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Unintentional firearms mortality disparities across states ’01-21

Background

Firearms kill over 130 Americans daily. Most deaths are the result of intentional acts, but in 2021, 549 deaths (1.5 deaths/day) were unintentional. Strategies to prevent unintentional versus intentional firearms deaths differ. This study describes unintentional firearm-related mortality across the US states and within individual states between 2001 and 2021 and considers factors that might explain disparities across states.

Methods

Unintentional firearms mortality from 2001 to 2021, both for the full country and by state, was obtained online along with data for five state-level predictors: rurality, non-white population, poverty, population and gun ownership.

Results

The highest unintentional firearm-related mortality rates clustered in Southeastern states, followed by states in the Northern Plains and Mountain West. The lowest rates were in the Northeast, followed by scattered states in the West and Midwest. At the state level, unintentional firearms mortality correlated positively with per cent below the poverty level (r=0.54, p<0.01), rural (r=0.59, p<0.01) and owning firearms (r=0.72, p<0.01). In a multivariable regression model predicting unintentional firearms mortality by state, three factors emerged as significant: per cent white (β=–0.22, p<0.05), below the poverty level (β=0.43, p<0.01) and owning firearms (β=0.54, p<0.01).

Conclusions

Large disparities exist across the 50 US states in unintentional firearms mortality. Crude rates in the most afflicted states are ~10 times those in the least afflicted states. Nationwide, over 12 000 lives were lost to unintentional firearms mortality between 2001 and 2021. Factors that create disparities are multifaceted and include rurality, poverty and firearms ownership.

Firearm access, carriage and use; sample of young adults in Texas

Background Despite the high rates of firearm ownership and firearm-related injuries and mortalities in Southern US states, understandings on the factors contributing to these are lacking.

Methods Using wave 10 (2021) data from a longitudinal study, we examined firearm-related experiences among 636 ethnically diverse young adults (mean age=26 years; 62% female) in Texas, USA.

Results Just over half of participants had ready access to firearms, with 22.3% having carried a firearm outside of their home, 4.9% having been threatened with a firearm by a romantic partner and 4.4% by a non-romantic partner. More firearm access and carriage were reported in males, white participants and those with >US$50 000 income. More females than males had been threatened with a firearm by a romantic partner, but more males than females had been threatened by a non-partner. Participants with recent financial difficulties were proportionally more likely to be threatened with a firearm than those without difficulties.

Conclusion Findings emphasise the alarming rate of firearm access and carriage in Texas and highlight the disparities in firearms experiences by sociodemographic characteristics.

Expansion of SNAP eligibility and rates of firearm deaths

Introduction

Poverty is a consistent correlate of firearm-involved mortality, yet little work has considered the effects of social and economic policies on these deaths. This study examined associations of state elimination of the asset test and increases in the income limit for Supplemental Nutrition Assistance Program (SNAP) eligibility with rates of firearm-involved suicide and homicide deaths in the United States.

Methods

This ecological repeated cross-sectional study used 2015–2019 data from the SNAP Policy Database and death certificate data from the National Vital Statistics System. The exposures were (1) state elimination of the asset test for SNAP eligibility and (2) state elimination of the asset test and increases in the income limit for SNAP eligibility, compared with (3) state adoption of neither policy. The outcomes were firearm-involved suicide deaths and firearm-involved homicide deaths. The research team conducted mixed-effects regressions to estimate associations.

Results

State elimination of the asset test for SNAP eligibility (incidence rate ratio (IRR), 0.67; 95% CI, 0.48 to 0.91) and state adoption of both eliminating the asset test and increasing the income limit for SNAP eligibility (IRR, 0.68; 95% CI, 0.49 to 0.92) were associated with decreased rates of firearm-involved suicide deaths compared with state adoption of neither policy. There were no associations with state firearm-involved homicide rates.

Conclusions

SNAP is an important social safety net programme that addresses food insecurity, and the present results suggest it may also contribute to reducing firearm-involved suicide.

Childrens participatory needs in injury prevention

Background

Child-centred approaches in injury prevention emphasise the importance of practising bidirectional communications and decentring researcher–child power relations to support children’s participation in research. To date, however, a dearth of scholarship offers methodological reflections on how to bolster children’s feelings of comfort in discussing sensitive topics such as their injury experiences.

Goal

Drawing from lessons we learnt working with children in a low-income to mid-income neighbourhood in Vancouver, Canada, we discuss the ways in which our strategies to support their participation succeeded in, and at times fell short of, supporting their participatory needs.

Discussion

Our discussions focus attention on two important areas for consideration in future injury prevention studies: (1) Children’s inclusion in research and the demand for them to share experience and (2) supporting children’s right to invite and comfort in discussing sensitive topics such as injury experiences. We discuss the benefits of making research fun for children and being sensitive to their needs at preliminary recruitment and data collection stages.

Implications

These discussions can strengthen researchers’ work with children by helping them to reflect on strategies that can bolster their desire to participate and feel comfortable sharing perspectives.