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What Works? Three Laws that Prevent Gun Deaths

Ballistic fingerprinting and background checks for guns and ammo can save lives. (Volume 9, Issue 11)

A number of laws have been passed at the state level to address firearm safety. Some laws loosen restrictions on gun ownership while others tighten restrictions on gun ownership. Not all firearm-related laws are effective.

Researchers conducted a cross-sectional, state-level study examining 2008 – 2010 data from the Brady Center to Prevent Gun Violence and government databases to assess the effect of different gun laws on firearm mortality.

Source: Flickr/CC

Source: Flickr/CC

The three laws most strongly associated with reducing firearm mortality were universal background checks for firearm purchase, background checks for ammunition, and ballistic fingerprinting or microstamping to identify guns. Because this study was based in the United States, these results easily could be applied to the general population.

Many Americans, including gun owners, support universal background checks. Since 1998, the National Instant Criminal Background Check System (NICS) has conducted 230 million checks and prevented more than 1 million people from buying guns.

Firearm identification was associated with reduced suicide-specific gun mortality. These laws allow law enforcement to connect cartridges to the firearm that fired them. More research is needed to understand this connection.

Requiring background checks before gun and ammunition purchases could help keep weapons from dangerous people. Congress should work together to pass these widely supported, effective laws to reduce gun violence. Similarly, voters should support politicians willing to adopt intelligent firearm restrictions to decrease gun-related deaths.

commentary by Bich-May Nguyen

Abstract

BACKGROUND: In an effort to reduce firearm mortality rates in the USA, US states have enacted a range of firearm laws to either strengthen or deregulate the existing main federal gun control law, the Brady Law. We set out to determine the independent association of different firearm laws with overall firearm mortality, homicide firearm mortality, and suicide firearm mortality across all US states. We also projected the potential reduction of firearm mortality if the three most strongly associated firearm laws were enacted at the federal level.

METHODS: We constructed a cross-sectional, state-level dataset from Nov 1, 2014, to May 15, 2015, using counts of firearm-related deaths in each US state for the years 2008-10 (stratified by intent [homicide and suicide]) from the US Centers for Disease Control and Prevention’s Web-based Injury Statistics Query and Reporting System, data about 25 firearm state laws implemented in 2009, and state-specific characteristics such as firearm ownership for 2013, firearm export rates, and non-firearm homicide rates for 2009, and unemployment rates for 2010. Our primary outcome measure was overall firearm-related mortality per 100,000 people in the USA in 2010. We used Poisson regression with robust variances to derive incidence rate ratios (IRRs) and 95% CIs.

FINDINGS: 31,672 firearm-related deaths occurred in 2010 in the USA (10·1 per 100,000 people; mean state-specific count 631·5 [SD 629·1]). Of 25 firearm laws, nine were associated with reduced firearm mortality, nine were associated with increased firearm mortality, and seven had an inconclusive association. After adjustment for relevant covariates, the three state laws most strongly associated with reduced overall firearm mortality were universal background checks for firearm purchase (multivariable IRR 0·39 [95% CI 0·23-0·67]; p=0·001), ammunition background checks (0·18 [0·09-0·36]; p<0·0001), and identification requirement for firearms (0·16 [0·09-0·29]; p<0·0001).

INTERPRETATION: Very few of the existing state-specific firearm laws are associated with reduced firearm mortality, and this evidence underscores the importance of focusing on relevant and effective firearms legislation. Implementation of universal background checks for the purchase of firearms or ammunition, and firearm identification nationally could substantially reduce firearm mortality in the USA. PMID 26972843 

Kalesan B et al. Lancet. 2016; 387 (10030): 1847-1855.

Bich-May Nguyen, MD, MPH
About Bich-May Nguyen, MD, MPH

Bich-May Nguyen cares for patients at a community health center and teaches medical students, residents, and faculty development fellows. Dr. Nguyen received her MD in the Underserved Track from Baylor College of Medicine and an MPH from Harvard School of Public Health. She completed her residency training in Family Medicine at Boston University. Dr. Nguyen is involved with the National Physicians Alliance and serves on the Executive Board of the New Leaders Council Houston. You can follow her at @bicmay. She began contributing to Policy Prescriptions® in 2013. Contact: Facebook | Twitter | Google+ | More Posts