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Handgun ownership is ‘a substantial and enduring risk’ for suicide, study finds

In the study, the suicide rate among people who owned handguns was almost four times higher than among who didn’t own a gun.

REUTERS/Joshua Lott
More than 24,000 people committed suicide with a gun in 2018. Handguns were involved in approximately three-quarters of those suicides.
Buying a handgun dramatically increases the purchaser’s risk of suicide, according to a study published Thursday in the New England Journal of Medicine (NEJM).

The risk is greatest during the first few weeks of owning a handgun, but it remains elevated for years, the study also found.

“Our findings confirm what virtually every study that has investigated this question over the last 30 years has concluded: Ready access to a gun is a major risk factor for suicide,” says David Studdert, the study’s lead author and a professor of health law at Stanford University, in a released statement.

This study goes beyond most other studies on this topic, however. Instead of looking (as most previous studies have done) at the risk at the population level — for example, by comparing state-level gun ownership and suicide rates — the current study examines the risk at the individual level. It does this by following a large group of people from the time they bought a handgun to up to 12 years later.

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As the study’s authors point out, gun ownership is more prevalent in the United States than in any other country. The U.S. also has one of the highest rates of firearm suicides. More than 24,000 people committed suicide with a gun in 2018. Handguns were involved in approximately three-quarters of those suicides.

“Suicide attempts are often impulsive acts, driven by transient life crises,” the authors write. “Most attempts are not fatal, or do not go on to die in a future suicide. Whether a suicide attempt is fatal depends heavily on the lethality of the method used, and firearms are extremely lethal.”

Study details

For the study, Studder and his colleagues tracked a cohort of 26.3 million California adults from October 2004 through December 2016. Using California state data on handgun purchases and transfers, the researchers determined that 676,425 of those adults (less than 3 percent) had acquired one or more handguns during the study period. These were mostly first-time gun purchases.

State mortality data showed that 1.4 million of the people in the cohort died during the 14 years of the study. Nearly 18,000 of them died by suicide, and 6,691 of those suicides involved a firearm.

The researchers then compared the suicide rate of the people who owned a handgun with those who didn’t. They found a striking difference. The rate among people who owned handguns was almost four times higher than among who didn’t own a gun.

“This risk was driven by a much higher rate of suicide by firearm — not by higher rates of suicide by other methods,” the researchers point out.

Men who bought handguns were eight times more likely than men who didn’t to die of a self-inflicted gunshot wound, while women who bought handguns were 35 times more likely to kill themselves with a handgun than women who didn’t own such a weapon.

Women accounted for only 16 percent of all suicides by firearms in the study. So what accounts for the stark difference in risk?

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“Handgun ownership may impose a particularly high relative risk of suicide for women because of the pairing of their higher propensity to attempt [suicide] with ready access to and familiarity with an extremely lethal method,” the researchers write.

The risk of suicide by firearm peaked during the 30 days immediately following the purchase of the gun, but it remained relatively high 12 years later. This finding suggests, say the researchers, that although some people buy a gun with the specific purpose of harming themselves, having a gun in the house raises the risk of suicide for gun owners in general.

“New handgun buyers had extremely high risks of dying by firearm suicide immediately after the purchase,” says Dr. Matthew Miller, the study’s senior author and a professor of health sciences and epidemiology at Northwestern University, in a released statement. “However, more than half of all firearm suicides in this group occurred a year or more later. Consistent with prior work, our findings indicate that gun access poses a substantial and enduring risk.”

Limitations and implications

This is an observational study, so it can’t prove a direct relationship between gun ownership and suicide. In addition, the researchers were unable to adjust the data for mental illness, although they point out that research has shown that gun owners have similar rates of depression and thoughts of suicide as non-gun owners.

Still, this is a large and well-designed study. And, as its authors point out, the study’s results may actually underestimate the association between handgun ownership and suicide. That’s because California has stricter guns laws than many other states, including ones that impose a waiting period and that prohibit the purchasing of firearms by people with severe mental illness.

“Fifty-nine people were killed in the mass shooting in Las Vegas in 2017, the deadliest in U.S. history,” the researchers write. “Approximately the same number die each day in the United States from suicide by firearm. Many of these deaths are preventable.”

“Our study bolsters and extends the message from previous research: ready access to firearms, particularly handguns, is a major risk factor for suicide. Health care providers and policymakers should be aware of this risk. This information is also important for current and prospective firearm owners seeking to weigh the risks and perceived benefits of ownership.”

FMI: You’ll find the study on the NEJM website.

If you or anyone you know are having thoughts about suicide, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).