The relationship between firearms and suicide: A review of the literature

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Abstract

Suicide rates are affected by many factors—psychiatric, biological, familial and situational. This paper focuses on one potential risk factor for completed suicide in the United States—the availability of firearms. Whether the availability of firearms might increase the rate of attempted suicide is not examined. This article is not an exhaustive review of every existing firearm-related suicide study. Rather, it provides a detailed review of the most commonly cited, representative, and thorough empirical studies in the published peer-reviewed literature relating firearms and suicide, focusing largely on the United States. The empirical studies reviewed are grouped according to whether the unit of analysis is the individual (e.g., case-control studies) or a population (e.g., ecological studies) and further divided depending on whether the analysis uses cross-sectional or time-series (longitudinal) data. We begin with a very brief overview of the suicide problem in the United States.

Section snippets

Suicide in the united states

AMONG INDUSTRIALIZED NATIONS, the overall suicide rate in the United States (19 per 100,000 population for men and 4 per 100,000 population for women in 1993) falls roughly in the middle (Moscicki, 1995). However, suicides among younger persons are relatively high in the United States: for children under 15 years of age, the overall suicide rate in the U.S. is twice that of the average of other industrialized countries, largely due to a firearm-related suicide rate that is 11 times that of the

Gun suicide in the united states

In the United States, more people kill themselves with guns than with all other methods combined (U.S. National Center for Health Statistics, 1997). In 1996, there were approximately 30,000 suicide deaths, of which 60% were caused by guns (U.S. National Center for Health Statistics, 1997). The number of suicides (29,790) exceeded the number of homicides (21,340), and the number of gun suicides (18,140) exceeded the number of gun homicides (15,230) (U.S. National Center for Health Statistics,

Gun ownership and storage in the u.s

The United States has more guns in civilian hands than any developed country, almost one gun for every man, woman and child. Males, whites, and residents of the South and the Rocky Mountain states are more likely than others to own a gun (Chapdelaine et al., 1991).

It is not only the total arsenal of guns that distinguishes the United States but that so many of the guns are handguns, owned for personal pleasure or protection. Blendon, Young, and Hemenway (1996) analyzed national survey data and

The suicide-gun connection

Many suicides appear to be the result of impulsive behavior. Individuals who take their own lives often do so when confronting a severe but temporary crisis (Seiden, 1977). Impulsive behavior is a particular problem among potential youth suicides. A higher risk to teens is consistent with the notion that they are more likely to act impulsively and therefore are more likely to be affected by the means at hand (Rich et al., 1986).

There appears to be an alcohol-gun-suicide connection, especially

Cross-Sectional Studies

No study is ideal. A problem for all case-control studies is finding reasonable controls, achieving high participation rates among those selected and obtaining accurate data. Since control groups are never perfect, studies must try to account for all other confounding variables. Regression analysis is the most common approach used to account for such confounders, but using regression analysis can create problems that threaten the validity of inference, including multicollinearity,

Ecological studies

Cross-sectional studies have various problems. One, sometimes called the “ecological fallacy,” concerns the potential pit-falls associated in drawing causal inferences about individual behavior from group level data. Potential discrepancies between group and individual level correlations are usually attributed to the difficulty of holding constant all other factors which affect the dependent variable (e.g., internal validity, confounding). Confounding is often a more refractory issue in

Conclusion

The best empirical evidence concerning the possible association between gun availability and suicide currently comes from the case-control studies. The results of these studies are compelling, in part, because all their subsidiary findings correspond to current knowledge about risk factors for suicide, and because these studies hold constant many important factors correlated with suicide.

All case-control studies indicate that a gun in the home is significantly associated with a higher risk of

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