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Attitudes toward physician-provided gun safety counselling among current and prospective gun owners in the USA

Background

Americans increasingly perceive that homes with guns are safer than those without, and physician counselling about in-home firearm safety and injury risks occurs infrequently, despite encouragement from major medical organisations (eg, American Medical Association, American Academy of Pediatrics). Safety counselling that does occur may be limited to gun owners at high risk of injury; however, given the increasing rates of first-time gun ownership in the USA, understanding attitudes toward firearms and firearm safety messaging among persons who may become firearm owners is needed to inform and support continued injury prevention efforts.

Methods

Survey data from a cross-section of firearm owners (n=396) and non-owners (n=551) collected in February 2023 was used to examine differences in perceptions about the safety of firearm households, openness toward firearm safety counselling and comfort with law enforcement compared with physician firearm safety discussions.

Results

Over three-quarters of current and possible future gun owners agreed that firearms make homes safer, compared with just over one-third of non-owners. All three groups favoured law enforcement over physicians for firearm safety messengers and were more comfortable speaking with law enforcement than physicians about firearm safety.

Discussion and conclusion

Public health and injury prevention safety counselling that combines messaging from law enforcement and medical perspectives may be similarly accessible for both current firearm owners and those considering owning firearms in the future.

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.

Deconstructing Mass Shootings: Exploring Opportunities for Intervention

When it comes to mass shootings, the United States is tragically in a class of its own. There are more mass public shootings in the US than in any other country in the world (Lankford, 2016). By some estimates the United States has experienced 318 mass public shootings between 1966 and 2017 (Capellan, Johnson, Porter, & Martin, 2019). These attacks resulted in 1,167 dead and 1,777 injured victims. Unfortunately, mass public shootings show no signs of slowing down. Most research indicates that the rate of mass public shootings has been accelerating over time. For example, Joel Capellan finds that in the 1970s a mass shooting occurred, on average, every 608 days. By the current decade, a mass public shooting occurred, on average, every 20 days. Due to their reoccurring and devastating nature, mass public shootings are starting to be considered a major public health hazard.

Research on mass public shootings has focused almost exclusively on either the characteristics of offenders or the causes leading to these massacres. Although this research is invaluable to our theoretical understanding of the sociological and psychological factors that lead to mass public shootings, it has yet to provide an actionable understanding of how to prevent or mitigate the lethality of these massacres. In this policy report, we argue that prevention requires us to refocus our attention from why to how mass public shootings happen. To this end, we deconstruct mass public shootings into a series of stages and decisions and explore various opportunities for intervention. We analyze the motivations, preparatory behaviors, execution, and conclusion of 318 mass public shootings in the United States between 1966 and 2017. Furthermore, we offer some potential policy solutions to exploit these opportunities for intervention.

In Search of Common Ground: Expert Judgments on Gun Policy Effects

As our review of the existing literature demonstrated, there is very little scientific evidence available to support the decisions that policymakers and the public must make about whether to implement or change various gun policies. Without strong scientific evidence, policymakers and the public rely heavily on what advocates or social scientists believe the effects of policies are most likely to be. The opinions of these gun policy experts are an important influence on gun policy debates and decisions because people believe that the experts have an especially well-informed understanding of the gun polices under consideration, how similar laws have performed historically, and how specific policies would affect particular stakeholder groups.

Different communities of gun policy experts have sharply divided views on many gun policies, as often becomes clear in the debates that occur when states and the federal government consider new gun legislation. Less clear is whether there are laws or policies for which such differences are less stark, or whether there may be a combination of policies that experts of every stripe could regard as an improvement over existing policies. Finally, it has not been clear whether experts disagree about which objectives gun policies should be trying to achieve or whether experts agree on the objectives but disagree on which policies are most likely to achieve those objectives. If the experts chiefly disagree on the latter, this suggests a role for new and better scientific study of the true effects of gun policies.

To begin to answer these questions, RAND researchers surveyed 173 gun policy experts (across two fieldings in 2016 and 2020) on what they believed the effects of the following 19 gun policies would be on ten different outcomes.