The effect of gun buy-back law reform on homicides and suicides in Australia.

In this paper we use the synthetic control method (SCM) to estimate the causal effects of a national legislative reform accompanied by mandatory gun buy-backs in Australia on both suicide and homicide rates. Using a rich international dataset, we are able to separate not only these two death types, but also to distinguish deaths by firearm and by other means, thereby enabling us to test substitution-of-means hypotheses. Specifically, we apply the SCM to determine whether any reductions in firearm-related death rates where wholly or partly offset by increases in the use of other means (e.g., bladed weapons, poisons) to commit suicides and perpetrate homicides. Our findings show that these gun control policies substantially reduced both homicides and suicides by firearm, but also some evidence of other-means substitution.

Gun violence among young adults with a juvenile crime record in North Carolina: Implications for firearm restrictions based on age and risk.

Youth who acquire a juvenile crime record may be at increased risk of perpetrating gun violence as adults. North Carolina and 22 other states permit young adults who were adjudicated by a juvenile court - even for some felony-equivalent offenses - to legally access firearms. Effectiveness of gun restrictions for adults with juvenile crime histories has not been systematically studied. This article reports findings from a longitudinal study of arrests and convictions for gun-involved and other offenses in 51,059 young adults in North Carolina, comparing those with gun-disqualifying and not-disqualifying juvenile records. The annualized rate of arrest for gun-involved crime in those with a felony-level juvenile record was 9 times higher than the rate of reported comparable offenses in the same age group in the North Carolina general population (3349 vs. 376 per 100,000). Among those with a felony-equivalent juvenile delinquency adjudication who became legally eligible to possess firearms at age 18, 61.8% were later arrested for any criminal offense, 14.3% for a firearm-involved offense. Crimes with guns were most likely to occur among young adults who had committed more serious (felony or equivalent) offenses before age 18; had been adjudicated at younger ages; acquired a felony conviction as a youth; and spent time in prison. The prevalence of arrests for crimes involving guns among young adults in North Carolina with a gun-disqualifying felony record acquired before age 18 suggests that the federal gun prohibitor conferred by a felony record is not highly effective as currently implemented in this population. From a risk-based perspective, these restrictions appear to be justified; better implementation and enforcement may improve their effectiveness. Gun crime prevention policies and interventions should focus on these populations and on limiting illegal access to firearms.

A Closer Look at the Rising Epidemic of Mass Shootings in the United States and Its Association With Gun Legislation, Laws, and Sales.

INTRODUCTION: Mass shootings pose a considerable threat to public safety and significantly cost the United States in terms of lives and expenses. The following are the specific aims of this study: (1) to assess US mass shootings, firearm-related sales, laws, and regional differences from 2015 to 2021 and (2) to investigate changes in mass shootings and firearm sales before and during the Coronavirus Disease 2019 pandemic. METHODS: A retrospective review was conducted of mass shootings, gun sales, and laws regarding the minimum age required to purchase a firearm within the United States from 2015 to 2021. The 10 states/regions with the greatest mean mass shootings/capita from 2015 to 2021 were selected for further analysis. RESULTS: Mass shootings correlated significantly with firearm sales from 2015 to 2021 nationwide (P < 0.02 for all). The growth in mass shootings, the number killed/injured, and gun sales were greater in 2020 and 2021 compared to the years prior. The 10 states with the highest mean mass shooting/capita over the study period were Alabama, Arkansas, the District of Columbia, Illinois, Louisiana, Maryland, Mississippi, Missouri, South Carolina, and Tennessee. No significant correlation was found between the number of mass shootings/capita and the minimum age to purchase a firearm. CONCLUSIONS: Firearm sales correlated significantly with mass shootings from 2015 to 2021. Mass shootings and gun sales increased at greater rates during the Coronavirus Disease 2019 pandemic compared to the years before the pandemic. Mass shootings exhibited inconsistent trends with state gun laws regarding the minimum age to purchase a firearm. Future studies may consider investigating the methods by which firearms used in mass shootings are obtained to further identify targets for prevention.

Gun Laws and Youth Gun Carrying: Results from the Youth Risk Behavior Surveillance System, 2005-2017.

