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Aim: The U.S. prohibits firearm purchase among individuals with specific risk factors. These prohibitions are operationalized using background checks for firearm purchase. Despite these restrictions, prohibited persons have obtained firearms after passing background checks, sometimes with devastating effects. Materials and Methods: We conducted a mixed‐methods, descriptive study of the records and record‐keeping practices that underpin background checks for firearm transfers. Sources included key informant interviews with individuals working in a leadership capacity with state record‐keeping systems as well as data from state surveys and administrative records. We analyzed quantitative data using descriptive statistics and qualitative data using a thematic analysis approach to code the data and identify themes. Three investigators coded each interview. We returned to all data sources to develop key findings in an iterative process. Results: Key informants described major improvements in the collection of specific record types that were previously a "black hole" (e.g. criminal history records housed in military justice systems, and records relating to involuntary commitments for mental illness) and advances in the automation of record transfer across agencies, themes corroborated by administrative data. Key informants also identified potential causes and solutions for challenges relating to missing or incomplete information and delays in resolving ambiguous background check results. Examples include manual processes for confirming relationship status in misdemeanor crimes of domestic violence and discordant practices for processing arrest and court records that result in dispositions that cannot be entered or arrests with no disposition. Conclusion: Background checks are the backbone of many policies designed to prevent firearm harm in the United States. This study highlights actionable ways in which states could make background check practices and policies more robust. [ABSTRACT FROM AUTHOR]

BackgroundFirearm violence is a major public health problem in the United States, yet most states lack a mechanism to temporarily remove firearms from individuals who are at high and imminent risk of harming themselves or others and are not otherwise prohibited. Extreme risk protection order (ERPO) laws are intended to close this gap. The current study examines the passage of California's gun violence restraining order (GVRO) bill using Kingdon's multiple streams framework.MethodsThis study was based on an analysis of interview data from six key informants involved in the passage of the GVRO legislation.ResultsFindings indicate policy entrepreneurs framed the problem and designed the policy to target individuals at behavioral risk of imminent firearm violence. Policy entrepreneurs comprised an integrated policy network that engaged in a lengthy period of collaboration and bargained with interest groups to yield a bill that satisfied diverse concerns.ConclusionsThis case study may inform efforts in other states to pass ERPO policies and other firearm safety laws.

Despite promising results from individual-level studies, state-level studies of the effectiveness of comprehensive background-check (CBC) policies in reducing firearm fatalities have yielded null results in multiple states. These prior studies focused on CBC laws adopted in the 1990s, when record keeping was far less complete. We estimated the effect of the implementation of CBC policies on state-level firearm homicide and suicide rates in states implementing CBC policies from 2013 to 2015 (Colorado, Delaware, Oregon, and Washington). We compared age-adjusted firearm homicide and suicide rates, measured annually from 15 years prior to policy implementation until 2019, in each treated state to rates in control groups constructed using the synthetic control group method. Differences in firearm homicide rates for Colorado, Oregon, and Washington post treatment were all small (0.09 to 0.18 per 100,000 residents per year) and not well distinguished from natural variation. Oregon had on average 0.80 per 100,000 fewer firearm suicides per year than did synthetic Oregon post treatment. However, these results were inconsistent across modeling approaches and not well distinguished from natural variation. Our models produced poor fit for Delaware. Coupled with previous null results from Indiana, California, Maryland, Pennsylvania, and Tennessee, the present results suggest that extending background check requirements to private transfers alone and implementing these policies as is currently done is not sufficient to achieve significant state-level reductions in firearm fatalities.

Abstract Background Despite growing evidence about how state-level firearm regulations affect overall rates of injury and death, little is known about whether potential harms or benefits of firearm laws are evenly distributed across demographic subgroups. In this systematic review, we synthesized available evidence on the extent to which firearm policies produce differential effects by race and ethnicity on injury, recreational or defensive gun use, and gun ownership or purchasing behaviors. Main body We searched 13 databases for English-language studies published between 1995 and February 28, 2023 that estimated a relationship between firearm policy in the USA and one of eight outcomes, included a comparison group, evaluated time series data, and provided estimated policy effects differentiated by race or ethnicity. We used pre-specified criteria to evaluate the quality of inference and causal effect identification. By policy and outcome, we compared policy effects across studies and across racial/ethnic groups using two different ways to express effect sizes: incidence rate ratios (IRRs) and rate differences. Of 182 studies that used quasi-experimental methods to evaluate firearm policy effects, only 15 estimated policy effects differentiated by race or ethnicity. These 15 eligible studies provided 57 separate policy effect comparisons across race/ethnicity, 51 of which evaluated interpersonal violence. In IRR terms, there was little consistent evidence that policies produced significantly different effects for different racial/ethnic groups. However, because of different baseline homicide rates, similar relative effects for some policies (e.g., universal background checks) translated into significantly greater absolute differences in homicide rates among Black compared to white victims. Conclusions The current literature does not support strong conclusions about whether state firearm policies differentially benefit or harm particular racial/ethnic groups. This largely reflects limited attention to these questions in the literature and challenges with detecting such effects given existing data availability and statistical power. Findings also emphasize the need for additional rigorous research that adopts a more explicit focus on testing for racial differences in firearm policy effects and that assesses the quality of race/ethnicity information in firearm injury and crime datasets.

