Regional differences in firearm ownership, storage and use: results from a representative survey of five US states.

BACKGROUND: Firearm access and storage practices influence risk for injury and death; however, prior research has considered only national and regional differences on these variables, overlooking state-level differences. OBJECTIVES: To analyse and describe statewide differences in firearm ownership, storage and use in a representative sample of five US states. DESIGN: Variables were assessed via an online self-report survey administered between 29 April 2022 and 15 May 2022. SETTING: Surveys were completed online. PARTICIPANTS: Participants (n=3510) were members of knowledge panel, a probability-based sample recruited to be representative of US adults. All participants were aged 18+ and resided in one of five states: Colorado, Minnesota, Mississippi, New Jersey or Texas. MEASUREMENTS: We used χ2 tests to examine state differences in firearm ownership, childhood firearm experiences and purchasing. A series of analyses of covariance were then used to assess differences in firearm storage, firearms owned and carrying behaviours while adjusting for pertinent demographic characteristics. RESULTS: We found significant differences in firearm ownership across states. There were significantly more first-time firearm purchasers during the firearm purchasing surge in New Jersey. Both Mississippi and Texas have elevated rates of unsecure storage practices and firearm carrying outside of the home. LIMITATIONS: Results are cross-sectional and self-report. Findings may not generalise beyond the five states assessed in this survey. CONCLUSIONS: Public health messaging around firearm safety should account for differences in key firearm behaviours related to ownership, storage and use to ensure effective communication and reduce the risk of gun injury and death across states.

Law enforcement and firearms: understanding firearm ownership and storage habits.

OBJECTIVE: This study seeks to better understand firearm ownership among law enforcement officers (LEO), with the goal of informing future firearm injury and suicide prevention efforts. We describe the frequency and sociodemographic correlates of firearm ownership and storage practices among, and examine the association between suicidal ideation and current firearm storage practices. METHODS: The present study used data from a large online study (n=6410) and included data from individuals who were currently or previously being employed as an LEO (n=369; M (SD) age=39.2 y (15.8 y), 75.2% male, 66.7% white). Self-report measures were used to assess for firearm ownership, storage habits and suicidal ideation. Descriptive statistics were used to describe the frequency of firearm ownership and logistic regressions were used to examine the extent to which demographic characteristics and suicidal ideation were associated with firearm ownership. RESULTS: Overall, 70.5% (n=261) of the sample reported firearm ownership. LEO who were older had significantly lower odds of reporting firearm ownership. Those who were married and those who reported lifetime suicidal ideation had significantly greater odds of reporting firearm ownership. Whereas firearm-owning LEO who reporting storing a firearm locked had significantly lower odds of reporting lifetime suicidal ideation, those who reported storing a firearm unloaded had significantly greater odds of reporting lifetime suicidal ideation. CONCLUSION: Findings have important public health implications and can be used to increase adherence with secure storage recommendations. Increasing secure storage may help reduce suicide risk among LEO, a sample at heightened risk for suicide.

Predicting potential underreporting of firearm ownership in a nationally representative sample.

PURPOSE: This study utilized demographic and intrapersonal variables to identify individuals who may have falsely denied firearm ownership and determined if individuals can be divided into meaningful subgroups. METHODS: Participants were United States residents (N = 3500) recruited from January to June 2020. matched to the 2010 census data for age, race, sex, income, and education level. A Zero-Inflated Negative Binomial (ZINB) regression was utilized to determine potential underreporting of firearm ownership, and a latent class analysis was utilized to determine unique subgroups of those who were identified as underreporting firearm ownership in the ZINB. RESULTS: Participants (N = 1306) were identified as underreporting firearm ownership (excess zeros) based on a model that included demographic and intrapersonal variables. A latent class analysis indicated that among excess zeros, three unique subgroups exist. CONCLUSIONS: Determining who may be underreporting firearm ownership will allow for a more comprehensive understanding of firearm ownership in the US and more targeted safe storage messages that may reach those who own firearms and are at risk for firearm-related injury and death.

Female military service members and veterans: Understanding treatment seeking behavior and previous suicide risk among suicide decedents.

To examine the differences in treatment seeking behaviors, previous suicidal thoughts, previous suicide attempts, and disclosure of suicidal thoughts among female service members (SM)/Veteran suicide decedents who used a firearm and those who used another method. Data was acquired from the National Violent Death Reporting System which is maintained and monitored by the Center for Disease Control and Prevention. Data included in the present study were from suicide deaths that occurred between 2003-2018. Female SM/Veterans who died by firearm suicide had lower proportions of current mental health or substance use treatment, lifetime mental health or substance use treatment, and previous suicide attempts compared to those who used another method. Female SM/Veterans who die by firearm suicide are less likely to encounter mental health services than those who use another method. Conversations on secure firearm storage need to occur outside of the health care setting.

