Guns in the home and risk of a violent death in the home: findings from a national study

Data from a US mortality follow-back survey were analyzed to determine whether having a firearm in the home increases the risk of a violent death in the home and whether risk varies by storage practice, type of gun, or number of guns in the home. Those persons with guns in the home were at greater risk than those without guns in the home of dying from a homicide in the home (adjusted odds ratio = 1.9, 95% confidence interval: 1.1, 3.4). They were also at greater risk of dying from a firearm homicide, but risk varied by age and whether the person was living with others at the time of death. The risk of dying from a suicide in the home was greater for males in homes with guns than for males without guns in the home (adjusted odds ratio = 10.4, 95% confidence interval: 5.8, 18.9). Persons with guns in the home were also more likely to have died from suicide committed with a firearm than from one committed by using a different method (adjusted odds ratio = 31.1, 95% confidence interval: 19.5, 49.6). Results show that regardless of storage practice, type of gun, or number of firearms in the home, having a gun in the home was associated with an increased risk of firearm homicide and firearm suicide in the home.     

Response of African-American Adolescents in North Carolina to Gun Carrying by School Mates

ABSTRACT: This study examined adolescents' perceptions concerning the presence of guns in their school and the adolescents' emotional and behavioral responses associated with these perceptions. Survey data from 376 African-American sixth, seventh, and eighth grade students of a low-income area of a North Carolina city were studied. Twenty-eight percent of adolescents reported that other students brought guns to school. 36% felt afraid that someone would hurt or attack them while at school, 15% avoided school (or places in school) because of fear that a student would hurt or attack them, and 20% carried weapons to school for self-protection. Logistic regression analyses found that, compared to their peers, adolescents who perceived that their school mates brought guns to school were almost twice as likely to experience fear while at school, were more than three times more likely to exhibit school avoidance behavior, and were more than twice as likely to bring a weapon to school themselves for self-protection. Educators and school health professionals are urged to work together to address these problems concerning school safety. (J Sch Health, 1996;66(1):23–26)     

Children and guns in a well child cohort

BACKGROUND: The purpose of this study was to estimate the extent of and to identify predictors of preadolescent gun use in a well child cohort with matched parent and child data. METHODS: We analyzed self-report questionnaires from children and their parents using conditional logistic regression models. Questionnaires were given to 3,145 ten- to twelve-year-old children and 3,145 parents enrolled by their pediatricians in a prevention cohort study. RESULTS: Thirty-two percent of the children lived in households with guns. Children and parents generally agreed about the presence of guns in their homes; 17% had access to unlocked guns in their homes; 22% had fired guns. In this preadolescent cohort, firing guns was associated with being male, having guns in the home, having friends who use guns, and initiation of alcohol use. CONCLUSIONS: In this well child cohort, significant numbers of preadolescent, healthy boys in white, middle-class U.S. homes have access to guns, are using guns, and have friends who use guns. These children are also early alcohol adopters. Safety interventions with parents of preadolescents about the risks for accidental injury, death, and suicide due to child gun use may prove beneficial.     

Firearm Storage in Gun-Owning Households with Children: Results of a 2015 National Survey