BackgroundExtreme risk protection order (ERPO) laws are a tool for firearm violence prevention (in effect in 19 states), often enacted in the wake of a public mass shooting when media coverage of gun violence tends to spike. We compared news media framing of ERPOs in states that passed and those that considered but did not pass such laws after the 2018 mass shooting in Parkland, Florida.MethodsWe conducted a content analysis of 244 newspaper articles about ERPOs, published in 2018, in three passing (FL, VT, RI) and three non-passing states (PA, OH, CO). Measures included language used, stakeholders mentioned, and scientific evidence cited. We use chi-square tests to compare the proportion of articles with each measure of interest in passing versus non-passing states.ResultsCompared to newspaper coverage of non-passing states, news articles about ERPOs in passing states more often used only official policy names for ERPOs (38% vs. 23%, p = .03), used less restrictive language such as "prevent" to describe the process of suspending firearm access (15% vs. 3%, p

Background: Despite growing evidence about how state-level firearm regulations affect overall rates of injury and death, little is known about whether potential harms or benefits of firearm laws are evenly distributed across demographic subgroups. In this systematic review, we synthesized available evidence on the extent to which firearm policies produce differential effects by race and ethnicity on injury, recreational or defensive gun use, and gun ownership or purchasing behaviors. Main body: We searched 13 databases for English-language studies published between 1995 and February 28, 2023 that estimated a relationship between firearm policy in the USA and one of eight outcomes, included a comparison group, evaluated time series data, and provided estimated policy effects differentiated by race or ethnicity. We used pre-specified criteria to evaluate the quality of inference and causal effect identification. By policy and outcome, we compared policy effects across studies and across racial/ethnic groups using two different ways to express effect sizes: incidence rate ratios (IRRs) and rate differences. Of 182 studies that used quasi-experimental methods to evaluate firearm policy effects, only 15 estimated policy effects differentiated by race or ethnicity. These 15 eligible studies provided 57 separate policy effect comparisons across race/ethnicity, 51 of which evaluated interpersonal violence. In IRR terms, there was little consistent evidence that policies produced significantly different effects for different racial/ethnic groups. However, because of different baseline homicide rates, similar relative effects for some policies (e.g., universal background checks) translated into significantly greater absolute differences in homicide rates among Black compared to white victims. Conclusions: The current literature does not support strong conclusions about whether state firearm policies differentially benefit or harm particular racial/ethnic groups. This largely reflects limited attention to these questions in the literature and challenges with detecting such effects given existing data availability and statistical power. Findings also emphasize the need for additional rigorous research that adopts a more explicit focus on testing for racial differences in firearm policy effects and that assesses the quality of race/ethnicity information in firearm injury and crime datasets. [ABSTRACT FROM AUTHOR]

Objectives: This study examines how characteristics of victims and types of incidents described in a media account of gun violence affect public support for three categories of policies that regulate firearms. Methods: A randomized experiment with a sample of US public (N = 3410). Results: Victim race, particularly if the victim was Black, was a strong predictor of less public support for all tested categories of firearm regulation. Respondents were less supportive of policies to address gun suicide or accidents and more supportive of policy solutions to mass shootings, compared to street-level gun homicides. Depictions of victim gender, mental illness, prior incarceration, and age were less salient to support across categories of firearm regulation, compared to race and type of incident. Conclusions: Media coverage of gun violence has heterogenous effects on public support for firearm regulation and may influence support for policies aimed at reducing specific types of gun violence. [ABSTRACT FROM AUTHOR]

ObjectivesStricter firearm policies correlate with lower suicides by firearm in the US. However, much work examines policies in isolation and does not investigate firearm policies as they relate to US pro-gun culture. We examine the relation between permissiveness of state firearm laws, gun culture, and suicides by firearm.Study designPanel longitudinal study.MethodsThe count of suicides by firearm for 50 US states from 2000 to 2016 served as the outcome. Permissiveness of multiple state firearm laws, based on ratings from the Traveler's Guide to the Firearm Laws of the Fifty States, served as the exposure. These ratings, measured at the state-year, capture not only the overall policy environment but also the extent to which the state exhibits a pro-gun culture. We applied a fixed effects negative binomial count model, which controls for the population-at-risk, to examine suicides overall and by race/ethnicity and gender.ResultsA 10-unit increase in permissiveness of state firearm laws corresponds with 2% greater suicides by firearm overall (Incidence rate ratio [IRR] = 1.02; 95% CI: 1.01-1.03) and among non-Hispanic white males ([IRR] = 1.02, 95% CI: 1.01-1.02).ConclusionsFindings, if replicated, indicate that states enacting more restrictive firearm policies, and lessening a pro-gun culture, may lead to reductions in suicide by firearm.

