Household firearm storage practices: Do responses differ by whether or not individuals ever use firearms?

INTRODUCTION: The prevalence with which firearms are stored loaded or unlocked has been measured in previous surveys. Our purpose was to compare household firearm storage practices reported by firearm users and nonusers. METHODS: We analyzed telephone survey data from the 1992 and 1993 Oregon Behavioral Risk Factor Surveillance System on 2454 randomly selected adults in households with firearms. We compared reported firearm storage practices among persons who ever used firearms with persons who had never used firearms by demographics and type of firearm. RESULTS: Nonusers of firearms were much less likely than firearm users to report that household firearms were always or sometimes stored loaded [odds ratio (OR) = 0.45, 95% confidence interval (CI):0.36-0.54] or stored loaded and unlocked (OR = 0.46, 95% CI: 0.36-0.57). Except for persons aged 18 to 34 years and persons in handgun-only households, differences in reported firearm storage practices between nonusers and users varied little by demographic characteristics or by type of firearm. Nonusers of household firearms may be unaware that firearms are stored loaded or stored loaded and unlocked in their homes. CONCLUSIONS: Surveys that do not consider firearm use status may underestimate household exposure to loaded firearms or to loaded and unlocked firearms.     

Firearm storage patterns in US homes with children

OBJECTIVES: This study determined the prevalence and storage patterns of firearms in US homes with children. METHODS: We analyzed data from the 1994 National Health Interview Survey and Year 2000 objectives supplement. A multistage sample design was used to represent the civilian noninstitutionalized US population. RESULTS: Respondents from 35% of the homes with children younger than 18 years (representing more than 22 million children in more than 11 million homes) reported having at least 1 firearm. Among homes with children and firearms, 43% had at least 1 unlocked firearm (i.e., not in a locked place and not locked with a trigger lock or other locking mechanism). Overall, 9% kept firearms unlocked and loaded, and 4% kept them unlocked, unloaded, and stored with ammunition; thus, a total of 13% of the homes with children and firearms--1.4 million homes with 2.6 million children--stored firearms in a manner most accessible to children. In contrast, 39% of these families kept firearms locked, unloaded, and separate from ammunition. CONCLUSIONS: Many children live in homes with firearms that are stored in an accessible manner. Efforts to prevent children's access to firearms are needed.     

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.     

Firearm ownership and storage practices, U.S. households, 1992-2002. A systematic review

BACKGROUND: Because the presence and improper storage of household firearms are risk factors for injury, it is important to understand the prevalence of ownership and storage practices within households to help guide intervention development. This systematic review of published articles (1992 to 2002) provides prevalence estimates of firearm ownership and storage practices in U.S. households. METHODS: A search of bibliographic databases (MedLine, CINAHL, PsycInfo, Sociological Abstracts) was completed in January 2003. RESULTS: Although all were cross-sectional, the 42 articles included in this review varied in type; there were seven national and five state prevalence studies, as well as studies using clinic-based convenience samples (n =14) and samples of professionals (n =10). Published studies indicate that firearms are present in about one third of U.S. households. Handguns in particular are present in more than half of U.S. households with firearms, or about 19% of all U.S. households. The prevalence of firearms and handguns in households with young people was similar to the prevalence overall. Firearm ownership was highest in the South. CONCLUSIONS: Although the methodologic rigor of published articles varies substantially, the literature clearly establishes that firearms are common in U.S. households, even in the homes of medical professionals and those with children.     

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.     

Storage of household firearms: an examination of the attitudes and beliefs of married women with children

Although safe firearm storage is a promising injury prevention strategy, many parents do not keep their firearms unloaded and locked up. Using the theory of planned behavior as a guiding conceptual framework, this study examines factors associated with safe storage among married women with children and who have firearms in their homes. Data come from a national telephone survey (n=185). We examined beliefs about defensive firearm use, subjective norms, perceived behavioral control and firearm storage practices. A Wilcoxon-Mann-Whitney test was conducted to assess associations between psychosocial factors and firearm storage practices. Women were highly motivated to keep firearms stored safely. Those reporting safe storage practices had more favorable attitudes, more supportive subjective norms and higher perceptions of behavioral control than those without safe storage. One-fourth believed a firearm would prevent a family member from being hurt in case of a break-in, 58% believed a firearm could scare off a burglar. Some 63% said they leave decisions about firearm storage to their husbands. Women were highly motivated to store firearms safely as evidenced by favorable attitudes, supportive subjective norms and high perceptions of behavioral control. This was especially true for those reporting safer storage practices.     

