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California’s comprehensive background check and misdemeanor violence prohibition policies, and firearm mortality
Abstract
Purpose:
In 1991, California implemented a law that mandated a background check for all firearm purchases with limited exceptions (comprehensive background check or CBC policy) and prohibited firearm purchase and possession for persons convicted within the past 10 years of certain violent crimes classified as misdemeanors (MVP policy). We evaluated the population effect of the simultaneous implementation of CBC and MVP policies in California on firearm homicide and suicide.
Methods:
Quasi-experimental ecological study using the synthetic control group methodology. We included annual firearm and nonfirearm mortality data for California and 32 control states for 1981-2000, with secondary analyses up to 2005.
Results:
The simultaneous implementation of CBC and MVP policies was not associated with a net change in the firearm homicide rate over the ensuing 10 years in California. The decrease in firearm suicides in California was similar to the decrease in nonfirearm suicides in that state. Results were robust across multiple model specifications and methods.
Conclusions:
CBC and MVP policies were not associated with changes in firearm suicide or homicide. Incomplete and missing records for background checks, incomplete compliance and enforcement, and narrowly constructed prohibitions may be among the reasons for these null findings.
... There was also notable variability across studies in 13 studies considered access restrictions. [21][22][23][24][25][26][27][28][29][30][31][32][33] These laws included age restrictions, requirements for permits and licensure, locking requirements, and bans on certain firearms or activities. Across studies that did not use a synthetic control approach, available absolute and relative effect size measures were consistent with a small effect, if any, on cause-specific or all-cause suicide mortality. ...
... Three of these studies used a synthetic control approach. 23 24 33 Two studies reported no evidence of an effect of background checks or prohibition for violent misdemeanours. 23 33 However, the third study found weak evidence (the placebo test resulted in the probability of 5.1%) of a benefit for legislation requiring a permit, background check and safety course, with a comparable decrease in risk for both firearm and non-firearm suicide deaths. ...
... 23 24 33 Two studies reported no evidence of an effect of background checks or prohibition for violent misdemeanours. 23 33 However, the third study found weak evidence (the placebo test resulted in the probability of 5.1%) of a benefit for legislation requiring a permit, background check and safety course, with a comparable decrease in risk for both firearm and non-firearm suicide deaths. 24 Three studies evaluated laws that required the removal of firearms. ...
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.
... Although individual-level studies of background checks suggest that they are effective, 2-4 recent state-level research casts doubt on the population-level effectiveness of CBC laws alone in reducing firearm-related deaths. [5][6][7] Studies suggesting CBC law effectiveness have methodological limitations including cross-sectional designs 8 and exclusion of CBC laws that apply only to handguns. 9 In 2018, handguns accounted for 90% of the firearms used in homicides in which the type of firearm was specified. ...
... Following the example of some earlier studies of licensing and CBC laws, 6,7,11,13 we used the synthetic control method 17 to compare each state's homicide and suicide rates with estimates of the counterfactual: each intervention state's forecasted homicide and suicide rates had the law not been enacted. In accord with the synthetic control method, we used a series of preintervention outcomes and other covariates to construct a convex combination of weighted donor states that best approximated the pretreatment outcome and covariate trends in the treated state (the state with the relevant policy change). ...
... Yet, licensing laws were linked to lower homicide rates. Consistent with previous longitudinal studies, 6,7 ...
Objectives. To estimate and compare the effects of state background check policies on firearm-related mortality in 4 US states.
Methods. Annual data from 1985 to 2017 were used to examine Maryland and Pennsylvania, which implemented point-of-sale comprehensive background check (CBC) laws for handgun purchasers; Connecticut, which adopted a handgun purchaser licensing law; and Missouri, which repealed a similar law. Using synthetic control methods, we estimated the effects of these laws on homicide and suicide rates stratified by firearm involvement.
Results. There was no consistent relationship between CBC laws and mortality rates. There were estimated decreases in firearm homicide (27.8%) and firearm suicide (23.2%–40.5%) rates associated with Connecticut’s law. There were estimated increases in firearm homicide (47.3%), nonfirearm homicide (18.1%), and firearm suicide (23.5%) rates associated with Missouri’s repeal.
Conclusions. Purchaser licensing laws coupled with CBC requirements were consistently associated with lower firearm homicide and suicide rates, but CBC laws alone were not.
Public Health Implications. Our results contribute to a body of research showing that CBC laws are not associated with reductions in firearm-related deaths unless they are coupled with handgun purchaser licensing laws. (Am J Public Health. Published online ahead of print August 20, 2020: e1–e7. doi:10.2105/AJPH.2020.305822)
... Studies evaluating firearm acquisition laws included permit to purchase laws [82,[96][97][98][99][100][101][102][103][104], Saturday night special laws [101,[105][106][107], waiting period laws [51,97,[118][119][120][121][122][123][124][125][126][127][128][129][130][131][132], background checks [48][49][50][51][52][53][54][55][56][57][58], the Brady Handgun Violence Prevention Act [59,60], Federal Gun Control Act [89,147], intimate partner violence restrictive laws [84,85], and the District of Columbia's Firearm Control Regulations Act [83]. Most studies evaluating firearm acquisition laws noted a decrease in rates of homicide and suicide, apart from three studies that noted an increase [101,105,119] or four noting no association [52,60,103,107]. ...
... State-specific amendments, such as additional penalties or permit requirements, were found to contribute to the desired effect of reducing firearm violence [45,69]. Permit to purchase laws [82,[96][97][98][99][100][101][102][103][104], waiting periods [51,97,[118][119][120][121][122][123][124][125][126][127][128][129][130][131][132]178,179], and background checks [48][49][50][51][52][53][54][55][56][57][58] more consistently were associated with reductions in firearm violence [6,180]. These policies aim to reduce firearm access to high-risk individuals [101,181] however, despite these laws, prohibited offenders can still access firearms [154], from within the same home [182] or through underground markets [183], undermining the original intent of these laws. ...
Background
The literature on gun violence is broad and variable, describing multiple legislation types and outcomes in observational studies. Our objective was to document the extent and nature of evidence on the impact of firearm legislation on mortality from firearm violence.
Methods
A scoping review was conducted under PRISMA-ScR guidance. A comprehensive peer-reviewed search strategy was executed in several electronic databases from inception to March 2024. Grey literature was searched for unpublished sources. Data were extracted on study design, country, population, type of legislation, and overall study conclusions on legislation impact on mortality from suicide, homicide, femicide, and domestic violence. Critical appraisal for a sample of articles with the same study design (ecological studies) was conducted for quality assessment.
Findings
5057 titles and abstracts and 651 full-text articles were reviewed. Following full-text review and grey literature search, 202 articles satisfied our eligibility criteria. Federal legislation was identified from all included countries, while state-specific laws were only reported in studies from the U.S. Numerous legislative approaches were identified including preventative, prohibitive, and more tailored strategies focused on identifying high risk individuals. Law types had various effects on rates of firearm homicide, suicide, and femicide. Lack of robust design, uneven implementation, and poor evaluation of legislation may contribute to these differences.
Interpretation
We found that national, restrictive laws reduce population-level firearm mortality. These findings can inform policy makers, public health researchers, and governments when designing and implementing legislation to reduce injury and death from firearms.
Funding
Funding is provided by the Strategy for Patient-Oriented Research (SPOR) Evidence Alliance and in part by St. Michael’s Hospital, University of Toronto.
Scoping review registration
Open Science Framework (OSF): https://osf.io/sf38n.
... Longitudinal studies that seek to isolate the independent associations between the enactment or repeal of CBC laws and changes in firearm mortality rates have not identified such associations. [8][9][10] These studies are distinct from the previous studies in that they estimate effects of a policy change (rather than effects of firearm purchase denial) on state level mortality rates (rather than risk among persons meeting prohibiting criteria). ...
... Previous research supports the effectiveness of background checks among people meeting denial criteria, 5-7 yet many state-level studies have failed to identify an effect on fatal outcomes. [8][9][10] The current study is novel in its focus on states with fairly robust record keeping ...
Studies of the effectiveness of comprehensive background check (CBC) policies in multiple states have yielded null results. These prior studies focused on CBC laws adopted in the 1990s, when record keeping was far less complete. We estimate the effect of the implementation of CBC policies on state-level firearm homicide and suicide rates in states implementing CBC policies from 2013-2015 (Colorado, Delaware, Oregon, Washington). We compare age-adjusted firearm homicide and suicide rates measured annually from 15 years prior to policy implementation until 2019 in each treated state to rates in control groups constructed using the synthetic control group method. Differences in firearm homicide rates for Colorado, Oregon, and Washington were all small (0.09 to 0.18 per 100,000) and not well distinguished from natural variation. Oregon had on average 0.80 per 100,000 fewer firearm suicides per year than did synthetic Oregon. However, these results were inconsistent across modeling approaches. Our models produced poor fit for Delaware. Coupled with previous null results from Indiana, California, Maryland, Pennsylvania, and Tennessee, the current results suggest extending background check requirements to private transfers alone and implementing as is currently done is not sufficient to achieve significant state-level reductions in firearm fatalities.
