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State firearm laws, race and law enforcement–related deaths in 16 US states: 2010–2016
  1. Josie J Sivaraman,
  2. Stephen W Marshall,
  3. Shabbar I Ranapurwala
  1. Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  1. Correspondence to Josie J Sivaraman, Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27515, USA; josie_caves{at}


The aim of this study was to assess the association between state firearm legislation and law enforcement–related deaths (LEDs) and its modification by race. We used secondary data from an ecological cohort of 16 states (2010 to 2016), using the National Violent Death Reporting System (NVDRS), the State Firearm Law Database and additional public sources. Poisson regression with generalised estimating equations and inverse probability of exposure weights to account for time-varying confounding were used to quantify the association. LEDs were also disaggregated by race (Black vs non-Black). A total of 1593 LEDs took place during the 6-year study period. After adjusting for confounders, the IRR among non-Blacks was 0.48 (95% CI 0.26 to 0.89) and 1.53 (95% CI 0.93 to 2.54) among Blacks. Our findings highlight the fact that increased firearm provisions may decrease rates of LED among non-Black American individuals—an association not observed among Black Americans.

  • public health
  • firearm
  • ecological study
  • epidemiology

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  • Contributors JJS contributed data management, analysis, interpretation of findings and writing to this manuscript. SWM and SR contributed analytical guidance, subject area expertise and writing to this manuscript. Yasmin Mohamed Ali contributed to the literature review. The National Violent Death Reporting System (NVDRS) is administered by the CDC by participating NVDRS states.

  • Funding This research was originally funded by the Raluca Iosif Intimate Partner Research Award, sponsored by IntraHealth International. Dr. Marshall is partly supported by an R49 award (CE19-003092) for an Injury Control Research Center from the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.

  • Disclaimer The findings and conclusions of this study are those of the authors alone and do not necessarily represent the official position of the CDC or the participating NVDRS states.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval The University of North Carolina Institutional Review Board granted an exemption for this study because of the secondary and de-identified nature of the data (IRB 18-1042).

  • Provenance and peer review Not commissioned; externally peer reviewed.