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Social isolation and firearm secure storage in the USA: results from the 2022 BRFSS

Background

Firearm secure storage (ie, storing firearms unloaded and locked) is recommended to reduce unintentional injuries and suicides. However, the relationship between psychological states, such as social isolation, and firearm secure storage practices is under-researched.

Methods

Data are from 7136 individuals with firearms in their households from the 2022 Behavioral Risk Factor Surveillance System. Multinomial logistic regression was used to explore the relationship between social isolation and firearm storage.

Results

Among respondents, 71.6% reported storing firearms unloaded, 14.2% stored firearms loaded and locked and 14.2% stored firearms loaded and unlocked. Most respondents reported feeling ‘never’ (40.7%) or ‘rarely’ (33.3%) socially isolated, with 18.7% reporting ‘sometimes’, 4.3% ‘usually’ and 3.0% ‘always’ feeling socially isolated. Covariate-adjusted multinomial logistic regression analysis revealed that respondents who felt ‘always’ socially isolated had an over threefold greater risk of storing firearms loaded and unlocked (relative risk ratio=3.733, 95% CI 1.443 to 9.662, p=0.007) compared with unloaded.

Conclusion

Results suggest a link between feelings of social isolation and unsecured firearm storage. Public health strategies should address both firearm safety education and the underlying issue of social isolation.

State assault weapons bans are associated with fewer fatalities: analysis of US county mass shooting incidents (2014-2022)

Background

The need for evidence to inform interventions to prevent mass shootings (MS) in the USA has never been greater.

Methods

Data were abstracted from the Gun Violence Archive, an independent online database of US gun violence incidents. Descriptive analyses consisted of individual-level epidemiology of victims, suspected shooters and weapons involved, trends and county-level choropleths of population-level incident and fatality rates. Counties with and without state-level assault weapons bans (AWB) were compared, and we conducted a multivariable negative binomial model controlling for county-level social fragmentation, median age and number of gun-related homicides for the association of state-level AWB with aggregate county MS fatalities.

Results

73.3% (95% CI 72.1 to 74.5) of victims and 97.2% (95% CI 96.3 to 98.3) of shooters were males. When compared with incidents involving weapons labelled ‘handguns’, those involving a weapon labelled AR-15 or AK-47 were six times more likely to be associated with case-fatality rates greater than the median (OR=6.1, 95% CI 2.3 to 15.8, p<0.00001). MS incidents were significantly more likely to occur on weekends and during summer months. US counties in states without AWB had consistently higher MS rates throughout the study period (p<0.0001), and the slope for increase over time was significantly lower in counties with AWB (beta=–0.11, p=0.01). In a multivariable negative binomial model, counties in states with AWB were associated with a 41% lower incidence of MS fatalities (OR=0.58, 95% CI 0.37 to 0.97, p=0.02).

Conclusions

Counties located in states with AWB were associated with fewer MS fatalities between 2014 and 2022.

Assessing the national and subnational firearm violence trends in Mexico from 1990 to 2019: secondary data analysis from the Global Burden of Disease study

Background

Mexico is among the countries with the highest mortality rates by firearms worldwide. We aimed to analyse the trend in the burden of firearm violence (FV) by age and sex in Mexico at a national and subnational level, and the association between this burden and the Sociodemographic Index.

Methods

We used estimates from the Global Burden of Disease (GBD)-2019 study for the analysis of FV mortality, premature mortality and disability for all available age-groups and by sex. The GBD data separates FV into three categories—interpersonal violence from firearms, unintentional injuries from firearms and self-harm from firearms. We used a joinpoint regression analysis to analyse the temporal trends of the FV burden.

Results

FV exhibited a non-significant increase. By cause, there was a significant increase in the burden of interpersonal violence from firearms, a non-significant decrease in the burden of self-harm from firearms and a significant decrease in the burden of unintentional injuries from firearms. Most of the FV burden is attributed to interpersonal violence from firearms. Almost the entirety of the burden of FV results from premature mortality. The incidence of FV disability adjusted life years (DALYs) was significantly higher among males than females, and was most concentrated in males aged 20–44 and females aged 15–49. Significant heterogeneity in FV DALY trends was observed at the subnational level.

Conclusion

These results may help to better understand the burden of FV and help the design and implementation of national and local preventive policies.

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…

Systematic review of the impact of interventions changing access to lethal means on suicide attempts and deaths

Objective

The study objective was to examine if interventions changing access to lethal means are associated with changes in suicide deaths and/or attempts by conducting a systematic review of controlled intervention studies.

Methods

Authors searched key databases (PubMed, PsycInfo, CINAHL) from inception to March 2024 for longitudinal controlled intervention studies with at least one contemporaneous comparator group evaluating the impact of interventions changing access to lethal means on suicide attempts and/or deaths in a primarily adult population. Reviewers dually screened articles, then extracted study characteristics and assessed methodological quality.

Results

Researchers screened 8522 studies and 36 articles met eligibility for inclusion. Most studies evaluated the impact of population-level firearm interventions on suicide deaths and found that stricter regulations were associated with a small reduction, if any, in total and/or firearm-specific suicide deaths. The ecological level of analysis precluded individual-level causal inference. Findings within interventions targeting methods other than firearms were limited, mixed and/or inconclusive. Notably, no high-quality randomised controlled trials (RCTs) were identified that met our eligibility criteria.

Conclusion

Future studies should use an RCT design or advanced statistical causal inference techniques to further elucidate the effectiveness of these interventions on suicide deaths and/or attempts.

PROSPERO registration number

CRD42022364775.

Circumstantial variables preceding firearm suicide among females with and without mobility disability in the USA: comparative analysis using data from the National Violent Death Reporting System

Background

Mobility disability impacts approximately 12% of the US population; females are overrepresented among persons with mobility disability. Those with mobility disability are at increased risk of suicide compared with their non-disabled counterparts. Suicide using a firearm has increased among females in the last two decades. This study aims to describe and explore significant circumstantial variables (eg, socio-demographic, health indicators) preceding firearm suicide among females with mobility disability as compared with females without mobility disability.

Methods

This is a secondary comparative, retrospective analysis of the narrative data from the National Violent Death Reporting System Restricted Access Database. Persons with mobility disability were identified through text mining and manual review and subsequently analysed with a summative form of content analysis. Pearson/Fisher’s X2 or t-tests were used to assess differences in the circumstantial variables between those with and without mobility disabilities.

Results

Among female firearm suicide decedents, persons with mobility disability were more commonly older (p<0.001), identified as a homemaker (p<0.001), were perceived to be in a depressed mood before death (p<0.05), had a history of suicidal thoughts (p<0.05) and were perceived to have physical pain (p<0.001); they less commonly had relationship problems (p<0.05).

Conclusions

Females with mobility disability who die by firearm suicide may be differentiated from suicide decedents without mobility disability by age, employment status, depressive mood, relationship problems and physical pain. The significance of these variables as independent risk factors for firearm suicide may be tested with prospective study designs, which in turn may inform the development of targeted or disability-inclusive prevention strategies.