Current Issue Pic Top Harvard Health Policy Review Current Issue Top
Current Issue Pic Middle About Us Fill Current Issue Bottom
Links  
Contact Us Fall 2001; Volume 2, Number 2
Feature: Violence and Healthcare

Firearm Prevalence and the Risk of Suicide: A Review

Continued

page 1 | page 2 | page 3 | page 4

(b) Area-wide

Many studies have examined whether geographical areas with higher levels of gun ownership have higher rates of suicide. Studies have looked across census regions, states and cities. Across regions, even with a small sample size (n=9 census regions), some studies have found a statistically significant relationship between levels of household gun ownership and suicide rates.17 A more recent regional analysis for 1979-1994 found a statistically significant relationship across regions, which held for young people and the elderly, even after controlling for levels of divorce, education, unemployment and urbanization.18
A limitation of state and city studies has been the lack of reliable data on gun ownership levels. Crude proxies have been used (e.g. the accidental death rate from firearms, and subscriptions to gun magazines). Nonetheless, studies consistently find a positive association between gun ownership levels and suicide, and many find a statistically significant relationship.19-21

Recent analyses of state level data for 1988-1997 also find a strong, statistically significant relationship between measures of and proxies for levels of household gun ownership and suicide rates.22 The proxy used in this study was validated against survey-based gun ownership levels at the international, regional and state levels (correlation coefficients were all >0.8). The relationship between gun availability and suicide rates could be seen in both genders and for every age group.


  Suicide Cases Control
Firearm in Home 65% 41%
Handgun in Home 50% 23%

Table 4: Case Control Study of Firearm ownership in Memphis and Seattle. (438 cases), Kellerman, et al. and Case Control study of Handguns purchased from liscenced dealers in Washington State. (353 suicide victims) Cummings P, et al.


A variety of studies have also examined the relationship between the strictness of gun control laws and suicide rates. Many of these studies are cross-sectional in nature and are therefore subject to confounding by cultural, social and economic differences that are difficult to take into account. Nevertheless, most cross-sectional studies find that strict state gun control laws are significantly associated with lower levels of suicide Lester & Murrell 1986.23-27 For example, cross-sectional studies find that suicide rates in 1970,28 1980 and 1985 (Boor and Bair 1990) were significantly lower in those U.S. states with stricter gun control laws.29,30

Time-series studies in the US and Canada also find a significant reduction in suicide rates after enactment of strict gun control laws.31,32 In 1978, for example, Canada imposed tighter restrictions on gun ownership, virtually outlawing handguns; a nationwide educational campaign about safe use and storage of the firearms was also undertaken. It appears the law led to a one time drop in both the firearm and total suicide rates, but not the non-firearms suicide rate (Lester and Leenaars 1993, 1994).33-35 In 1976, the District of Columbia adopted a very restrictive handgun law.

A time-series analysis covering the years 1968-1987 found that the adoption of the law coincided with an abrupt and sustained 23% decline in the suicide rate by firearms. There were no parallel increases in suicide from non-firearm methods, nor were similar declines in firearm suicide rates seen in adjacent metropolitan areas of Maryland or Virginia, to which the legislation did not apply.36 Despite the limitations inherent in these approaches, a recent review of the impact of gun control legislation on suicide concluded that restricting access to firearms through gun control legislation diminishes suicide rates, and substitution of other means does not appear to offset the benefits of restrictions (Lambert and Silva 1998).37

Summary

Case-control studies provide strong evidence that suicide risk is heightened where guns are more readily available. The results of these studies are compelling, in part because all of their ancillary findings correspond to current knowledge about risk factors for suicide, and in part because these studies hold constant many important characteristics correlated with suicide. The results from these studies consistently indicate that a gun in the home is significantly associated with a higher risk of suicide, especially among youth.

That firearms may pose a higher suicide risk to teens than to older adults is consonant with the notion that adolescents are particularly likely to act impulsively and therefore are more likely to be affected by availability of the means at hand (Rich, Young, & Fowler, 1986).38 Several cross-national studies have found similar results and lend credibility to the notion that availability of weapons matters, especially among impulsive individuals.
Ecological studies provide less compelling evidence linking guns to overall suicide rates, in part due to the difficulty in accounting for cultural differences between comparison groups. Another major limitation of these studies is the lack of reliable data on firearm availability. Nevertheless, it is remarkable that despite poor measures of firearm availability (which should make it harder to see effects even if they exist) many ecological studies, particularly in the United States, still find that firearms are a risk factor for overall suicide rates.

Taken as a whole, the preponderance of current evidence indicates that gun availability is a risk factor for suicide, especially among youth. This is precisely the conclusion reached by the American Association of Suicidology in their consensus statement on youth suicide, which provides a fitting conclusion to our review as well: “There is a positive association between the accessibility and availability of firearms in the home and the risk of youth suicide. Guns in the home, particularly loaded guns, are associated with increased risk of suicide by youth, both with and without identifiable mental health problems or suicidal risk factors.”39

page 1 | page 2 | page 3 | page 4
Subscribe
EPIHC
 
Home
 
Fill
Spring 2001, Volume 2, Number 1
Table of Contents
Editor's Note
Features: Violence and Healthcare
Gun Violence
Health Highlights
In Focus
Seal
 
Bar

about us | links | contact us | subscribe | epihc