National Burden of Injury and Deaths From Shootings by Police in the United States, 2015‒2020.

Objectives. To describe all-outcome injurious shootings by police and compare characteristics of fatal versus nonfatal injurious shootings nationally. Methods. From July 2021 to April 2023, we manually reviewed publicly available records on all 2015-2020 injurious shootings by US police, identified from Gun Violence Archive. We estimated injury frequency, case fatality rates, and relative odds of death by incident and victim characteristics. Results. A total of 1769 people were injured annually in shootings by police, 55% fatally. When a shooting injury occurred, odds of fatality were 46% higher following dispatched responses than police-initiated responses. Injuries associated with physically threatening or threat-making behaviors, behavioral health needs, and well-being checks were most frequently fatal. Relative to White victims, Black victims were overrepresented but had 35% lower odds of fatal injury when shot. Conclusions. This first multiyear, nationwide analysis of injurious shootings by US police suggests that injury disparities are underestimated by fatal shootings alone. Nonpolicing responses to social needs may prevent future injuries. Public Health Implications. We call for enhanced reporting systems, comprehensive evaluation of emerging reforms, and targeted investment in social services for equitable injury prevention. (Am J Public Health. 2024;114(4):387-397. https://doi.org/10.2105/AJPH.2023.307560).

Differences in Perceptions of Gun-Related Safety by Race and Gun Ownership in the United States.

Motivated by disparities in gun violence, sharp increases in gun ownership, and a changing gun policy landscape, we conducted a nationally representative survey of U.S. adults (n=2,778) in 2021 to compare safety-related views of white, Black, and Hispanic gun owners and non-owners. Black gun owners were most aware of homicide disparities and least expecting of personal safety improvements from gun ownership or more permissive gun carrying. Non-owner views differed. Health equity and policy opportunities are discussed.

Impact of Changes to Concealed-Carry Weapons Laws on Fatal and Nonfatal Violent Crime, 1980-2019.

The United States faces rapidly rising rates of violent crime committed with firearms. In this study, we sought to estimate the impact of changes to laws that regulate the concealed carrying of weapons (concealed-carry weapons (CCW) laws) on violent crimes committed with a firearm. We used augmented synthetic control models and random-effects meta-analyses to estimate state-specific effects and the average effect of adopting shall-issue CCW permitting laws on rates of 6 violent crimes: homicide with a gun, homicide by other means, aggravated assault with a gun, aggravated assault with a knife, robbery with a gun, and robbery with a knife. The average effects were stratified according to the presence or absence of several shall-issue permit provisions. Adoption of a shall-issue CCW law was associated with a 9.5% increase in rates of assault with a firearm during the first 10 years after law adoption and was associated with an 8.8% increase in rates of homicide by other means. When shall-issue laws allowed violent misdemeanants to acquire CCW permits, the laws were associated with higher rates of gun assaults. It is likely that adoption of shall-issue CCW laws has increased rates of nonfatal violent crime committed with firearms. Harmful effects of shall-issue laws are most clear when provisions intended to reduce risks associated with civilian gun-carrying are absent.

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.

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.

The Supreme Court Expands Second Amendment Rights as the Nation Experiences Historic Levels of Firearms Violence.

This Viewpoint discusses the recent Supreme Court decision declaring a broad right to carry firearms in public and offers a public health strategy for firearms safety laws.

Reimagining public safety: Public opinion on police reform and gun violence prevention by race and gun ownership in the United States.

Inequitable experiences of community gun violence and victimization by police use of force led to nationwide calls to "reimagine public safety" in 2020. In January 2021, we examined public support among U.S. adults for 7 policy approaches to reforming policing and investing in community gun violence prevention. Using a nationally representative sample (N = 2778), with oversampling for Black Americans, Hispanic Americans, and gun owners, we assessed support overall and by racial, ethnic, and gun owner subgroups. Overall, we found majority support for funding and implementing police and mental health co-responder models (66% and 76%, respectively), diversion from incarceration for people with symptoms of mental illness (72%), stronger laws to assure police accountability (72%), and funding for community-based and hospital-based gun violence prevention programs (69% and 60%, respectively). Support for redirecting funding from the police to social services was more variable (44% overall; White: 35%, Black: 60%, Hispanic: 43%). For all survey items, support was strongest among Black Americans. Gun owners overall reported lower support for public safety reforms and investments than respondents who did not own guns, but this distinction was found to be driven by White gun owners. The views of Black gun owners were indistinguishable from Black non-owners and were similar to White non-owners on most issues. These findings suggest that broad public support exists for innovative violence reduction strategies and public safety reforms.

