National support for gun policies among U.S. adults in 2019 and 2021.

Gun-related deaths and gun purchases were at record highs in 2020. In light of the COVID-19 pandemic, public protests against police violence, and a tense political environment, which may influence policy preferences, we aimed to understand the current state of support for gun policies in the U.S. We fielded a national public opinion survey in January 2019 and January 2021 using an online panel to measure support for 34 gun policies among U.S. adults. We compared support over time, by gun ownership status, and by political party affiliation. Most respondents supported 33 of the 34 gun regulations studied. Support for seven restrictive policies declined from 2019 to 2021, driven by reduced support among non-gun owners. Support declined for three permissive policies: allowing legal gun carriers to bring guns onto college campuses or K-12 schools and stand your ground laws. Public support for gun-related policies decreased from 2019 to 2021, driven by decreased support among Republicans and non-gun owners.

Creating and Disseminating a Resource for State Policy Makers About Injury and Violence Prevention: A Case Example of Translating Research to Policy.

The gap between evidence and policy is a challenge that can be bridged through strategic outreach and translation efforts. We developed and disseminated the Resource for State Policy Makers (the Resource) to lessen the information gap between state policy makers and injury prevention researchers in Maryland. Our goal was to produce and disseminate a resource for policy makers that could be replicated by public health professionals in other states and regions. The Maryland Department of Health assumed production of the Resource in 2017, with assistance from our team. Several states and regions have replicated the Resource for their own jurisdictions. This experience provides an informative case example of one approach to increasing the role of evidence in policy making.

Public Support for Gun Violence Prevention Policies Among Gun Owners and Non-Gun Owners in 2017.

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.

Comprehensive background check policy and firearm background checks in three US states.

BACKGROUND: Comprehensive background check (CBC) policies are hypothesised to reduce firearm-related violence because they extend background checks to private party firearm sales, but no study has determined whether these policies actually increase background checks, an expected intermediary outcome. We evaluate the association between CBC policies and the rates of firearm background checks in three states that recently implemented these policies: Delaware (July 2013), Colorado (July 2013) and Washington (December 2014). METHODS: We used the synthetic control group method to estimate the difference from estimated counterfactual postintervention trends in the monthly rate of background checks per 1 00 000 people for handguns, long guns and both types combined, using data for January 1999 through December 2016. Inference was based on results from permutation tests. We conducted multiple sensitivity analyses to assess the robustness of our results. RESULTS: Background check rates increased in Delaware, by 22%-34% depending on the type of firearm, following enactment of its CBC law. No overall changes were observed in Washington and Colorado. Our results were robust to changes in the comparison group and statistical methods. CONCLUSIONS: The enactment of CBC policies was associated with an overall increase in firearm background checks only in Delaware. Data external to the study suggest that Washington experienced a modest, but consistent, increase in background checks for private party sales, and Colorado experienced a similar increase in checks for sales not at gun shows. Non-compliance may explain the lack of an overall increase in background checks in Washington and Colorado.

Advocacy for booster seat legislation in Florida: a lesson in politics and policy formation.

MVCs are a major contributor to child injury and death. Infant restraint seats and child booster seats have been shown to reduce the odds of severe injury or death when used correctly. While all states have mandated the use of these restraint systems, the age at which a child can be legally restrained using an adult seat belt varies from state to state. Efforts to strengthen Florida's weak child restraint laws have failed for more than a decade; in the 2014 legislative session, advocates succeeded in raising the state's age requirement from 3 years to 5  years. While many factors contributed to this year's success, some key elements included efficient communication of supporting data, a strong and broad advocacy network and the leveraging of election year political rivalries. Efforts to further strengthen the law will continue into future legislative sessions.

Creating smoke-free places through the UN Convention on the Rights of Persons With Disabilities.

In some high-, middle-, and low-income countries, law has been employed to limit individuals' secondhand smoke exposure. Innovative legal tools are still needed, especially in low- and middle-income countries where smoking prevalence continues to rise. For some persons with severe respiratory conditions, the presence of secondhand smoke is intolerable and prevents their entrance into restaurants and other venues. With its adoption of the Convention on the Rights of Persons with Disabilities (CRPD) in 2006, the United Nations gave countries a new way to promote the rights of disabled individuals and simultaneously address secondhand smoke exposure. We analyze the CRPD's potential to advance tobacco control goals and offer recommendations for advocates, policymakers, and others seeking to apply this approach.