BackgroundFollowing the 2018 mass shooting at Marjory Stoneman Douglas High School in Parkland, Florida, there was a dramatic increase in media coverage of extreme risk protection orders (ERPOs) and in state policy proposals for ERPO laws. This study documents the frequency of news coverage of ERPOs throughout 2018 and examines the narratives used by media outlets to describe this risk-based firearm policy.MethodsUsing a mixed-method descriptive design, we examine the frequency of national news media coverage of ERPO legislation in 2018, before and after the Parkland shooting, and analyze the content of news articles related to a sample of states that considered ERPO legislation after the shooting.ResultsWe find a sharp increase in the frequency of articles related to ERPOs following the Parkland shooting and smaller increases in coverage surrounding ERPO policy proposals and other public mass shootings that year. Nearly three-quarters of articles in our content analysis mentioned the Parkland shooting. The news media often mentioned or quoted politicians compared to other stakeholders, infrequently specified uses for ERPOs (e.g., prevention of mass violence, suicide, or other violence), and rarely included evidence on effectiveness of such policies. More than one-quarter of articles mentioned a mass shooting perpetrator by name, and one-third of articles used the term "gun control."ConclusionsThis study describes the emerging public discourse, as informed by media messaging and framing, on ERPOs as states continue to debate and implement these risk-based firearm violence prevention policies.

Abstract Background Firearm violence is a major public health problem in the United States, yet most states lack a mechanism to temporarily remove firearms from individuals who are at high and imminent risk of harming themselves or others and are not otherwise prohibited. Extreme risk protection order (ERPO) laws are intended to close this gap. The current study examines the passage of California’s gun violence restraining order (GVRO) bill using Kingdon’s multiple streams framework. Methods This study was based on an analysis of interview data from six key informants involved in the passage of the GVRO legislation. Results Findings indicate policy entrepreneurs framed the problem and designed the policy to target individuals at behavioral risk of imminent firearm violence. Policy entrepreneurs comprised an integrated policy network that engaged in a lengthy period of collaboration and bargained with interest groups to yield a bill that satisfied diverse concerns. Conclusions This case study may inform efforts in other states to pass ERPO policies and other firearm safety laws.

High-profile school shootings in recent years have fueled fear and uncertainty among stakeholders (e.g., parents, teachers, and students) and the public debate on gun control legislation nationwide. These fears are reflected in the public discourse and the academic community, which focuses their investigation on rampage school shootings. To address this gap in the empirical literature, the current study's goal is twofold: (1) to contribute to the descriptive understanding of school shooting characteristics; and (2) address the gaps in the extant literature through examining the perpetrators relationship with the school on the total number of victims during a school shooting incident. Secondary data analysis was performed on the K-12 School Shooting database (K-12 SSDB). A negative binomial and descriptive analysis were conducted on the K-12 School Shooting database, established by the Naval Postgraduate School's Center for Homeland Defense and Security (CHDS) in 2018, which has been recently updated to reflect recent incidents. The findings and policy implications of the findings are discussed in detail in the manuscript. [ABSTRACT FROM AUTHOR]

Background: Firearm violence is one of the leading preventable causes of death and injury in the United States and is on the rise. While policies regulating access to firearms offer opportunities to prevent firearm-related deaths, an understanding of the holistic impact of changing state firearm policies on firearm homicide rates over the last 30 years is limited. Objectives: To identify US states that showed unexpected decreases and increases in firearm homicide rates and summarise their firearm policy changes in the last three decades. Methods: We analysed changes in firearm homicide rates by US state and county from 1990 to 2019. We triangulated across three estimation approaches to derive state rankings and identify the top and bottom three states which consistently showed unexpected decreases (low outliers) and increases (high outliers) in firearm homicide rates. We summarised firearm policy changes in state outliers using the RAND State Firearm Law Database. Results: We identified New York, District of Columbia, and Hawaii as low state outliers and Delaware, New Jersey, and Missouri as high state outliers. Low state outliers made more restrictive firearm policy changes than high state outliers, which covered a wider range of policy types. Restrictive changes in high state outliers primarily targeted high-risk populations (e.g., prohibited possessors, safe storage). Specific legislative details, such as the age threshold (18 vs 21 years old) for firearm minimum age requirements, also emerged as important for differentiating low from high state outliers. Conclusions: While no firearm law change emerged as necessary or sufficient, an accumulation of diverse restrictive firearm policies may be key to alleviating the death toll from firearm homicide.

