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JAMA Pediatr. 2019 May 13. doi: 10.1001/jamapediatrics.2019.1078. [Epub ahead of print]

Association of Increased Safe Household Firearm Storage With Firearm Suicide and Unintentional Death Among US Youths.

Author information

1
Division of Emergency Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts.
2
Harvard Injury Control Research Center, Department of Health Policy and Management, T. H. Chan Harvard School of Public Health, Boston, Massachusetts.
3
Department of Health Sciences, Northeastern University, Bouve College of Health Sciences, Boston, Massachusetts.

Abstract

Importance:

Firearm injury is the second leading cause of death in the United States for children and young adults. The risk of unintentional and self-inflicted firearm injury is lower when all household firearms are stored locked.

Objective:

To estimate the reduction in youth firearm suicide and unintentional firearm mortality that would result if more adults in households with youth stored household guns locked.

Design, Setting, and Participants:

A modeling study using Monte Carlo simulation of youth firearm suicide and unintentional firearm mortality in 2015. A simulated US national sample of firearm-owning households where youth reside was derived using nationally representative rates of firearm ownership and storage and population data from the US Census to test a hypothetical intervention, safe storage of firearms in the home, on youth accidental death and suicide. Data analyses were performed from August 3, 2017, to January 9, 2018.

Exposures:

Observed and counterfactual household-level safe firearm storage (ie, storing all firearms locked), the latter estimated by varying the probability that a hypothetical intervention increased safe firearm storage beyond that observed in 2015.

Main Outcomes and Measures:

Observed and counterfactual counts of firearm suicide and unintentional firearm mortality among youth aged 0 to 19 years, the latter estimated by incorporating an empirically based estimate of the mortality benefit expected from additional safe storage (beyond that observed in 2015).

Results:

A hypothetical intervention among firearm owners residing with children with a 20% probability of motivating these owners to lock all household firearms was significantly associated with a projected reduction in youth firearm mortality (median incidence rate ratio = 0.90; interquartile range, 0.87-0.93). In the overall model, 6% to 32% of deaths were estimated to be preventable depending on the probability of motivating safer storage.

Conclusions and Relevance:

Results of this modeling study suggest that a relatively modest uptake of a straightforward safe storage recommendation-lock all household firearms-could result in meaningful reductions in firearm suicide and unintentional firearm fatalities among youth. Approaches that will motivate additional parents to store firearms safely are needed.

PMID:
31081861
PMCID:
PMC6515586
[Available on 2020-05-13]
DOI:
10.1001/jamapediatrics.2019.1078

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