Data from a nationally representative probability-based online survey sample of US adults conducted in 2015 (n?=?3949, response rate 55%) were used to assess self-reported gun storage practices among gun owners with children. The presence of firearms and children in the home, along with other household and individual level characteristics, was ascertained from all respondents. Questions pertaining to household firearms (how guns are stored, number, type, etc.) were asked only of those respondents who reported that they personally owned a gun. We found that approximately one in three US households contains at least one firearm, regardless of whether children lived in the home (0.34 [0.29–0.39]) or not (0.35 [0.32–0.38]). Among gun-owning households with children, approximately two in ten gun owners store at least one gun in the least safe manner, i.e., loaded and unlocked (0.21 [0.17–0.26]); three in ten store all guns in the safest manner, i.e., unloaded and locked (0.29, [0.24–0.34]; and the remaining half (0.50 [0.45–0.55]) store firearms in some other way. Although firearm storage practices do not appear to vary across some demographic characteristics, including age, sex, and race, gun owners are more likely to store at least one gun loaded and unlocked if they are female (0.31 [0.23–0.41]) vs. male (0.17 [0.13–0.22]); own at least one handgun (0.27 [0.22–0.32] vs. no handguns (0.05 [0.02–0.15]); or own firearms for protection (0.29 [0.24–0.35]) vs. do not own for protection (0.03 [0.01–0.08]). Approximately 7% of US children (4.6 million) live in homes in which at least one firearm is stored loaded and unlocked, an estimate that is more than twice as high as estimates reported in 2002, the last time a nationally representative survey assessed this outcome. To the extent that the high prevalence of children exposed to unsafe storage that we observe reflects a secular change in public opinion towards the belief that having a gun in the home makes the home safer, rather than less safe, interventions that aim to make homes safer for children should address this misconception. Guidance alone, such as that offered by the American Academy of Pediatrics, has fallen short. Our findings underscore the need for more active and creative efforts to reduce children’s exposure to unsafely stored firearms.     

Validating survey responses to questions about gun ownership among owners of registered handguns

While survey-based data on firearm ownership are essential for epidemiologic studies of the relation between gun ownership and injuries, the validity of respondent answers to questions about gun ownership has not been confirmed. In order to assess the accuracy of interview data about firearms, in June to August 1987, the authors attempted to contact residents of 75 homes in the cities of Memphis, Tennessee and Seattle, Washington listed as the address of the owner of a recently registered handgun. Despite problems with inaccurate registration data, contact was ultimately made with 55 households, 35 of which consented to a general interview that included a series of questions about gun ownership. Respondents in 31 of these 35 households (88.6%) readily acknowledged that one or more guns were kept in their home. Respondents in three of the remaining four households (8.6%) stated that guns were recently kept in their homes but were no longer kept there. Only one respondent (2.9%) denied categorically that guns of any kind were kept in her home. The authors conclude that, at least among registered gun owners, respondent answers to questions about gun ownership are generally valid and that survey data of this type can be utilized with confidence.     

State Firearm Laws and Interstate Transfer of Guns in the USA, 2006–2016

In a cross-sectional, panel study, we examined the relationship between state firearm laws and the extent of interstate transfer of guns, as measured by the percentage of crime guns recovered in a state and traced to an in-state source (as opposed to guns recovered in a state and traced to an out-of-state source). We used 2006–2016 data on state firearm laws obtained from a search of selected state statutes and 2006–2016 crime gun trace data from the Bureau of Alcohol, Tobacco, Firearms, and Explosives. We examined the relationship between state firearm laws and interstate transfer of guns using annual data from all 50 states during the period 2006–2016 and employing a two-way fixed effects model. The primary outcome variable was the percentage of crime guns recovered in a state that could be traced to an original point of purchase within that state as opposed to another state. The main exposure variables were eight specific state firearm laws pertaining to dealer licensing, sales restrictions, background checks, registration, prohibitors for firearm purchase, and straw purchase of guns. Four laws were independently associated with a significantly lower percentage of in-state guns: a waiting period for handgun purchase, permits required for firearm purchase, prohibition of firearm possession by people convicted of a violent misdemeanor, and a requirement for relinquishment of firearms when a person becomes disqualified from owning them. States with a higher number of gun laws had a lower percentage of traced guns to in-state dealers, with each increase of one in the total number of laws associated with a decrease of 1.6 percentage points in the proportion of recovered guns that were traced to an in-state as opposed to an out-of-state source. Based on an examination of the movement patterns of guns across states, the overall observed pattern of gun flow was out of states with weak gun laws and into states with strong gun laws. These findings indicate that certain state firearm laws are associated with a lower percentage of recovered crime guns being traced to an in-state source, suggesting reduced access to guns in states with those laws.     