Public opinion on laws regulating public gun carrying.

This study sought to examine public support for gun carrying-related policies from 2019 to 2021, a period encompassing the COVID-19 pandemic and increasing calls for racial and social justice. We conducted the National Survey of Gun Policy in January 2019 and 2021. The surveys were fielded using the NORC AmeriSpeak panel. Respondents indicated support for six policies regulating civilian gun carrying. Analyses, conducted in 2021, incorporated survey weights for nationally representative estimates. There were significant declines in support from 2019 to 2021 for two policies that would expand where civilians can lawfully carry guns: allowing concealed carry when on K-12 school grounds (23% in 2021 vs 31% in 2019) and college/university campuses (27% vs 36%). Support was also significantly lower for requiring concealed carry applicants to pass a test demonstrating safe and lawful use (74% in 2021 vs 81% in 2019). For the two new policies in the 2021 survey, more than half of respondents overall supported prohibiting open carry at demonstrations/rallies (54%) and prohibiting the carry of guns into government buildings (69%). There was lower support among gun owners (39% and 57%, respectively). Since 2019, there has been a decline in support for expanding locations for civilian gun carrying. Support remains high among U.S. adults, including the two-thirds of gun owners, for requiring concealed carry applicants to demonstrate competence in safe and lawful gun use. Our findings in support of a more regulated approach to concealed carry are in direct contrast to state-level shifts eliminating concealed gun carrying regulations.

Using synthetic control methodology to estimate effects of a Cure Violence intervention in Baltimore, Maryland.

OBJECTIVE: To estimate the long-term impact of Safe Streets Baltimore, which is based on the Cure Violence outreach and violence interruption model, on firearm violence. METHODS: We used synthetic control methods to estimate programme effects on homicides and incidents of non-fatal penetrating firearm injury (non-fatal shootings) in neighbourhoods that had Safe Streets' sites and model-generated counterfactuals. Synthetic control analyses were conducted for each firearm violence outcome in each of the seven areas where Safe Streets was implemented. The study also investigated variation in programme impact over time by generating effect estimates of varying durations for the longest-running programme sites. RESULTS: Synthetic control models reduced prediction error relative to regression analyses. Estimates of Safe Streets' effects on firearm violence varied across intervention sites: some positive, some negative and no effect. Beneficial programme effects on firearm violence reported in prior research were found to have attenuated over time. CONCLUSIONS: For highly targeted interventions, synthetic control methods may provide more valid estimates of programme impact than panel regression with data from all city neighbourhoods. This research offers new understanding about the effectiveness of the Cure Violence intervention over extended periods of time in seven neighbourhoods. Combined with existing Cure Violence evaluation literature, it also raises questions about contextual and implementation factors that might influence programme outcomes.

Gun purchasing behaviours during the initial phase of the COVID-19 pandemic, March to mid-July 2020.

We sought to characterize gun and ammunition purchasing during the initial phase of the COVID-19 pandemic using a nationally representative sample of U.S. adults. We fielded a survey using NORC's Amerispeak Panel between 7 and 22 July 2020 (survey completion rate = 91.1%, N = 1337). We used survey-weighted data to calculate the proportion of adults who purchased a gun during this time period and types of guns and amount of ammunition purchased. Between March and mid-July 2020, 6% of adults purchased a gun and 9% bought ammunition. Of those purchasing a gun, 34% were first-time purchasers. Among those purchasing ammunition, 19% reported purchasing more than usual in response to the COVID-19 pandemic while 27% purchased less than usual. An estimated 6,451,163 adults bought guns for the first time between March and mid-July 2020. Increases in gun purchasing, particularly among first-time gun owners, could pose significant short- and long-term implications for public health.

Public opinion on gun policy by race and gun ownership status.