Abstract Background Extreme risk protection order (ERPO) laws are a tool for firearm violence prevention (in effect in 19 states), often enacted in the wake of a public mass shooting when media coverage of gun violence tends to spike. We compared news media framing of ERPOs in states that passed and those that considered but did not pass such laws after the 2018 mass shooting in Parkland, Florida. Methods We conducted a content analysis of 244 newspaper articles about ERPOs, published in 2018, in three passing (FL, VT, RI) and three non-passing states (PA, OH, CO). Measures included language used, stakeholders mentioned, and scientific evidence cited. We use chi-square tests to compare the proportion of articles with each measure of interest in passing versus non-passing states. Results Compared to newspaper coverage of non-passing states, news articles about ERPOs in passing states more often used only official policy names for ERPOs (38% vs. 23%, p = .03), used less restrictive language such as “prevent” to describe the process of suspending firearm access (15% vs. 3%, p

We aim to study the association between state child access prevention (CAP) and overall firearm laws with pediatric firearm-related mortality. The Centers for Disease Control and Prevention Web-based Injury Statistics Query and Reporting System was queried for pediatric (aged < 18 y) all-intent (accidental, suicide, and homicide) firearm-related crude death rates (CDRs) among the 50 states from 1999 to 2019. States were into three groups: Always CAP (throughout the 20-year period), Never CAP, and New CAP (enacted CAP during study period). We used the Giffords Law Center Annual Gun Law Scorecard (A, B, C, D, F) to group states into strict (A, B) and lenient (C, D, F) firearm laws. A scatter plot was constructed to display state CDR based on CAP laws by year. The top 10 states by CDR per year were tabulated based on CAP law status. Wilcoxon rank-sum was used to compare CDR between strict and lenient scorecard states in 2019. There were 12 Always CAP, 21 Never CAP, and 17 New CAP states from 1999 to 2019. No states changed from CAP laws to no CAP laws. Never CAP and New CAP states dominated the high outliers in CDR compared to Always CAP. The top 10 states with the highest CDR per year were most commonly Never CAP. Strict firearm laws states had lower median CDR in 2019 than lenient states (0.79 [0-1.67] versus 2.59 [1.66-3.53], P = 0.007). Stricter overall gun laws are associated with three-fold lower all-intent pediatric firearm-related deaths. For 2 decades, the 10 states with the highest CDR were almost universally those without CAP laws. Our findings support the RAND Gun Policy in America initiative's claims on the importance of CAP laws in reducing suicide, unintentional deaths, and violent crime among children, but more research is needed. [Display omitted] [ABSTRACT FROM AUTHOR]

Intimate partner homicides (IPHs) often occur in the context of violent relationships, and firearms often facilitate lethal outcomes. Accordingly, policies have been implemented to reduce firearm access among individuals with histories of intimate partner violence (IPV) or violent propensities. There is considerable variation, however, in the enactment and implementation of such state-level firearm protection laws. Some states fail to extend IPV-related firearm related protections to dating partners, creating what has been referred to elsewhere as the "boyfriend loophole", or what will be referred to here as the "partner loophole". The goal of this analysis was to examine trends in National Violent Death Reporting System (NVDRS) data to assess the relationship of IPHs among unmarried victims in association with state partner loopholes. State policies were abstracted to identify partner loopholes. A series of negative binomial generalized estimating equations were performed using lagged policy variables, year fixed-effects, robust standard errors, and errors clustered by state. Model findings suggest that increased firearm access is related to higher rates of unmarried IPH victimization, however, the associations between the presence of a partner loophole and IPH rates amongst unmarried victims varied between racial subgroups. Significant, protective relationships with closed partner loopholes were identified for the IPH rates amongst white unmarried victims, however, not amongst victims of color. The partner loophole policies considered here, and other individual IPV-related and/or firearm-related policies may be an important component of protections, however, our findings suggest they are not independently sufficient to equitably reduce the burden of IPH. Continuing to develop public health and policy evaluation literature will be essential to progressing towards a policy landscape and cultural environment that are equitably protective. [ABSTRACT FROM AUTHOR]