A Preliminary Investigation of Inner City Adolescents'' Perceptions of Guns

Three hundred seventy-seven African-American and 201 white adolescents, primarily of low socioeconomic status, were surveyed on perceptions of guns. Chi-square analyses found significant differences by gender and ethnicity. African-American males were more likely to have a pistol at home (47%); both African-American males and females were more likely to have known someone who took a gun to school (57% and 47%) and to have personally known someone who had been shot (87% and 91%). Differences between African-American and white adolescents and between males and females regarding gun control, gun safety, and consequences of gun use are described.     

'In the safety of your own home': results from a national survey on gun use at home

In the US, guns, particularly handguns, are typically brought into the home for protection. The wisdom of having a firearm in the home, however, is disputed. While guns appear to be a risk factor for family homicide, suicide and unintentional firearm fatality, no evidence has been available about gun use at home to intimidate family members and little about gun use to thwart crimes by intruders, or about the use of other weapons in home self-defense. Over the past decade, various private surveys have asked questions about the respondent's use of guns in self-defense. None, however, has asked detailed questions about the use of guns to threaten or intimidate the respondent. This study presents results from a national random digit dial telephone survey of 1906 US adults conducted in the spring of 1996. Respondents were asked about hostile gun displays and use of guns and other weapons in self-defense at home in the past five years. The objective of the survey was to assess the relative frequency and characteristics of weapons-related events at home. Thirteen respondents reported that a gun was displayed against them at home, two reported using a gun in self-defense at home, and 24 reported using another weapon (e.g. knife, baseball bat) in home self-defense. While we do not always know whose weapon was used in these incidents, most gun brandishings were by male intimates against women. A gun in the home can be used against family members or intruders and can be used not only to kill and wound, but to intimidate and frighten. This small study provides some evidence that guns may be used at least as often by family members to frighten intimates as to thwart crime, and that other weapons are far more commonly used against intruders than are guns.     

Factors associated with assault-related firearm injuries in male adolescents.

PURPOSE: To identify factors associated with an increased prevalence of assault-related firearm injuries in male adolescents. METHODS: This study is a retrospective comparison of two samples of adolescent males from the same geographic localities regarding their involvement in the juvenile justice system (court involvement) and injury status (current or prior firearm injury at the time of the study). The subjects included adolescent male patients admitted to an urban, Level I trauma center for assault-related firearm injuries (court-involved and noncourt- involved, n = 65); and incarcerated juvenile offenders (prior firearm injury and no known firearm injury, n = 267). RESULTS: Two-thirds of the male assault-related pediatric firearm injury victims treated over a two-year period were involved in the juvenile justice system (court involved). Court-involved adolescents were almost 22 times more likely to have sustained an assault-related firearm injury, when compared to noncourt-involved patients with firearm injuries. Additional analysis documented recent substance use and/or involvement in criminal offenses in 82% of the victims. For most of the juvenile offenders (88%), court involvement preceded their injuries. Analysis of the injury patterns revealed an increased prevalence of truncal injuries (injuries to thorax or abdomen) in the court-involved victims, when compared to their noncourt-involved peers (40% and 14% for the court-involved and noncourt-involved samples, respectively; p <.05). Incarceration was associated with a 17-fold increase in the firearm injury prevalence over the court-involved, but not incarcerated, sample. CONCLUSIONS: These results suggest that involvement in substance use and/or the criminal justice system is associated with an increased risk of firearm injuries in male adolescents, and that an increased level of involvement in the juvenile justice system is associated with a concomitant increase in firearm injuries.     

Prevalence of youth access to alcohol, guns, illegal drugs, or cigarettes in the home and association with health-risk behaviors