Effects of Baltimore's Safe Streets Program on gun violence: a replication of Chicago's CeaseFire Program.

Chicago's CeaseFire program is an evidence-based public health approach to preventing gun violence. Baltimore is one of many US cities attempting to replicate the program. We compared changes in the number of homicide and nonfatal shooting incidents per month in four intervention neighborhoods with changes in high-crime comparison areas (police posts) without the intervention, while controlling for several measures of police activity and baseline levels of homicide and nonfatal shootings. In South Baltimore there were large program-related reductions in homicide and nonfatal shooting incidents. Among three East Baltimore program sites, the program was associated with a reduction of homicides in one area, a reduction in nonfatal shootings in another area, and a simultaneous increase in homicides and decrease in nonfatal shootings in another area. In some instances, program effects extended to neighborhoods bordering the intervention areas. Program-related reductions in homicides appear to be linked with conflict mediations conducted by program outreach workers.

Changing the constitutional landscape for firearms: the US Supreme Court's recent Second Amendment decisions.

In 2 recent cases-with important implications for public health practitioners, courts, and researchers-the US Supreme Court changed the landscape for judging the constitutionality of firearm laws under the Constitution's Second Amendment. In District of Columbia v Heller (2008), the court determined for the first time that the Second Amendment grants individuals a personal right to possess handguns in their home. In McDonald v City of Chicago (2010), the court concluded that this right affects the powers of state and local governments. The court identified broad categories of gun laws-other than handgun bans-that remain presumptively valid but did not provide a standard to judge their constitutionality. We discuss ways that researchers can assist decision makers.

Local All-Age Bicycle Helmet Ordinances in the United States: A Review and Analysis.

Bicycle helmets protect against head injury. Mandatory helmet laws likely increase their use. Although 21 states and Washington, DC have mandatory helmet laws for youth (variously defined) bicyclists, no U.S. state has a mandatory helmet law that applies to all ages; however, some localities have all-age helmet laws for bicyclists. This study abstracted local helmet laws applicable to all-ages to examine their elements.

California's comprehensive background check and misdemeanor violence prohibition policies and firearm mortality.

PURPOSE: In 1991, California implemented a law that mandated a background check for all firearm purchases with limited exceptions (comprehensive background check or CBC policy) and prohibited firearm purchase and possession for persons convicted within the past 10 years of certain violent crimes classified as misdemeanors (MVP policy). We evaluated the population effect of the simultaneous implementation of CBC and MVP policies in California on firearm homicide and suicide. METHODS: Quasi-experimental ecological study using the synthetic control group methodology. We included annual firearm and nonfirearm mortality data for California and 32 control states for 1981-2000, with secondary analyses up to 2005. RESULTS: The simultaneous implementation of CBC and MVP policies was not associated with a net change in the firearm homicide rate over the ensuing 10 years in California. The decrease in firearm suicides in California was similar to the decrease in nonfirearm suicides in that state. Results were robust across multiple model specifications and methods. CONCLUSIONS: CBC and MVP policies were not associated with changes in firearm suicide or homicide. Incomplete and missing records for background checks, incomplete compliance and enforcement, and narrowly constructed prohibitions may be among the reasons for these null findings.

Circumstances of fatal lockout/tagout-related injuries in manufacturing.

BACKGROUND: Over the past few decades, hundreds of manufacturing workers have suffered fatal injuries while performing maintenance and servicing on machinery and equipment. Using lockout/tagout procedures could have prevented many of these deaths. METHODS: A narrative text analysis of OSHA accident investigation report summaries was conducted to describe the circumstances of lockout/tagout-related fatalities occurring in the US manufacturing industry from 1984 to 1997. RESULTS: The most common mechanisms of injury were being caught in or between parts of equipment, electrocution, and being struck by or against objects. Typical scenarios included cleaning a mixer or blender, cleaning a conveyor, and installing or disassembling electrical equipment. Lockout procedures were not even attempted in the majority (at least 58.8%) of fatal incidents reviewed. CONCLUSIONS: Lockout/tagout-related fatalities occur under a wide range of circumstances. Enhanced training and equipment designs that facilitate lockout and minimize worker contact with machine parts may prevent many lockout/tagout-related injuries.

Preemption and the obesity epidemic: state and local menu labeling laws and the nutrition labeling and education act.

