Half of Americans anticipate a U.S. civil war soon, survey finds.

Findings suggest rising gun violence will spill into the political sphere, driven by conspiracy theories.

2020: Deadliest Year for Gun Violence in Decades.

And the surge in violence doesn't show any signs of abating.

Patterns and Trends of Gun Violence Against Women in the United States.

OBJECTIVE: To examine patterns and trends of firearm injuries in a nationally representative sample of US women. SUMMARY OF BACKGROUND DATA: Gun violence in the United States exceeds rates seen in most other industrialized countries. Due to the paucity of data little is known regarding demographics and temporal variations in firearm injuries among women. METHODS: Data were extracted from the Centers for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System (2001-2017) for women 18 years and older. Number of nonfatal firearm assaults and homicide per year were extracted and crude population-based injury rates were calculated. Sub-stratification by age-group and time period were performed. RESULTS: Between 2001 and 2017, there were 88,823 nonfatal firearm assaults involving women and 29,106 firearm homicides. There were 4116 victims of nonfatal firearm assault in 2001 (3.8 per 105) and 12,959 by 2017 (10.0 per 105). Homicide rates were 1.5 per 105 in 2001 and 1.7 per 105 in 2017. Sub-stratification by age-group and time period showed that there were no significant changes in nonfatal firearm assault rates between 2001 and 2010 (P-trend = 0.132 in 18-44 yo; 0.298 in 45-64 yo). However between 2011 and 2017, nonfatal assault rates increased from 7.10 per 105 to 19.24 per 105 in 18-44 yo (P-trend = 0.013) and from 1.48 per 105 to 3.93 per 105 in 45-64 yo (P-trend = 0.003). Similar trends were seen with firearm homicide among 18-44 yo (1.91 per 105 to 2.47 per 105 in 2011-2017, P-trend = 0.022). However, the trends among 45-64 yo were not significant in both time periods. CONCLUSIONS: Female victims of gun violence are increasing and more recent years have been marked with higher rates of firearm injuries, particularly among younger women. These data suggest that improved public health strategies and policies may be beneficial in reducing gun violence against US women.

New York State and the Nation: Trends in Firearm Purchases and Firearm Violence During the COVID-19 Pandemic.

BACKGROUND: The impacts of social stressors on violence during the coronavirus disease 2019 (COVID-19) pandemic are unknown. We hypothesized that firearm purchases and violence would increase surrounding the pandemic. This study determined the impact of COVID-19 and shelter-in-place (SIP) orders on firearm purchases and incidents in the United States (US) and New York State (NYS). METHODS: Scatterplots reflected trends in firearm purchases, incidents, and deaths over a 16-month period (January 2019 to April 2020). Bivariate comparisons of SIP and non-SIP jurisdictions before and after SIP (February 2020 vs. April 2020) and April 2020 vs. April 2019 were performed with the Mann-Whitney U test. RESULTS: The incidence of COVID-19 in the US increased between February and April 2020 from 24 to 1 067 660 and in NYS from 0 to 304 372. When comparing February to March to April in the US, firearm purchases increased 33.6% then decreased 22.0%, whereas firearm incidents increased 12.2% then again increased by 3.6% and firearm deaths increased 23.8% then decreased in April by 3.8%. In NYS, comparing February to March to April 2020, firearm purchases increased 87.6% then decreased 54.8%, firearm incidents increased 110.1% then decreased 30.8%, and firearm deaths increased 57.1% then again increased by 6.1%. In both SIP and non-SIP jurisdictions, April 2020 firearm purchases, incidents, deaths, and injuries were similar to April 2019 and February 2020 (all P = NS). DISCUSSION: Coronavirus disease 2019-related stressors may have triggered an increase in firearm purchases nationally and within NYS in March 2020. Firearm incidents also increased in NYS. SIP orders had no effect on firearm purchases and firearm violence.

The relation between state gun laws and the incidence and severity of mass public shootings in the United States, 1976-2018.

OBJECTIVE: In this study, we analyzed the relationship between state firearm laws and the incidence and severity (i.e., number of victims) of mass public shootings in the United States during the period 1976-2018. HYPOTHESES: We hypothesized that states requiring permits to purchase firearms would have a lower incidence of mass public shootings than states not requiring permits. We also hypothesized that states banning large-capacity ammunition magazines would experience a lower number of victims in mass public shootings that did occur than states without bans. METHOD: We developed a panel of annual, state-specific data on firearm laws and mass public shooting events and victim counts. We used a generalized estimating equations logistic regression to examine the relationship between eight state firearm laws and the likelihood of a mass public shooting. We then used a zero-inflated negative binomial model to assess the relationship between these laws and the number of fatalities and nonfatal injuries in these incidents. RESULTS: State laws requiring a permit to purchase a firearm were associated with 60% lower odds of a mass public shooting occurring (95% confidence interval [CI: -32%, -76%]). Large-capacity magazine bans were associated with 38% fewer fatalities (95% CI [-12%, -57%]) and 77% fewer nonfatal injuries (95% CI [-43%, -91%]) when a mass shooting occurred. CONCLUSION: Laws requiring permits to purchase a gun are associated with a lower incidence of mass public shootings, and bans on large capacity magazines are associated with fewer fatalities and nonfatal injuries when such events do occur. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

A systematic review of the causes and prevention strategies in reducing gun violence in the United States.

