Archives

Examining the impacts of firearm purchaser licensing laws on firearm deaths among youth aged 15 to 24, by age group–USA, 1990-2019

Background

Youth aged 15–24 experience high rates of firearm homicide and suicide, yet there is limited research on the impact of promising preventative policies, such as firearm purchaser licensing (FPL) laws, among this age group. The purpose of this study was to evaluate the effect of adopting or repealing an FPL law on homicide and suicide among those aged 15–24, by age subgroup (ie, 15–17, 18–20, 21–24).

Methods

Mortality data from 1990 to 2019 were obtained from the National Center for Health Statistics. We used augmented synthetic controls to estimate the effect of FPL law adoption in Connecticut and Maryland and repeal in Missouri and Michigan on youth homicide and suicide rates. Analyses were stratified by age subgroup and firearm involvement.

Results

FPL adoption was associated with decreases in firearm homicide and suicide among those aged 15–24 overall and among most age subgroups in Connecticut. FPL repeal was consistently associated with increases in firearm suicide among each age subgroup, with less consistent results for firearm homicide.

Discussion and conclusions

FPL law changes had meaningful impacts on firearm homicide and suicide among youth aged 15–24, with consistent protective effects observed following adoption in Connecticut and consistent harmful effects following repeal in Missouri. Mixed results in Maryland and Michigan highlight the importance of policy features and sociopolitical context in shaping the effectiveness of these laws. These findings reinforce the effectiveness of FPL laws as a strategy to reduce firearm-related mortality among youth.

Global trends in youth suicide

Suicide is the third leading cause of death in young people. It accounts for more than 150 000 deaths each year worldwide, most of which occur in low and middle income countries (LMICs).1 Concerningly, youth suicide rates seem to be rising in many countries, including in the UK.2 In India and China, which together account for around a third of the world’s youth population, previously downward trends appear to have reversed.34Interpreting these trends is complex. Suicide data can be affected by numerous biases,1 and ecological studies, which examine exposures and outcomes at the group or population level and are fundamental to assessing population level drivers of suicide trends, have methodological limitations.5 Nonetheless, the global pattern of rising youth suicide rates warrants explanation.234Suicide related research has typically prioritised mental illness as a key determinant.26 However, for youth suicide prevention strategies to have the greatest global impact, it is essential to understand…

Acceptability and feasibility of video-based firearm safety education in a Colorado emergency department for caregivers of adolescents in firearm-owning households

Background

Easy firearm access increases injury risk among adolescents. We evaluated the acceptability and feasibility of improving knowledge of a 3 min safe firearm storage education video in the paediatric emergency department.

Methods

We conducted a single-centre block trial in a large paediatric emergency department (August 2020–2022). Participants were caregivers of adolescents (10–17 years) in firearm-owning households. First block participants (control) completed a baseline survey about child safety behaviours (including firearms). Second block participants (intervention) completed a baseline survey, watched the safe firearm storage video and evaluated acceptability. Participants completed a 3-month follow-up survey about firearm safety behaviours and knowledge recall. Demographic and clinical variables were compared between the intervention and control groups using Fisher’s exact and 2 tests. McNemar’s test was used to compare firearm storage behaviours at the initial and 3-month visit within each group.

Results

Research staff approached 1264 caregivers; 371 consented to participate (29.4%) and 144 (38.8%) endorsed firearm ownership. There were 95 participants in the control group and 62 in the intervention group. Follow-up was lower in the intervention group (53.7% vs 37.1%, p=0.04). Among participants viewing the video, 80.3% liked the video and 50.0% felt they learnt something new from the video.

Conclusions

Video-based firearm education in a paediatric emergency department is acceptable among a population of caregivers of adolescents with household firearms. This is a higher-risk group that may uniquely benefit from consistent education in the paediatric emergency department. Further study with larger populations is needed to evaluate intervention effectiveness.

Trial registration

The study was registered with ClinicalTrials.gov (NCT05168878).