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To date, there have been no peer-reviewed studies in the United States estimating the impact of gun-free zone policies in alcohol-serving establishments on rates of firearm violence in and around such establishments. In this study, we utilized a cross-sectional design to estimate the impact of Texas's 51% alcohol law, which prohibits the carrying of firearms in establishments that generate over half of their revenue from alcohol sales. The analysis focused on the difference in shooting incidents in and around establishments with and without firearm carrying prohibitions in 2021 and 2022. After adjusting for establishment type (bar/restaurant), alcohol sales volume, census tract level demographic factors, and the number of nearby restaurants and bars, results indicated that gun-prohibiting bars experienced significantly fewer shootings compared to those that allowed guns. Specifically, establishments that were gun-prohibited had 37% fewer shootings within 50 m than those that were gun-allowing, with a 95% confidence interval ranging from 60% fewer to 0.2% fewer. This association was more prominent in bars than in restaurants. The protective association with gun-prohibited status diminished with increased distance from the establishments; results were not significant at 100 m. Our study findings align with research suggesting that gun-free zones can reduce firearm violence. However, future studies using quasi-experimental designs that can better support causal inference are needed to support such a conclusion, as are studies exploring the efficacy of such policies in various settings and over longer periods., (© 2024. The Author(s).)

Competing Interests: The author has no financial or personal relationships with other people or organisations.

Background: In recent years, the United States (US) has witnessed a rise in political violence. Prior research has found that an individual's social network is associated with their likelihood of engaging in various forms of violence, but research on social networks and political violence in the US context is limited. This study examined associations between social network size and endorsement of political violence in a recent nationally representative survey and explored how the relationship varied by use of social media as a major news source, perceptions of the government as an enemy, and membership in a marginalized or privileged racial or ethnic group., Methods: This was a nationally representative cross-sectional survey study of adults aged 18 and older in the US, administered from May 13-June 2, 2022. The exposure was social network size, defined by the number of strong social connections. We examined three violence-related outcomes: support for non-political violence, support for political violence, and personal willingness to engage in political violence. We estimated prevalence ratios for associations using survey-weighted Poisson regression with robust standard errors, adjusting for hypothesized confounders and including interaction terms to examine effect measure modification., Results: The sample included 8,620 respondents. Median age was 48.4 years (95% CI = 47.9-48.8), 51.5% were female (95% CI = 50.4-52.7%), and 62.7% self-identified as non-Hispanic White (95% CI = 61.4-65.9%). In adjusted models, those with zero strong connections were more likely than those with 1-4 strong social connections to consider political violence usually/always justified in general (PR = 2.43, 95% CI = 1.47-4.01). Those with 50 + strong connections were more likely than those with 1-4 strong social connections to consider political violence usually/always justified in at least one situation (PR = 1.19, 95% CI = 1.03-1.37) and were more likely to report being willing to personally use political violence (PR = 1.52, 95% CI = 1.13-2.04). Associations varied somewhat by social media use, perceptions of the government as an enemy, and racialized identity., Conclusions: Individuals who reported very few and very many strong social connections were more likely than others to support political violence or be personally willing to engage in it in one form or another. Findings point toward potential intervention and prevention opportunities., (© 2024. The Author(s).)

