State-level homicide victimization rates in the US in relation to survey measures of household firearm ownership, 2001–2003
Introduction
Approximately two in three homicide victims in the US are killed with guns(Centers for Disease Control and Prevention), yet the role of household firearms in homicide victimization has not been well characterized. Case-control studies suggest that the presence of a gun in the home is a risk factor for homicide in the home (Kellermann et al., 1993), that the risk is higher for women than for men (Bailey et al. (1997a), Bailey et al. (1997b)), and that when any family member purchases a handgun all members of the household are at increased risk of homicide victimization (Cummings, Koepsell, Grossman, Savarino, & Thompson, 1997). Limitations of existing case–control studies include not controlling for (1) possible differential recall of firearm ownership by cases compared to controls, and (2) possible reverse causation—i.e. gun ownership may sometimes be a response to an increased risk of homicide victimization (Hemenway, 2004; Hepburn & Hemenway, 2004; National Research Council, 2005).
Most (Brearly, 1932; Brill, 1977; Cook, 1979; Duggan, 2001; Lester (1988), Lester (1990); Seitz, 1972), but not all, (Kaplan & Geling, 1998; Kleck & Patterson, 1993) ecologic studies have found a positive association between various measures of firearm availability and overall rates of homicide. Among nationally representative studies, those using surveys to estimate household firearm ownership have been limited to evaluating variation across the 9 US Census regions. With only 9 units of observation, these studies have not been able to control for potential ecologic confounders. Until now, for state, city and county analyses, researchers have been forced to use proxies of firearm ownership (Duggan, 2001; Miller, Azrael, & Hemenway, 2002; Price, Thompson, & Dake, 2004), the use of which has been criticized by a recent NAS report as possibly introducing bias (National Research Council, 2005). It is only since the 2001, Behavioral Risk Factor Surveillance System (2001) added questions about household firearm ownership that large-scale survey data have been available on household firearm ownership for all 50 states. The present investigation is the first nationally representative study to use state-level, survey-based estimates of household firearm ownership to examine the association between household gun ownership and homicide rates.
Section snippets
Methods
In this analysis, outcomes are state-level rates of homicide, firearm homicide and non-firearm homicide, aggregated over the 3-year study period, 2001–2003. Homicide mortality data for each state were obtained through the CDC's Web-based Injury Statistics Query and Reporting System (Centers for Disease Control and Prevention). Homicide data, grouped by firearm (ICD-10 E-codes X93-X95) and non-firearm methods (E-codes X85-X92, X96-Y09, Y87.1), were further stratified by gender and age (5–14,
Results
For the population as a whole, over the three year study period the (unweighted) mean number of homicides, firearm homicides and non-firearm homicides per state (+standard deviation; range) were, respectively, 1043 (+1301; 28 to 7150), 693 (+909; 16 to 5181), and 351 (+ 405; 8 to 1969). The median number of homicides, firearm homicides and non-firearm homicides per state were, respectively, 586, 358, and 224. Our measure of state level household firearm ownership had a mean of 35%, a standard
Discussion
States with higher rates of household firearm ownership had significantly higher homicide victimization rates in multivariate analyses. The association between firearm prevalence and homicide victimization in our study was driven by gun-related homicide victimization rates; non-gun-related victimization rates were not significantly associated with rates of firearm ownership. This result held overall, for women and for men, and across age groups, consistent with previous ecologic work that
Acknowledgement
This study was supported by the Joyce Foundation.
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