In the United States, more than 45,000 women died from gun violence over the last decade.
To determine whether measures of firearm availability are related to rates of suicide, homicide, and unintentional firearm deaths among women in the United States.
Pooled cross-sectional time series data on suicide, homicide, and unintentional firearm deaths (1988–1997) were used to estimate the association between the rate of violent death among women and four proxies of firearm availability. Two proxies came from survey reports of household firearm ownership rates; two were derived from mortality statistics.
United States, 1988–1997.
The increased rate of suicide and homicide in states with high gun levels was accounted for primarily by significantly elevated firearm suicide and firearm homicide rates. Unintentional firearm death rates were also increased in states with more guns. At the regional level, qualitatively similar results were obtained.
Between 1988 and 1997, the suicide, homicide, and unintentional firearm death rates among women were disproportionately higher in states where guns were more prevalent. The elevated rates of violent death in states with more guns was not entirely explained by a state’s poverty or urbanization and was driven primarily by lethal firearm violence, not by lethal nonfirearm violence.
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1. National Center for Health Statistics, Hyattsville, MD: US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention; 1998 Available at: http://wonder.cdc.gov/mortsql.shtml. Accessed June 2, 2001.
2. Bailey JE, Kellermann AL, Somes GW, Banton JG, Rivara FP, Rushforth NP. Risk factors for violent death of women in the home. Arch Intern Med. 1997;157(7):777–782. doi: 10.1001/archinte.157.7.777. [PubMed] [Cross Ref] 3. Kellermann AL, Rivara FP, Rushforth NB, et al. Gun ownership as a risk factor for homicide in the home. N Engl J Med. 1993;329(15):1084–1091. doi: 10.1056/NEJM199310073291506. [PubMed] [Cross Ref] 4. Kellermann AL, Rivara FP, Somes G, et al. Suicide in the home in relation to gun ownership. N Engl J Med. 1992;327(7):467–472. doi: 10.1056/NEJM199208133270705. [PubMed] [Cross Ref] 5. Cummings P, Koepsell TD, Grossman DC, Savarino J, Thompson RS. The association between the purchase of a handgun and homicide or suicide. Am J Public Health. 1997;87(6):974–978. doi: 10.2105/AJPH.87.6.974. [PubMed] [Cross Ref] 6. Brent DA, Perper JA, Goldstein CE, et al. Risk factors for adolescent suicide. A comparison of adolescent suicide victims with suicidal inpatients. Arch Gen Psychiatry. 1988;45(6):581–588. [PubMed] 7. Brent DA, Perper JA, Allman CJ, Moritz GM, Wartella ME, Zelenak JP. The presence and accessibility of firearms in the homes of adolescent suicides. A case-control study. JAMA. 1991;266(21):2989–2995. doi: 10.1001/jama.266.21.2989. [PubMed] [Cross Ref] 8. Brent DA, Perper J, Moritz G, Baugher M, Allman C. Suicide in adolescents with no apparent psychopathology. J Am Acad Child Adolesc Psychiatry. 1993;32(3):494–500. doi: 10.1097/00004583-199305000-00002. [PubMed] [Cross Ref] 9. Brent DA, Perper JA, Moritz G, Baugher M, Schweers J, Roth C. Firearms and adolescent suicide. A community case-control study. Am J Dis Child. 1993;147(10):1066–1071. [PubMed] 10. Bukstein OG, Brent DA, Perper JA, et al. Risk factors for completed suicide among adolescents with a lifetime history of substance abuse: a case-control study. Acta Psychiatr Scand. 1993;88(6):403–408. doi: 10.1111/j.1600-0447.1993.tb03481.x. [PubMed] [Cross Ref] 11. Loftin C, McDowall D, Wiersema B, Cottey TJ. Effects of restrictive licensing of handguns on homicide and suicide in the District of Columbia. N Engl J Med. 1991;325(23):1615–1620. doi: 10.1056/NEJM199112053252305. [PubMed] [Cross Ref] 12. Sloan JH, Kellermann AL, Reay DT, et al. Handgun regulations, crime, assaults, and homicide. A tale of two cities. N Engl J Med. 1988;319(19):1256–1262. doi: 10.1056/NEJM198811103191905. [PubMed] [Cross Ref] 13. Wintemute GJ, Parham CA, Beaumont JJ, Wright M, Drake C. Mortality among recent purchasers of handguns. N Engl J Med. 1999;341(21):1583–1589. doi: 10.1056/NEJM199911183412106. [PubMed] [Cross Ref]
14. Cook P. The effect of gun availability on robbery and robber murder: a cross sectional study of 50 cities. Policy Stud Rev Annu. 1979;3:743–781.