... 24 A study of California's comprehensive background check policy and violent misdemeanor prohibition, both of which took effect in 1991, found no attributable change in firearm homicide or suicide rates. 25 In one instance, comprehensive background check policies were associated with increased rates of firearm homicide. 26 A three-state study of recently enacted comprehensive background check policies that examined subsequent trends in background checks themselves-insufficient time had elapsed for a study of mortality or crime rates-found a post-enactment increase in only one state. ...
... Failure To Include Private-Party Transfers It is very important to note that the most rigorous population-level studies finding no effect of comprehensive background check policies on population-level rates of violence 22,25 relied on data from before 2007, when criminal and particularly mental health prohibiting events were much less frequently reported to the FBI. It is very likely that the false-negative rate on background checks was much higher in the past than it is today, and that rate is likely to continue to decrease. ...
Mandatory background checks on firearm purchasers receive widespread support from the general public and firearm owners. Background checks appear to reduce the risk of violence substantially among prohibited persons whose purchases are denied. However, population-level studies, including studies of comprehensive background check policies, have often shown no clear evidence of benefit. There is one notable exception: Permit-to-purchase policies have consistently been associated with beneficial population-level effects. The findings of no benefit may in part be an artifact of history, as the completeness of the data on which background checks are run has improved substantially since the periods examined by those studies. Nonetheless, significant problems with implementation and design still limit the population-level effectiveness of background check policies. In this article I review nine of these problem areas and suggest actions that could substantially improve the effectiveness of background check policies in preventing firearm-related violence.
... A high-risk approach may even have population-level impacts when the predictive power is strong, prevalence is high, and the response mechanism is effective and has sufficient reach [11,12]. However, it is challenging for high-risk approaches to produce population-level effects given the ubiquity of gun violence, the difficulty of predicting who will commit harms with firearms [13], possible misclassification of at-risk individuals, potential loopholes in the background check system, and the existence of the black market [14][15][16][17]. ...
Background
Firearm violence remains a persistent public health threat. Comparing the impact of targeted high-risk versus population-based approaches to prevention may point to efficient and efficacious interventions. We used agent-based modeling to conduct a hypothetical experiment contrasting the impact of high-risk (disqualification) and population-based (price increase) approaches on firearm homicide in New York City (NYC).
Methods
We simulated 800,000 agents reflecting a 15% sample of the adult population of NYC. Three groups were considered and disqualified from all firearm ownership for five years, grouped based on prevalence: low prevalence (psychiatric hospitalization, alcohol-related misdemeanor and felony convictions, 0.23%); moderate prevalence (drug misdemeanor convictions, domestic violence restraining orders, 1.03%); and high prevalence (all other felony/misdemeanor convictions, 2.30%). Population-level firearm ownership was impacted by increasing the price of firearms, assuming 1% price elasticity.
Results
In this hypothetical scenario, to reduce firearm homicide by 5% in NYC, 25% of the moderate prevalence group, or 12% of the high prevalence group needed to be effectively disqualified; even when all of the low prevalence group was disqualified, homicide did not decrease by 5%. An 18% increase in price similarly reduced firearm homicide by 5.37% (95% CI 4.43–6.31%). Firearm homicide declined monotonically as the proportion of disqualified individuals increased and/or price increased. A combined intervention that both increased price and effectively disqualified “high-risk” groups achieved approximately double the reduction in homicide as any one intervention alone. Increasing illegal firearm ownership by 20%, a hypothetical response to price increases, did not meaningfully change results.
Conclusion
A key takeaway of our study is that adopting high-risk versus population-based approaches should not be an “either-or” question. When individual risk is variable and diffuse in the population, “high-risk approaches” to firearm violence need to focus on relatively prevalent groups and be highly efficacious in disarming people at elevated risk to achieve meaningful reductions in firearm homicide, though countering issues of social justice and stigma should be carefully considered. Similar reductions can be achieved with population-based approaches, such as price increases, albeit with fewer such countering issues.
... Negative controls are useful for detecting biases including unmeasured confounding, recall bias, and analytic flaws [160]. For example, suicides completed with means other than firearms have been used as a negative control when evaluating the impacts of firearm policies on firearm suicides [161]. If firearm and nonfirearm suicides have similar determinants, but nonfirearm suicides are unaffected by firearm policies, then testing the association of firearm policies with nonfirearm suicides can be used to detect residual confounding due to these factors. ...
Purposeof Review
Epidemiologic research on the health effects of social policies is growing rapidly because of the potentially large impact of these policies on population health and health equity. We describe key methodological challenges faced in this nascent field and promising tools to enhance the validity of future studies.
Recent Findings
In epidemiologic studies of social policies, causal identification is most commonly pursued through confounder-control but use of instrument-based approaches is increasing. Researchers face challenges measuring relevant policy exposures; addressing confounding and positivity violations arising from co-occurring policies and time-varying confounders; deriving precise effect estimates; and quantifying and accounting for interference. Promising tools to address these challenges can enhance both internal validity (randomization, front door criterion for causal identification, new estimators that address interference and practical positivity violations) and external validity (data-driven methods for evaluating heterogeneous treatment effects; methods for transporting and generalizing effect estimates to new populations).
Summary
Common threats to validity in epidemiologic research play out in distinctive ways in research on the health effects of social policies. This is an active area of methodologic development, with ongoing advances to support causal inferences and produce policy-relevant findings. Researchers must navigate the tension between research questions of greatest interest and research questions that can be answered most accurately and precisely with the data at hand. Additional work is needed to facilitate integration of modern epidemiologic methods with econometric tools for policy evaluation and to increase the size and measurement quality of datasets.
... Parenthetically, there is no evidence that California's universal background checks reduce firearm mortality(Castillo-Carniglia et al., 2019) 16 The figure and all to follow in this section were constructed after the interrupted time series model was specified and implemented. They were not used in model specification. ...
There have been many claims in the media and a bit of respectable research about the causes of variation in firearm sales. The challenges for causal inference can be quite daunting. This paper reports an analysis of daily handgun sales in California from 1996 through 2018 using an interrupted time series design and analysis. The design was introduced to social scientists in 1963 by Campbell and Stanley, analysis methods were proposed by Box and Tiao in 1975, and more recent treatments are easily found (Box et al., 2016). But this approach to causal inference can be badly overmatched by the data on handgun sales, especially when the causal effects are estimated. More important for this paper are fundamental oversights in the standard statistical methods employed. Test multiplicity problems are introduced by adaptive model selection built into recommended practice. The challenges are computational and conceptual. Some progress is made on both problems that arguably improves on past research, but the take-home message may be to reduce aspirations about what can be learned.
... Studies of CBC laws adopted in the 1990s that did not require a permit or license to purchase firearms have not produced evidence that the laws reduce homicides or suicides Castillo-Carniglia et al. 2019). ...
Background:
Comprehensive background check (CBC) laws extend background check requirements to private party firearm transfers to prevent firearm acquisitions by prohibited persons. The aim of our study was to estimate the association between CBC policies and changes in background check rates for firearm acquisition in two states (Oregon and Washington) that have newly-enacted CBC policies.
Methods:
We used data on handgun background checks from January 1999 to December 2018 from the National Instant Criminal Background Check System. Observed trends in exposed states were contrasted with counterfactual trends estimated with the synthetic control group method.
Findings:
CBC policies were associated with increases in background checks in Oregon (by 18.0%; p = 0.074), but not in Washington (4%; p = 0.321). A gradual increase in private party checks was seen following enactment in Washington; however, firearm transactions coded as "private" represent less than 5% of total background checks in that state.
Conclusions:
Comprehensive background check policies appear to be effective in increasing pre-firearm-sale background checks in Oregon but not in Washington. Differences appear to be related to variations in the proportion of firearm sales that are private party transfers and to gradual adaptation to the new law by private gun sellers.
... 2,30 Household gun availability is the ratio of firearm suicides to overall suicides and was calculated with data from the Centers for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System (WISQARS). 33 This proxy measure is widely used in longitudinal firearm policy analysis for both homicide and suicide outcomes 17,21,[27][28][29][34][35][36][37][38][39][40][41] and was validated using Behavioral Risk Factor Surveillance System survey data from 2001, 2002, and 2004, years during which respondents were asked about firearm ownership. We obtained state firearm homicide rates from WISQARS. ...