Children and firearms in Turkish homes

Background Unintentional firearm injuries are an important cause of preventable deaths and disabilities among children. Keeping firearms at home and letting children to see or touch them increases the risk of injury. Methods This cross‐sectional study was conducted to estimate the extent of the firearm problem in an Anatolian province in Turkey. A random sample of families were approached and were asked to answer a series of questions completed by research assistants. Results In 974 randomly selected households, there were 2129 children aged less than 18 years, 11.1% of the fathers have a job in the firearms industry or in the security sector, and 12.3% of the households kept a firearm at home. Only 25.6% of the firearms were kept in a safe place, and 29.3% of the firearms and ammunition were kept separately. Overall, 70.9% of the children whose parents have firearms saw the firearm and 27.2% had handled it. Conclusions Results of this study pointed to the urgent need for preventive measures for the physical separation of guns from children. The establishment of effective firearms safety programmes requires an understanding of the culture and routine behaviours of the target population.     

Safer storage of firearms at home and risk of suicide: a study of protective factors in a nationally representative sample

OBJECTIVE: To estimate the protective effect of storing firearms locked or unloaded, or both, on the risk of suicide by firearms among people with relatively low intention to die. DESIGN AND SETTING: Cross sectional survey. The 1993 National Mortality Followback Survey of 22 957 deaths in the United States, representing 2.2 million people, conducted by the National Center for Health Statistics. PARTICIPANTS: Decedent's next of kin answered questions regarding various aspects of decedent's life to supplement information from death certificates. MAIN RESULTS: Compared with decedents who stored their firearm unlocked or loaded, those who stored their firearms locked or unloaded, or both, were less likely to commit suicide by firearms (locked: OR = 0.39, 95% CI = 0.24 to 0.66; unloaded OR = 0.30, 95% CI = 0.18 to 0.49). CONCLUSIONS: This study further supports the utility of devices and practices intended to reduce the likelihood of unauthorised or impulsive use of firearms.     

State Firearm Laws,Firearm Ownership,and Safety Practices Among Families of Preschool-Aged Children

Objectives. We investigated how state-level firearms legislation is associated with firearm ownership and storage among families with preschool-aged children.Methods. Using 2005 nationally representative data from the Early Childhood Longitudinal Study-Birth Cohort (n = 8100), we conducted multinomial regression models to examine the associations between state-level firearms legislation generally, child access prevention (CAP) firearms legislation specifically, and parental firearm ownership and storage safety practices.Results. Overall, 8% of families with children aged 4 years living in states with stronger firearm laws and CAP laws owned firearms compared with 24% of families in states with weaker firearm laws and no CAP laws. Storage behaviors of firearm owners differed minimally across legislative contexts. When we controlled for family- and state-level characteristics, we found that firearm legislation and CAP laws interacted to predict ownership and storage behaviors, with unsafe storage least likely among families in states with both CAP laws and stronger firearm legislation.Conclusions. Broader firearm legislation is linked with the efficacy of child-specific legislation in promoting responsible firearm ownership.Family firearm safety practices are a major public health concern, with firearm-related deaths being one of the leading causes of injury-related fatalities among young children.1 Recent media attention on accidental shootings involving young children has heightened public and policy debate over the role of government in restricting access to firearms and the effectiveness of firearm laws.2,3 Some states have implemented laws—often referred to generally as child access prevention (CAP) laws—that legislate safe firearm storage practices among families with children and make adults criminally liable for children’s unsupervised use of firearms. Studies examining the effects of CAP laws, however, report mixed findings, suggesting that they have a greater effect on child morbidity and mortality when instituted in states with higher levels of pediatric firearm incidents and when the penalties associated with firearm usage are more stringent.4–8 One explanation for the lack of consistent findings is that most studies have not directly measured the behavior CAP laws intend to regulate. That is, little is known about how these access laws are associated with factors beyond mortality and morbidity, such as firearm storage behaviors. We addressed this gap by empirically testing the relationship between CAP laws and firearm storage behaviors in a nationally representative sample.Currently, limitations of this literature constrain the ability to draw strong conclusions about the effects of state-level policies on firearm ownership and storage practices.4,9 For example, because person-level data on firearm-related behavior is scarce, many studies that rely on macrolevel statistics (e.g., state firearm ownership, firearm-related mortality) run the risk of creating ecological fallacies, whereby associations at the aggregate level are erroneously extrapolated to the individual level.10 Similarly, aggregate-level data do not allow the examination of the specific populations that the policies address and, hence, may not be sufficiently sensitive to directly test these policies’ effects. A lack of data that can be used to compare ownership and specific aspects of that ownership, such as safety practices, also makes it difficult to determine if stronger laws generally affect firearm ownership or laws directed at specific unsafe behaviors work. Furthermore, the potential for state policies to be a product of the selectivity of the residents of the state complicates disentangling the effects of state-level firearm laws.11 Lawmakers in states with a high proportion of firearm owners may be more reluctant to pass laws that regulate firearm practices; consequently, observed correlations between laws and state-level firearm ownership may reflect state population characteristics or state “gun culture” to a greater extent than states’ firearm policy (or lack thereof).In line with the American Academy of Pediatrics’ recommendation that parents who own firearms store them locked and unloaded, with ammunition locked and stored separately,12 we examined how laws aimed at firearm storage practices—along with general state-level firearm laws—are associated with firearm ownership and storage behaviors among families with preschool-aged children. Previous research has suggested a theoretical framework emphasizing the importance of both situational and individual characteristics in understanding patterns of firearm ownership.13 For example, studies link higher socioeconomic status, being White, and having a man in the house with higher levels of firearm ownership.14,15 We anticipated that (1) families in states with stronger general and child-specific firearm legislation would have the lowest rates of firearm ownership and the highest rates of safe firearm storage, (2) families in states with weaker firearm legislation would report the highest levels of ownership and the lowest levels of storage safety, and (3) families in states with a relatively strong set of laws in one domain but not in the other would fall between these 2 groups, with higher levels of ownership and safer storage practices in states with CAP laws but weaker general laws than in states with the opposite combination of laws.     

