State Firearm Laws and Interstate Firearm Deaths From Homicide and Suicide in the United States,JAMA Internal Medicine

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State Firearm Laws and Interstate Firearm Deaths From Homicide and Suicide in the United States
JAMA Internal Medicine ( IF 22.5 ) Pub Date : 2018-05-01 , DOI: 10.1001/jamainternmed.2018.0190
Elinore J. Kaufman ₁ , Christopher N. Morrison ₂ , Charles C. Branas ₃ , Douglas J. Wiebe ₂

Affiliation

Importance Firearm laws in one state may be associated with increased firearm death rates from homicide and suicide in neighboring states. Objective To determine whether counties located closer to states with lenient firearm policies have higher firearm death rates. Design, Setting, and Participants This cross-sectional study of firearm death rates by county for January 2010 to December 2014 examined data from the US Centers for Disease Control and Prevention for firearm suicide and homicide decedents for 3108 counties in the 48 contiguous states of the United States. Exposures Each county was assigned 2 scores, a state policy score (range, 0-12) based on the strength of its state firearm laws, and an interstate policy score (range, −1.33 to 8.31) based on the sum of population-weighted and distance-decayed policy scores for all other states. Counties were divided into those with low, medium, and high home state and interstate policy scores. Main Outcomes and Measures County-level rates of firearm, nonfirearm, and total homicide and suicide. With multilevel Bayesian spatial Poisson models, we generated incidence rate ratios (IRR) comparing incidence rates between each group of counties and the reference group, counties with high home state and high interstate policy scores. Results Stronger firearm laws in a state were associated with lower firearm suicide rates and lower overall suicide rates regardless of the strength of the other states’ laws. Counties with low state scores had the highest rates of firearm suicide. Rates were similar across levels of interstate policy score (low: IRR, 1.34; 95% credible interval [CI], 1.11-1.65; medium: IRR, 1.36, (95% CI, 1.15-1.65; and high: IRR, 1.43; 95% CI, 1.20-1.73). Counties with low state and low or medium interstate policy scores had the highest rates of firearm homicide. Counties with low home state and interstate scores had higher firearm homicide rates (IRR, 1.38; 95% CI, 1.02-1.88) and overall homicide rates (IRR, 1.32; 95% CI, 1.03-1.67). Counties in states with low firearm policy scores had lower rates of firearm homicide only if the interstate firearm policy score was high. Conclusions and Relevance Strong state firearm policies were associated with lower suicide rates regardless of other states’ laws. Strong policies were associated with lower homicide rates, and strong interstate policies were also associated with lower homicide rates, where home state policies were permissive. Strengthening state firearm policies may prevent firearm suicide and homicide, with benefits that may extend beyond state lines.

中文翻译：

美国各州枪支法和州际枪支死亡因凶杀和自杀

重要性一州的枪支法可能与邻州因凶杀和自杀导致的枪支死亡率增加有关。目的确定靠近枪支政策宽松的州的县是否拥有更高的枪支死亡率。设计、设置和参与者这项关于 2010 年 1 月至 2014 年 12 月按县划分的枪支死亡率的横断面研究检查了美国疾病控制与预防中心提供的美国 48 个相邻州 3108 个县的枪支自杀和凶杀死者数据美国。暴露每个县都被分配了 2 个分数，一个基于其州枪支法律强度的州政策得分（范围，0-12），以及一个基于人口加权总和的州际政策得分（范围，-1.33 到 8.31）。以及所有其他州的距离衰减政策分数。县被分为低、中、高本州和州际政策得分的县。主要结果和措施县级枪支、非枪支、杀人和自杀总数。使用多级贝叶斯空间泊松模型，我们生成了发生率比率 (IRR)，比较了每组县与参考组、具有高本州和高州际政策分数的县之间的发生率。结果一个州更严格的枪支法律与更低的枪支自杀率和更低的总体自杀率相关，而不管其他州的法律如何。州得分低的县的枪支自杀率最高。跨州政策评分水平的比率相似（低：IRR，1.34；95% 可信区间 [CI]，1.11-1.65；中：IRR，1.36，（95% CI，1.15-1.65；高：IRR，1.43; 95% 置信区间，1.20-1.73）。州际政策得分低、州际政策得分低或中等的县的枪支凶杀率最高。本州和州际评分较低的县的枪支凶杀率（IRR，1.38；95% CI，1.02-1.88）和总体凶杀率（IRR，1.32；95% CI，1.03-1.67）较高。只有在州际枪支政策得分较高的情况下，枪支政策得分较低的州县的枪支凶杀率较低。结论和相关性无论其他州的法律如何，强有力的州枪支政策都与较低的自杀率相关。强有力的政策与较低的凶杀率相关，而强有力的州际政策也与较低的凶杀率相关，因为本州的政策是宽松的。加强国家枪支政策可以防止枪支自杀和杀人，

更新日期：2018-05-01

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