Objectives. To examine the impact of right-to-carry (RTC) firearm laws on firearm workplace homicides (WPHs) in the United States from 1992 to 2017.
Methods. We employed 2 longitudinal methods to examine the average effect (pooled, cross-sectional, time-series analysis) and the state-specific effect (random effects meta-analysis) of RTC laws on WPHs committed by firearms from 1992 to 2017 in a 50-state panel. Both methods utilized a generalized linear mixed model with a negative binomial distribution.
Results. From 1992 to 2017, the average effect of having an RTC law was significantly associated with 29% higher rates of firearm WPHs (95% confidence interval [CI] = 1.14, 1.45). No other state-level policies were associated with firearm WPHs. Sensitivity analyses suggest robust findings. State-specific estimates suggest that passing an RTC law during our study period was significantly associated with 24% increase in firearm WPH rates (95% CI = 1.09, 1.40).
Conclusions. This is the first study to our knowledge to examine the link between RTC firearm laws and firearm WPHs. Findings indicate that RTC laws likely pose a threat to worker safety and contribute to the recent body of literature that finds RTC laws are associated with increased incidence of violence.
Objective
To understand how the implementation and enforcement of universal background check (UBC) laws may influence the use of background checks during private party firearm transfers in the USA.
Methods
This is a mixed-method, descriptive study. Data included the content of relevant state statutes and sentencing information from the 19 states with UBC laws in 2019, prosecutions and convictions for private party firearm transfer violations from 5 states and New York City, firearm transfer education and promotion efforts, and key informant interviews.
Results
Information on conducting safe and legal private-party firearm transfers was widely available, but persuasive language encouraging background checks was rare. The median maximum prison time for violating UBC laws was 12 months and the median of the maximum fines was US$5000. However, the chances of being prosecuted in our sample states were extremely low. Finally, public support for UBC policies is high, but among some firearm owners, the perceived utility of such laws is very low.
Conclusions
Available data suggest that enforcement of UBC requirements for private party transfers is rare. Additionally, advocacy efforts to encourage private gun sellers to make sales contingent on buyers passing background checks are few. People may choose to avoid the additional burden of undergoing a background check when they feel neither social nor legal pressure to comply. The results of this research can be used to identify potential avenues for enhancing enforcement of and compliance with private party firearm background check laws.
Importance
A loophole in US gun policy is that people can purchase guns from private sellers without going through any background check. Some states have addressed this loophole by requiring universal background checks for all gun sales, either at the point of sale or through a permit system; however, most studies on the effectiveness of universal background checks have not analyzed these 2 policy mechanisms separately.
Objective
To assess the association of point-of-sale background check law and gun permit law, separately, with firearm homicide rates from 1976 through 2022 using the same methods and model specification.
Design, Setting, and Participants
This cross-sectional study used a difference-in-differences, fixed-effects regression model to evaluate firearm laws and firearm homicide rates in 48 states from 1976 through 2022. Data were obtained for 48 states except New Hampshire and Vermont and were analyzed in January 2024.
Exposures
Implementation of either the law requiring a universal background check at point of sale for all firearms without a permit or the laws combining universal background checks and a state permit requirement for all gun purchasers.
Main Outcomes and Measures
Annual, state-specific rates of firearm homicide per 100 000 people.
Results
From 1976 through 2022, 12 states adopted the universal background check laws without permitting requirements and 7 states implemented gun permit laws covering all firearms. The mean (SD) firearm homicide rate was 4.3 (0.1) per 100 000 people. Universal background checks for all firearms alone (without a state permitting system) were not associated with overall homicide rates (percentage change, 1.3%; 95% CI, −6.9% to 10.4%) or firearm homicide rates (percentage change, 3.7%; 95% CI, −5.3% to 13.6%). A law requiring a permit for the purchase of all firearms was associated with significantly lower overall homicide rates (percentage change, −15.4%; 95% CI, −28.5% to −0.01%) and firearm homicide rates (percentage change, −18.3%; 95% CI, −32.0% to −1.9%).
Conclusions and Relevance
This cross-sectional study found that universal background checks alone were not associated with firearm homicide rates, but a permit requirement for the purchase and possession of firearms was associated with substantially reduced rates of firearm homicide. The findings suggest that combining universal background checks and permit-to-purchase requirements is an effective strategy for firearm-related fatality reduction.
Aim
The U.S. prohibits firearm purchase among individuals with specific risk factors. These prohibitions are operationalized using background checks for firearm purchase. Despite these restrictions, prohibited persons have obtained firearms after passing background checks, sometimes with devastating effects.
Materials and Methods
We conducted a mixed‐methods, descriptive study of the records and record‐keeping practices that underpin background checks for firearm transfers. Sources included key informant interviews with individuals working in a leadership capacity with state record‐keeping systems as well as data from state surveys and administrative records. We analyzed quantitative data using descriptive statistics and qualitative data using a thematic analysis approach to code the data and identify themes. Three investigators coded each interview. We returned to all data sources to develop key findings in an iterative process.
Results
Key informants described major improvements in the collection of specific record types that were previously a “black hole” (e.g. criminal history records housed in military justice systems, and records relating to involuntary commitments for mental illness) and advances in the automation of record transfer across agencies, themes corroborated by administrative data. Key informants also identified potential causes and solutions for challenges relating to missing or incomplete information and delays in resolving ambiguous background check results. Examples include manual processes for confirming relationship status in misdemeanor crimes of domestic violence and discordant practices for processing arrest and court records that result in dispositions that cannot be entered or arrests with no disposition.
Conclusion
Background checks are the backbone of many policies designed to prevent firearm harm in the United States. This study highlights actionable ways in which states could make background check practices and policies more robust.
We present the rationale behind four types of laws that restrict access to firearms for those who are deemed to be a high risk for future gun violence and two types of laws that implement firearm purchase prohibitions. We also present evidence on the effectiveness of these laws. Broadly, these are laws that restrict access for domestic violence abusers, individuals convicted of misdemeanor violence, and individuals at high risk of violence against themselves or others. We briefly discuss relinquishment of firearms by those who are newly restricted, but we focus mainly on how purchase restrictions are implemented by the federal government and across states. Extant research shows that well-implemented firearm policy that is based on evidence-based risk factors can be effective in reducing firearm injury.
Purpose of Review
Firearm policies have the potential to alleviate the public health burden of firearm violence, yet it is unclear which policies are effective. The current review aims to summarize studies that use synthetic control methods to overcome previous methodological limitations when examining the impacts of firearm policies.
Recent Findings
Evidence from studies using synthetic control methods find compelling evidence that purchasing licensing laws for all individuals (e.g., permit-to-purchase) have a preventive effect on firearm deaths. Otherwise, the effects of other firearm policies targeting firearm availability, ownership, sales, and use varied across studies and contexts.
Summary
Synthetic control evaluations find heterogenous effects of firearm policies, suggesting that previous inconsistent findings might reflect their varying impacts across regions rather than methodological limitations alone. Future research should aim to exploit the complementary biases of synthetic control methods to triangulate evidence across evaluation approaches and understand why firearm policies have differential impacts.
Federal funding for firearm-related research in the health sciences has incurred Congressional restrictions and executive actions. Little is known about the funding landscape for published scholarship in this field. This study’s aim was to characterize the number and sources of funding, including federal and non-federal sources, for firearm-related research articles published in health sciences journals. We performed a scoping review of original, empirical, peer-reviewed articles related to firearms published in health science journals and indexed in PubMed between January 2000 and December 2019, using the PRISMA extension for Scoping Review checklist. Four reviewers independently screened each article twice for inclusion. Included articles were reviewed again to identify funding sources. Articles were characterized as having explicitly declared funding, explicitly declared no funding, or no explicit funding declaration. Among articles with funding, we examined proportions by funding source. 812 articles met the inclusion criteria. 119 (14.7%) of the articles declared not having received any funding, and 240 (29.6%) had no funding declaration. 453 (55.8%) of the articles declared at least one source of funding. Of those, 221 (48.8%) reported at least one federal grant, and 232 (51.2%) reported at least one philanthropic grant. The number of published articles increased by 328.6% between 2000 and 2019. While the volume increased during the study period, the proportion of articles with funding was lower in 2019 (55.6%) than it was in 2000 (87.5%; proportion difference: 31.9%; 95% CI: 16.7%-47.2%). This study highlights the continued funding limitations in this field despite a growing volume of research.
Guns are used in the majority of homicides in the United States, making the problem of homicide largely a problem of gun violence. This article presents three types of gun homicide (mass shootings, intimate partner homicide, and community gun violence), and briefly discusses the state of knowledge on their risk factors and promising interventions. Future directions for research are presented, focusing on examining differential implementation and impacts of interventions by racialized groups and communities, as well as interrogating conventional approaches and methodologies.
