Firearm ownership and access to healthcare in the U.S.: A cross-sectional analysis of six states

Paladhi, Unmesha Roy; Dalve, Kimberly; Gurrey, Sixtine Olivia; Hawes, Stephen E.; Mills, Brianna

doi:10.1016/j.ypmed.2021.106830

Cited by 3 publications

(1 citation statement)

References 28 publications

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“…More compelling evidence of validity comes from several recent state-specific BRFSS surveys that were not included in our analyses. Our HFR estimates are generally within a few percentage points of the published estimates for the 7 states that collected this more recent firearm data (eAppendix 3 in Supplement 1).…”

Section: Discussionsupporting

confidence: 69%

Geographic and Demographic Differences in the Proportion of Individuals Living in Households With a Firearm, 1990-2018

Morral,

Smart,

Schell

et al. 2024

JAMA Netw Open

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ImportanceMeasures of the proportion of individuals living in households with a firearm (HFR), over time, across states, and by demographic groups are needed to evaluate disparities in firearm violence and the effects of firearm policies.ObjectiveTo estimate HFR across states, years, and demographic groups in the US.Design, Setting, and ParticipantsIn this survey study, substate HFR totals from 1990 to 2018 were estimated using bayesian multilevel regression with poststratification to analyze survey data on HFR from the Behavioral Risk Factor Surveillance System and the General Social Survey. HFR was estimated for 16 substate demographic groups defined by gender, race, marital status, and urbanicity in each state and year.ExposuresSurvey responses indicating household firearm ownership were analyzed and compared with a common proxy for firearm ownership, the fraction of suicides completed with a firearm (FSS).Main Outcome and MeasureHFR, FSS, and their correlations and differences.ResultsAmong US adults in 2018, HFR was significantly higher among married, nonurban, non-Hispanic White and American Indian male individuals (65.0%; 95% credible interval [CI], 61.5%-68.7%) compared with their unmarried, urban, female counterparts from other racial and ethnic groups (7.3%; 95% CIs, 6.0%-9.2%). Marginal HFR rates for larger demographic groups also revealed important differences, with racial minority groups and urban dwellers having less than half the HFR of either White and American Indian (39.5%; 95% CI, 37.4%-42.9% vs 17.2%; 95% CI, 15.5%-19.9%) or nonurban populations (46.0%; 95% CI, 43.8%-49.5% vs 23.1%; 95% CI, 21.3%-26.2%). Population growth among groups less likely to own firearms, rather than changes in ownership within demographic groups, explains 30% of the 7 percentage point decline in HFR nationally from 1990 to 2018. Comparing HFR estimates with FSS revealed the expected high overall correlation across states (r = 0.84), but scaled FSS differed from HFR by as many as 20 percentage points for some states and demographic groups.Conclusions and RelevanceThis survey study of HFR providing detailed, publicly available HFR estimates highlights key disparities among individuals in households with firearms across states and demographic groups; it also identifies potential biases in the use of FSS as a proxy for firearm ownership rates. These findings are essential for researchers, policymakers, and public health experts looking to address geographic and demographic disparities in firearm violence.

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Section: Discussionsupporting

confidence: 69%