Background: Surveys have found concerningly high levels of agreement that the United States will experience civil war soon. This study assesses variation in expectation of and perceived need for civil war with respondent sociopolitical characteristics, beliefs, firearm ownership, and willingness to engage in political violence., Methods: Findings are from Wave 2 of a nationally representative annual longitudinal survey of members of the Ipsos KnowledgePanel, conducted May 18-June 8, 2023. All respondents to 2022's Wave 1 who remained in KnowledgePanel were invited to participate. Outcomes are expressed as weighted proportions and adjusted prevalence differences, with p-values adjusted for the false discovery rate and reported as q-values., Results: The completion rate was 84.2%; there were 9385 respondents. After weighting, half the sample was female (50.7%, 95% CI 49.4%, 52.1%); the weighted mean (± standard deviation) age was 48.5 (25.9) years. Approximately 1 respondent in 20 (5.7%, 95% CI 5.1%, 6.4%) agreed strongly or very strongly that "in the next few years, there will be civil war in the United States." About 1 in 25 (3.8%, 95% CI 3.2%, 4.4%), and nearly 40% (38.4%, 95% CI 32.3%, 44.5%) of those who strongly or very strongly agreed that civil war was coming, also agreed strongly or very strongly that "the United States needs a civil war to set things right." Expectation of and perceived need for civil war were higher among subsets of respondents who in Wave 1 were more willing than others to commit political violence, including MAGA Republicans, persons in strong agreement with racist beliefs or statements of the potential need for violence to effect social change, persons who strongly approved of specified extreme right-wing political organizations and movements, firearm owners who purchased firearms in 2020 or later, and firearm owners who carried firearms in public all or nearly all the time., Conclusions: In 2023, the expectation that civil war was likely and the belief that it was needed were uncommon but were higher among subsets of the population that had previously been associated with greater willingness to commit political violence. These findings can help guide prevention efforts., (© 2024. The Author(s).)

Objective: This study investigates the association between replacement thinking, status threat perceptions, and the endorsement of political violence among non-Hispanic white adults in the United States. It explores how perceived threats to social status can drive support for extreme measures aimed at preserving white hegemony, addressing a gap in research on factors contributing to political violence, a public health concern., Methods: The 2022 Life in America Survey provided data for this cross-sectional study, focusing on status threat and replacement thinking among non-Hispanic white respondents. Status threat was inferred from relative income, education level, and racial segregation in residential census tracts, while replacement thinking was derived through agreement with the statement "in America, native-born white people are being replaced by immigrants." The outcome was the endorsement of political violence. Analysis utilized a survey-weighted robust modified Poisson model., Results: Among 5,976 non-Hispanic white respondents, 18.7 % supported political violence in at least one scenario. A U-shaped relationship was observed between racial segregation and political violence endorsement: respondents from more diverse communities were less likely to support political violence. Those endorsing replacement thinking were 233 %-229 % more likely to endorse political violence than those who did not, dependent on income levels. White respondents without a high school degree were 29 % more likely to endorse political violence., Conclusion: The study found a positive association between replacement thinking, markers of status threat, and political violence endorsements among non-Hispanic white Americans. These findings emphasize the need for research and interventions to mitigate these perceptions and prevent political violence., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: Most Americans believe that gun-free zones make locations more vulnerable to violent crimes, particularly active shootings. However, there is no empirical evidence regarding the impact of gun-free zones on protecting locations from violence. The objective of this study was to estimate the association between gun-free zones and active shootings., Methods: We used a pair-matched case-control study where cases were all US establishments where active shootings occurred between 2014 and 2020, and controls were randomly selected US establishments where active shootings could have but did not occur, pair-matched by establishment type, year, and county. Gun-free status of included establishments was determined via local laws, company policy, news reporting, Google Maps and posted signage, and calling establishments., Findings: Of 150 active shooting cases, 72 (48.0%) were determined to have occurred in a gun-free zone. Of 150 controls where no active shooting occurred, 92 (61.3%) were determined to be gun-free. After accounting for matched pairs, the conditional odds of an active shooting in gun-free establishments were 0.38 times those in non-gun-free establishments, with a 95% confidence interval of 0.19-0.73 (p-value = 0.0038). Several robustness analyses affirmed these findings., Interpretation: It is unlikely that gun-free zones attract active shooters; gun-free zones may be protective against active shootings. This study challenges the proposition of repealing gun-free zones based on safety concerns., Funding: This work was funded in part by the National Collaborative on Gun Violence Research and the Arnold Foundation., Competing Interests: The authors, PR, CM, AG, SR DW and CB, declare no competing interests., (© 2024 The Author(s).)