PURPOSE: To describe the prevalence of access to alcohol, guns, drugs, or cigarettes in the home and its association with related health-risk behaviors among adolescents.METHODS: We analyzed cross-sectional data from the 1995 in-home survey of the National Longitudinal Study on Adolescent Health which used a nationally representative school-based sample (N = 6,504) of adolescents in grades 7-12. We used logistic regression analysis, adjusted for gender, race/ethnicity and age, to examine the associations between access to alcohol, guns, drugs, and cigarettes in the home and the practice of risk behaviors involving those variables.RESULTS: Overall, 1,817 (28%) adolescents reported having easy access to alcohol in the home, 1,616 (25%) had access to a gun, 189 (3%) had access to drugs, and 2,067 (32%) had access to cigarettes. Associations were found between easy home access to alcohol and drinking during the past 12 months (Adj. OR = 2.16, 95% CI = 1.89-2.47), ever being drunk at school (Adj. OR = 2.33, 95% CI = 1.85-2.95, and ever driving drunk (Adj. OR = 1.64, 95% CI = 1.29-2.09). Access to a gun at home was associated with carrying a gun to school (Adj. OR = 2.54, 95% CI = 1.40-4.64). Associations were also found between access to drugs and cigarettes in the home and ever using drugs and smoking regularly.CONCLUSIONS: Easy access to alcohol, guns, and cigarettes in the home is prevalent among adolescents and may increase involvement in risky behaviors. Limiting access therefore is important in order to reduce the occurrence of health-risk behaviors associated with substance use, deliquency and injury among adolescents.     

Improving firearm storage habits: impact of brief office counseling by family physicians

BACKGROUND: Firearm injury is the leading cause of injury-related death among youth and second leading cause of injury-related death overall in the United States. Our objective is to determine the impact of brief office counseling by family physicians on patients' firearm storage habits. METHODS: Of the 1,233 patients who completed the enrollment questionnaire, 156 (13%) reported they had guns in their household and agreed to participate in the study. Postintervention survey instruments were completed by 127 (81%) of participants. Participants received either no counseling, verbal counseling alone, or counseling and a gun safety brochure from their physician. Firearm storage habits were measured at baseline and 60 to 90 days after intervention. RESULTS: At the postintervention interview, 64% of the group receiving verbal counseling and 58% of the group receiving verbal counseling plus written information made a safe change in gun storage compared with 33% of participants in the no-intervention group (P =. 02). A logistic regression model controlling for demographics and gun ownership showed that compared with the no-intervention group, intervention participants were three times more likely to make safe changes. CONCLUSIONS: Family physicians' brief counseling efforts made a significant positive impact in the firearm storage habits of their patients. With a verbal or written recommendation, a significant improvement was observed in firearm storage.     

Physician firearm ownership as a predictor of firearm injury prevention practice

OBJECTIVES: This study explored the relation between physicians' gun ownership and their attitudes and practices regarding firearm injury prevention. METHODS: Internists and surgeons were surveyed, and logistic regression models were developed with physicians' personal involvement with firearms (in the form of a gun score) as the primary independent variable. RESULTS: Higher gun scores were associated with less agreement that firearm injury is a public health issue and that physicians should be involved in firearm injury prevention but with a greater likelihood of reporting the inclusion of firearm ownership and storage as part of patient safety counseling. CONCLUSIONS: Despite being less likely to say that doctors should participate in firearm injury prevention, physician gun owners are more likely than nonowners to report counseling patients about firearm safety.     

Sex information given to Latina adolescents by parents

This study explores Latina adolescents' perceptions of how muchtheir parents told them about sexuality as it relates to sexualbehavior. Two groups of Latina adolescents, one never pregnant(N = 40) and one pregnant or parenting (N = 43), were interviewedby phone about their communication with parents regarding sexuality.Latina adolescents who reported receiving more information fromtheir parents about sexuality were less likely to be pregnant.Other predictors of not being pregnant were having an intactfamily, having an older age at menarche, being younger and havinga more positive attitude toward school. Of five major sexualtopics, Latina adolescents reported receiving the least informationfrom their parents about birth control. Implications for trainingLatino parents to communicate more openly with their childrenabout sexuality are discussed.     