We sought to examine support for gun polices by race and ethnicity, and among gun owning subgroups. We combined two waves of the National Survey of Gun Policy (January 2017 and 2019 [N = 3804]). We used chi-square tests to assess whether support for gun policies differed by race or ethnicity overall and among subgroups of gun owners. Most U.S. adults supported 17 of 21 gun-related policies. Among gun owners, Blacks supported six policies at higher levels than whites, including minimum age requirements for gun ownership and assault weapon and ammunition-related restrictions. Hispanic gun owners supported safe storage requirements at higher levels than white gun owners. While support differed by race and ethnicity for some policies, majorities of U.S. adults supported nearly all gun policies examine regardless of race. One notable exception, carrying a concealed gun on K-12 school grounds did not reach majority support among any subgroup. While tailored messaging may be appropriate in certain circumstances, it is important to highlight the similarities in support for evidence-based gun polices across racial and ethnic groups.

Association between gun owner attitudes and their behavior in private firearm sales.

Federal law places no regulations on unlicensed, private firearm sellers. However, a majority of the firearms used in crime come from these unregulated markets. This study aims to characterize the demographics of gun owners who engage in private sales, determine how often these individuals engage in selling behaviors, and ascertain whether sellers' attitudes are associated with their reported behaviors in the private market. A nationally representative web-based survey of 1444 gun owners, fielded in Spring 2016, were asked about their participation in the private market. The 238 respondents who participated in the private market were asked about their behavior on their last sale and the extent to which they felt it was the responsibility of sellers to ensure purchasers were legally able to own a firearm. Less than half of private gun sellers agreed that it is the seller's responsibility to ensure purchasers are eligible to buy guns (46%). Among private sellers, only 44% checked purchasers for eligibility and 32% denied a sale due to concerns about whether the firearm would be used safely. Sellers who agreed it was their responsibility to ensure purchasers were eligible to buy a gun had 4.52 (95% CI:1.78 to 11.5) times greater odds of reporting checking for a permit or conduct a background check on their last sale. it. These findings suggest a need for strategies to increase gun sellers' perceptions of responsibility for ensuring only eligible purchasers purchase guns, potentially including communication campaigns or educational programs.

Worth the risk? Gun carrying and perceived criminal justice responses in Baltimore.

INTRODUCTION: Policing strategies to deter illegal gun carrying by high-risk people are associated with reductions in gun violence. Many factors influence decisions to use or carry a gun in public, but it is unclear whether perceptions of the criminal justice system's response influence those decisions. METHODS: We used a 2016 cross-sectional survey of criminal justice system-involved men in Baltimore City (n=195) to assess their recent frequency of gun carrying and perceptions of criminal justice system responses. RESULTS: Forty-two per cent of respondents reported carrying a gun at least once; 15% carried a gun at least monthly. Those who carried at least monthly were significantly less likely than others to report that it was likely they would be caught carrying a gun on the street (31% vs 53%). CONCLUSIONS: Challenges with holding accountable those who illegally possess or carry guns in public may influence behaviours and perceptions of the effectiveness of the criminal justice system.

Purchaser Licensing, Point-of-Sale Background Check Laws, and Firearm Homicide and Suicide in 4 US States, 1985-2017.

Objectives. To estimate and compare the effects of state background check policies on firearm-related mortality in 4 US states.Methods. Annual data from 1985 to 2017 were used to examine Maryland and Pennsylvania, which implemented point-of-sale comprehensive background check (CBC) laws for handgun purchasers; Connecticut, which adopted a handgun purchaser licensing law; and Missouri, which repealed a similar law. Using synthetic control methods, we estimated the effects of these laws on homicide and suicide rates stratified by firearm involvement.Results. There was no consistent relationship between CBC laws and mortality rates. There were estimated decreases in firearm homicide (27.8%) and firearm suicide (23.2%-40.5%) rates associated with Connecticut's law. There were estimated increases in firearm homicide (47.3%), nonfirearm homicide (18.1%), and firearm suicide (23.5%) rates associated with Missouri's repeal.Conclusions. Purchaser licensing laws coupled with CBC requirements were consistently associated with lower firearm homicide and suicide rates, but CBC laws alone were not.Public Health Implications. Our results contribute to a body of research showing that CBC laws are not associated with reductions in firearm-related deaths unless they are coupled with handgun purchaser licensing laws.

