Association of Increased Safe Household Firearm Storage With Firearm Suicide and Unintentional Death Among US Youths

Abstract

Importance: Firearm injury is the second leading cause of death in the United States for children and young adults. The risk of unintentional and self-inflicted firearm injury is lower when all household firearms are stored locked.

Objective: To estimate the reduction in youth firearm suicide and unintentional firearm mortality that would result if more adults in households with youth stored household guns locked.

Design, setting, and participants: A modeling study using Monte Carlo simulation of youth firearm suicide and unintentional firearm mortality in 2015. A simulated US national sample of firearm-owning households where youth reside was derived using nationally representative rates of firearm ownership and storage and population data from the US Census to test a hypothetical intervention, safe storage of firearms in the home, on youth accidental death and suicide. Data analyses were performed from August 3, 2017, to January 9, 2018.

Exposures: Observed and counterfactual household-level safe firearm storage (ie, storing all firearms locked), the latter estimated by varying the probability that a hypothetical intervention increased safe firearm storage beyond that observed in 2015.

Main outcomes and measures: Observed and counterfactual counts of firearm suicide and unintentional firearm mortality among youth aged 0 to 19 years, the latter estimated by incorporating an empirically based estimate of the mortality benefit expected from additional safe storage (beyond that observed in 2015).

Results: A hypothetical intervention among firearm owners residing with children with a 20% probability of motivating these owners to lock all household firearms was significantly associated with a projected reduction in youth firearm mortality (median incidence rate ratio = 0.90; interquartile range, 0.87-0.93). In the overall model, 6% to 32% of deaths were estimated to be preventable depending on the probability of motivating safer storage.

Conclusions and relevance: Results of this modeling study suggest that a relatively modest uptake of a straightforward safe storage recommendation-lock all household firearms-could result in meaningful reductions in firearm suicide and unintentional firearm fatalities among youth. Approaches that will motivate additional parents to store firearms safely are needed.

Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure.. Estimate of Median Deaths Prevented, Stratified by Probability of Augmented Locked Storage and Effectively Preventive Probability

Median estimate across 1000 simulation repetitions of youth unintentional and suicide firearm deaths prevented in 2015, stratified by probability of augmented locked firearm storage (over empirical baseline) and effectively preventive probability (ie, probability that safe storage would prevent a death that would otherwise have occurred); values are the point estimate (0.64) and the upper and lower bounds of the 95% and 99% CIs.