Determining who healthcare providers screen for firearm access in the United States.

Healthcare providers are well positioned to screen for firearm access to reduce risk of suicides, yet there is a limited understanding of how often and for whom firearm access screening occurs. The present study examined the extent to which providers screen for firearm access and sought to identify who has been screened in the past. The representative sample included 3510 residents from five US states who reported whether they have been asked about their access to firearms by a healthcare provider. The findings demonstrate that most participants have never been asked by a provider about firearm access. People who have been asked were more likely to be White, male, and firearm owners. Those with children under 17 years old in the home, that have been in mental health treatment, and report a history of suicidal ideation were more likely to be screened for firearm access. Although there are interventions for mitigating firearm related risks in healthcare settings, many providers may be missing the opportunity to implement these because they do not ask about firearm access.

Public Perception of Gun Violence-Related Headline Accuracy and the Credibility of Media Sources.

The present study sought to determine the extent to which the message or messenger is more important for news media portrayal of gun violence prevention. Exploratory analyses also examined factors related to Fox News and MSNBC credibility. Participants (N = 3,500) were US adults matched to the 2010 US Census on several demographic variables. Two mock headlines were presented: "Gun violence is result of mental health problems" and "Storing firearms in a safe can help prevent suicides." Headlines were reported to be from either Fox News or MSNBC. Participants then rated accuracy of the headline and credibility of the news source. Headline content did not predict perceived accuracy of the headline. Perceived credibility of the messenger was associated with perceived accuracy for both mock headlines. Exploratory analyses indicated several demographic factors related to Fox News and MSNBC credibility. Regardless of the content of a headline, the degree to which participants perceived it as accurate was associated with how credible they believed the source to be. These findings highlight the importance of credible media portrayal of accurate information on gun violence prevention.

Demographic differences in the type of firearm and location of bodily injury in firearm suicide decedents.

This study describes the type of firearm used and location of bodily injury among demographic subgroups of suicide decedents. Data on those who died by suicide via firearm from the National Violent Death Reporting System (N = 117,126) between the years 2003-2018 was utilized. A series of five logistic regression analyses examining the age of decedent, type of firearm, location of wound site, loaded vs. unloaded firearms, and locked vs. unlocked storage, using predictors including gender, race, who owns the firearm and age were performed. Findings have important public health implications. Increasing safe storage or removing the specific types of firearms one is likely to use in their death from the home during a time of crisis may decrease risk of suicide.

Examining characteristics and experiences of Black firearm owners.

OBJECTIVE: The present study sought to better understand the characteristics of those who own firearms in the Black community; and to understand how Black firearm owners differ from nonfirearm owning Black individuals on a variety of variables related to safety, threat concerns, and suicide risk. METHODS: Two samples were utilized in this study. The first was a subsample of those who identified as Black from a nationally representative sample (N = 502) seeking to understand firearm ownership within the United States. The second used a subsample of those who identified as Black (N = 1086) from a representative sample from New Jersey, Minnesota, and Mississippi. Variables related to safety and threat concerns were included in the second sample. RESULTS: In both samples, multiple demographic variables, such as being a woman and having higher education, predicted firearm ownership. In the second sample, experiences of everyday discrimination and crime experiences were associated with firearm ownership. Additionally, Black firearm owners reported significantly more suicidal ideation than Black nonfirearm owners. CONCLUSION: The findings demonstrate the unique characteristics and experiences of Black firearm owners and show that firearm ownership is associated with increased suicide risk factors for Black adults. Findings should be used to advocate for the creation of more culturally relevant suicide prevention and firearm means safety strategies.

An examination of preferred messengers on firearm safety for suicide prevention.

This study sought to determine differences in preferred messengers on the topic of safe firearm storage and suicide prevention between firearm owners and non-firearm owners, and among firearm owners of different racial groups and sexes. Participants were 6200 United States residents recruited via Qualtrics Panels to complete an online survey. Data were collected during March 2020. The total sample and all subsamples ranked law enforcement, current military personnel, and military veterans as the top three most credible sources to discuss firearm safety for suicide prevention. Significant differences existed among the mean ranking of sources between firearm owners and non-firearm owners as well as between several subgroups of firearm owners. The identical ranking of the top three sources indicates that these groups agree on the relative credibility of multiple sources, although the average level of credibility for particular sources may vary. These findings highlight that the effectiveness of messaging on safe firearm storage may hinge on the identity of the individual delivering the message and provide an initial roadmap for how to consider packaging specific messages.