Suicide accounts for approximately 4000 deaths a year in Canada, of which about 16% of those are suicide using a firearm. Canada has undertaken legislative efforts to regulate and control firearms, Bill C-51 in 1977 and Bills C-17 and C-68 in 1991 and 1995. Regulatory approaches that decrease the availability of firearms are hypothesized to reduce suicide by firearm however the substitution effect suggests it is possible that people may substitute other methods of suicide in place. Canadian studies on associations between legislation, regulation, and suicide rates have been published over the last three decades, and a search revealed thirteen that met the criteria. Seven studies examined the association between Bill C-51 and suicide rates and found that while rates of suicide by firearm appeared to have declined in association with regulations, there appears to be a substitution effect into other methods and no overall change in suicide rates. Six studies examining the effects of Bill C-17 and C-68 revealed a decrease in the rates of suicide by firearms, with a corresponding increase in non-firearms suicide rates and no decrease in overall suicide rates. One study even suggested no associated decrease in firearm suicide rates with an increasing rate of suicide by hanging possibly due to changes in preferences. These results suggest legislation has mixed effects on firearm suicide rates and may not alone reduce overall suicide in Canada.
Rates of firearm injury and mortality are far higher in the United States compared to other high-income nations. Patterns of firearm injury have complex causal pathways; different social contexts may be differentially affected by firearm legislation. In the context of the diversity of social, political, and legal approaches at the state level, we suggest the application of the social ecological model as a conceptual public health framework to guide future policy interventions in the U.S.
Background checks are designed to prevent firearm acquisition by people prohibited from purchasing or possessing firearms. There is limited information about background checks, particularly on a state by state basis. We conducted a state-representative, probability-based, Internet survey of California adults in 2018 (n=2558; completion rate 49%) to describe where, when, and how firearms are acquired and to estimate the proportion of current firearm owners who purchased their most recent firearm without a background check. An estimated 17.2% (95% CI: 9.6–28.8) of firearm owners who purchased their most recent firearm within California in 1991 or later, following implementation of the state's comprehensive background check law, reported doing so without a background check. This percentage was 44.6% (95% CI: 27.1–63.5) among owners who purchased their most recent firearm before 1991 and 27.1% (95% CI: 13.1–47.7) among those who purchased their most recent firearm outside California. Firearm purchases without background checks occurred more often for firearms purchased from private sellers (72.3%; 95% CI: 35.5–92.5) than retailers (8.5%; 95% CI: 3.4–19.7). Overall, firearm purchases without background checks are considerably less common in California than in states without regulations on private sales. However, gaps in implementation and proper enforcement remain. Future research could investigate reasons for such lapses, as well as complementary state policy approaches that require background checks prior to point of purchase.
In December 2019, for the first time in more than 20 years, the US Congress appropriated, and the president signed, a bill that included $25 million for gun violence prevention research at the Centers for Disease Control and Prevention and the National Institutes of Health. This research should find ways to reduce injury, death, and suffering while protecting the right of law-abiding citizens to own firearms. Four questions can structure this research agenda. First, what is the problem: How many people get shot, who are they, where does it happen, what is the relationship between the shooter and the victim, what other types of damage are incurred, and are the shootings increasing or decreasing? Second, what are the causes: What is the role of alcohol and drugs; what is the role of gangs, poverty, and systemic racism; what is the role of mental illness, robbery, and domestic violence; what is the role of private gun ownership (both positive and negative) and easy access to guns? What are the factors that protect us, such as stable families and safe environments? Third, what works: Which practices, interventions, policies, and laws work best to prevent these deaths and injuries? And fourth, how do you do it: How do you implement the findings and translate them into policies, legislation, and practices that can be scaled up?
Expected final online publication date for the Annual Review of Public Health, Volume 42 is April 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
The Stockholm Prize for 2020 was awarded for research on gun violence and its prevention, and recognizes the growing depth and scope of this field. I am honored to be a co‐recipient, together with Franklin E. Zimring. This essay focuses on three of the topics that have been on my agenda over the course of the last 45 years: how best to conceptualize and measure the problem of gun violence; the availability of guns to violent offenders; and how and why to improve police investigations of criminal shooting incidents, including assaults and homicides.
Importance:
Suicide by firearm is a major cause of mortality in young Missouri residents. Changes in statewide firearm policy may have contributed to changes in suicide rates.
Objective:
To evaluate if changes in Missouri permit-to-purchase (PTP) and concealed carry firearm laws were associated with changes in rates of suicide by firearms in young Missouri residents.
Design, settings, and participants:
This cross-sectional study examined rates of suicide by firearm in Missouri among adolescents (ages 14-18 years) and young adults (ages 19-24 years) from January 1999 to December 2018, following changes to state PTP and concealed carry law, in comparison with a donor state pool with existing firearm laws (13 states in PTP pool; 42 states in concealed carry pool) that did not make changes during this period. This study used a quasiexperimental, synthetic control design at the state level that defined Missouri as the treated state and treatment as changes in firearm laws.
Exposures:
Legislative changes to Missouri's PTP and concealed carry firearm laws.
Main outcomes and measures:
Age-adjusted annual rates of firearm-related suicide mortality per 100 000 people for adolescents (aged 14-18 years) and young adults (aged 19-24 years).
Results:
Repeal of the PTP law was associated with a 21.8% increase in firearm suicide rates in young adults aged 19 to 24 years in Missouri. Lowering the minimum age of concealed carry to 19 years in Missouri was associated with a 32.0% increase in firearm suicide rates and a 29.7% increase in nonfirearm suicide rates in adolescents aged 14 to 18 years, and a 7.2% increase in firearm suicide rates in young adults aged 19 to 24 years.
Conclusions and relevance:
Increases in rates of suicide by firearms in adolescents and young adults were seen following repeal of Missouri's PTP law and lowering of the minimum age for concealed carry in 2014. Changes in Missouri's firearm policies may be an important contributor to rates of suicide by firearm in young Missouri residents.
The U.S. suicide rate continues to increase, despite federal investment in developing preventive behavioral health care interventions. Important determinants of suicide-social, economic, and circumstantial-have little or no connection to psychopathology. Firearm injuries account for over half of suicides, and firearm access is perhaps the most important modifiable determinant. Thus gun safety policy deserves special attention as a pathway to suicide prevention. This article summarizes arguments for several recommended statutory modifications to firearm restrictions at the state level. The policy challenge is to develop and implement evidence-based strategies to keep guns out of the hands of people at highest risk of suicide, without unduly infringing the rights of a large number of gun owners who are unlikely to harm anyone. Recommendations for states include expansion and refinement of legal criteria prohibiting firearm purchase, possession, or access to better align with suicide risk, including prohibition for persons with brief involuntary psychiatric holds or repeated alcohol-impaired driving convictions; enactment of extreme risk protection order laws, which allow temporary removal of firearms from persons who are behaving dangerously, and entering purchase prohibition data for these persons in the FBI's background-check database; and adoption of an innovative policy known as precommitment against suicide as well as voluntary self-enrollment in the FBI's background-check database.
Background
Approximately 100 lives are lost each day as a result of gun violence in the United States (US) with civilian mass shootings increasing annually. The gun violence rate in the US is almost 20 times higher than other comparable developed countries and has the most gun ownership per capita of any nation in the world. Understanding the causes and risk factors are paramount in understanding gun violence and reducing its incidence.
Methods
A literature search of all published articles relating to gun violence and mass shootings in the US was conducted using the Medline and PMC databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used in conducting this study. Rayyan statistical software was utilized for analysis. Statistical significant was defined as p < .05.
Results
Of the initial 2304 eligible manuscripts identified, 22 fulfilled our selection criteria. A variety of common causal and contributory factors were identified including but not limited to mental illness, suicidal ideation, intimate partner violence, socioeconomic status, community distress, family life, childhood trauma, current or previous substance abuse, and firearm access.
Conclusion
Gun violence is pervasive and multi-factorial. Interventions aimed at reducing gun violence should be targeted towards the most common risk factors cited in the literature such as access, violent behavioral tendencies due to past exposure or substance abuse, and mental illness including suicidal ideation.
Research Summary
We used data from the FBI's Supplemental Homicide Reports and other publicly available databases to calculate state‐level annual incidence of fatal mass shootings for 1984–2017. Negative binomial regression models were used to estimate the associations between changes in key gun laws and fatal mass shootings. Handgun purchaser licensing laws and bans of large‐capacity magazines (LCMs) were associated with significant reductions in the incidence of fatal mass shootings. Other laws commonly advocated as solutions to mass shootings—comprehensive background checks, assault weapons bans, and de‐regulation of civilian concealed carry of firearms—were unrelated to fatal mass shootings.