High-profile school shootings in recent years have fueled fear and uncertainty among stakeholders (e.g., parents, teachers, and students) and the public debate on gun control legislation nationwide. These fears are reflected in the public discourse and the academic community, which focuses their investigation on rampage school shootings. To address this gap in the empirical literature, the current study’s goal is twofold: (1) to contribute to the descriptive understanding of school shooting characteristics; and (2) address the gaps in the extant literature through examining the perpetrators relationship with the school on the total number of victims during a school shooting incident. Secondary data analysis was performed on the K-12 School Shooting database (K-12 SSDB). A negative binomial and descriptive analysis were conducted on the K-12 School Shooting database, established by the Naval Postgraduate School’s Center for Homeland Defense and Security (CHDS) in 2018, which has been recently updated to reflect recent incidents. The findings and policy implications of the findings are discussed in detail in the manuscript.

Abstract Background Following the 2018 mass shooting at Marjory Stoneman Douglas High School in Parkland, Florida, there was a dramatic increase in media coverage of extreme risk protection orders (ERPOs) and in state policy proposals for ERPO laws. This study documents the frequency of news coverage of ERPOs throughout 2018 and examines the narratives used by media outlets to describe this risk-based firearm policy. Methods Using a mixed-method descriptive design, we examine the frequency of national news media coverage of ERPO legislation in 2018, before and after the Parkland shooting, and analyze the content of news articles related to a sample of states that considered ERPO legislation after the shooting. Results We find a sharp increase in the frequency of articles related to ERPOs following the Parkland shooting and smaller increases in coverage surrounding ERPO policy proposals and other public mass shootings that year. Nearly three-quarters of articles in our content analysis mentioned the Parkland shooting. The news media often mentioned or quoted politicians compared to other stakeholders, infrequently specified uses for ERPOs (e.g., prevention of mass violence, suicide, or other violence), and rarely included evidence on effectiveness of such policies. More than one-quarter of articles mentioned a mass shooting perpetrator by name, and one-third of articles used the term “gun control.” Conclusions This study describes the emerging public discourse, as informed by media messaging and framing, on ERPOs as states continue to debate and implement these risk-based firearm violence prevention policies.

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

How does social identity shape Protestant attitudes about guns in the United States? Numerous studies show that religion shapes attitudes about guns, but the role of Protestantism in forming those attitudes is undertheorized and undertested. We draw from the extensive literature on religion-as-identity and the burgeoning literature of gun-ownership-as-identity to test the theory about the role of Protestant religion in cultivating a gun identity. We argue that for many Protestants, gun ownership has taken on the characteristics of a distinctive social identity, but that there are clear differences between different types of Protestants—notably, evangelicals and mainliners—that render the expansive category of "Protestant" largely irrelevant as an explanatory variable. While that finding might seem straightforward to scholars of religion and politics, the broad categorical approach—that is, treating "Protestant" as explanatory—has proven surprisingly durable in studies of gun ownership and attitudes about gun control. The analysis uses a recent Pew survey with batteries of questions about gun identity, gun policy, and religion. While this research note does not fully test why this relationship between Protestantism and gun identity exists, we do show that the relationship not only exists but also affects gun policy attitudes. [ABSTRACT FROM AUTHOR]

Objectives: Stricter firearm policies correlate with lower suicides by firearm in the US. However, much work examines policies in isolation and does not investigate firearm policies as they relate to US pro-gun culture. We examine the relation between permissiveness of state firearm laws, gun culture, and suicides by firearm. Study design: Panel longitudinal study. Methods: The count of suicides by firearm for 50 US states from 2000 to 2016 served as the outcome. Permissiveness of multiple state firearm laws, based on ratings from the Traveler's Guide to the Firearm Laws of the Fifty States, served as the exposure. These ratings, measured at the state-year, capture not only the overall policy environment but also the extent to which the state exhibits a pro-gun culture. We applied a fixed effects negative binomial count model, which controls for the population-at-risk, to examine suicides overall and by race/ethnicity and gender. Results: A 10-unit increase in permissiveness of state firearm laws corresponds with 2% greater suicides by firearm overall (Incidence rate ratio [IRR] = 1.02; 95% CI: 1.01–1.03) and among non-Hispanic white males ([IRR] = 1.02, 95% CI: 1.01–1.02). Conclusions: Findings, if replicated, indicate that states enacting more restrictive firearm policies, and lessening a pro-gun culture, may lead to reductions in suicide by firearm.

