“States regulate how firearms are bought, sold, and tracked, as well as who may purchase them,” Elinore J. Kaufman, M.D., M.S.H.P., of the Department of Surgery at New York-Presbyterian Weill Cornell Medicine and colleagues wrote. “Stronger firearm policy environments have been associated with lower rates of firearm deaths, as have specific laws, such as licensing and inspection of firearm dealers, licensing and background checks for handgun sales, including private sales and laws regulating the availability of inexpensive handguns. Laws, however, vary widely among states, and evidence of their impact is limited.”
Kaufman and colleagues examined the effect of home state and out-of-state firearm laws on firearm death rates in U.S. counties between January 2010 and December 2014 by analyzing counts of death attributed to firearm suicide and homicide for 3,108 counties in the 48 contiguous states of the United States. Each county was assigned two scores, a state policy score based on the strength of its state firearm laws, and an interstate policy score based on the firearm laws of nearby states. Counties were divided into those with low, medium, and high home state and interstate policy scores.
The authors found that counties in states with high firearm policy scores had the lowest rates of firearm suicide and overall suicide, regardless of the strength of the firearm policies of other states. Counties with low state scores had the highest rates of firearm suicide. Stronger home state laws were also associated with lower rates of firearm homicide, while counties in states with weaker laws had lower rates of firearm homicide only when surrounding states had stronger laws.
“Because suicidal ideation is often transient, and because firearms are a highly lethal method of suicide, access to firearms is an important risk factor for completed suicide attempts,” the authors wrote. “Considered in the context of prior studies, our findings provide evidence that stronger state firearm laws could help to prevent firearm suicides, without an equivalent increase in suicide by other methods.”
“For homicides, the study provides evidence that when a state strengthens its firearm laws, both the state and its neighboring states may benefit,” added JAMA Internal Medicine Editor at Large Robert Steinbrook, M.D., in an accompanying editor’s note. “Because Congress has been unwilling or unable to act, the need for effective state firearm laws and policies in the United States has never been greater.”
For related information, see the Psychiatric News article “Firearms and Suicide: Risk Assessment and Management,” by Liza Gold, M.D.
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