According to background information in the article, the presence of a household firearm is associated with an increased risk of suicide among adults and adolescents. In a study of suicide attempters and completers, investigators found that 75 percent of the guns were stored in the residence of the victim, friend, or relative. Another study found that 35 percent of homes in the United States with children younger than 18 years reported at least 1 firearm, and that 43 percent of these homes had at least 1 unlocked firearm. Many organizations and health authorities advocate locking firearms and ammunition to prevent access to guns by children and adolescents. The association of these firearm storage practices with the reduction of firearm injury risk has been unclear.
David Grossman, M.D., M.P.H., of the Group Health Cooperative and the University of Washington, Seattle, and colleagues measured the association of household firearm storage practices and the risk of unintentional and self-inflicted firearm injuries as a result of child or adolescent access to firearms in the home. The researchers examined records from medical examiner and coroner offices and hospitals from 37 counties in Washington, Oregon, and Missouri, and 5 trauma centers in Seattle, Spokane, and Tacoma, Wash., and Kansas City, Mo. They included data that involved an incident in which a child or adolescent younger than 20 years gained access to a firearm and shot himself/herself intentionally or unintentionally or shot another individual unintentionally.
The researchers identified a control group of eligible households with at least 1 firearm and children living or visiting in the home. The researchers interviewed 106 respondents in which a shooting incident occurred (case firearms/households) and 480 with control firearms to ascertain gun storage practices. Of the shootings associated with the case firearms, 81 were suicide attempts (95 percent fatal) and 25 were unintentional injuries (52 percent fatal).
The researchers found that guns from case households were 70 percent less likely to be stored unloaded than control guns. Similarly, case guns were 73 percent less likely to be stored locked, stored separately from ammunition (55 percent less likely), or to have ammunition that was locked (61 percent less likely) than were control guns. These findings were consistent for both handguns and long guns and were also similar for both suicide attempts and unintentional injuries.
"In summary, storing household guns as locked, unloaded, or separate from the ammunition is associated with significant reductions in the risk of unintentional and self-inflicted firearm injuries and deaths among adolescents and children. Programs and policies designed to reduce accessibility of guns to youth, by keeping households guns locked and unloaded, deserve further attention as one avenue toward the prevention of firearm injuries in this population," the authors write.
(JAMA. 2005;293:707-714. Available post-embargo at JAMA.com)
Editor's Note: Funding for this study was provided by the Centers for Disease Control and Prevention.
Editorial: Storing Guns Safely in Homes With Children and Adolescents
In an accompanying editorial, Thomas B. Cole, M.D., M.P.H., Contributing Editor, JAMA, Chicago, and Reneé M. Johnson, M.P.H., Ph.D., of the Harvard School of Public Health, Boston, comment on the study in this week's JAMA on gun storage practices.
"The study by Grossman et al establishes that safe firearm storage is associated with a reduced risk for firearm injury. The next step is to help families make informed decisions about safe storage of firearms, recognizing that keeping children safe is as important to parents who own guns as those who do not. Experience suggests that persuading gun-owning families to store their firearms safely is not an easy task. Educational interventions to promote safe storage of firearms (including physician counseling) have not been successful in the past. Part of the problem may be that safe storage programs may not have been informed by a comprehensive understanding of the determinants of firearm storage practices."
"Generating widespread improvement in firearm storage practices will require a commitment to conducting behavioral science research and applying new information to design effective interventions. First, research outlining the determinants of storage practices is needed. Specifically, studies should address parents' risk perceptions about firearm injury to children in conjunction with their beliefs about the effectiveness of guns for defense and motivations underlying parents' firearm storage practices. Surprisingly, little of this information is available. Next, what is learned from behavioral research should be applied to small-scale interventions, using behavioral science theory to guide intervention development," they write.
(JAMA. 2005;293:740-741. Available post-embargo at JAMA.com)
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