Passage of child access protection and concealed carry permits laws could substantially reduce firearm suicides

(Boston)—Firearm suicides (FS) are a major public health issue in the United States (U.S.) with a rate eight times higher than other high-income nations. Despite the disproportionate media coverage of firearm homicides, most firearm-related deaths are suicides. Although firearm homicides have decreased in the post-pandemic period, suicides using firearms reached new records with more than 26,000 deaths in 2022.

In recent decades, U.S. firearm laws have been primarily determined at the state level and as a result, vary greatly across the country. Rates of suicide by firearms also differ widely by state, and the general association between more restrictive state firearm legislation and reduced FS has been well studied. However, an important but unaddressed issue in the analysis of role of firearm laws in FS prevention is how a given type of firearm law may have variable effectiveness in different states with substantially different laws, populations and socioeconomic conditions.

A new study by researchers from Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, has found that more than 110,000 firearm suicides could potentially have been prevented (from 2010-2019) had each state implemented the most impactful firearm related law in that state, specifically including child access prevention laws and concealed carry permitting policies.

“States have different laws, demographics and socioeconomic characteristics and may benefit differently or not at all from different firearm laws and policies. While other studies have examined national or state-specific data, we examined all states individually and the potential impact of firearm laws which were missing in each state. Overall, concealed carry permitting and child access prevention laws could have prevented the most deaths in the most states,” explained corresponding author Dane Scantling, DO, MPH, FACS, Assistant Professor of Surgery at BU.

The researchers performed a retrospective state-level study looking at the effects of state firearm laws on rates of firearm studies in each of the 'lower 48' states. They used data from 2010-2019 and 12 categories of firearm laws comprised of 125 individual policies. They then evaluated the relationship of a number of different demographic, societal and legal factors and incorporated the impact of legislation in neighboring states to estimate whether effective firearm laws like concealed carry permitting and child access prevention laws could have reduced firearm suicides per 100,000 people.

According to the researchers, a distinct state-by-state approach to firearm suicide is needed. “We hope that this data supports specific, standardized and evidence-based policies that could possibly save tens of thousands of American lives in the years to come,” said Scantling who also is a trauma surgeon and surgical critical care intensivist at Boston Medical Center.

Third-year BU medical student Aksel Laudon is the first author of this study.

These findings appear online in the journal Annals of Surgery.