Background: A 2022 survey in the USA found concerningly high prevalences of support for and personal willingness to engage in political violence, of beliefs associated with such violence, and of belief that civil war was likely in the near future. It is important to determine the durability of those findings., Methods: Wave 2 of a nationally representative cohort survey was conducted May 18-June 8, 2023; the sample comprised all respondents to 2022's Wave 1. Outcomes are expressed as weighted proportions; changes from 2022 to 2023 are for respondents who participated in both surveys, based on aggregated individual change scores., Results: The completion rate was 84.2%; there were 9385 respondents. After weighting, 50.7% (95% confidence interval (CI) 49.4%, 52.1%) were female; weighted mean (SD) age was 48.5 (25.9) years. About 1 in 20 respondents (5.7%, 95% CI 5.1%, 6.4%) agreed strongly/very strongly that "in the next few years, there will be civil war in the United States," a 7.7% decrease. In 2023, fewer respondents considered violence to be usually/always justified to advance at least 1 of 17 specific political objectives [25.3% (95% CI 24.7%, 26.5%), a 6.8% decrease]. However, more respondents thought it very/extremely likely that within the next few years, in a situation where they consider political violence justified, "I will be armed with a gun" [9.0% (95% CI 8.3%, 9.8%), a 2.2% increase] and "I will shoot someone with a gun" [1.8% (95% CI 1.4%, 2.2%), a 0.6% increase]. Among respondents who considered violence usually/always justified to advance at least 1 political objective, about 1 in 20 also thought it very/extremely likely that they would threaten someone with a gun (5.4%, 95% CI 4.0%, 7.0%) or shoot someone (5.7%, 95% CI 4.3%, 7.1%) to advance such an objective., Conclusions: In this cohort, support for political violence declined from 2022 to 2023, but predictions of firearm use in political violence increased. These findings can help guide prevention efforts, which are urgently needed., (© 2024. The Author(s).)

Importance: Little is known about support for and willingness to engage in political violence in the United States. Such violence would likely involve firearms., Objective: To evaluate whether firearm owners' and nonowners' support for political violence differs and whether support among owners varies by type of firearms owned, recency of purchase, and frequency of carrying a loaded firearm in public., Design, Setting, and Participants: This cross-sectional nationally representative survey study was conducted from May 13 to June 2, 2022, among US adult members of the Ipsos KnowledgePanel, including an oversample of firearm owners., Exposure: Firearm ownership vs nonownership., Main Outcomes and Measures: Main outcomes concern (1) support for political violence, in general and to advance specific political objectives; (2) personal willingness to engage in political violence, by severity of violence and target population; and (3) perceived likelihood of firearm use in political violence. Outcomes are expressed as weighted proportions and adjusted prevalence differences, with P values adjusted for the false-discovery rate and reported as q values., Results: The analytic sample comprised 12 851 respondents: 5820 (45.3%) firearm owners, 6132 (47.7%) nonowners without firearms at home, and 899 (7.0%) nonowners with firearms at home. After weighting, 51.0% (95% CI, 49.9%-52.1%) were female, 8.5% (95% CI, 7.5%-9.5%) Hispanic, 9.1% (95% CI, 8.1%-10.2%) non-Hispanic Black, and 62.6% (95% CI, 61.5%-63.8%) non-Hispanic White; the mean (SD) age was 48.5 (18.0) years. Owners were more likely than nonowners without firearms at home to consider violence usually or always justified to advance at least 1 of 17 specific political objectives (owners: 38.8%; 95% CI, 37.3%-40.4%; nonowners: 29.8%; 95% CI, 28.5%-31.2%; adjusted difference, 6.5 percentage points; 95% CI, 4.5-9.3 percentage points; q < .001) but were not more willing to engage in political violence. Recent purchasers, owners who always or nearly always carry loaded firearms in public, and to a lesser extent, owners of assault-type rifles were more supportive of and willing to engage in political violence than other subgroups of firearm owners., Conclusions and Relevance: In this study of support for political violence in the United States, differences between firearm owners and nonowners without firearms at home were small to moderate when present. Differences were greater among subsets of owners than between owners and nonowners. These findings can guide risk-based prevention efforts.