At this time, the relationship between firearm minimum age laws and pediatric injury rates remains unclear. In September 2015, Alabama implemented Act 2015–341 (Act 341) which allowed minors to carry guns with parental permission. The purpose of this study was to evaluate the effect that Act 341 had on firearm injury rates. We created a database of all pediatric patients who presented to the Children’s of Alabama’s (CoA) emergency department and the Jefferson County Coroner’s Office (JCCO) with a gunshot wound injury between May 2011 to December 2019. Wilcoxon ranked sum test analysis were used to contrast the average number of monthly patients arriving before and after implementation of Act 341 and Wilcoxon ranked sum test and Fisher Exact were used to evaluate differences in demographic and outcome data.A total of 316 patients presented within the specified time period with 116 arriving prior to Act 341 and 200 arriving after; an average of 2.21 and 3.85 patients per month respectively. We found an increase of 1.63 patients per month (p

Background: Alcohol and firearms are commonly involved in suicide in the United States. State alcohol and firearm policies may impact alcohol and firearm related suicide, yet little is known about these relationships. This study examines relationships between state alcohol and firearm policies and suicides involving alcohol, guns, or both, and explores interactive policy associations.Methods: Alcohol policies were assessed with the Alcohol Policy Scale. Firearm policies were assessed using the Gun Law Scorecard from Giffords Law Center. Suicide data from the National Violent Death Reporting System in 2015 covered 22 states. State- and individual-level GEE Poisson and logistic regression models assessed relationships between policies and firearm- and/or alcohol-involved suicides with a 1-year lag.Results: In 2015, there were 8996 suicide deaths with blood alcohol concentration test results in the 22 included states. Of those deaths, alcohol and/or firearms were involved in 5749 or 63.9%. Higher alcohol and gun law scores were associated with reduced incidence rates and odds of suicides involving either alcohol or firearms (adjusted incidence rate ratios [IRR] 0.72 (95% CI 0.63, 0.83) for alcohol policies, 0.86 (95% CI 0.82, 0.90) for firearm policies). Relationships were similar for suicides involving both alcohol and firearms, and there was an interactive effect, such that states with restrictive policies for both had the lowest rates of suicides involving alcohol or guns.Conclusions: More restrictive alcohol and firearm policies are associated with lower rates and odds of suicides involving alcohol or firearms, and alcohol and firearms, and may be a promising means by which to reduce suicide. [ABSTRACT FROM AUTHOR]

The U.S. suicide rate continues to increase, despite federal investment in developing preventive behavioral health care interventions. Important determinants of suicide-social, economic, and circumstantial-have little or no connection to psychopathology. Firearm injuries account for over half of suicides, and firearm access is perhaps the most important modifiable determinant. Thus gun safety policy deserves special attention as a pathway to suicide prevention. This article summarizes arguments for several recommended statutory modifications to firearm restrictions at the state level. The policy challenge is to develop and implement evidence-based strategies to keep guns out of the hands of people at highest risk of suicide, without unduly infringing the rights of a large number of gun owners who are unlikely to harm anyone. Recommendations for states include expansion and refinement of legal criteria prohibiting firearm purchase, possession, or access to better align with suicide risk, including prohibition for persons with brief involuntary psychiatric holds or repeated alcohol-impaired driving convictions; enactment of extreme risk protection order laws, which allow temporary removal of firearms from persons who are behaving dangerously, and entering purchase prohibition data for these persons in the FBI's background-check database; and adoption of an innovative policy known as precommitment against suicide as well as voluntary self-enrollment in the FBI's background-check database. [ABSTRACT FROM AUTHOR]

Any student of macroeconomics should be able to tell you about the "guns versus butter" tradeoff in a national economy. According to an analytical tool referred to as the production possibilities curve, a nation can choose to allocate its capital toward the production of either consumer or military (security) goods and services. The important conclusion of the analysis is that the economy is constrained in its ability to produce and that the cost of producing one is the reduction in production of the other. [ABSTRACT FROM AUTHOR]

Gun Buyback programs have been implemented in various forms in countries such as the UK, USA, Brazil, Australia, and Argentina. Whether or not these programs are an effective approach for reducing national violent crime and homicides, however, remains unclear. Much of the uncertainty is due to the different ways in which Gun Buyback programs have been implemented. The Australian Gun Buyback program is distinguished from Gun Buyback programs in other countries by its abrupt implementation, its narrow focus on a particular class of firearms, and its broad application across the entire population. We assess the impact of Australia's 1996 Gun Buyback program on national homicide rates using a synthetic control group quasi-experimental design, comparing the results to suicide and motor vehicle fatality trends to test for plausible alternative hypotheses. Results suggest that the Gun Buyback program significantly reduced Australia's homicide rate in the decade following the intervention (1997-2007). [ABSTRACT FROM AUTHOR]