Obesity is widely recognized as a preventable cause of death and disease. Reducing obesity among adults and children has become a national health goal in the United States. As one approach to the obesity epidemic, public health practitioners and others have asserted the need to provide consumers with information about the foods they eat. Some state and local governments across the United States have introduced menu labeling bills and regulations that require restaurants to post information, such as calorie content, for foods offered on their menus or menu boards. A major dilemma is whether state and local menu labeling laws are preempted by the federal Nutrition Labeling and Education Act (NLEA). While few courts have addressed this issue, ongoing litigation in New York City provides an early glimpse of judicial interpretation in this area. This article explores these preemption issues, arguing that appropriately written and implemented menu labeling laws should not be preempted by the NLEA. We offer guidance for states and localities that wish to develop and implement menu labeling laws.

The ethics of restrictive licensing for handguns: comparing the United States and Canadian approaches to handgun regulation.

The United States and Canada regulate firearms, particularly handguns, quite differently. With only a few state and local exceptions, the U.S. approach emphasizes the ability of most individuals to purchase, possess, and carry handguns. By comparison, Canada has a form of restrictive licensing for handguns that places a premium on community safety. The authors first review the potential individual and community level harms and benefits associated with these differing fre-arm policies. Using this information, they explore the ethical dimensions of the U.S. and Canadian approaches through three major themes of autonomy, prevention of harms, and social justice. The authors conclude that the Canadian approach is consistent with respect for the autonomy of persons, fosters the prevention of harms, and more appropriately furthers social justice.

Ignition Interlock Laws: Effects on Fatal Motor Vehicle Crashes, 1982-2013.

INTRODUCTION: Alcohol-involved motor vehicle crashes are a major cause of preventable mortality in the U.S., leading to more than 10,000 fatalities in 2013. Ignition interlocks, or alcohol-sensing devices connected to a vehicle's ignition to prevent it from starting if a driver has a predetermined blood alcohol content (BAC) level, are a promising avenue for preventing alcohol-involved driving. This study sought to assess the effects of laws requiring ignition interlocks for some or all drunk driving offenders on alcohol-involved fatal crashes. METHODS: A multilevel modeling approach assessed the effects of state interlock laws on alcohol-involved fatal crashes in the U.S. from 1982 to 2013. Monthly data on alcohol-involved crashes in each of the 50 states was collected in 2014 from the National Highway Traffic Safety Administration Fatality Analysis Reporting System. Random-intercept models accounted for between-state variation in alcohol-involved fatal crash rates and autocorrelation of within-state crash rates over time. Analysis was conducted in 2015. RESULTS: State laws requiring interlocks for all drunk driving offenders were associated with a 7% decrease in the rate of BAC >0.08 fatal crashes and an 8% decrease in the rate of BAC ≥0.15 fatal crashes, translating into an estimated 1,250 prevented BAC >0.08 fatal crashes. Laws requiring interlocks for segments of high-risk drunk driving offenders, such as repeat offenders, may reduce alcohol-involved fatal crashes after 2 years of implementation. CONCLUSIONS: Ignition interlock laws reduce alcohol-involved fatal crashes. Increasing the spread of interlock laws that are mandatory for all offenders would have significant public health benefit.

Regulation of firearm dealers in the United States: an analysis of state law and opportunities for improvement.

Firearms were associated with 30, 136 deaths in the United States in 2003. Most guns are initially sold to the public through a network of retail dealers. Licensed firearm dealers are an important source of guns for criminals and gun traffickers. Just one percent of licensed dealers were responsible for more than half of all guns traced to crime. Federal law makes it difficult for ATF to inspect and revoke the licenses of problem gun dealers. State licensing systems, however, are a greatly under-explored opportunity for firearm dealer oversight. We identify and categorize these state systems to identify opportunities for interventions to prevent problem dealers from supplying guns to criminals, juveniles, or gun traffickers. Just seventeen states license gun dealers. Twenty-three states permit routine inspections of dealers but only two mandate that those inspections occur on a regular basis. Twenty-six states impose record-keeping requirements for gun sales. Only thirteen states require some form of store security measures to minimize firearm theft. We conclude with recommendations for a comprehensive system of state licensing and oversight of gun dealers. Our findings can be useful for the coalition of more than fifty U.S. mayors that recently announced it would work together to combat illegal gun trafficking.