Policy Implications
Our findings suggest that laws requiring firearm purchasers to be licensed through a background check process supported by fingerprints and laws banning LCMs are the most effective gun policies for reducing fatal mass shootings.
Background
Comprehensive background check (CBC) policies are hypothesised to reduce firearm-related violence because they extend background checks to private party firearm sales, but no study has determined whether these policies actually increase background checks, an expected intermediary outcome. We evaluate the association between CBC policies and the rates of firearm background checks in three states that recently implemented these policies: Delaware (July 2013), Colorado (July 2013) and Washington (December 2014).
Methods
We used the synthetic control group method to estimate the difference from estimated counterfactual postintervention trends in the monthly rate of background checks per 1 00 000 people for handguns, long guns and both types combined, using data for January 1999 through December 2016. Inference was based on results from permutation tests. We conducted multiple sensitivity analyses to assess the robustness of our results.
Results
Background check rates increased in Delaware, by 22%–34% depending on the type of firearm, following enactment of its CBC law. No overall changes were observed in Washington and Colorado. Our results were robust to changes in the comparison group and statistical methods.
Conclusions
The enactment of CBC policies was associated with an overall increase in firearm background checks only in Delaware. Data external to the study suggest that Washington experienced a modest, but consistent, increase in background checks for private party sales, and Colorado experienced a similar increase in checks for sales not at gun shows. Non-compliance may explain the lack of an overall increase in background checks in Washington and Colorado.
Despite a well-established literature investigating race-related predictors of riot incidence, the racial aftermath of riots remains unexamined. In this study, I use the 1960s U.S. race riots to investigate trends in black residential segregation levels following large-scale riot activity in seven major U.S. cities. I use a novel approach-namely, synthetic control matching-to select a group of cities against which segregation trends can be compared. I find that levels of black segregation rose in 1970 for four of the seven cities, but these increases disappeared in 1980 and 1990 except in Detroit. These results mask differential trends at lower geographic levels: suburban neighborhoods in affected areas experienced larger and longer-term increases in segregation, particularly in traditionally hypersegregated cities in the Midwest and Northeast.
Federal firearms law divides the population into two groups: those prohibited from legally possessing a firearm due to their criminal record or certain other disqualifying conditions and everyone else. The vast majority of the adult public is allowed to acquire and possess all the firearms they want, thus preserving the personal right to "keep and bear arms" that has been established by recent U.S. Supreme Court rulings.1 But that right, like all rights, has limits. People with serious criminal records or severe mental illness may reasonably be deemed at such high risk of misusing firearms that public-safety concerns take precedence over gun rights. While in practice it is impossible to keep all members of high-risk groups disarmed in a gun-rich environment, a selective prohibition may cause some reduction in gun misuse and save enough lives to be worthwhile.
Purpose
This article describes epidemiological evidence concerning risk of gun violence and suicide linked to psychiatric disorders, in contrast to media-fueled public perceptions of the dangerousness of mentally ill individuals, and evaluates effectiveness of policies and laws designed to prevent firearms injury and mortality associated with serious mental illnesses and substance use disorders.
Methods
Research concerning public attitudes towards persons with mental illness is reviewed and juxtaposed with evidence from benchmark epidemiological and clinical studies of violence and mental illness and of the accuracy of psychiatrists’ risk assessments. Selected policies and laws designed to reduce gun violence in relation to mental illness are critically evaluated; evidence-based policy recommendations are presented.
Results
Media accounts of mass shootings by disturbed individuals galvanize public attention and reinforce popular belief that mental illness often results in violence. Epidemiological studies show that the large majority of people with serious mental illnesses are never violent. However, mental illness is strongly associated with increased risk of suicide, which accounts for over half of US firearms-related fatalities.
Conclusion
Policymaking at the interface of gun violence prevention and mental illness should be based on epidemiological data concerning risk, to improve the effectiveness, feasibility, and fairness of policy initiatives.
This study examines the relationship between the types of background-information check required by states prior to firearm purchases, and firearm homicide and suicide deaths.
Negative binomial models are used to analyze state-level data for homicides and suicides in the U.S. from 1996 to 2005. Data on types of background information are retrieved from the Surveys of State Procedures Related to Firearm Sales, and the violent death data are from the WISQARS. Several other state level factors were controlled for.
More background checks are associated with fewer homicide (IRR:0.93, 95% CI:0.91-0.96) and suicide (IRR:0.98, 95% CI:0.96-1.00) deaths. Firearm homicide deaths are lower when states have checks for restraining orders (IRR:0.87, 95% CI:0.79-0.95) and fugitive status (IRR:0.79, 95% CI:0.72-0.88). Firearm suicide deaths are lower when states have background checks for mental illness (IRR:0.96, 95% CI:0.92-0.99), fugitive status (IRR:0.95, 95% CI:0.90-0.99) and misdemeanors (IRR:0.95, 95% CI:0.92-1.00). It does not appear that reductions in firearm deaths are offset by increases in non-firearm violent deaths.
More extensive background checks prior to gun purchase are mostly associated with reductions in firearm homicide and suicide deaths. Several study limitations are acknowledged, and further research is called for to ascertain causality.
Background:
Gun possession by high-risk individuals presents a serious threat to public safety. U.S. federal law establishes minimum criteria for legal purchase and possession of firearms; many states have laws disqualifying additional categories for illegal possession.
Methods:
We used data from a national survey of state prison inmates to calculate: 1) the proportion of offenders, incarcerated for crimes committed with firearms in 13 states with the least restrictive firearm purchase and possession laws, who would have been prohibited if their states had stricter gun laws; and 2) the source of gun acquisition for offenders who were and were not legally permitted to purchase and possess firearms.
Results:
Nearly three of ten gun offenders (73 of 253 or 28.9%) were legal gun possessors but would have been prohibited from purchasing or possessing firearms when committing their most recent offense if their states had stricter prohibitions. Offenders who were already prohibited under current law acquired their gun from a licensed dealer, where a background check is required, five times less often than offenders who were not prohibited (3.9% vs. 19.9%; χ(2)=13.31; p≤0.001). Nearly all (96.1%) offenders who were legally prohibited, acquired their gun from a supplier not required to conduct a background check.
Conclusions:
Stricter gun ownership laws would have made firearm possession illegal for many state prison inmates who used a gun to commit a crime. Requiring all gun sales to be subject to a background check would make it more difficult for these offenders to obtain guns.
Building on an idea in Abadie and Gardeazabal (2003), this article investigates the application of synthetic control methods to comparative case studies. We discuss the advantages of these methods and apply them to study the effects of Proposition 99, a large-scale tobacco control program that California implemented in 1988. We demonstrate that following Proposition 99 tobacco consumption fell markedly in California relative to a comparable synthetic control region. We estimate that by the year 2000 annual per-capita cigarette sales in California were about 26 packs lower than what they would have been in the absence of Proposition 99. Given that many policy interventions and events of interest in social sciences take place at an aggregate level (countries, regions, cities, etc.) and affect a small number of aggregate units, the potential applicability of synthetic control methods to comparative case studies is very large, especially in situations where traditional regression methods are not appropriate. The methods proposed in this article produce informative inference regardless of the number of available comparison units, the number of available time periods, and whether the data are individual (micro) or aggregate (macro). Software to compute the estimators proposed in this article is available at the authors' web-pages.Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.
We investigated the possible relationship between being shot in an assault and possession of a gun at the time.
We enrolled 677 case participants that had been shot in an assault and 684 population-based control participants within Philadelphia, PA, from 2003 to 2006. We adjusted odds ratios for confounding variables.
After adjustment, individuals in possession of a gun were 4.46 (P < .05) times more likely to be shot in an assault than those not in possession. Among gun assaults where the victim had at least some chance to resist, this adjusted odds ratio increased to 5.45 (P < .05).
On average, guns did not protect those who possessed them from being shot in an assault. Although successful defensive gun uses occur each year, the probability of success may be low for civilian gun users in urban areas. Such users should reconsider their possession of guns or, at least, understand that regular possession necessitates careful safety countermeasures.
Under current federal law, many persons with prior convictions for misdemeanor offenses pass criminal records background checks and legally purchase handguns.
To determine whether authorized handgun purchasers with prior misdemeanor convictions are more likely than those with no criminal history to be charged with new crimes, particularly offenses involving firearms and violence.
Retrospective cohort study.
A total of 5923 authorized purchasers of handguns in California in 1977 who were younger than 50 years, identified by random sample.
Incidence and relative risk (RR) of first charges for new criminal offenses after handgun purchase.
