Handgun Ownership and Suicide in California.

Adult Aged Aged, 80 and over California / epidemiology Cause of Death Female Firearms Gun Violence / statistics & numerical data Humans Male Middle Aged Ownership Risk Factors Suicide / statistics & numerical data Survival Analysis Young Adult Suicide Prevention

Journal

The New England journal of medicine
ISSN: 1533-4406
Titre abrégé: N Engl J Med
Pays: United States
ID NLM: 0255562

Informations de publication

Date de publication:
04 06 2020
Historique:
entrez: 4 6 2020
pubmed: 4 6 2020
medline: 12 6 2020
Statut: ppublish

Résumé

Research has consistently identified firearm availability as a risk factor for suicide. However, existing studies are relatively small in scale, estimates vary widely, and no study appears to have tracked risks from commencement of firearm ownership. We identified handgun acquisitions and deaths in a cohort of 26.3 million male and female residents of California, 21 years old or older, who had not previously acquired handguns. Cohort members were followed for up to 12 years 2 months (from October 18, 2004, to December 31, 2016). We used survival analysis to estimate the relationship between handgun ownership and both all-cause mortality and suicide (by firearm and by other methods) among men and women. The analysis allowed the baseline hazard to vary according to neighborhood and was adjusted for age, race and ethnic group, and ownership of long guns (i.e., rifles or shotguns). A total of 676,425 cohort members acquired one or more handguns, and 1,457,981 died; 17,894 died by suicide, of which 6691 were suicides by firearm. Rates of suicide by any method were higher among handgun owners, with an adjusted hazard ratio of 3.34 for all male owners as compared with male nonowners (95% confidence interval [CI], 3.13 to 3.56) and 7.16 for female owners as compared with female nonowners (95% CI, 6.22 to 8.24). These rates were driven by much higher rates of suicide by firearm among both male and female handgun owners, with a hazard ratio of 7.82 for men (95% CI, 7.26 to 8.43) and 35.15 for women (95% CI, 29.56 to 41.79). Handgun owners did not have higher rates of suicide by other methods or higher all-cause mortality. The risk of suicide by firearm among handgun owners peaked immediately after the first acquisition, but 52% of all suicides by firearm among handgun owners occurred more than 1 year after acquisition. Handgun ownership is associated with a greatly elevated and enduring risk of suicide by firearm. (Funded by the Fund for a Safer Future and others.).

Sections du résumé

BACKGROUND
Research has consistently identified firearm availability as a risk factor for suicide. However, existing studies are relatively small in scale, estimates vary widely, and no study appears to have tracked risks from commencement of firearm ownership.
METHODS
We identified handgun acquisitions and deaths in a cohort of 26.3 million male and female residents of California, 21 years old or older, who had not previously acquired handguns. Cohort members were followed for up to 12 years 2 months (from October 18, 2004, to December 31, 2016). We used survival analysis to estimate the relationship between handgun ownership and both all-cause mortality and suicide (by firearm and by other methods) among men and women. The analysis allowed the baseline hazard to vary according to neighborhood and was adjusted for age, race and ethnic group, and ownership of long guns (i.e., rifles or shotguns).
RESULTS
A total of 676,425 cohort members acquired one or more handguns, and 1,457,981 died; 17,894 died by suicide, of which 6691 were suicides by firearm. Rates of suicide by any method were higher among handgun owners, with an adjusted hazard ratio of 3.34 for all male owners as compared with male nonowners (95% confidence interval [CI], 3.13 to 3.56) and 7.16 for female owners as compared with female nonowners (95% CI, 6.22 to 8.24). These rates were driven by much higher rates of suicide by firearm among both male and female handgun owners, with a hazard ratio of 7.82 for men (95% CI, 7.26 to 8.43) and 35.15 for women (95% CI, 29.56 to 41.79). Handgun owners did not have higher rates of suicide by other methods or higher all-cause mortality. The risk of suicide by firearm among handgun owners peaked immediately after the first acquisition, but 52% of all suicides by firearm among handgun owners occurred more than 1 year after acquisition.
CONCLUSIONS
Handgun ownership is associated with a greatly elevated and enduring risk of suicide by firearm. (Funded by the Fund for a Safer Future and others.).

Identifiants

DOI: 10.1056/NEJMsa1916744 PMID: 32492303
pubmed: 32492303
doi: 10.1056/NEJMsa1916744
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2220-2229

Subventions

Organisme : United States
ID : GA004696
Pays : United States
Organisme : Joyce Foundation
ID : 17-37241
Pays : International
Organisme : School of Medicine, Stanford University
ID : internal funds
Pays : International

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2020 Massachusetts Medical Society.

