Background There continues to be considerable controversy overwhether ownership of a handgun increases or decreases the riskof violent death.
Methods We conducted a population-based cohort study to comparemortality among 238,292 persons who purchased a handgun in Californiain 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 December31, 1996. The standardized mortality ratio (the ratio of thenumber of deaths observed among handgun purchasers to the numberexpected on the basis of age- and sex-specific rates among adultsin California) was the principal outcome measure.
Results In the first year after the purchase of a handgun, suicidewas the leading cause of death among handgun purchasers, accountingfor 24.5 percent of all deaths and 51.9 percent of deaths amongwomen 21 to 44 years old. The increased risk of suicide by anymethod among handgun purchasers (standardized mortality ratio,4.31) was attributable entirely to an excess risk of suicidewith a firearm (standardized mortality ratio, 7.12). In thefirst week after the purchase of a handgun, the rate of suicideby 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 purchaseof a handgun was greater than expected for women (standardizedmortality ratio, 1.09), and the entire increase was attributableto the excess number of suicides by means of a firearm. As comparedwith the general population, handgun purchasers remained atincreased risk for suicide by firearm over the study periodof up to six years, and the excess risk among women in thiscohort (standardized mortality ratio, 15.50) remained greaterthan that among men (standardized mortality ratio, 3.23). Therisk of death by homicide with a firearm was elevated amongwomen (standardized mortality ratio at one year, 2.20; at sixyears, 2.01) but low among men (standardized mortality ratioat one year, 0.84; at six years, 0.79).
Conclusions The purchase of a handgun is associated with a substantialincrease in the risk of suicide by firearm and by any method.The increase in the risk of suicide by firearm is apparent withina week after the purchase of a handgun and persists for at leastsix years.
Source Information
From the Violence Prevention Research Program, University of California, Davis.
Address reprint requests to Dr. Wintemute at the Violence Prevention Research Program, University of California, Davis, Medical Center, 2315 Stockton Blvd., Sacramento, CA 95817.
Firearms and Suicide
de Moore G. M., Robertson A. R., Wintemute G. J.
Extract |
Full Text
N Engl J Med 2000;
342:1528-1529, May 18, 2000.
Correspondence
This article has been cited by other articles:
Sorenson, S. B., Vittes, K. A.
(2008). Mental Health and Firearms in Community-Based Surveys: Implications for Suicide Prevention. Eval Rev
32: 239-256
[Abstract]
Vernick, J. S., Hodge, J. G. Jr., Webster, D. W.
(2007). The Ethics of Restrictive Licensing for Handguns: Comparing the United States and Canadian Approaches to Handgun Regulation. J Law Med Ethics
35: 668-678
Simpson, J. R.
(2007). Bad Risk? An Overview of Laws Prohibiting Possession of Firearms by Individuals With a History of Treatment for Mental Illness. J Am Acad Psychiatry Law
35: 330-338
[Abstract][Full Text]
Vernick, J. S., Teret, S. P., Smith, G. A., Webster, D. W.
(2006). Counseling About Firearms: Proposed Legislation Is a Threat to Physicians and Their Patients. Pediatrics
118: 2168-2172
[Abstract][Full Text]
Kyriacou, D N, Monkkonen, E H, Peek-Asa, C, Lucke, R E, Labbett, S, Pearlman, K S, Hutson, H R
(2006). Police deaths in New York and London during the twentieth century.. Inj. Prev.
12: 219-224
[Abstract][Full Text]
Miller, M, Azrael, D, Hepburn, L, Hemenway, D, Lippmann, S J
(2006). The association between changes in household firearm ownership and rates of suicide in the United States, 1981-2002.. Inj. Prev.
12: 178-182
[Abstract][Full Text]
Mahon, M. J., Tobin, J. P., Cusack, D. A., Kelleher, C., Malone, K. M.
(2005). Suicide Among Regular-Duty Military Personnel: A Retrospective Case-Control Study of Occupation-Specific Risk Factors for Workplace Suicide. Am. J. Psychiatry
162: 1688-1696
[Abstract][Full Text]
Sidman, E. A., Grossman, D. C., Koepsell, T. D., D'Ambrosio, L., Britt, J., Simpson, E. S., Rivara, F. P., Bergman, A. B.