Utility of indices of gun availability in the community

OBJECTIVE: To estimate the degree to which the proportion of homicides and suicides committed with a gun is associated with reported availability of firearms across Chicago neighbourhoods. METHODS: Data were collected as part of the Project on Human Development in Chicago Neighborhoods (PHDCN), a combined neighbourhood and individual level study of the city of Chicago. The study used data from 837 PHDCN participants between the ages of 17 and 22, residing in 170 different neighbourhoods. Gun availability was measured via participant reports on whether they had carried a gun and whether they perceived gun access to be easy in their community. Data on suicides and homicides were obtained from the Chicago Department of Health. RESULTS: A 10% change in the proportion of homicides committed by a gun in a neighbourhood was associated with a 20% increase in both the odds of reported gun access and reported gun carrying (p=0.002 and 0.048, respectively). The proportion of firearm related suicides was not associated with either of those self reported measures. CONCLUSIONS: The proportion of firearm related homicides, but not the proportion of firearm related suicides, is a useful predictor of gun availability across small areas such as neighbourhoods.     

Perceptions of smoking and nonsmoking peers: the value of smoker and nonsmoker prototypes in predicting smoking onset and regular smoking among adolescents.

Adolescents' perceptions of persons their age who smoke cigarettes (also known as prototypes of smoking peers) play a critical role in an adolescent's decision to start smoking. However, adolescents' perceptions of their peers who do not smoke (prototypes of nonsmoking peers) could be implicated in adolescents' smoking decisions as well. In the present study, the authors examined the additional role of nonsmoker prototypes in adolescents' smoking onset and regular smoking. At seven high schools, Dutch students (n = 1,035) between the ages of 12 and 15 years who were attending the eighth grade provided self-reported data on their smoker and nonsmoker prototypes and smoking behavior during a baseline and 6-month follow-up measurement. Logistic regression analyses showed that both smoker and nonsmoker prototypes assessed at Time 1 predicted smoking onset by Time 2 among nonsmoking adolescents. However, only nonsmoker prototypes predicted regular smoking among adolescents who smoked occasionally at baseline.     

Weapons in the lives of battered women

OBJECTIVES: We assessed weapon use in intimate partner violence and perspectives on hypothetical firearm policies. METHODS: We conducted structured in-person interviews with 417 women in 67 battered women's shelters. RESULTS: Words, hands/fists, and feet were the most common weapons used against and by battered women. About one third of the battered women had a firearm in the home. In two thirds of these households, the intimate partner used the gun(s) against the woman, usually threatening to shoot/kill her (71.4%) or to shoot at her (5.1%). Most battered women thought spousal notification/consultation regarding gun purchase would be useful and that a personalized firearm ("smart gun") in the home would make things worse. CONCLUSIONS: A wide range of objects are used as weapons against intimate partners. Firearms, especially handguns, are more common in the homes of battered women than in households in the general population.     

Perceived legitimacy of parental authority and tobacco and alcohol use during early adolescence.

PURPOSE: To assess the likelihood that young adolescents perceive that parents have legitimate authority regarding cigarette smoking and alcohol consumption; to test whether perceived parental authority predicts adolescents' use of tobacco and alcohol, and to test the association between parenting style and the legitimacy of parental authority regarding tobacco and alcohol. METHODS: Survey data were obtained in 1997 from 1220 sixth and eighth grade adolescents enrolled in a central North Carolina school district. The sample comprised 72.3% of 1687 eligible students and 92.3% of 1321 students with parental consent; 83.8% of the sample was European-American and 16.2% African-American. Students completed self-report questionnaires administered in classrooms. Logistic regression models were used to test the study hypotheses. RESULTS: Adolescents were significantly more likely to legitimize parental authority regarding tobacco and alcohol than parental authority regarding conventional or contemporary issues. Failure to legitimize parental authority was associated with significantly greater odds of current smoking (OR = 4.06; p <.000) or drinking (OR = 3.81; p <.000) among all respondents, and significantly greater odds of intending to smoke (OR = 3.38; p <.000) or drink (OR = 3.38; p <.000) among abstinent respondents. Adolescents' perceptions of parental authority regarding tobacco and alcohol varied significantly by parenting style. CONCLUSIONS: The results discredit the myth that adolescents uniformly disregard parental values and rules regarding tobacco and alcohol. The results also showed that general parenting style covaried strongly with adolescents' perceptions of parental authority regarding substance use. Additional research is warranted to test for causal relations between general parenting style, adolescents' perceptions of parental authority regarding substance use, and adolescents' risk of substance use.     