Differentiating suicide decedents who died by firearm verse hanging.

This present study sought to examine how demographics and the availability of means for suicide converge to impact method selection between firearms and hanging, which are the two most lethal and commonly used methods for suicide in the United States. Data were collected as part of a larger online study that gathered information about suicide decedents and the circumstances around their death from family members and friends; the most common sources being parents, friends, and other family members. This study used data from those who died by suicide by firearm or hanging (n = 149); and was restricted to those who identified as male and white. The study examined if age, education, marital status, military affiliation, and firearm ownership impacted method selection. Results indicated that age and owning a firearm were associated with using a firearm in a suicide death. Additionally, those who used a firearm were significantly younger and more likely to own a firearm than those who used another method; and those who died by hanging were significantly younger than those who used another method. Findings from this study can be leveraged to improve the effectiveness of means safety efforts and create more personalised public health messages on firearm safe storage.

Essential workers: Past month suicidal ideation and COVID-19 stress.

OBJECTIVE: This study examined if essential workers (EW) reported higher past month suicidal ideation (SI) and coronavirus-19 (COVID-19) stress than non-EW, explored if the association between EW status and SI is indirect through COVID stress, and tested whether EW who identified as black, indigenous, and people of color (BIPOC) experienced more past month SI and COVID stress than white EW. METHODS: Participants (N = 3500) were predominately white and female. COVID-19 was assessed with the COVID-19 subscale. RESULTS: EWs reported higher past month ideation and COVID-19 stress than non-EWs. EWs who identified as BIPOC reported higher past month ideation and higher fears about economic consequences and compulsive checking and reassurance seeking subscales compared to White EWs. CONCLUSION: EWs experience higher rates of SI and stress than non-EW; and BIPOC EWs experience higher SI and stress than White EWs. Accessibility of support should be a priority for this group at high risk for both the physical and emotional burden of COVID-19.

Self-Reported Likelihood of a Future Suicide Attempt: The Role of Plans for Suicide.

OBJECTIVE: The present study seeks to add to the existing literature by determining if having a plan for suicide, is associated with an individual's self-reported likelihood of attempting suicide in the future. METHOD: Data came from a sample of 97 United States Army personnel with past week ideation or lifetime attempt history. Assessments were collected at baseline, 1-month, 3-month, and 6-months. RESULTS: Self-reported likelihood of attempting suicide in the future was not associated with the presence of a plan for suicide overall or a plan with a specific method (i.e., firearm, cutting/scratching, and medication). DISCUSSION: Although a plan for suicide is commonly thought to indicate elevated risk our findings suggest that presence or absence of suicide plans is not associated with more self-reported likelihood of a future suicide attempt.

The self-reported likelihood of attempting suicide in the future was not associated with the presence of a plan for suicide among service members.Findings suggest that presence or absence of suicide plans is not associated with self-reported likelihood of suicidal behavior among service members.Clinicians and researchers working with a military population may benefit from a broader approach to risk assessment and safety planning that does not rely too heavily on an individual's self-reported plans for suicide.

Perceptions of the utility of secure firearm storage methods as a suicide prevention tool among firearm owners who currently store their firearms loaded and unlocked.

BACKGROUND: Although secure firearm storage can prevent firearm injury and death, secure storage is relatively rare. This tendency may be driven in part by a perceived lack of utility for secure storage in preventing suicide and other gun violence-related outcomes. METHOD: We recruited a large (n = 3510) representative sample of residents from five US states and assessed the degree to which those who do and do not store their firearms securely perceive different utility in specific firearm storage practices for suicide prevention. To test for specificity, we examined if those differences hold when considering unintentional shooting and firearm theft prevention. RESULTS: Those who currently store their firearms unsecured reported lower perceived utility in several firearm storage practices, particularly for suicide and theft prevention. CONCLUSIONS: Our findings highlight that a lack of perceived utility in secure firearm storage may partially drive unsecure firearm storage. Efforts to promote secure storage must address this misperception.

Determining who military service members deem credible to discuss firearm safety for suicide prevention.