Of the 5923 authorized purchasers, 3128 had at least 1 conviction for a misdemeanor offense prior to handgun purchase, and 2795 had no prior criminal history. Follow-up to the end of the 15-year observation period or to death was available for 77.8% of study subjects and for a median 8.9 years for another 9.6%. Handgun purchasers with at least 1 prior misdemeanor conviction were more than 7 times as likely as those with no prior criminal history to be charged with a new offense after handgun purchase (RR, 7.5; 95% confidence interval [CI], 6.6-8.7). Among men, those with 2 or more prior convictions for misdemeanor violence were at greatest risk for nonviolent firearm-related offenses such as weapon carrying (RR, 11.7; 95% CI, 6.8-20.0), violent offenses generally (RR, 10.4; 95% CI, 6.9-15.8), and Violent Crime Index offenses (murder or non-negligent manslaughter, forcible rape, robbery, or aggravated assault) (RR, 15.1; 95% CI, 9.4-24.3). However, even handgun purchasers with only 1 prior misdemeanor conviction and no convictions for offenses involving firearms or violence were nearly 5 times as likely as those with no prior criminal history to be charged with new offenses involving firearms or violence.
Handgun purchasers with prior misdemeanor convictions are at increased risk for future criminal activity, including violent and firearm-related crimes.
There continues to be considerable controversy over whether ownership of a handgun increases or decreases the risk of violent death.
We conducted a population-based cohort study to compare mortality among 238,292 persons who purchased a handgun in California in 1991 with that in the general adult population of the state. The observation period began with the date of handgun purchase (15 days after the purchase application) and ended on December 31, 1996. The standardized mortality ratio (the ratio of the number of deaths among handgun purchasers to the number expected on the basis of age- and sex-specific rates among adults in California) was the principal outcome measure.
In the first year after the purchase of a handgun, suicide was the leading cause of death among handgun purchasers, accounting for 24.5 percent of all deaths and 51.9 percent of deaths among women 21 to 44 years old. The increased risk of suicide by any method among handgun purchasers (standardized mortality ratio, 4.31) was attributable entirely to an excess risk of suicide with a firearm (standardized mortality ratio, 7.12). In the first week after the purchase of a handgun, the rate of suicide by means of firearms among purchasers (644 per 100,000 person-years) was 57 times as high as the adjusted rate in the general population. Mortality from all causes during the first year after the purchase of a handgun was greater than expected for women (standardized mortality ratio, 1.09), and the entire increase was attributable to the excess number of suicides by means of a firearm. As compared with the general population, handgun purchasers remained at increased risk for suicide by firearm over the study period of up to six years, and the excess risk among women in this cohort (standardized mortality ratio, 15.50) remained greater than that among men (standardized mortality ratio, 3.23). The risk of death by homicide with a firearm was elevated among women (standardized mortality ratio at one year, 2.20; at six years, 2.01) but low among men (standardized mortality ratio at one year, 0.84; at six years, 0.79).
The purchase of a handgun is associated with a substantial increase in the risk of suicide by firearm and by any method; the increase in the risk of suicide by firearm is apparent within a week after the purchase of a handgun. The magnitude of the increase and the relation between handgun purchase and the risk of death by homicide differ between men and women.
This 11-city study sought to identify risk factors for femicide in abusive relationships.
Proxies of 220 intimate partner femicide victims identified from police or medical examiner records were interviewed, along with 343 abused control women.
Preincident risk factors associated in multivariate analyses with increased risk of intimate partner femicide included perpetrator's access to a gun and previous threat with a weapon, perpetrator's stepchild in the home, and estrangement, especially from a controlling partner. Never living together and prior domestic violence arrest were associated with lowered risks. Significant incident factors included the victim having left for another partner and the perpetrator's use of a gun. Other significant bivariate-level risks included stalking, forced sex, and abuse during pregnancy.
There are identifiable risk factors for intimate partner femicides.
Background:
In 2016, firearms killed 38,658 people in the United States. Federal law requires licensed gun dealers, but not private parties, to conduct background checks on prospective firearm purchasers with the goal of preventing prohibited persons from obtaining firearms. Our objective was to estimate the effect of the repeal of comprehensive background check laws - requiring a background check for all handgun sales, not just sales by licensed dealers - on firearm homicide and suicide rates in Indiana and Tennessee.
Methods:
We compared age-adjusted firearm homicide and suicide rates, measured annually from 1981-2008 and 1994-2008 in Indiana and Tennessee, respectively, to rates in control groups constructed using the synthetic control method.
Results:
The average rates of firearm homicide and suicide in Indiana and Tennessee following repeal were within the range of what could be expected given natural variation (differences = 0.7 firearm homicides and 0.5 firearm suicides per 100,000 residents in Indiana and 0.4 firearm homicides and 0.3 firearm suicides per 100,000 residents in Tennessee). Sensitivity analyses resulted in similar findings.
Conclusion:
We found no evidence of an association between the repeal of comprehensive background check policies and firearm homicide and suicide rates in Indiana and Tennessee. In order to understand whether comprehensive background check policies reduce firearm deaths in the United States generally, more evidence on the impact of such policies from other states is needed.
The effectiveness of laws depends on circumstances affecting their enforcement. To assess such circumstances for comprehensive background check (CBC) and straw purchase laws for firearm sales, we examined prosecutions for CBC and straw purchase violations in Pennsylvania and CBC violations in Maryland. We generated pre-post variables and conducted t-tests to assess differences in the mean number of prosecutions filed following changes to the legal environments. The annual number of prosecutions for straw purchase violations increased significantly in Pennsylvania following the passage of a law that strengthened penalties for these violations (difference in means = +1310.86, P=0.003). The annual number of prosecutions for CBC violations decreased significantly in Maryland following a court decision that narrowed the definition of a firearm transfer making enforcement more difficult (difference in means = −20.52, P=0.026). Our findings suggest enforcement is likely influenced by the penalties associated with violating these laws and the interpretation of the language of the laws.
In this research, we estimate the association of firearm restrictions for domestic violence offenders with intimate partner homicides (IPHs), based on the strength of the policies. We posit that the association of firearm laws with IPHs depends on the laws': 1) breadth of coverage of high-risk individuals and situations restricted; 2) power to compel firearm surrender or removal from prohibited persons; and 3) systems of accountability that prevent prohibited persons from obtaining guns. We conducted a quantitative policy evaluation using annual state-level data from 1980 through 2013 for 45 US states. Based on the results of a series of robust negative binomial regression models with state fixed effects, domestic violence restraining order firearm prohibition laws are associated with 9% reductions in IPH. Statistically significant protective associations were evident only when restraining order prohibitions covered dating partners (-10%) and ex parte orders (-12%). Laws prohibiting access to those convicted of non-specific violent misdemeanors were associated with a 23% reduction in IPH rates; there was no association when prohibitions were limited to domestic violence. Permit-to-purchase laws were associated with 10% reductions in IPHs. These findings should inform policymakers considering laws to maximize protections against intimate partner homicide.
We examine the impact of the 2006 Massachusetts healthcare reform on substance use disorder (SUD) treatment facilities' provision of care. We test the impact of the reform on treatment quantity and access. We couple data on the near universe of specialty SUD treatment providers in the USA with a synthetic control method approach. We find little evidence that the reform lead to changes in treatment quantity or access. Reform effects were similar among for-profit and non-profit facilities. In an extension, we show that the reform altered the setting in which treatment is received, the number of offered services, and the number of programs for special populations. These findings may be useful in predicting the implications of major health insurance expansions on the provision of SUD treatment. Copyright © 2017 John Wiley & Sons, Ltd.
Background:
In 1994, 40% of U.S. gun owners who had recently acquired a firearm did so without a background check. No contemporary estimates exist.
Objective:
To estimate the proportion of current U.S. gun owners who acquired their most recent firearm without a background check, by time since and manner of acquisition, for the nation as a whole and separately in states with and without legislation regulating private sales.
Design:
Probability-based online survey.
Setting:
United States, 2015.
Participants:
1613 adult gun owners.
Measurements:
Current gun owners were asked where and when they acquired their last firearm; if they purchased the firearm; and whether, as part of that acquisition, they had a background check (or were asked to show a firearm license or permit).
Results:
22% (95% CI, 16% to 27%) of gun owners who reported obtaining their most recent firearm within the previous 2 years reported doing so without a background check. For firearms purchased privately within the previous 2 years (that is, other than from a store or pawnshop, including sales between individuals in person, online, or at gun shows), 50% (CI, 35% to 65%) were obtained without a background check. This percentage was 26% (CI, 5% to 47%) for owners residing in states regulating private firearm sales and 57% (CI, 40% to 75%) for those living in states without regulations on private firearm sales.
Limitation:
Potential inaccuracies due to recall and social desirability bias.