BACKGROUND: Approximately 100 lives are lost each day as a result of gun violence in the United States (US) with civilian mass shootings increasing annually. The gun violence rate in the US is almost 20 times higher than other comparable developed countries and has the most gun ownership per capita of any nation in the world. Understanding the causes and risk factors are paramount in understanding gun violence and reducing its incidence. METHODS: A literature search of all published articles relating to gun violence and mass shootings in the US was conducted using the Medline and PMC databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used in conducting this study. Rayyan statistical software was utilized for analysis. Statistical significant was defined as p < .05. RESULTS: Of the initial 2304 eligible manuscripts identified, 22 fulfilled our selection criteria. A variety of common causal and contributory factors were identified including but not limited to mental illness, suicidal ideation, intimate partner violence, socioeconomic status, community distress, family life, childhood trauma, current or previous substance abuse, and firearm access. CONCLUSION: Gun violence is pervasive and multi-factorial. Interventions aimed at reducing gun violence should be targeted towards the most common risk factors cited in the literature such as access, violent behavioral tendencies due to past exposure or substance abuse, and mental illness including suicidal ideation.

Effect of firearms legislation on suicide and homicide in Canada from 1981 to 2016.

Canada implemented a series of laws regulating firearms including background and psychological screening, licensing, and training in the years 1991, 1994, and 2001. The effects of this legislation on suicide and homicide rates were examined over the years 1981 to 2016. Models were constructed using difference-in-difference analysis of firearms and non firearms death rates from 1981 to 2016. In addition, negative binomial regression was used to test for an association between rates of suicide by Canadian Province and firearms prevalence, using licensing rates as a proxy for prevalence. No associated benefit from firearms legislation on aggregate rates of male suicide was found. In men aged 45 to 59 an associated shift from firearms suicide after 1991 and 1994 to an increase in hanging resulted in overall rate ratios of 0.994 (95%CI, 0.978,1.010) and 0.993 (95%CI, 0.980,1.005) respectively. In men 60 and older a similar effect was seen after 1991, 1994, and 2001, that resulted in rate ratios of 0.989 (95%CI, 0.971,1.008), 0.994 (95%CI, 0.979,1.010), and 1.010 (95%CI, 0.998,1.022) respectively. In females a similar effect was only seen after 1991, rate ratio 0.983 (95%CI, 0.956,1.010). No beneficial association was found between legislation and female or male homicide rates. There was no association found with firearm prevalence rates per province and provincial suicide rates, but an increased association with suicide rates was found with rates of low income, increased unemployment, and the percentage of aboriginals in the population. In conclusion, firearms legislation had no associated beneficial effect on overall suicide and homicide rates. Prevalence of firearms ownership was not associated with suicide rates. Multifaceted strategies to reduce mortality associated with firearms may be required such as steps to reduce youth gang membership and violence, community-based suicide prevention programs, and outreach to groups for which access to care may be a particular issue, such as Aboriginals.

The Legal and Empirical Case for Firearm Purchaser Licensing.

This article argues that state government actors concerned about gun violence prevention should prioritize enactment of robust firearm purchaser regimes at the state level. First, the article outlines the empirical evidence base for purchaser licensing. Then, the article describes how state governments can design this policy. Next, the article assesses the likelihood that purchaser licensing legislation will continue to be upheld by federal courts. Finally, the article addresses the implications of this policy, aimed at curbing gun deaths, for equally important racial justice priorities. Taken together, these various considerations indicate that purchaser licensing policies are among the most effective firearm-focused laws state governments can enact to reduce gun deaths within the existing federal legislative and legal frameworks.

The National Epidemic of Gun Violence: The Vermont Department of Health Response.

This case study details a 2018 "near miss" school mass-shooting event in Vermont that involved a former student and occurred contemporaneously with the Parkland, Florida, tragedy. The situation "jolted" this rural state's governor, lending urgency to the need to enact sensible gun control laws. He comes to support a series of proactive bills already in the legislature and advocate for further preventive strategies. The state's commissioner of health plays public health's traditional role within state government as trusted health promotion and education resource to frame the issue in public health and public safety terms. He portrayed health data on firearm injuries and deaths and formed a public health strategy including surveillance, identification of risk factors, and resources for school- and community-based prevention. On April 11, 2018, Governor Phil Scott signed a package of gun-related legislation that included increasing the legal age for gun purchases, expanding background checks for private gun sales, banning high-capacity magazines and rapid-fire bump stocks, and extreme risk protection orders. The final results were examined from an evidence-based public health standpoint, acknowledging the lack of gun research by federal agencies since the 1996 enactment of the Dickey Amendment that prohibits the Centers for Disease Control and Prevention from conducting firearms-related research. The case study illustrates the paradox of moving forward on gun safety, where more research is needed, but research does not necessarily influence political leaders or policy. It also demonstrates how prevention of gun violence can be portrayed in a public health framework, drawing upon data and strategies used in upstream preventive efforts in areas such as early childhood development, mental health, and substance misuse.

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.