Youth who carry guns are at increased risk of violence and premature death-but what impact firearm legislation plays in deterring this behavior is less known. The present study aims to fill this gap by exploring the associations between state gun laws and youth gun carrying behavior using the Youth Risk Behavior Surveillance System (YRBSS). This work builds on previous research but expands it by considering a greater number of years than previous work and using an academic, as opposed to an advocacy-based, gun law coding system. Two models were assessed using generalized estimating equations (GEE): (1) youth gun carrying, (2) youth weapon carrying at school (e.g., guns, knives, clubs). The sample for Model 1 included data for 20 of the 50 U.S. states with 1 state from the northeast, 4 from the midwest, 10 from the south, and 5 from the west. The sample for Model 2 included 33 of the 50 U.S. states with 3 states from the northeast, 9 from the midwest, 12 from the south, and 9 from the west. Data for each state across the 2005-2017 YRBSS biennial surveys were included in the analysis. For youth gun carrying and overall weapon carrying, the total gun regulation index was a significant predictor with lower gun regulation index scores associated with greater youth gun and weapon carrying behavior. The present study points to the potential of gun laws in reducing youth gun carrying behavior. States with more gun laws had fewer youth reporting gun-carrying behavior.

The Influence of New York's SAFE Act on Individuals Seeking Mental Health Treatment.

Responding to mass shootings, some states have passed gun removal laws (e.g., NYS' SAFE Act), requiring that mental health professionals report patients who might potentially harm themselves/others. The purpose of this study was to assess whether knowledge of the SAFE Act impacts patients' mental health treatment-seeking and symptom-reporting behaviors. Patients at two mental health centers were surveyed during 2014-2018. Participants were asked if they would be concerned about being reported to county government, likelihood of seeking mental health treatment, and willingness to report mental health symptoms/behaviors given the SAFE Act's provisions. 228 patients (71.5% response rate) completed questionnaires. About 18% were concerned about being reported to county government, 9% would be less likely to seek mental health treatment, and about 23% would be less willing to report mental health symptoms/behaviors. Although these behaviors were not affected for most participants, there was a small minority who were concerned and less willing to report mental health symptoms/behaviors.

The lagged effect of state gun laws on the reduction of state-level firearm homicide mortality in the United States from 1999 to 2017.

OBJECTIVES: Gun violence is a pressing concern in the United States, where many laws targeting gun violence vary across states and localities. Studies have investigated the association between gun laws and gun violence, but not many focus on the role of time, which is critical for implementation. This study aims to determine the lagged association of gun laws with firearm homicide mortality to better understand the impacts of state gun laws over time. STUDY DESIGN: The design of this study is a longitudinal study. METHODS: This study applied the distributed lag non-linear model to assess the lagged association between firearm homicide mortality and the number of gun law provisions at the state level from 1999 to 2017. State gun law provisions were analyzed in aggregate and also across five groups of regulations. All estimates were transformed into relative risks (RRs). RESULTS: Regarding all state gun laws, regardless of how many gun law provisions were on the books in any year, a significantly reduced RR of firearm homicide mortality was not observed until 7 years later. Among the five regulation groups, a significant RR less than 1 was more likely to happen in longer lags ≥5. The lowest significant RR = 0.24 (95% confidence interval = 0.15, 0.39) was observed in the gun types, components, and trafficking group at lag 8. All regulation groups had an overall impact to reduce significantly the RR of firearm homicide mortality with more gun law provisions, except for the dealer regulation group. CONCLUSIONS: State gun law provisions appear to impact firearm homicide mortality differently over time. This emphasizes the centrality of enforcement. Firearm policy researchers need to consider how specific gun laws are implemented over time to help inform law-based interventions.

The color of risk protection orders: gun violence, gun laws, and racial justice.

BACKGROUND: Extreme risk protection order (ERPO) laws give municipal police officers new authority, through a civil restraining order, to remove firearms from people who are deemed to pose an imminent risk of causing serious harm to others or themselves. Despite the expected public safety benefit of ERPOs, it is possible that implicit racial bias could infect ERPO petitions, the court processes that authorize and extend the gun removal orders, or the behavior of the police in serving and enforcing them. How might potential racial disparities in ERPO implementation qualify the evidence that this intervention saves lives? What should gun violence prevention researchers and stakeholders do to promote racial justice? MAIN TEXT: This commentary reflects upon an innovative and promising legal tool for gun violence prevention through the lens of racial justice concerns. Emerging research, guided by a public health paradigm, asks whether ERPOs save lives. But now is the time to pose other important questions as well. Preventing gun violence and mitigating the disproportionate impact of arrests and incarceration in communities of color are two important goals that may collide. The origin story of many U.S. firearm restrictions, and the continuing disparities in their enforcement and implementation, are intertwined with the legacy of systemic racial discrimination in policing and criminal justice in the United States. The public policy challenge of balancing risk and rights is increasingly fraught, especially as constituencies with a different interest in one or the other concern find themselves standing on opposite sides of a privilege chasm. CONCLUSION: Saving lives from gun violence matters, but ensuring that the lives saved are also respected--free from racial oppression, afforded equal justice--also matters. This commentary is a call to include racial disparities impact as an essential outcome of interest for ERPO studies specifically, but more broadly for all public health law research studies at the intersection of firearm injury prevention, law enforcement, and criminal justice.