Adolescents and firearms: a California statewide survey

OBJECTIVES: We assessed the prevalence and correlates of adolescents' reports regarding firearms in their homes, of their own, of close friends, and of same-aged peers. METHODS: Random-digit-dialed interviews were conducted with 5801 adolescents as part of the California Health Interview Survey. RESULTS: One fifth (19.6%) of California adolescents reported having a firearm in their homes; few (3.0%) reported having their own gun. Characteristics associated with having one's own gun and with perceptions regarding others' guns generally were consistent with characteristics associated with having a firearm in the home. The 2 exceptions were related to socioeconomic status and to ethnicity. CONCLUSIONS: The source from which adolescents obtain guns, especially adolescents from less wealthy households, merits further investigation. Further research is needed to ascertain the accuracy of Black and Latino adolescents' perceptions regarding handguns among their peers.     

Changing times: a longitudinal analysis of international firearm suicide data

We investigated changes in the proportion of firearm suicides in Western countries since the 1980s and the relation of these changes to the change in the proportion of households owning firearms. Several countries had an obvious decline in firearm suicides: Norway, United Kingdom, Canada, Australia, and New Zealand. Multilevel modeling of longitudinal data confirmed the effect of the proportion of households owning firearms. Legislation and regulatory measures reducing the availability of firearms in private households can distinctly strengthen the prevention of firearm suicides.     

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.     

Factors associated with smoke-free homes in NSW: results from the 1998 NSW Health Survey

Objective : To examine the socio‐demographic characteristics associated with smoke‐free homes (SFHs) in NSW and specify high‐risk groups with a low prevalence of household smoking restrictions. Methods : Data were drawn from the 1998 NSW Health Survey, a computer‐assisted telephone interview survey of 17,494 randomly selected respondents aged 16 years across NSW (response rate =70%). Logistic regression analyses, stratified by smoking status, were used. Results : Overall, 72% of adults reported having a SFH; 87% of never‐smokers, 81% of ex‐and 35% of current smokers. The highest percentages of SFHs were reported in households with young children (78%) and with older children (72%) or with adults only (72%). For smokers, SFHs were independently associated with the presence of young children (OR=3.8, 95% Cl 3.1–4.7) compared with those who lived alone, but the odds of living in a SFH were only slightly increased for smokers living with older children (aged 6–15) and for those living with adults only (OR=1.9, OR=1.8 respectively). Speaking a language other than English at home, having more than 10 years' education, and being <35 years old were independently and positively associated with SFH. Being employed in smoke‐free workplaces increased the likelihood of SFHs for both current and past smokers (OR=1.6, OR=1.2 respectively). Conclusion : Most NSW homes have restrictions on smoking inside, but more than half the households with children and at least one smoker adult are not smoke free. Implications : Interventions to shape parents' smoking behaviour around older children are warranted. Strategies need to address never‐smokers in communities with high prevalence of smoking and adults with lower levels of education. A continued commitment to workplace smoking bans is important as they may affect household smoking restrictions.     

The choice of weapons in firearm suicides.

We report on the firearms used in 235 suicides in Sacramento County, California, during 1983-85. Handguns were used in 69 per cent of firearm suicides--65 per cent for males, 88 per cent for females--and in all such deaths among women ages 35 and older. We tested the hypothesis that the choice of firearms by persons committing suicide at home would passively reflect the reported prevalence of firearms by type in households in the region. Handguns were used more frequently (rate ratio 2.00; 95% CI = 1.68, 2.39), and rifles and shotguns less frequently than expected.     