(2005). Evaluation of a Community-Based Handgun Safe-Storage Campaign. Pediatrics
115: e654-e661
[Abstract][Full Text]
Dahlberg, L. L., Ikeda, R. M., Kresnow, M.-j.
(2004). Guns in the Home and Risk of a Violent Death in the Home: Findings from a National Study. Am J Epidemiol
160: 929-936
[Abstract][Full Text]
Shenassa, E. D, Rogers, M. L, Spalding, K. L, Roberts, M. B
(2004). Safer storage of firearms at home and risk of suicide: a study of protective factors in a nationally representative sample. J. Epidemiol. Community Health
58: 841-848
[Abstract][Full Text]
Webster, D. W., Vernick, J. S., Zeoli, A. M., Manganello, J. A.
(2004). Association Between Youth-Focused Firearm Laws and Youth Suicides. JAMA
292: 594-601
[Abstract][Full Text]
Miller, M, Hemenway, D
(2004). Unsupervised firearm handling by California adolescents. Inj. Prev.
10: 163-168
[Abstract][Full Text]
Longjohn, M M, Christoffel, K K
(2004). Are medical societies developing a standard for gun injury prevention?. Inj. Prev.
10: 169-173
[Abstract][Full Text]
Oslin, D. W., Zubritsky, C., Brown, G., Mullahy, M., Puliafico, A., Ten Have, T.
(2004). Managing Suicide Risk in Late Life: Access to Firearms as a Public Health Risk. AJGP
12: 30-36
[Abstract][Full Text]
Brent, D. A., Bridge, J.
(2003). Firearms Availability and Suicide: Evidence, Interventions, and Future Directions. American Behavioral Scientist
46: 1192-1210
[Abstract]
Grassel, K M, Wintemute, G J, Wright, M A, Romero, M P
(2003). Association between handgun purchase and mortality from firearm injury. Inj. Prev.
9: 48-52
[Abstract][Full Text]
Rivara, F P
(2002). Prevention of injuries to children and adolescents. Inj. Prev.
8: iv5-8
[Abstract][Full Text]
Carney, C. P., Allen, J., Doebbeling, B. N.
(2002). Receipt of Clinical Preventive Medical Services Among Psychiatric Patients. Psychiatr. Serv.
53: 1028-1030
[Abstract][Full Text]
Conwell, Y., Duberstein, P. R., Connor, K., Eberly, S., Cox, C., Caine, E. D.
(2002). Access to Firearms and Risk for Suicide in Middle-Aged and Older Adults. AJGP
10: 407-416
[Abstract][Full Text]
Kuhn, E M, Nie, C L, O'Brien, M E, Withers, R L, Wintemute, G J, Hargarten, S W
(2002). Missing the target: a comparison of buyback and fatality related guns. Inj. Prev.
8: 143-146
[Abstract][Full Text]
Burns, K., Raia, J., Stinson, B.
(2002). Firearms Risk Management. Psychiatr. Serv.
53: 483-483
[Full Text]
Sherman, M. E., Burns, K., Ignelzi, J., Raia, J., Lofton, V., Toland, D., Stinson, B., Tilley, J. L., Coon, T.
(2001). Firearms Risk Management in Psychiatric Care. Psychiatr. Serv.
52: 1057-1061
[Abstract][Full Text]
Brent, D. A.
(2001). Firearms and Suicide. Ann. N. Y. Acad. Sci.
932: 225-240
[Abstract][Full Text]
Laraque, D., Spivak, H., Bull, M.
(2001). Serious Firearm Injury Prevention Does Make Sense. Pediatrics
107: 408-410
[Full Text]
Lott, J. R. Jr, Kleck, G., Marvell, T., Blackman, P. H., Wintemute, G. J., Bennett, J. A., Ludwig, J., Cook, P. J., Rosenfeld, R.
(2000). Impact of the Brady Act on Homicide and Suicide Rates. JAMA
284: 2718-2721
[Full Text]
Hargarten, S W, Kuhn, E M, Mercy, J A, Withers, R L, Nie, C L, O'Brien, M E
(2000). Suicide guns: why collect this information?. Inj. Prev.
6: 245-246
[Full Text]
de Moore, G. M., Robertson, A. R., Wintemute, G. J.
(2000). Firearms and Suicide. NEJM
342: 1528-1529
[Full Text]
Previous