Violence.

Violence affects all sectors of society and burdens population health and the health care system. This DataGraphic highlights the geographic sweep of violence, the lack of federally funded research focused on violence against children, the risk of homicide and suicide among adults, and beliefs regarding health care providers talking to their patients about firearm safety.

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.

Associations Between Gun Laws and Suicides.

We examined the impact of a state gun law environment on suicides overall and within demographic subgroups. We linked 211,766 firearm suicides and 204,625 nonfirearm suicides in the 50 states of the United States for 2005-2015 to the population in each state, year, race/ethnicity, sex, and age, as well as to an index of state-level gun control. Difference-in-differences, zero-inflated, negative-binomial models were used to evaluate the impact of strengthening gun control on firearm and nonfirearm suicides. We subsequently stratified by sex and tested for interactions with race/ethnicity and age. We found 25 states strengthened gun control by an average of 6 points. Such an increase may result in a 3.3% (incidence rate ratio = 0.967; 95% confidence interval: 0.938, 0.996) decrease in firearm suicides. Although no impact on nonfirearm suicides was found overall, interaction models showed an increase in nonfirearm suicides among black men, white women, black women, and older individuals. Strengthening gun control may reduce firearm suicides overall but may increase nonfirearm suicides in some populations. The results indicate stricter gun laws should be advocated for and that additional policies are needed for populations who shifted to nonfirearm suicides.

Holding Sweden hostage: firearm-related violence.

Swedish as well as foreign publications have reported a sharp increase in firearm-related violence in Sweden. None of these publications, however, combined official statistics from the Swedish police, the National Council for Crime Prevention (NCCP), and the National Board of Health and Welfare (NBHW), to study firearm-related violence in the last 2 years: 2016-2017. The results of this study show that firearm-related violence in Sweden has greatly increased compared to other Scandinavian countries, especially in recent years. This is probably the reason for the increase in the rate of deadly violence. Further, the increasing number of gangs and criminal networks, as well as the high inflow of illegal firearms to Sweden, is believed to have contributed to the disturbing increase of firearm-related violence in the country. Although Sweden is one of the most democratic and freest countries in the world, and has some of the world's strictest gun laws, the country still faces significant firearm-related violence. This study not only reveals the increasing rate of firearm-related violence in Sweden, but also shows that Sweden is in dire need of additional policies to combat the illegal flow of firearms and to curb gang criminality.

Weaker gun state laws are associated with higher rates of suicide secondary to firearms.

BACKGROUND: Firearm-related suicides comprise over two-thirds of gun-related violence in the United States, and gun laws and policies remain under scrutiny, with many advocating for revision of the regulatory map for lawful gun ownership, aiming at restricting access and distribution of these weapons. However, the quantitative relationship between how strict gun laws are and the incidence of firearm violence with their associated mortality is largely unknown. We therefore, sought to explore the impact of firearm law patterns among states on the incidence and outcomes of firearm-related suicide attempts, utilizing established objective criteria. METHODS: The National Inpatient Sample for the years 1998-2011 was queried for all firearm-related suicides. Discharge facilities were stratified into five categories (A, B, C, D, and F, with A representing states with the most strict and F representing states with the least strict laws) based on the Brady Campaign to prevent Gun Violence that assigns scorecards for every state. The primary outcomes were suicide attempts and in-hospital mortality per 100,000 populations by Brady state grade. RESULTS: During the 14-year study period, 34,994 subjects met inclusion criteria. The mean age was 42.0 years and 80.1% were male. A handgun was utilized by 51.8% of patients. The overall mortality was 33.3%. Overall, 22.0% had reported psychoses and 19.3% reported depression. After adjusting for confounding factors and using group A as reference, there were higher adjusted odds for suicide attempts for patients admitted in group C, D, and F category states (1.73, 2.09, and 1.65, respectively, all P < 0.001). CONCLUSIONS: Firearm-related suicide attempt injuries are more common in states with less strict gun laws, and these injuries tend to be associated with a higher mortality. Efforts aimed at nationwide standardization of firearm state laws are warranted, particularly for young adults and suicide-prone populations. LEVEL OF EVIDENCE: III. STUDY TYPE: Trauma Outcomes study.