Conclusion:
22% of current U.S. gun owners who acquired a firearm within the past 2 years did so without a background check. Although this represents a smaller proportion of gun owners obtaining firearms without background checks than in the past, millions of U.S. adults continue to acquire guns without background checks, especially in states that do not regulate private firearm sales.
Primary funding source:
Fund for a Safer Future and the Joyce Foundation.
Gun violence kills about ninety people every day in the United States, a toll measured in wasted and ruined lives and with an annual economic price tag exceeding $200 billion. Some policy makers suggest that reforming mental health care systems and improving point-of-purchase background checks to keep guns from mentally disturbed people will address the problem. Epidemiological research shows that serious mental illness contributes little to the risk of interpersonal violence but is a strong factor in suicide, which accounts for most firearm fatalities. Meanwhile, the effectiveness of gun restrictions focused on mental illness remains poorly understood. This article examines gun-related suicide and violent crime in people with serious mental illnesses, and whether legal restrictions on firearm sales to people with a history of mental health adjudication are effective in preventing gun violence. Among the study population in two large Florida counties, we found that 62 percent of violent gun crime arrests and 28 percent of gun suicides involved individuals not legally permitted to have a gun at the time. Suggested policy reforms include enacting risk-based gun removal laws and prohibiting guns from people involuntarily detained in short-term psychiatric hospitalizations.
https://epirev.oxfordjournals.org/content/early/2016/02/10/epirev.mxv012.abstract
Firearms account for a substantial proportion of external causes of death, injury, and disability across the world. Legislation to regulate firearms has often been passed with the intent of reducing problems related to their use. However, lack of clarity around which interventions are effective remains a major challenge for policy development. Aiming to meet this challenge, we systematically reviewed studies exploring the associations between firearm- related laws and firearm homicides, suicides, and unintentional injuries/deaths. We restricted our search to studies published from 1950 to 2014. Evidence from 130 studies in 10 countries suggests that in certain nations the simultaneous implementation of laws targeting multiple firearms restrictions is associated with reductions in firearm deaths. Laws restricting the purchase of (e.g., background checks) and access to (e.g., safer storage) firearms are also associated with lower rates of intimate partner homicides and firearm unintentional deaths in children, respectively. Limitations of studies include challenges inherent to their ecological design, their execution, and the lack of robustness of findings to model specifications. High quality research on the association between the implementation or repeal of firearm legislation (rather than the evaluation of existing laws) and firearm injuries would lead to a better understanding of what interventions are likely to work given local contexts. This information is key to move this field forward and for the development of effective policies that may counteract the burden that firearm injuries pose on populations.
The December 2012 tragedy at Newtown may soon settle in the collective memory of senseless rampages by unstable young men. But inthe immediate aftermath, the question of what might have been done to prevent those 28 untimely deaths may galvanize the attention of policymakers desperate to respond. Shall we now hold mental health systems more accountable for failing to find, treat, or confine people who incline to violence? Should we fault the loose enforcement of federal firearms restrictions, and a loophole-ridden system of background-checks, for failing to keep guns out of the hands of dangerous people? Does the problem lie with the laws themselves, with their blunt and archaic definitions that leave risky people untouched while sweeping up legions of the harmless?
In 2013, more than 40,000 individuals died from suicide in the United States. Restricting access to lethal means has the potential to prevent suicide, as suicidal thoughts are often transient. Permit-to-Purchase (PTP) laws for handguns could potentially reduce suicides by making it more difficult for persons at risk of suicide to purchase a handgun. We used a quasi-experimental research design with annual, state-level suicide data to evaluate changes to PTP laws in Connecticut and Missouri. Data were analyzed for 1981-2012. We used synthetic control modeling as the primary method to estimate policy effects. This methodology provided better prediction of pre-PTP-law-change trends in the two states with PTP law changes than econometric models and are thus likely to provide more accurate estimates of policy effects. The synthetic control model estimated a 15.4% reduction in firearm suicide rates associated with Connecticut's PTP law. Missouri's PTP law repeal was associated with a 16.1% increase in firearm suicide rates. Evidence that PTP laws were associated with non-firearm suicide rates was mixed in Connecticut and negative in Missouri. The findings are consistent with prior research linking firearm availability to increased risk of suicide and lower suicide risks to PTP handgun laws.
Copyright © 2015. Published by Elsevier Inc.
We sought to estimate the effect of Connecticut's implementation of a handgun permit-to-purchase law in October 1995 on subsequent homicides.
Using the synthetic control method, we compared Connecticut's homicide rates after the law's implementation to rates we would have expected had the law not been implemented. To estimate the counterfactual, we used longitudinal data from a weighted combination of comparison states identified based on the ability of their prelaw homicide trends and covariates to predict prelaw homicide trends in Connecticut.
We estimated that the law was associated with a 40% reduction in Connecticut's firearm homicide rates during the first 10 years that the law was in place. By contrast, there was no evidence for a reduction in nonfirearm homicides.
Consistent with prior research, this study demonstrated that Connecticut's handgun permit-to-purchase law was associated with a subsequent reduction in homicide rates. As would be expected if the law drove the reduction, the policy's effects were only evident for homicides committed with firearms. (Am J Public Health. Published online ahead of print June 11, 2015: e1-e6. doi:10.2105/AJPH.2015.302703).
In the USA, homicide is a leading cause of death for young males and a major cause of racial disparities in life expectancy for men. There are intense debate and little rigorous research on the effects of firearm sales regulation on homicides. This study estimates the impact of Missouri's 2007 repeal of its permit-to-purchase (PTP) handgun law on states' homicide rates and controls for changes in poverty, unemployment, crime, incarceration, policing levels, and other policies that could potentially affect homicides. Using death certificate data available through 2010, the repeal of Missouri's PTP law was associated with an increase in annual firearm homicides rates of 1.09 per 100,000 (+23 %) but was unrelated to changes in non-firearm homicide rates. Using Uniform Crime Reporting data from police through 2012, the law's repeal was associated with increased annual murders rates of 0.93 per 100,000 (+16 %). These estimated effects translate to increases of between 55 and 63 homicides per year in Missouri.
Numerous social indicators turned negative for Blacks in the 1980s and rebounded a decade later. We explore whether crack cocaine explains these patterns. Absent a direct measure, we construct a crack prevalence index using multiple proxies. Our index reproduces spatial and temporal patterns described in ethnographic accounts of the crack epidemic. It explains much of the 1980s rise in Black youth homicide and more moderate increases in adverse birth outcomes. Although our index remains high through the 1990s, crack's deleterious social impact fades. Changes over time in behavior, crack markets, and the user population may have mitigated crack's damaging impacts.
It has been suggested that limiting access to firearms could prevent many suicides, but this belief is controversial. To assess the strength of the association between the availability of firearms and suicide, we studied all suicides that took place in the homes of victims in Shelby County, Tennessee, and King County, Washington, over a 32-month period.
For each suicide victim (case subject), we obtained data from police or the medical examiner and interviewed a proxy. Their answers were compared with those of control subjects from the same neighborhood, matched with the victim according to sex, race, and age range. Crude and adjusted odds ratios were calculated with matched-pairs methods.
During the study period, 803 suicides occurred in the two counties, 565 of which (70 percent) took place in the home of the victim. Fifty-eight percent (326) of these suicides were committed with a firearm. After excluding 11 case subjects for various reasons, we were able to interview 80 percent (442) of the proxies for the case subjects. Matching controls were identified for 99 percent of these subjects, producing 438 matched pairs. Univariate analyses revealed that the case subjects were more likely than the controls to have lived alone, taken prescribed psychotropic medication, been arrested, abused drugs or alcohol, or not graduated from high school. After we controlled for these characteristics through conditional logistic regression, the presence of one or more guns in the home was found to be associated with an increased risk of suicide (adjusted odds ratio, 4.8; 95 percent confidence interval, 2.7 to 8.5).
Ready availability of firearms is associated with an increased risk of suicide in the home. Owners of firearms should weigh their reasons for keeping a gun in the home against the possibility that it might someday be used in a suicide.
It is unknown whether keeping a firearm in the home confers protection against crime or, instead, increases the risk of violent crime in the home. To study risk factors for homicide in the home, we identified homicides occurring in the homes of victims in three metropolitan counties.
After each homicide, we obtained data from the police or medical examiner and interviewed a proxy for the victim. The proxies' answers were compared with those of control subjects who were matched to the victims according to neighborhood, sex, race, and age range. Crude and adjusted odds ratios were calculated with matched-pairs methods.