There have been no peer-reviewed, quantitative research studies on the effectiveness of gun-free school zones. The objective of this study was to use a cross-sectional, multi-group controlled ecological study design in St. Louis, MO city that compared the counts of crimes committed with a firearm occurring in gun-free school zones compared to a contiguous area immediately surrounding the gun-free school zone (i.e., gun-allowing zones) in 2019. Gun-free school zones were measured and analyzed in two ways. In the primary analysis, boundaries of the tax parcels were used for each school as the beginning of the gun-free school zone. Results from this analysis, after adjustment for pair-matching and confounding, were null. In the secondary analysis, gun-free school zones were measured as beginning at the geographic centroid of the school's address. After adjusting for the pair-matching and confounding, this analysis showed 13.7% significantly fewer crimes committed with a firearm in gun-free school zones compared to gun-allowing zones. These results suggest that gun-free school zones are not being targeted for firearm crime in St. Louis, MO., (© 2023. The New York Academy of Medicine.)

Background: Current conditions in the USA suggest an increasing risk for political violence. Little is known about the prevalence of beliefs that might lead to political violence, about support for and personal willingness to engage in political violence, and about how those measures vary with individual characteristics, lethality of violence, political objectives that violence might advance, or specific populations as targets., Methods: This cross-sectional US nationally representative survey was conducted on May 13 to June 2, 2022, of adult members of the Ipsos KnowledgePanel. Outcomes are weighted, population-representative proportions of respondents endorsing selected beliefs about American democracy and society and violence to advance political objectives., Results: The analytic sample included 8620 respondents; 50.5% (95% confidence interval (CI) 49.3%, 51.7%) were female; and weighted mean (± standard deviation) age was 48.4 (± 18.0) years. Nearly 1 in 5 (18.9%, 95% CI 18.0%, 19.9%) agreed strongly or very strongly that "having a strong leader for America is more important than having a democracy"; 16.2% (95% CI 15.3%, 17.1%) agreed strongly or very strongly that "in America, native-born white people are being replaced by immigrants," and 13.7% (95% CI 12.9%, 14.6%) agreed strongly or very strongly that "in the next few years, there will be civil war in the United States." One-third of respondents (32.8%, 95% CI 31.7%, 33.9%) considered violence to be usually or always justified to advance at least 1 of 17 specific political objectives. Among all respondents, 7.7% (95% CI 7.0%, 8.4%) thought it very or extremely likely that within the next few years, in a situation where they believe political violence is justified, "I will be armed with a gun"; 1.1% (95% CI 0.9%, 1.4%) thought it very or extremely likely that "I will shoot someone with a gun." Support for political violence and for the use of firearms in such violence frequently declined with increasing age, education, and income., Conclusions: Small but concerning proportions of the population consider violence, including lethal violence, to be usually or always justified to advance political objectives. Prevention efforts should proceed urgently based on the best evidence available., (© 2023. Columbia University Center for Injury Epidemiology and Prevention.)

Intentional shootings in K-12 schools in the U.S. persist as a public health problem. The number of shootings in K-12 schools has increased precipitously since 2017. And with approximately 100,000 K-12 public schools nationally serving 51 million children, investing in a comprehensive gun violence prevention strategy is critical. Unfortunately, our current school gun violence prevention approach almost exclusively centers reactive strategies that are in place to respond to acts of gun violence in the moment, rather than preventive strategies that would prevent them from occurring at all. Reliance on these strategies alone, however, is not sufficient. In line with the core tenets of public health prevention and the Whole School, Whole Child, Whole Community model, we present a more expansive school gun violence prevention framework that broadens the spectrum of what constitutes "school gun violence prevention." Our work highlights how enhancing basic neighborhood and school structures-including investments in public libraries, affordable housing, and universal school-based violence prevention programs-are key to both preventing gun violence and promoting well-being. We also highlight the role of stricter gun laws, reasonable school security efforts, bystander interventions, building awareness within school communities, and meaningful investments in early interventions and mental health services. Children, who have been tragically exposed to any number of adverse experiences in the wake of the COVID-19 pandemic, deserve more reasoned choices and large-scale investments in understanding and cutting off the root causes of school gun violence; not just a reliance on strategies that focus on what to do in the moment of a violent act. As gun violence in K-12 schools persists, we must reframe the discourse about school gun violence around prevention, not reaction., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Inc. All rights reserved.)

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., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Authors. Published by Elsevier Inc.)