We conducted a scoping review to determine the current state of knowledge and areas for advancements in research on the association of firearm laws with child and adolescent firearm-related outcomes. We queried Scopus, EMBASE, Pubmed, and CJ Abstracts for English language original empirical research articles on policies affecting child and adolescent firearm-related outcomes published between January 1, 1985 and July 1, 2018. Data were abstracted, and methodologic quality assessed. Twenty articles met inclusion criteria. Among the policies studied were child access prevention laws (12 studies) and minimum age restrictions for firearm purchase and possession (4 studies). Outside of child access prevention laws, which are associated with reductions in child and adolescent unintentional and firearm suicide deaths, there is, at best, equivocal evidence of policy effects. This area is understudied, particularly in regard to nonfatal firearm injuries, for which the lack of a national surveillance system hampers research efforts. Further rigorous firearm policy evaluations are needed. [ABSTRACT FROM AUTHOR]

This paper examines the context within which research and policy have developed by tracing the historical development of gun research across decades and topics. While the journey is not necessarily linear, nor is it always clear, the work done by researchers on gun issues offers some hope for improving both the debate and outcomes associated with this area. Identifying seminal moments in gun research and policy history aid in the exploration of this issue and offer directions for the future. Research has addressed many of the challenges of firearms in society. The purpose of this paper is to note the failure of the research to recognize the role of guns in America even as it attempts to bring change within the volatile arena of guns in America. This disconnect between the research and the social problems and harm associated with guns is clear in the literature and the policy that attempts to respond. [ABSTRACT FROM AUTHOR]

In the comparative interrupted time series design (also called the method of difference-in-differences), the change in outcome in a group exposed to treatment in the periods before and after the exposure is compared with the change in outcome in a control group not exposed to treatment in either period. The standard difference-in-difference estimator for a comparative interrupted time series design will be biased for estimating the causal effect of the treatment if there is an interaction between history in the after period and the groups; for example, there is a historical event besides the start of the treatment in the after period that benefits the treated group more than the control group. We present a bracketing method for bounding the effect of an interaction between history and the groups that arises from a time-invariant unmeasured confounder having a different effect in the after period than the before period. The method is applied to a study of the effect of the repeal of Missouri's permit-to-purchase handgun law on its firearm homicide rate. We estimate that the effect of the permit-to-purchase repeal on Missouri's firearm homicide rate is bracketed between 0.9 and 1.3 homicides per 100,000 people, corresponding to a percentage increase of 17% to 27% (95% confidence interval: 0.6, 1.7 or 11%, 35%). A placebo study provides additional support for the hypothesis that the repeal has a causal effect of increasing the rate of state-wide firearm homicides. [ABSTRACT FROM AUTHOR]

Growing in range and urgency, humanitarian needs now pose increasingly acute questions for national security policy formulation. Whether over forced migration, food scarcity or nefarious electronic penetration, state security preferences face uneasy accommodations with individual needs be it for child survival, basic sustenance or rights to privacy. This paper deliberates a further field of increasingly apparent value contest: that involving the transfer, diversion and lethal use of small arms and light weapons (SALW). After outlining the scale of this phenomenon, existing regulatory mechanisms over SALW transfers are assessed. It is argued that these controls are inadequate, a deficiency that is embedded within a range of inter-linked disjunctions. They are outlined in a model that is evaluated against empirical findings. Where SALW control inadequacy is causally connected to the disjunctive model, it is argued, current levels of SALW-induced casualties are unlikely to abate. The paper concludes by considering feasible options for enhanced management of global SALW proliferation. [ABSTRACT FROM AUTHOR]

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The article discusses considerations with regard to the proposal of the policy in U.S. for arming teachers and school staff so as to ensure safety of school teachers and students in light of increasing number of brutal school shootings in the country. Topics discussed include the concept of security as an educational value and policy concerns with regard to teachers becoming dangerous when armed.

For more than 20 years, the American College of Physicians (ACP) has advocated for the need to address firearm-related injuries and deaths in the United States. Yet, firearm violence continues to be a public health crisis that requires the nation's immediate attention. The policy recommendations in this paper build on, strengthen, and expand current ACP policies approved by the Board of Regents in April 2014, based on analysis of approaches that the evidence suggests will be effective in reducing deaths and injuries from firearm-related violence. [ABSTRACT FROM AUTHOR]

Objectives. To compare donations to individual politicians from physician organization political action committees (PACs) and from the National Rifle Association Political Victory Fund (NRA PVF) in 2018. Methods. We identified 7 organizations with published firearm injury prevention policy. We determined the difference in funds received from physician organization PACs and the NRA PVF for each congressmember. We examined their voting records on firearm-related legislation. Results. A total of 141 congressmembers received funds from both physician organization PACs and the NRA PVF. Of these, 99.3% voted for legislation not consistent with organization recommendations. The majority (70.2%) received more funds from the combined physician organization PACs than from the NRA PVF. Conclusions. Physician organization PACs have a financial impact on NRA-backed congressmembers. They currently contribute to politicians with voting records inconsistent with their own policy recommendations. Firearm violence prevention does not currently outweigh other legislative priorities for physician organization PAC contributions. [ABSTRACT FROM AUTHOR]