Support for gun policies among young adults in the U.S., 2017-2019.

After the school shooting at Marjory Stoneman Douglas High School in Parkland, Florida in 2018, there was an increase in gun violence prevention-related advocacy. While much of this recent political activity and engagement was led by young adults, little is known about support for specific gun policies within this age group. This study uses data from two nationally representative surveys fielded in 2017 and 2019 to compare public support for gun policies: (1) between young adults age 18-29 years and adults age 30 and older, and (2) between young adults in 2017 and young adults in 2019, before and after the Parkland shooting. Relative to adults age 30 and older, young adults had lower support for 16 of 20 gun violence prevention policies examined. Public support was largely unchanged between 2017 and 2019 among survey respondents ages 18-29; however, support for requiring a safety test for concealed carry decreased significantly among young adults between 2017 and 2019. Despite owning fewer guns and finding gun violence prevention important generally, young adults appear to have lower support for policies that regulate guns compared to older adults.

Differences in public support for handgun purchaser licensing.

OBJECTIVE: To assess whether there are differences in support for handgun purchaser licensing. METHODS: We used data from four waves of online, national polling on gun policy. To estimate differences in support for licensing across groups, we categorised respondents by whether they personally owned a gun, lived in a state with handgun purchaser licensing or lived in a state regulating private sales without a licensing system. RESULTS: Eighty-four per cent of adults living in states with licensing supported the policy compared with 74% in states without the law (p<0.001). Seventy-seven per cent of gun owners living in states with licensing supported the policy vs 59% of gun owners in states without licensing (p<0.001). CONCLUSIONS: Support for licensing among gun owners living in states with these laws, many of whom have presumably gone through the process, was much higher than gun owners in states without such laws.

Effect on background checks of newly-enacted comprehensive background check policies in Oregon and Washington: a synthetic control approach.

BACKGROUND: Comprehensive background check (CBC) laws extend background check requirements to private party firearm transfers to prevent firearm acquisitions by prohibited persons. The aim of our study was to estimate the association between CBC policies and changes in background check rates for firearm acquisition in two states (Oregon and Washington) that have newly-enacted CBC policies. METHODS: We used data on handgun background checks from January 1999 to December 2018 from the National Instant Criminal Background Check System. Observed trends in exposed states were contrasted with counterfactual trends estimated with the synthetic control group method. FINDINGS: CBC policies were associated with increases in background checks in Oregon (by 18.0%; p = 0.074), but not in Washington (4%; p = 0.321). A gradual increase in private party checks was seen following enactment in Washington; however, firearm transactions coded as "private" represent less than 5% of total background checks in that state. CONCLUSIONS: Comprehensive background check policies appear to be effective in increasing pre-firearm-sale background checks in Oregon but not in Washington. Differences appear to be related to variations in the proportion of firearm sales that are private party transfers and to gradual adaptation to the new law by private gun sellers.

Trends In Public Opinion On US Gun Laws: Majorities Of Gun Owners And Non-Gun Owners Support A Range Of Measures.

Gun policy is a prominent topic of debate in the 2020 US election cycle. Tracking evolving public attitudes about gun policy is critical in this context. Using data from the National Survey of Gun Policy fielded in 2013, 2015, 2017, and 2019 by the Johns Hopkins Center for Gun Policy and Research, we examined trends in support for more than two dozen gun policies over time by gun ownership status and political party affiliation, and across states. Most policies that we considered had majority support across the study period. We identified increases in public support over time for licensing and universal background checks of handgun purchasers, stronger regulation of gun dealers, and extreme risk protection orders. Gun owners and non-gun owners were highly supportive of requiring tests to demonstrate safe handling before carrying a concealed weapon, but there were large differences in support for other concealed carry policies by gun ownership status. A new item included in the 2019 survey showed that 84 percent of Americans supported requiring first-time gun purchasers to take a safety course. While gun policy continues to be characterized as highly polemical, large majorities of both gun owners and non-gun owners strongly support a range of measures to strengthen US gun laws.