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Suicides Account for Bulk of Firearm Deaths

(Volume 9, Issue 1) Policies that reduce firearm ownership will likely reduce suicides

Suicide is the 10th leading cause of death in the United States and the 2nd leading cause of death among youth ages 16 to 25. Politicians have renewed interest in the gun control debate in the wake of several mass shootings; however, suicides account for the bulk of firearm deaths (21,175 persons in 2013). In this study, investigators examined the relationship between state level firearm ownership and state-specific suicide rates to gauge the public health impact of firearm ownership.

Source: A. K. Azad (Flickr/CC)

Source: A. K. Azad (Flickr/CC)

Using data and proxy measures of state-level firearm ownership (including firearm suicide and states’ hunting license rates), authors incorporated data from 1981 to 2013 and examined the rates (by gender) while controlling for many confounders. Researchers controlled for region, urbanization, population density, proportion of Catholic adherents, per capita gross domestic product, per capita personal disposal income, household income, education, divorce rate, alcohol use, violent crime rate, nonviolent crime rate, and incarceration rate. This large scale study of all 50 states contains 33 years of data analyzing the age-adjusted, gender-specific suicide rate (overall vs.  firearm-suicide vs. non-firearm suicide rate).

Average firearm ownership (among households) was 41% with lowest rate in Hawaii (12.2%) and the highest rate in Wyoming (72.8%). The average adjusted firearm suicide rate for the U.S. was 14.2 (per 100,000) for men and 2.1 for women, with the lowest rate in Massachusetts – the state with the 2nd lowest rate of firearm ownership – and the highest rate in Wyoming (26.1 men; 3.9 women). Firearm ownership showed a statistically significant increase of 3.3 (men) and 0.5 per 100,000 (women) in suicide rates for each 10 percentage point increase in firearm ownership. If firearm ownership in Wyoming was on par with national average, there would be a 16% decline in male suicides across the state.

This study underscores the public health importance of research concerning morbidity, mortality, and firearm ownership. In spite of strong evidence linking health and firearm ownership, policy makers continue to gag public health agencies and . In fact, the National Rifle Association has given more than $4 million to 44 current U.S. Senators and 249 Representatives to ensure unwise policies for the American people.


OBJECTIVES: To examine the relationship between state-level firearm ownership rates and gender-specific, age-adjusted firearm and total suicide rates across all 50 US states from 1981 to 2013.

METHODS: We used panel data for all 50 states that included annual overall and gender-specific suicide and firearm suicide rates and a proxy for state-level household firearm ownership. We analyzed data by using linear regression and generalized estimating equations to account for clustering.

RESULTS: State-level firearm ownership was associated with an increase in both male and female firearm-related suicide rates and with a decrease in nonfirearm-related suicide rates. Higher gun ownership was associated with higher suicide rates by any means among male, but not among female, persons.

CONCLUSIONS: We found a strong relationship between state-level firearm ownership and firearm suicide rates among both genders, and a relationship between firearm ownership and suicides by any means among male, but not female, individuals.

POLICY IMPLICATIONS: For male persons, policies that reduce firearm ownership will likely reduce suicides by all means and by firearms. For female persons, such policies will likely reduce suicides by firearms.

PMID: 27196643  Siegel, M & Rothman, EF. AJPH. 2016; 106 (7): 1316-22.

Laura K. Grubb, MD, MPH, FAAP
About Laura K. Grubb, MD, MPH, FAAP

Dr. Grubb is an adolescent medicine specialist and general pediatrician with research interests in health care reform implementation, single payer model realization in Vermont, and cost effectiveness of health care interventions. Dr. Grubb graduated cum laude with a BS in Biology from Georgetown University and received her MD from George Washington University. She completed pediatrics residency at the Naval Medical Center San Diego and is Board Certified in Pediatrics. She is a Fellow of the American Academy of Pediatrics. She served seven years in the Navy as a pediatrician and general medical officer. She completed her fellowship in Adolescent Medicine and an MPH (focusing on Health Systems Organization in the Management, Community Health, and Policy tract) at the University of Texas Health Sciences Center at Houston. She is currently an assistant professor of pediatrics at the Floating Hospital for Children at Tufts Medical Center in Boston. Contact: Website | Facebook | More Posts