Auteurs

David M Studdert (DM)

From the Stanford Law School (D.M.S.), School of Medicine (D.M.S, Y.Z., L.P., E.E.H.), and Department of Political Science (J.A.R.), Stanford University, Stanford, and the School of Medicine, University of California at Davis, Sacramento (G.J.W.) - all in California; the Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (S.A.S.); the Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia (M.J.S.); and the Bouvé College of Health Sciences, Northeastern University, Boston (M.M.).

Yifan Zhang (Y)

From the Stanford Law School (D.M.S.), School of Medicine (D.M.S, Y.Z., L.P., E.E.H.), and Department of Political Science (J.A.R.), Stanford University, Stanford, and the School of Medicine, University of California at Davis, Sacramento (G.J.W.) - all in California; the Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (S.A.S.); the Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia (M.J.S.); and the Bouvé College of Health Sciences, Northeastern University, Boston (M.M.).

Sonja A Swanson (SA)

From the Stanford Law School (D.M.S.), School of Medicine (D.M.S, Y.Z., L.P., E.E.H.), and Department of Political Science (J.A.R.), Stanford University, Stanford, and the School of Medicine, University of California at Davis, Sacramento (G.J.W.) - all in California; the Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (S.A.S.); the Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia (M.J.S.); and the Bouvé College of Health Sciences, Northeastern University, Boston (M.M.).

Lea Prince (L)

From the Stanford Law School (D.M.S.), School of Medicine (D.M.S, Y.Z., L.P., E.E.H.), and Department of Political Science (J.A.R.), Stanford University, Stanford, and the School of Medicine, University of California at Davis, Sacramento (G.J.W.) - all in California; the Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (S.A.S.); the Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia (M.J.S.); and the Bouvé College of Health Sciences, Northeastern University, Boston (M.M.).

Jonathan A Rodden (JA)

From the Stanford Law School (D.M.S.), School of Medicine (D.M.S, Y.Z., L.P., E.E.H.), and Department of Political Science (J.A.R.), Stanford University, Stanford, and the School of Medicine, University of California at Davis, Sacramento (G.J.W.) - all in California; the Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (S.A.S.); the Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia (M.J.S.); and the Bouvé College of Health Sciences, Northeastern University, Boston (M.M.).

Erin E Holsinger (EE)

From the Stanford Law School (D.M.S.), School of Medicine (D.M.S, Y.Z., L.P., E.E.H.), and Department of Political Science (J.A.R.), Stanford University, Stanford, and the School of Medicine, University of California at Davis, Sacramento (G.J.W.) - all in California; the Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (S.A.S.); the Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia (M.J.S.); and the Bouvé College of Health Sciences, Northeastern University, Boston (M.M.).

Matthew J Spittal (MJ)

From the Stanford Law School (D.M.S.), School of Medicine (D.M.S, Y.Z., L.P., E.E.H.), and Department of Political Science (J.A.R.), Stanford University, Stanford, and the School of Medicine, University of California at Davis, Sacramento (G.J.W.) - all in California; the Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (S.A.S.); the Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia (M.J.S.); and the Bouvé College of Health Sciences, Northeastern University, Boston (M.M.).

Garen J Wintemute (GJ)

From the Stanford Law School (D.M.S.), School of Medicine (D.M.S, Y.Z., L.P., E.E.H.), and Department of Political Science (J.A.R.), Stanford University, Stanford, and the School of Medicine, University of California at Davis, Sacramento (G.J.W.) - all in California; the Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (S.A.S.); the Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia (M.J.S.); and the Bouvé College of Health Sciences, Northeastern University, Boston (M.M.).

Matthew Miller (M)

From the Stanford Law School (D.M.S.), School of Medicine (D.M.S, Y.Z., L.P., E.E.H.), and Department of Political Science (J.A.R.), Stanford University, Stanford, and the School of Medicine, University of California at Davis, Sacramento (G.J.W.) - all in California; the Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (S.A.S.); the Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia (M.J.S.); and the Bouvé College of Health Sciences, Northeastern University, Boston (M.M.).

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Handgun Ownership and Suicide in California.
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Handgun Ownership and Suicide in California.
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Sujet âgé de 80 ans ou plus › Handgun Ownership and Suicide in California.
questionsmedicales.fr › Régions géographiques › Amériques › Amérique du Nord › États-Unis › États du Sud-Ouest des États-Unis › Californie › Handgun Ownership and Suicide in California.
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