Article Text

Firearm related deaths: the impact of regulatory reform
1. J Ozanne-Smith,
2. K Ashby,
4. V Z Stathakis,
5. A Clapperton
1. Monash University Accident Research Centre, Monash University, Victoria, Australia
1. Correspondence to:  Professor Joan Ozanne-Smith  Monash University Accident Research Centre, Building 70, Monash University, Victoria 3800, Australia; joan.ozanne-smithgeneral.monash.edu.au

## Abstract

Objectives: To examine trends in rates of firearm related deaths in Victoria, Australia, over 22 years in the context of legislative reform and describe and investigate impact measures to explain trends.

Design: Mortality data were extracted from vital statistics for 1979–2000. Data on firearm related deaths that were unintentional deaths, assaults, suicides, and of undetermined intent were analyzed. Rates were calculated with population data derived from estimates by the Australian Bureau of Statistics. A quasi-experimental design that used a Poisson regression model was adopted to compare relative rates of firearm related deaths for Victoria and the rest of Australia over three critical periods of legislative reform. The Wilcoxon signed ranks test was used to assess changes in the types of firearm related deaths before and after 1998.

Results: In Victoria, two periods of legislative reform related to firearms followed mass shooting events in 1988 and 1996. A national firearm amnesty and buyback scheme followed the latter. Victorian and Australian rates of firearm related deaths before reforms (1979–86) were steady. After initial Victorian reforms, a significant downward trend was seen for numbers of all firearm related deaths between 1988 and 1995 (17.3% in Victoria compared with the rest of Australia, p<0.0001). A further significant decline between 1997 and 2000 followed the later reforms. After the later all state legislation, similar strong declines occurred in the rest of Australia from 1997 (14.0% reduction compared with Victoria, p = 0.0372). Victorian reductions were observed in frequencies of firearm related suicides, assaults, and unintentional deaths before and after the 1988 reforms, but statistical significance was reached only for suicide.

Conclusion: Dramatic reductions in overall firearm related deaths and particularly suicides by firearms were achieved in the context of the implementation of strong regulatory reform.

• death rate trends
• firearms
• licencing
• regulatory reform
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## DISCUSSION

This study shows dramatic declines in rates of firearm related deaths in the state of Victoria, and for the rest of Australia, for the 22 years between 1979 and 2000 in the context of strong legislative reform. Earlier legislative reform in Victoria, compared with the rest of Australia, was associated with more rapid initial declines. Evidence for this relation is strengthened by the differential rates associated with the tightening of regulations earlier in Victoria (in 1988) compared with the remainder of Australia and the ultimate “catch up” by the rest of Australia after regulation was introduced in the other states. Declines in household ownership of firearms, firearm licences, and licenced shooters in Victoria and the national firearms buyback scheme (from 1996) were associated with these trends. These changes were associated with substantial publicity, unprecedented community awareness, and advocacy for gun control reform from antigun groups and the broader community.16

In particular, our data analysis shows significant reductions in firearm related suicides and assaults after both periods of reform in Victoria. Studies that focused only on suicide in the states of Queensland and South Australia support our findings.20,21 Similarly, two international studies by Rich et al and Loftin et al, which examined the effects of strengthened firearm laws in Ontario and Washington, DC in the United States, respectively, reported decreases in firearm related suicides.22,23

### Key points

• Significant and dramatic declines in rates of firearm related deaths occurred in Victoria and Australia after periods of strong legislative reform.

• Statistically significant reductions in firearm related suicides were observed after legislative reforms.

• In 2000, rates of firearm related deaths were less than two per 100 000 population for Victoria and Australia compared with 10.4 per 100 000 population for the United States.

• In Victoria, reductions in the numbers of registered firearms of 25% and of licensed shooters of 15% were seen over the four years between 1997–98 and 2000–01.

Supportive evidence for the relation between firearm ownership and prevalence of fatalities also comes from a number of American studies. Miller et al, in a pooled cross sectional time series analysis over 10 years (1988–97), found that a disproportionately high number of children aged 5–14 years died from suicide, homicide, and unintentional firearm related deaths in American states and regions in which firearms were more prevalent.6 Kellermann et al conducted case-control studies to examine the links between firearm ownership as a risk factor for suicide and homicide in the home.10,12 After controlling for several factors, they found that the presence of one or more firearms in the home was associated with an increased risk of suicide (adjusted odds ratio 4.8, 95% confidence interval 2.7 to 8.5).10 Similarly, keeping a firearm in the home was strongly and independently associated with an increased risk of homicide (adjusted odds ratio 2.7, 1.6 to 4.4).12

The methods used in this study were capable of showing a strong association between firearm regulations and the significant decline in firearm related fatalities. This relation was further supported by impact measures. Further evidence would be needed to show that the relation is causal. For reasons associated with coding systems, this study was unable to consider type of firearm.

For the same period, despite the declines related to firearms, overall suicide and homicide rates in Victoria did not show a similar decline. An analysis of substitution or displacement to other methods of suicide or homicide was beyond the scope of this study. Investigation of the rates of non-fatal firearm related injury was also out of the scope of this study.

The very low rate of fatalities from firearms achieved in Australia by the year 2000 (<2 per 100 000 population) raises the question of whether vision zero (elimination of firearm related fatalities) is achievable. In the course of this research, our own institution—Monash University—was the site of a shooting that resulted in the death of two members of our community. In the aftermath of the events at Monash, the Australian, state, and territory governments made a National Handgun Control Agreement. This agreement aims to reduce the number of handguns held in the community, particularly concealable handguns, and to strengthen control over access to handguns.24 The Firearms (Trafficking and Handgun Control) Act 2003 started in Victoria on 1 July 2003 with a supporting amnesty and buyback scheme to run until 31 December 2003. The impact of this further reform will be monitored.

## CONCLUSION

Dramatic reductions in overall firearm related deaths and particularly suicides by firearms are achievable in the context of the implementation of strong regulatory reform.

## Acknowledgments

This research was funded by the Victorian Department of Human Services, Victorian Health Promotion Foundation, and Monash University Accident Research Centre Strategic Development Program.

Information and support were provided by Superintendent David Dettman and Martin Stewart (Victoria Police), Wendy Cukier (Ryerson University, Toronto, Canada), and Margaret Trotter (Injury Prevention and Research Unit, University of Otago, New Zealand).

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