State estimates of household exposure to firearms, loaded firearms, and handguns, 1991 through 1995.

OBJECTIVES: Variations among states in household exposure to firearms, loaded firearms, and handguns were examined. METHODS: Data from the Behavioral Risk Factor Surveillance System in 22 states were used to estimate the prevalence of adults and children exposed to household firearms. RESULTS: The prevalence of adults living in households with firearms ranged from 12% to 57%; the corresponding ranges were 1% to 23% for loaded firearms and 5% to 36% for handguns. The prevalence of children less than 18 years of age living in households with loaded firearms ranged from 2% to 12%. CONCLUSIONS: Important variations among states exist in the prevalence of adults and children living in households with firearms, loaded firearms, and handguns.     

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.     

Firearms and youth suicide.

The firearm suicide rate for persons aged 10 to 24 has increased from 2.3 per 100,000 in 1933 to 5.5 per 100,000 in 1982. Over the same period, the suicide rate for this age group by all methods other than firearms has only risen from 2.5 to 3.3. The most dramatic rise in the firearm suicide rate has occurred primarily since 1970, notably among males aged 15 to 24. During the 1960s and 1970s there was a substantial increase in the number of civilian firearms in the United States.     

South Carolina's suicide mortality in the 1970s.

In an epidemiologic study of suicide mortality among South Carolina residents for the years 1970--78, death certificates for 2,763 persons were reviewed. The overall suicide rates were lower than those observed in the same period for the United States. As expected, the highest rates were among white males; females and nonwhite males had rates with intermediate values, and nonwhite females, the lowest rates. Rates for white males increased up to age 75. All other race-sex groups peaked at much younger ages. An increase in suicide rates over time appeared in those under 25 years, and a slight decline was observed in residents aged 50--74. Age-race-sex-adjusted rates proved relatively stable over the 9 years. Geographically, race-adjusted rates by county varied from calculated expected values, with some suggestion of a pattern for the counties with the highest rates. However, no urban-rural differences were seen. Examination of methods used to commit suicide reveals that firearms were the most common means in all race-sex groups, accounting for 78.7 percent of deaths. The percentage of firearm users was almost identical among white males and white females, differing markedly from the country as a whole. Females of both race groups were more likely to have used poisons than males, but the percentage of those who used poisons was much less than would be expected from national data. This study confirms previous findings of sex and race differentials, rate changes with age, increasing rates in young people, and lower overall rates in the Southeast compared with the entire country. Interpretation of race-sex specific rates, together with suicide methods, lends support to the assertion that suicide rates are independent of methods. Rate trends by age groups over time are believed to have important implications.     

Source of firearms used by students in school-associated violent deaths--United States, 1992-1999

During July 1, 1992-June 30, 1999, a total of 323 school-associated violent death events occurred in the United States, resulting in 358 deaths. To guide prevention efforts, CDC examined school-associated firearm violent death events committed by students in elementary and secondary schools in the United States and determined the sources of the firearms used in these events. The findings indicate that, among the incidents for which data are available, the majority of the firearms used in these events were obtained from perpetrators' homes or from friends or relatives. The safe storage of firearms is critically important and should be continued. In addition, other strategies that might prevent firearm-related injuries and deaths among students, such as safety and design changes for firearms, should be evaluated.     

An examination of interventions to reduce respiratory health and injury hazards in homes of low-income families

We evaluated whether combining asthma trigger reduction with housing structural repairs, device disbursement and education in low-income households with children would improve self-reported respiratory health and reduce housing-related respiratory health and injury hazards (convenience sample of n=67 homes with 63 asthmatic and 121 non-asthmatic children). At baseline, a visual assessment of the home environment and a structured occupant interview were used to examine 29 potential injury hazards and 7 potential respiratory health hazards. A home-specific intervention was designed to provide the children's parents or caretakers with the knowledge, skills, motivation, supplies, equipment, and minimum housing conditions necessary for a healthy and safe home. The enrolled households were primarily Hispanic and owned their homes. On average, 8 injury hazards were observed in the homes at baseline. Four months following intervention, the average declined to 2.2 hazards per home (p<0.001), with 97% of the parents reporting that their homes were safer following the interventions. An average of 3.3 respiratory health hazards were observed in the homes at baseline. Four months following intervention, the average declined to 0.9 hazards per home (p<0.001), with 96% of parents reporting that the respiratory health of their asthmatic children improved. A tailored healthy homes improvement package significantly improves self-reported respiratory health and safety, reduces respiratory health and injury hazards, and can be implemented in concert with a mobile clinical setting.