs has focused on how gun owners answer discrete questions about firearm risk. The current study is the first to use latent class analysis (LCA)...

Are Young Children’s Emotional and Behavioral Risk Factors Associated with Household Firearm Ownership and Storage?

Are Young Children’s Emotional and Behavioral Risk Factors Associated with Household Firearm Ownership and Storage?

Lessons learned in conducting youth suicide prevention research in emergency departments

IntroductionTo address youth suicide, we recruited seven emergency departments (EDs) for what we believe is the first controlled trial of an intervention to promote safer firearm and medication storage after...

Firearm storage practices in households with children: A survey of community-based firearm safety event participants

Safe firearm storage is associated with lower risk of unintentional and intentionally self-inflicted firearm injuries among children and adolescents. Ten community-based firearm safety events were conducted across Washington state from 2015 to 2018. We sought to describe characteristics of event participants and assess whether presence and age of children in the household were associated with household firearm locking practices. We assessed demographic characteristics and baseline firearm storage behaviors of participants using a 13-item survey. Multivariable Poisson regression models were used to estimate prevalence ratios (PR) and corresponding confidence intervals (CI) for the association of presence and age of children in households with prevalence of storing a household firearm unlocked. Of 2956 participants, 58.3% were male and 57.9% lived with an individual under 18 years. Among the 89.8% participants living with firearms, 40.1% stored at least one firearm unlocked and 39.1% stored at least one firearm loaded. In adjusted analyses, there was no statistically significant difference in prevalence of storing a household firearm unlocked between those living with no children (reference group) and those living with a child <11 years (PR = 0.91; 95% CI: 0.80,1.04), or a child aged 11–18 years (PR = 0.94; 95% CI: 0.81,1.09). A high proportion of participants stored a firearm unlocked or loaded at home and neither living with young children nor adolescents was associated with safe locking practices. In comparison with firearm safety interventions conducted in clinic settings, a majority of the participants in these community-based interventions were male and owned firearms.