Firearm ownership and health care workers.

OBJECTIVE. Health professionals have increasingly become aware of the public health hazards caused by firearms. This study was designed to determine the firearm ownership and storage practices of a group of health care workers. METHODS. All 6436 nonphysician employees of a large health maintenance organization were surveyed as part of an ongoing effort to enhance the organization''s effectiveness. Two questions regarding firearm ownership and storage practices were included in the 85-question survey instrument. A total of 4999 surveys were returned, for a response rate of 78%. RESULTS. Forty-two percent of the health workers surveyed reported keeping a firearm in their home, and 35% of firearm owners stored that firearm loaded. Men were more likely than women to report having a firearm in the home. Firearm ownership and storage of a loaded firearm decreased with higher levels of education in both sexes. A measure of increased alcohol consumption was related to higher rates of firearm ownership and storage of loaded firearms in men. CONCLUSIONS. A substantial number of health care workers had firearms in their homes and did not store them safely. Counseling regarding the risks associated with easy access to firearms should be considered for inclusion in employee health programs as well as in employee assistance and alcohol treatment programs.     

Body weight perception among Bahraini adolescents

BACKGROUND: This study examines the relationship between actual weight status and perceptions of body weight in Bahraini adolescents. The study also investigates the adolescents' perceptions of parents' and peers' opinions of weight. METHODS: A cross-sectional survey of 447 Bahraini male and female adolescents aged 12-17 years was conducted. Weight and height were measured and body mass index (BMI) was calculated. A short questionnaire was used to obtain their attitudes towards their weight status, as well as the attitudes of their parents and friends. The nine figure silhouettes illustration was used to measure perception of ideal body image and how it compares with their current body weight. RESULTS: The results revealed a significant discrepancy between adolescents' perception of body weight and actual BMI. There was a tendency for teenagers to underestimate their weight status, which was especially noteworthy among the overweight and obese. More than half of the girls and about one-third of the boys expressed discontent with their current body weight. One-third (33.5%) and 26.6% of the adolescents thought that their parents and their peers, respectively, would consider them to be overweight or obese. The percentage of adolescents who reported parental or peer underestimation was higher among those classified as overweight or obese than it was among those who were of normal weight. CONCLUSION: The study shows the existence of a distorted body image as reflected by failure of many overweight or obese adolescents to perceive themselves as such. Among Bahraini adolescents weight-related beliefs and attitudes exist at two ends of the spectrum: a tolerance of obesity at one end and an exaggerated concern for its occurrence at the other.     

Pregnant African-American teens are less likely than their nonpregnant peers to use condoms

OBJECTIVE: The aim of this study was to prospectively compare pregnant and nonpregnant adolescents' recent condom use and sexually transmitted disease (STD) acquisition. METHODS: Sexually active African-American females (N = 522), ages 14-18, were recruited from clinics and schools. Adolescents completed baseline interviews and provided vaginal swabs for STD testing, and urine for pregnancy testing. Assessments were repeated 6 and 12 months post baseline assessment. Analyses compared adolescents who became pregnant between baseline and the 6-month assessment with their peers who had negative pregnancy tests. Condom use between the 6- and 12-month assessments and incidence of STDs at the 12-month assessment served as outcomes. Adolescents who did not report sexual activity between the 6- and 12-month assessments were excluded. RESULTS: Ten percent of the adolescents became pregnant and continued sexual activity. Pregnant adolescents reported less overall condom use (P < 0.0001), more infrequent condom use (adjusted odds ratio [AOR] = 4.5, P < 0.001), and more unprotected vaginal sex (AOR = 4.7, P < 0.003). Pregnant adolescents were equally likely to test positive for STDs (31% vs 26%) and to self-report having STDs at the 12-month follow-up period (30% vs 23%). CONCLUSIONS: Findings suggest that pregnant adolescents may be less likely to use condoms than their nonpregnant peers and that STD incidence among pregnant adolescents may be high. Condom use promotion may be important during adolescents' prenatal care.