Trauma Surgeons' Perspective on Gun Violence and a Review of the Literature.

Background In the United States, there is a constant debate between the proponents of the right to bear arms and those desiring to reduce the epidemic of gun violence. We sought to capture the trauma surgeons' perspective on gun control. Methods We presented an on-line based survey to the members of the American Association for the Surgery of Trauma (AAST). Survey questions were chosen to reflect the popular media poll questions as well as trauma-specific perspectives. We compared the trauma surgeons' perspectives to that of the general populace from a poll conducted by the New York Times (NYT). Results A total of 120 trauma surgeons responded to the survey. The age group ranged from 34 to 82 years, and the median age was 51. Most respondents were male (64%, n = 67) and worked at a Level I trauma center (80%, n = 96) in an academic setting (67%, n = 80). About half of the responding surgeons owned a household firearm (40%; n = 48 of the AAST members vs. 47%; n = 521 of the general populace). Sixty-one percent of the trauma surgeons (n = 73) and 53% (n = 588) of the NYT respondents favor stricter gun control laws. While 80% (n = 888) of the NYT respondents felt that mental health screening and treatment would decrease gun violence, only 56% (n = 67) of surgeons felt that mental health screening would be beneficial. The majority (90%, n = 999) of the NYT poll respondents favor a law restricting the sale of guns only by licensed dealers. Only (66%, n = 79) of the trauma surgeons were in agreement with the stricter gun sale legislation by licensed dealers. Conclusion Trauma surgeons appear to share similar views with the general American populace regarding gun violence and injury control.

Gun Violence Following Inpatient Psychiatric Treatment: Offense Characteristics, Sources of Guns, and Number of Victims.

OBJECTIVE: This study presents data on the relative contribution to gun violence by people with a history of inpatient psychiatric treatment and on federal efforts to deter presumptively dangerous persons from obtaining firearms, information useful for analyzing the potential public health benefits of gun policies targeting people with serious mental illness. The study also estimates the reduction in gun violence victims that would be expected if individuals with a previous psychiatric hospitalization were prohibited from purchasing firearms. METHODS: Data from 838 violent gun offenders from a nationally representative sample of state prison inmates were analyzed. Those with and without a history of psychiatric hospitalization were compared on a range of offense characteristics, including relationship to the victim, number of victims, location of the offense, and source of firearms. RESULTS: Inmates with a history of hospitalization constituted 12% of all violent gun offenders and accounted for 13% of the sample's victims. They were less likely than those without a previous hospitalization to victimize strangers (odds ratio=.52) and were no more likely to commit gun violence in public or to have multiple victims. Among those with previous hospitalizations, 78% obtained guns from sources not subject to federal background checks. Of the total 1,041 victims of gun violence, only 3% were victimized by participants with a history of hospitalization who obtained guns from currently regulated sources. CONCLUSIONS: Prohibiting all individuals with a history of psychiatric hospitalization from purchasing firearms, absent expanded background checks, was estimated to reduce the number of gun violence victims by only 3%.

Strong gun laws are not enough: the need for improved enforcement of secondhand gun transfer laws in Massachusetts.

OBJECTIVE: Research suggests that an overwhelming majority of crime guns were transferred by private sellers before recovery by law enforcement. Unfortunately, most states do not regulate these transactions. This study examines whether analyses of state-level private transfer data could be used to develop interventions to reduce the supply of handguns to violent criminals. METHODS: Traced Boston crime handguns first sold at Massachusetts license dealers were matched to state secondhand gun transfer data. Logistic regression and descriptive statistics were used to analyze the characteristics of recovered crime guns and in-state primary and secondary market transaction patterns. RESULTS: For crime handguns with records of secondary market transactions in Massachusetts, many rapidly move from private transfer to recovery by the police. Unfortunately, important transaction data on the in-state sources of nearly 63% of recovered handguns were not readily available to law enforcement agencies. CONCLUSIONS: Data on private transfers of guns could be used to prevent violent injuries by reducing criminal access. However, the passage of strong private transfer gun laws needs to be accompanied by investments in the vigorous enforcement of reporting requirements.