Effect of firearms legislation on suicide and homicide in Canada from 1981 to 2016.

Canada implemented a series of laws regulating firearms including background and psychological screening, licensing, and training in the years 1991, 1994, and 2001. The effects of this legislation on suicide and homicide rates were examined over the years 1981 to 2016. Models were constructed using difference-in-difference analysis of firearms and non firearms death rates from 1981 to 2016. In addition, negative binomial regression was used to test for an association between rates of suicide by Canadian Province and firearms prevalence, using licensing rates as a proxy for prevalence. No associated benefit from firearms legislation on aggregate rates of male suicide was found. In men aged 45 to 59 an associated shift from firearms suicide after 1991 and 1994 to an increase in hanging resulted in overall rate ratios of 0.994 (95%CI, 0.978,1.010) and 0.993 (95%CI, 0.980,1.005) respectively. In men 60 and older a similar effect was seen after 1991, 1994, and 2001, that resulted in rate ratios of 0.989 (95%CI, 0.971,1.008), 0.994 (95%CI, 0.979,1.010), and 1.010 (95%CI, 0.998,1.022) respectively. In females a similar effect was only seen after 1991, rate ratio 0.983 (95%CI, 0.956,1.010). No beneficial association was found between legislation and female or male homicide rates. There was no association found with firearm prevalence rates per province and provincial suicide rates, but an increased association with suicide rates was found with rates of low income, increased unemployment, and the percentage of aboriginals in the population. In conclusion, firearms legislation had no associated beneficial effect on overall suicide and homicide rates. Prevalence of firearms ownership was not associated with suicide rates. Multifaceted strategies to reduce mortality associated with firearms may be required such as steps to reduce youth gang membership and violence, community-based suicide prevention programs, and outreach to groups for which access to care may be a particular issue, such as Aboriginals.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist. None of the authors are members of any organization other than the indicated University appointment at McMaster University Canada, as well as the Professional Organizations: Fellow of the Royal College of Medicine Canada and American Board of Emergency Medicine. There are no competing interests in this group.