OBJECTIVES: To examine rankings of credible sources for discussing secure storage within a representative sample of firearm-owning service members, and examine how combinations of demographic variables impact the ranking of credible sources. METHODS: The probability-based sample was collected with the help of Ipsos. Participants were US service members who owned a firearm at the time of the survey (n = 719). RESULTS: The total sample ranked service members, Veterans, and members of law enforcement as the most credible sources and faith leaders, casual acquittances, and celebrities as the least credible sources. Black men ranked the NRA as a highly credible source whereas Black females ranked the NRA as one of the least preferred sources. Regardless of political preference, those who lived in non-metropolitan rural environments ranked members of law enforcement as highly credible sources. Those who lived in non-metropolitan rural and urban settings and identified as liberal ranked the National Shooting Sports Foundation as a highly credible source. CONCLUSIONS: Law enforcement officers, military members, and Veterans are ranked as highly credible sources by most subgroups of firearm-owning service members. Leveraging these voices in firearm safety conversations is necessary, may increase adherence to secure storage recommendations, and ultimately reduce suicide.

Understanding Capability and Suicidal Ideation among First Responders.

OBJECTIVE: The present study seeks to determine differences in lifetime suicidal ideation, dispositional capability, acquired capability, and practical capability among those who have and have not served as first responders, and among subgroups of first responders. METHODS: Data were collected as part of a large online (n = 3,500) study seeking to understand firearm ownership in the United States. Participants were recruited via Qualtrics Panels and were demographically matched to the 2010 US census. Binary logistic regressions and an exploratory multinomial logistic regression examined differences between first responders and non-first responders and among subgroups of first responders. RESULTS: First responders reported more lifetime suicidal ideation and higher acquired, practical, and dispositional capability than did non-first responders. Findings indicated that first responders with and without military affiliation did not differ in terms of suicidal ideation or capability for suicide. Lastly, law enforcement officers (LEOs) reported more lifetime suicidal ideation than emergency medical technicians (EMTs). LEOs, EMTs, and firefighters did not differ in terms of capability for suicide. DISCUSSION: The findings highlight that suicidal ideation and capability for suicide differ between first responders and non-first responders and among subgroups of first responders. The mechanisms driving the increased rates of suicidal ideation and capability among first responders are unknown; however, it is likely due to a combination of personal and occupational factors. Although not without its limitations, the present study provides an understanding of suicide risk among first responders.

Practical Capability Among Veterinarians: Preliminary Evidence of the Importance of Access to Lethal Medications in the Workplace.

OBJECTIVE: Veterinarians die by suicide at elevated rates. Higher levels of capability for suicide among veterinarians, including access to lethal medications, may account for this discrepancy. This study aimed to determine the importance of accessibility of lethal medications in veterinary workplaces in the relationship between recent suicidal ideation and perceived likelihood of making a future suicide attempt. METHOD: Participants identifying with one or more groups at high-risk for suicide (e.g., veterinarians, firearm owners) were recruited via social media to complete online self-report questionnaires examining demographic, work-related, and suicide-related risk factors. The sample of veterinarians (n = 310) was primarily female, White, and worked in small animal practices. RESULTS: Method of lethal medication storage in the workplace moderated the relationship between past week ideation and perceived likelihood of a future suicide attempt such that the relationship became stronger among those storing medications unlocked during business hours and weaker among those storing medications locked during business hours. CONCLUSION: Secure storage of lethal medications in the workplace may protect against suicide risk. Barriers to lethal medications, when not actively in use, may reduce both physical and cognitive accessibility. Future research should determine the impact of workplace lethal medication storage on suicidal behavior among veterinarians.HIGHLIGHTSLethal med storage moderates link between suicidal thoughts and belief suicide is likelyStoring unlocked may increase physical and cognitive accessibility of this methodWorking with vets to develop and implement means safety strategies will be important.

Interactions at the point of firearm purchase and subsequent use of locking devices.