During the study period, 1860 homicides occurred in the three counties, 444 of them (23.9 percent) in the home of the victim. After excluding 24 cases for various reasons, we interviewed proxy respondents for 93 percent of the victims. Controls were identified for 99 percent of these, yielding 388 matched pairs. As compared with the controls, the victims more often lived alone or rented their residence. Also, case households more commonly contained an illicit-drug user, a person with prior arrests, or someone who had been hit or hurt in a fight in the home. After controlling for these characteristics, we found that keeping a gun in the home was strongly and independently associated with an increased risk of homicide (adjusted odds ratio, 2.7; 95 percent confidence interval, 1.6 to 4.4). Virtually all of this risk involved homicide by a family member or intimate acquaintance.
The use of illicit drugs and a history of physical fights in the home are important risk factors for homicide in the home. Rather than confer protection, guns kept in the home are associated with an increase in the risk of homicide by a family member or intimate acquaintance.
In February 1994, the Brady Handgun Violence Prevention Act established a nationwide requirement that licensed firearms dealers observe a waiting period and initiate a background check for handgun sales. The effects of this act have not been analyzed.
To determine whether implementation of the Brady Act was associated with reductions in homicide and suicide rates.
Analysis of vital statistics data in the United States for 1985 through 1997 from the National Center for Health Statistics.
Total and firearm homicide and suicide rates per 100,000 adults (>/=21 years and >/=55 years) and proportion of homicides and suicides resulting from firearms were calculated by state and year. Controlling for population age, race, poverty and income levels, urban residence, and alcohol consumption, the 32 "treatment" states directly affected by the Brady Act requirements were compared with the 18 "control" states and the District of Columbia, which had equivalent legislation already in place.
Changes in rates of homicide and suicide for treatment and control states were not significantly different, except for firearm suicides among persons aged 55 years or older (-0.92 per 100,000; 95% confidence interval [CI], -1.43 to -0.42). This reduction in suicides for persons aged 55 years or older was much stronger in states that had instituted both waiting periods and background checks (-1.03 per 100,000; 95% CI, -1.58 to -0.47) than in states that only changed background check requirements (-0.17 per 100,000; 95% CI, -1.09 to 0.75).
Based on the assumption that the greatest reductions in fatal violence would be within states that were required to institute waiting periods and background checks, implementation of the Brady Act appears to have been associated with reductions in the firearm suicide rate for persons aged 55 years or older but not with reductions in homicide rates or overall suicide rates. However, the pattern of implementation of the Brady Act does not permit a reliable analysis of a potential effect of reductions in the flow of guns from treatment-state gun dealers into secondary markets. JAMA. 2000;284:585-591
A previous study estimated that child access prevention (CAP) laws, which hold adults criminally liable for unsafe firearm storage in the environment of children, were associated with a 23% decline in unintentional firearm mortality rates among children.
To reassess the effects of CAP laws and more fully examine the consistency of the estimated law effects across states.
A pooled time-series study of unintentional firearm mortality among children from 1979 through 1997. Setting. The 50 states and the District of Columbia.
All children <15 years.
Rates of unintentional deaths attributable to firearms.
When the effects of all 15 state CAP laws enacted before 1998 were aggregated, the laws were associated with a 17% decline unintentional firearm death rates among children. The laws' effects were not equal across states. Florida's CAP law was associated with a 51% decline; however, there were no statistically significant aggregate or state-specific law effects in the other 14 states with CAP laws.
Florida's CAP law-1 of only 3 such laws allowing felony prosecution of violators-appears to have significantly reduced unintentional firearm deaths to children. However, there is no evidence of effects in the other 14 states with CAP laws.
Some states prohibit the purchase of handguns by persons convicted of selected misdemeanor crimes, but most do not. California has denied handgun purchases by violent misdemeanants since 1991; the effectiveness of these policies is unknown.
To determine the risk factors for new criminal activity among violent misdemeanants who seek to purchase handguns and whether denial of handgun purchase by violent misdemeanants affects their risk of arrest for new crimes, particularly gun and/or violent crimes.
Retrospective, population-based cohort study.
Persons aged 21 to 34 years who sought to purchase a handgun through a licensed dealer in California during 1989-1991 and who had at least 1 violent misdemeanor conviction in the preceding 10 years. The study cohorts consisted of 986 persons whose purchase applications were made in 1991 and were denied (denied persons) and 787 persons whose purchase applications were made in 1989-1990 and were approved (purchasers).
Incidence and relative risk of first arrest in California for new gun and/or violent crimes and for nongun, nonviolent crimes during a 3-year follow-up after actual or attempted handgun purchase.
During the 3-year follow-up, 546 (33.0%) of 1654 subjects with follow-up information were arrested for a new crime, including 296 (31.9%) of 927 denied persons and 250 (34.4%) of 727 purchasers. After adjusting for differences in age, sex, and prior criminal history, purchasers were more likely than denied persons to be arrested for new gun and/or violent crimes (relative hazard [RH], 1.29; 95% confidence interval [CI], 1.04-1.60), but not for nongun, nonviolent crimes (RH, 0.96; 95% CI, 0.78-1.19). In both groups, risk of arrest was strongly related to age and number of convictions accrued prior to actual or attempted handgun purchase.
Our results indicate that denial of handgun purchase to violent misdemeanants is associated with a specific decrease in risk of arrest for new gun and/or violent crimes.
Past ecologic analyses of firearm deaths have studied the effects of various gun-control laws; however, no study has analyzed the effects of the differences among states in the background checks required for firearm purchase. Some states utilize a federal agency to conduct the background checks; others use a state agency; still others use a local agency. The information potentially available to checking agencies at different levels of government varies; the consequence of this variation is not known.
In 2007, negative binomial regression models were used to assess the association between the Department of Justice classification of agencies conducting firearm background checks for each state in 2002-2004 and firearm suicide and homicide rates for the same years from the National Center for Injury Prevention and Control while controlling for age, race, unemployment, crime, income inequality, poverty, alcohol consumption, urbanization, and divorce rate.
Performing local-level background checks was associated with a 27%-lower firearm suicide rate (incidence rate ratio [IRR]=0.73, 95% CI=0.60, 0.89) and a 22%-lower homicide rate (IRR=0.78, 95% CI=0.61, 1.01) in adults>or=21 years.
Using local-level agencies to perform firearm background checks is associated with reduced rates of firearm suicide and homicide. Methods to increase local-level agency background checks, such as authorizing local police or sheriff's departments to conduct them, or developing the capability to share local-level records with federal databases, should be evaluated as a means of reducing firearm deaths.
Of the readily computed proxies for the prevalence of gun ownership, one, the percentage of suicides committed with a gun, is most highly correlated with survey-based estimates. It is the best choice for use in cross-section analysis of the effect of gun prevalence on crime patterns across states and larger counties.
Analysis of this proxy measure for the period 1979–1997 demonstrates that the geographic structure of gun ownership has been highly stable. That structure is closely linked to rural tradition. There is, however, some tendency toward homogenization over this period, with high-prevalence states trending down and low-prevalence states trending up.
A vast and often confusing economics literature relates competition to investment in innovation. Following Joseph Schumpeter, one view is that monopoly and large scale promote investment in research and development by allowing a firm to capture a larger fraction of its benefits and by providing a more stable platform for a firm to invest in R&D. Others argue that competition promotes innovation by increasing the cost to a firm that fails to innovate. This lecture surveys the literature at a level that is appropriate for an advanced undergraduate or graduate class and attempts to identify primary determinants of investment in R&D. Key issues are the extent of competition in product markets and in R&D, the degree of protection from imitators, and the dynamics of R&D competition. Competition in the product market using existing technologies increases the incentive to invest in R&D for inventions that are protected from imitators (e.g., by strong patent rights). Competition in R&D can speed the arrival of innovations. Without exclusive rights to an innovation, competition in the product market can reduce incentives to invest in R&D by reducing each innovator's payoff. There are many complications. Under some circumstances, a firm with market power has an incentive and ability to preempt rivals, and the dynamics of innovation competition can make it unprofitable for others to catch up to a firm that is ahead in an innovation race.
Statistical Tables Bureau of Justice Statistics. Washington D.C: U.S. Department of Justice
- J C Karberg
- R J Frandsen
- J M Durso
- T D Buskirk
- A D Lee
Karberg JC, Frandsen RJ, Durso JM, Buskirk TD, Lee AD. Background Checks for
Firearm Transfers, 2015. Statistical Tables Bureau of Justice Statistics. Washington D.C: U.S. Department of Justice; 2017. Contract No.: NCJ, 250978.
For the Military: a Long History of Failure to Report Crimes
- S Dewan
- R A Oppel
Dewan S, Oppel RA. For the Military: a Long History of Failure to Report
Crimes. New York, NY: New York Times; 2017.
Background Checks for Firearm Transfers, 2015
- Karberg