Regular Article
Access to Firearms and Risk for Suicide in Middle-Aged and Older Adults

https://doi.org/10.1097/00019442-200207000-00007Get rights and content

Elderly white men are at the highest risk for suicide. Firearms are the most common method of suicide used by both men and women in later life, and a greater proportion of older than younger suicide victims use a gun. This psychological autopsy study aimed to test hypotheses concerning the risk for suicide associated with access to and storage of firearms. Subjects included 86 suicide victims age 50 years of age and over and 86 community control subjects individually matched on age, sex, race, and county of residence. Presence of a firearm in the home was associated with increased risk for suicide, even after controlling for psychiatric illness. Elevated risk was accounted for by access to handguns rather than long guns and was more pronounced in men than women. Among subjects who kept a gun in the home, storing the weapon loaded and unlocked were independent predictors of suicide. Findings support the potential benefit for suicide prevention of restricting access to handguns. Education programs for older persons, their families, and healthcare providers concerning the risks of having a gun in the home and reinforcement of rules for safe storage may contribute to reducing the rate of suicide in older people.

Section snippets

Cases

Cases for this study were drawn from a consecutive series of suicides 50 years of age and older occurring in Monroe County (Rochester area) and Onondaga County (Syracuse area), New York, between December 11, 1996 and January 20, 2001. All were living in Monroe or Onondaga County at the time of the suicide. The Office of the Medical Examiner (ME) made all determinations of manner of death before our investigation. For inclusion, written informed consent of next-of-kin and the availability of one

RESULTS

Table 3 lists characteristics of cases and controls, demonstrating their closely matched age, sex, race, and county of residence. Thirty-three cases and controls were between the ages of 50 and 64 years; 53 were 65 years and over. Fifty-one cases (59.3%) resided in Monroe County and 35 (40.7%) in Onondaga County. There was no significant difference between these two groups in age, sex, race, education, living situation, or the proportion who maintained a gun in the home (analyses not shown).

DISCUSSION

The principal finding of this study is that firearms were significantly more likely to be found in the homes of suicide victims age 50-years-and-over than in homes of the carefully matched community controls. The increased risk for suicide associated with access to firearms was limited to men, the population subgroup that, with increasing age, also has the highest suicide rates in the United States. Furthermore, handguns, rather than long guns, appeared to account for the difference between

References (48)

  • PR Duberstein et al.

    Age differences in the personality characteristics of suicide completers: preliminary findings from a psychological autopsy study

    Psychiatry

    (1994)
  • Waern M, Rubenowitz E, Runeson B, et al: Physical illness and suicide in late life (abstract). 10th Congress of the...
  • DK Curran

    Adolescent Suicidal Behavior

    (1987)
  • D Parkin et al.

    Incidence of suicidal attempts in an urban community

    BMJ

    (1965)
  • B Barraclough

    Suicide in the elderly: recent developments in psychogeriatrics

    Br J Psychiatry

    (1971)
  • Y Conwell et al.

    Completed suicide at age 50 and over

    J Am Geriatr Soc

    (1990)
  • SS Carney et al.

    Suicide over 60: The San Diego Study

    J Am Geriatr Soc

    (1994)
  • JL McIntosh

    U.S.A. Suicide: 1999 Official Final Statistics

    (2002)
  • DA Brent et al.

    Risk factors for adolescent suicide: a comparison of adolescent suicide victims with suicidal inpatients

    Arch Gen Psychiatry

    (1988)
  • DA Brent et al.

    The presence and accessibility of firearms in the homes of adolescent suicides: a case-control study

    JAMA

    (1991)
  • DA Brent et al.

    Firearms and adolescent suicide: a community case-control study

    American Journal of Diseases of Children (Arch Pediatr Adolesc Med)

    (1993)
  • AL Kellermann et al.

    Suicide in the home in relation to gun ownership

    New Engl J Med

    (1992)
  • AL Beautrais et al.

    Access to firearms and the risk of suicide: a case-control study

    Aust N Z J Psychiatry

    (1996)
  • P Cummings et al.

    The association between the purchase of a handgun and homicide or suicide

    Am J Public Health

    (1997)
  • Cited by (210)

    • Suicide Among Persons Experiencing Homelessness

      2023, Journal of Surgical Research
    • Firearm ownership, attitudes, and safe storage practices among a nationally representative sample of older U.S. adults age 50 to 80

      2022, Preventive Medicine
      Citation Excerpt :

      Given that unintentional firearm injuries disproportionately affect children (Centers for Disease Control and Prevention, 2018; Cunningham et al., 2018), and over 75% of adolescent firearm suicide completers obtained the firearm from their home or that of a relative (Grossman et al., 1999; Johnson et al., 2010; Brent et al., 1991; Shah et al., 2000; Wright et al., 2008), our data highlights the need to provide storage counseling to older adult firearm owners as this may be an important source of unintended child/adolescent firearm access. Research has consistently identified a lower risk of self-inflicted injury and death in households practicing locked storage (Conwell et al., 2002; Brent et al., 1991; Shah et al., 2000; Brent et al., 1993a; Grossman et al., 2005; Brent et al., 1993b; Shenassa et al., 2004). Further, behavioral counseling has demonstrated efficacy increasing locked storage when employing motivational interviewing approaches paired with the provision of safety devices (Barkin et al., 2008; Carbone et al., 2005; Grossman et al., 2012).

    • The Rising Tide of Elderly African-American Suicides: A Call for Action

      2021, Journal of the National Medical Association
    View all citing articles on Scopus

    The authors acknowledge the invaluable assistance of the Chief Medical Examiners of Monroe County (Nicholas Forbes, M.D.) and Onondaga County (Mary Jumbelic, M.D.) and their staffs in conducting this study. We also thank Andrea DiGiorgio, Holly Wadkins, James Evinger, and Dr. Wendy Armenta for their help with data collection, and Kathleen Graffrath for her assistance with manuscript preparation.

    The study was supported by NIMH grants R01 MH54682 and K24 MH01759.

    e-mail: [email protected]

    View full text