BACKGROUND: Firearms account for over 40,000 deaths in the USA each year in addition to thousands of nonfatal injuries. One notable prevention strategy for firearm-related fatalities and nonfatal injuries is safe storage. Safe storage of firearms emphasizes using storage mechanisms that limit ready access of firearms to unauthorized users. Cable locks are one safe storage option that is easy to access and typically free, as they are included in many firearms sales. The present study examined the extent to which firearms retailers notifying purchasers at the point of sale about the included cable locks was associated with subsequent locking device use in two large samples and three subsamples. Exploratory analyses then examined demographic factors associated with frequency of seller notification of locks. METHODS: Sample 1 included 1203 firearm owners and sample 2 included 1556 firearm owners. Subsamples were drawn from sample 2 to examine if there were differences by state. The three subsamples included firearm owners from Minnesota (n = 515), Mississippi (535), and New Jersey (506). Logistic regressions were used to examine the association between frequency of sellers notifying buyers of locks and subsequent locking device use. Linear regressions were used to examine what demographic factors were associated with greater frequency of seller notification of locking devices. RESULTS: Results indicated a general trend such that more frequent notification of cable locks at the point of purchase was associated with greater likelihood of using locking devices to secure firearms. At the subsample level, these findings were most consistent for Mississippi relative to Minnesota and New Jersey. Exploratory analyses generally indicated those who were younger and those living in more densely populated areas were more likely to be notified about cable locks at the point of purchase. CONCLUSIONS: These findings suggest that interactions about cable locks at the point of firearm purchase has an impact on firearm storage behaviors. Such results indicate that encouraging firearm retailers to have these discussions with those purchasing firearms might be an important strategy for preventing firearm-related fatalities and nonfatal injuries.

Threat sensitivity, intolerance of uncertainty, and firearm purchasing during a firearm purchasing surge.

The firearm purchasing surge that began in 2020 has seen an unprecedented number of firearms purchased within the United States. The present study examined if those who purchased during the surge differed in their levels of threat sensitivity and intolerance of uncertainty from firearm owners who did not purchase during the surge and from non-firearm owners. A sample of 6,404 participants from New Jersey, Minnesota, and Mississippi were recruited through Qualtrics Panels. Results indicated that surge purchasers have higher levels of intolerance of uncertainty and threat sensitivity relative to firearm owners who did not purchase during the surge and non-firearm owners. Additionally, first time purchasers reported greater threat sensitivity and intolerance of uncertainty relative to established firearm owners who purchased additional firearms during the purchasing surge. Findings from the present study increase our understanding of how sensitivity to threats and the ability to tolerate uncertainty differs among firearm owners purchasing at this time. The results help us determine what programs will increase safety among firearm owners (e.g., buy back options, safe storage maps, firearm safety trainings).

Differences in firearm storage practices among United States military servicemembers who have and have not disclosed suicidal thoughts or attended behavioral health sessions.

INTRODUCTION: Two-thirds of military suicides are by firearm, and unsafe storage increases the risk of suicide. Understanding who is at risk for suicide, their interactions with behavioral healthcare, and their firearm storage habits have implications for suicide prevention. METHOD: Probability-based sampling was used. Inclusion criteria were current military service and firearm ownership. Analyses focused on those who endorsed past year (n = 180) or past month suicidal ideation (n = 85). RESULTS: Servicemembers with undisclosed past year ideation stored firearms at home more often and with a locking device less often. Servicemembers with past year ideation who did not attend recent behavioral health sessions stored firearms with a locking device and loaded less often. Servicemembers with undisclosed suicidal ideation in the past month stored firearms with a locking device less often. Servicemembers with past month ideation who have not attended recent behavioral health sessions stored firearms with a locking device and loaded less often. CONCLUSIONS: Servicemembers experiencing undisclosed suicidal ideation and who are not receiving treatment generally have more ready access to firearms. Safe firearm storage messaging needs to be disseminated in a manner that shifts social norms around firearm storage, whether or not suicide risk is known.

Determining subgroups that exist among US firearm owners.

OBJECTIVE: To identify and verify classes of firearm owners that exist within the United States and determine the sources that classes deemed credible to discuss firearm safety for suicide prevention. METHODS: The study is composed of two parts. Part 1 (N = 1018) utilizes a nationally representative sample of firearm owners. Part 2 (N = 1064) consists of firearm owners from Mississippi, Minnesota, and New Jersey. RESULTS: Four unique classes were identified in Sample 1: multiple firearms class, single handgun class, few firearms class, and long-gun class. A three-class solution was found for sample 2. Two of the classes from sample 1 replicated: multiple firearms class and single handgun class. Although many of the classes differed in the ranking of credible sources, a combination of The American Foundation for Suicide Prevention, law enforcement officers, and family members was ranked as credible sources among all classes. CONCLUSIONS: Findings provide evidence of the heterogenous nature of firearm owners and can be utilized to better understand the subgroups of firearm owners. Additionally, the findings from the credible sources analyses can be leveraged to create more effective safe firearm storage messaging which may increase adherence with safe storage suggestions and ultimately reduce suicide rates.