Objectives: Reducing access to firearms as a suicide prevention strategy is limited in the US today because of divergent cultural attitudes and political contentiousness surrounding gun restrictions. This research examined the effects of culturally-specific suicide prevention messages on the likelihood of restricting firearm access during periods of suicide risk.Methods: Focus groups and key informant interviews were conducted with rural gun owners in order to develop a suicide prevention message that highlighted the importance of restricting access to firearms during periods of risk without threatening second amendment concerns. The effectiveness of this gun culture message, relative to standard suicide prevention messaging and a control condition, was then tested with a national sample of gun owners.Results: Relative to all other conditions, respondents who received our culturally-specific message in conjunction with standard suicide prevention content reported the greatest likelihood of taking steps to restrict access to firearms. This tendency was enhanced for individuals who were more politically conservative, lived in more rural areas, and supported gun rights to a stronger degree.Conclusions: Findings underscore the importance of attending to cultural factors in public health messaging. Messaging that respects the values of gun owners could hold promise in promoting firearm restriction for suicide prevention. [ABSTRACT FROM AUTHOR]

The article examines whether regulations requiring the storage of firearms in locked containers and the locking of ammunition in a separate location in all foster homes violates foster parents' Second Amendment right as defined in the case District of Columbia v. Heller. Topics include the number of states that regulate firearm storage in foster homes, way a majority of states have chosen to regulate firearms in foster homes, and status of the Second Amendment.

Objectives. To compare public support for 24 different gun policies between gun owners and non-gun owners in 2017. Methods. We fielded a national public opinion survey in January 2017 using an online panel to measure US adults' support for 24 gun policies. We compared support among gun owners and non-gun owners. Results. For 23 of the 24 policies examined, most respondents supported restricting or regulating gun ownership. Only 8 of 24 policies had greater than a 10-point support gap between gun owners and non-gun owners. Conclusions. Policies with high public support and minimal support gaps by gun ownership status included universal background checks, greater accountability for licensed gun dealers unable to account for their inventory, higher safety training standards for concealed carry permit holders, improved reporting of records related to mental illness for background checks, gun prohibitions for persons subject to temporary domestic violence restraining orders, and gun violence restraining orders. Public Health Implications. Although there are important areas where Americans disagree on guns, large majorities of both gun owners and non-gun owners strongly support measures to strengthen US gun laws. [ABSTRACT FROM AUTHOR]

Background: In 2016, firearms killed 38,658 people in the United States. Federal law requires licensed gun dealers, but not private parties, to conduct background checks on prospective firearm purchasers with the goal of preventing prohibited persons from obtaining firearms. Our objective was to estimate the effect of the repeal of comprehensive background check laws-requiring a background check for all handgun sales, not just sales by licensed dealers-on firearm homicide and suicide rates in Indiana and Tennessee.Methods: We compared age-adjusted firearm homicide and suicide rates, measured annually from 1981 to 2008 and 1994 to 2008 in Indiana and Tennessee, respectively, to rates in control groups constructed using the synthetic control method.Results: The average rates of firearm homicide and suicide in Indiana and Tennessee following repeal were within the range of what could be expected, given natural variation (differences = 0.7 firearm homicides and 0.5 firearm suicides per 100,000 residents in Indiana and 0.4 firearm homicides and 0.3 firearm suicides per 100,000 residents in Tennessee). Sensitivity analyses resulted in similar findings.Conclusion: We found no evidence of an association between the repeal of comprehensive background check policies and firearm homicide and suicide rates in Indiana and Tennessee. In order to understand whether comprehensive background check policies reduce firearm deaths in the United States generally, more evidence on the impact of such policies from other states is needed. See video abstract at, http://links.lww.com/EDE/B353. [ABSTRACT FROM AUTHOR]

I analyze attitudes towards gun control from a recent survey of American high school students. For students who most closely identify as Republicans, cueing them to think about prior school shootings increases their agreement that armed staff in schools will improve safety and arming citizens will reduce risk of mass shootings. For those identifying as Democrats and Independents, providing them with selective information that certain states have loose gun control laws and low rates of gun violence makes them more supportive of gun rights. For Republicans, providing selective information that certain states have loose gun control laws and high rates of gun violence makes them less supportive of gun rights. These results suggest that emotional cues may exacerbate a priori biases, while informational cues may be more likely to change people's minds about firearm policies [ABSTRACT FROM AUTHOR]