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Epidemiology. 2018 Jul;29(4):494-502. doi: 10.1097/EDE.0000000000000838.

Repeal of Comprehensive Background Check Policies and Firearm Homicide and Suicide.

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From the Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis School of Medicine, Sacramento, CA.
Center for Gun Policy and Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
School of Public Health, University of California, Berkeley, Berkeley, CA.



In 2016, firearms killed 38,658 people in the United States. Federal law requires licensed gun dealers, but not private parties, to conduct background checks on prospective firearm purchasers with the goal of preventing prohibited persons from obtaining firearms. Our objective was to estimate the effect of the repeal of comprehensive background check laws-requiring a background check for all handgun sales, not just sales by licensed dealers-on firearm homicide and suicide rates in Indiana and Tennessee.


We compared age-adjusted firearm homicide and suicide rates, measured annually from 1981 to 2008 and 1994 to 2008 in Indiana and Tennessee, respectively, to rates in control groups constructed using the synthetic control method.


The average rates of firearm homicide and suicide in Indiana and Tennessee following repeal were within the range of what could be expected, given natural variation (differences = 0.7 firearm homicides and 0.5 firearm suicides per 100,000 residents in Indiana and 0.4 firearm homicides and 0.3 firearm suicides per 100,000 residents in Tennessee). Sensitivity analyses resulted in similar findings.


We found no evidence of an association between the repeal of comprehensive background check policies and firearm homicide and suicide rates in Indiana and Tennessee. In order to understand whether comprehensive background check policies reduce firearm deaths in the United States generally, more evidence on the impact of such policies from other states is needed. See video abstract at,

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