15. Boor M, Bair JH. Suicide rates, handgun control laws, and sociodemographic variables. Psychol Rep. 1990;66(3):923–930. doi: 10.2466/PR0.66.3.923-930. [PubMed] [Cross Ref] 16. Markush RE, Bartolucci AA. Firearms and suicide in the United States. Am J Public Health. 1984;74(2):123–127. doi: 10.2105/AJPH.74.2.123. [PubMed] [Cross Ref] 17. Marzuk PM, Leon AC, Tardiff K, Morgan EB, Stajic M, Mann JJ. The effect of access to lethal methods of injury on suicide rates. Arch Gen Psychiatry. 1992;49(6):451–458. [PubMed] 18. Cummings P, Grossman DC, Rivara FP, Koepsell TD. State gun safe storage laws and child mortality due to firearms. JAMA. 1997;278(13):1084–1086. doi: 10.1001/jama.278.13.1084. [PubMed] [Cross Ref] 19. Miller M, Azrael D, Hemenway D. Firearm Availability and Unintentional Firearm Deaths. Accid Anal Prev. 2001;33(4):477–484. doi: 10.1016/S0001-4575(00)00061-0. [PubMed] [Cross Ref] 20. Kellermann AL, Mercy JA. Men, women, and murder: gender-specific differences in rates of fatal violence and victimization. J Trauma. 1992;33(1):1–5. doi: 10.1097/00005373-199207000-00001. [PubMed] [Cross Ref] 21. Browning CH. Epidemiology of suicide: firearms. Compr Psychiatry. 1974;15(6):549–553. doi: 10.1016/0010-440X(74)90010-8. [PubMed] [Cross Ref]
22. Hellensten J. Motivation and Opportunity: an Ecological Investigation of US Urban Suicides 1970–1990 [dissertation]. University of California Irvine; 1995.
23. Baker S, O’Neill B, Ginsburg M, Li G. The Injury Fact Book. 2nd ed. New York: Oxford University Press; 1992.
24. Keck NJ, Istre GR, Coury DL, Jordan F, Eaton AP. Characteristics of fatal gunshot wounds in the home in Oklahoma: 1982–1983. Am J Dis Child. 1988;142(6):623–626. [PubMed] 25. Fingerhut LA, Ingram DD, Feldman JJ. Firearmand nonfirearmhomicide among persons 15 through 19 years of age. Differences by level of urbanization, United States, 1979 through 1989. JAMA. 1992;267(22):3048–3053. doi: 10.1001/jama.267.22.3048. [PubMed] [Cross Ref] 26. Fingerhut LA, Ingram DD, Feldman JJ. Homicide rates among US teenagers and young adults; differences by mechanism, level of urbanization, race, and sex, 1987 through 1995. JAMA. 1998;280(5):423–427. doi: 10.1001/jama.280.5.423. [PubMed] [Cross Ref] 27. Young TJ. Poverty, suicide, and homicide among Native Americans. Psychol Rep. 1990;67(3):1153–1154. [PubMed] 28. Powell KE, Jacklin BC, Nelson DE, Bland S. State estimates of household exposure to firearms, loaded firearms, and handguns, 1991 through 1995. Am J Public Health. 1998;88(6):969–972. doi: 10.2105/AJPH.88.6.969. [PubMed] [Cross Ref]
29. Davis J, Smith T. In: General Social Surveys, 1972–1998. NORC, editor. Chicago, IL: National Opinion Research Center; 1998.
30. Lester D. The availability of firearms and the use of firearms for suicide: a study of 20 countries. Acta Psychiatr Scand. 1990;81(2):146–147. doi: 10.1111/j.1600-0447.1990.tb06468.x. [PubMed] [Cross Ref] 31. Lester D. Relationship between firearm availability and primary and secondary murder. Psychol Rep. 1990;67:490–490. doi: 10.2466/PR0.67.6.490-490. [PubMed] [Cross Ref] 32. Lester D. Gun ownership and suicide in the United States. Psychol Med. 1989;19(2):519–521. doi: 10.1017/S0033291700012551. [PubMed] [Cross Ref] 33. Killias M. International correlations between gun ownership and rates of homicide and suicide. CMAJ. 1993;148(10):1721–1725. [PMC free article] [PubMed] 34. Adelson L. The gun and the sanctity of human life; or the bullet as pathogen. Pharos. 1980;43(3):15–25. [PubMed] 35. Baker SP. Without guns, do people kill people? Am J Public Health. 1985;75(6):587–588. doi: 10.2105/AJPH.75.6.587. [PubMed] [Cross Ref] 36. Browning CH. Handguns and homicide. A public health problem. JAMA. 1976;236(19):2198–2200. doi: 10.1001/jama.236.19.2198. [PubMed] [Cross Ref] 37. Clark R, Jones P. Suicide and the increased availability of handguns, in the United States. Soc Sci Med. 1989;28:805–809. doi: 10.1016/0277-9536(89)90109-3. [PubMed] [Cross Ref] 38. Sloan JH, Rivara FP, Reay DT, Ferris JA, Kellermann AL. Firearm regulations and rates of suicide. A comparison of two metropolitan areas. N Engl J Med. 1990;322(6):369–373. doi: 10.1056/NEJM199002083220605. [PubMed] [Cross Ref] 39. Schwartz S. The fallacy of the ecological fallacy: the potential misuse of a concept and the consequences. Am J Public Health. 1994;84(5):819–824. doi: 10.2105/AJPH.84.5.819. [PubMed] [Cross Ref] 40. Piantadosi S, Byar DP, Green SB. The ecological fallacy. Am J Epidemiol. 1988;127(5):893–904. [PubMed] 41. Kalimo E, Bice TW. Causal analysis and ecological fallacy in cross-national epidemiological research. Scand J Soc Med. 1973;1(1):17–24. [PubMed] 42. Dutton DG. Patriarchy and wife assault: the ecological fallacy. Violence Vict. 1994;9(2):167–182. [PubMed] 43. Ohsfeldt R, Morrisey M. Firearms, firearms injury and gun control: a critical survey of the literature. Adv Health Econ Health Serv Res. 1992;13:65–82. [PubMed] 44. Miller M, Hemenway D. The relationship between firearms and suicide: a review of the literature. Aggression Violent Behav. 1999;4:59–75. doi: 10.1016/S1359-1789(97)00057-8. [Cross Ref]