Guns and Suicide2000-2002

• 15 States• 116 million people• 47% Gun Ownership• Firearm Suicides

9749• Non Firearm suicides

5060• Total suicides

14,809• Firearm suicides per

100,000 8.4

• 6 States• 119 million people• 15% gun ownership• Firearm Suicides 2606• Non-firearm Suicides

5446• Total Suicides 8052• Firearm suicides per

100,000 2.2

High Gun Ownership Low Gun Ownership

Male Suicide RatesAge10-14

Age15-19

Age20-24

Year Fire-arm

Other All Fire-arm

Other All Fire-arm

Other All

1994 1.43 0.93 2.36 13.11 4.84 17.95 18.80 9.16 27.96

1999 0.77 0.78 1.85 8.40 4.65 13.05 12.81 8.04 20.85

2004 0.46 1.25 1.71 6.47 6.18 12.65 11.12 9.72 20.84

1994-2004

-.97 +.32 -0.65 -6.64 +1.34 -5.3 -7.68 +.56 -7.12

Risk of Suicide in a Home

• Case Control studies are often used to determine whether a gun in the home increases the risk of suicide

• These studies find a risk of 2.1 to 4.8 times greater for suicide when a gun is present

• Shah and colleagues looked at adolescent suicides in Colorado from 1991 to 1993

Adolescent Suicide in Colorado 1991-1993

• 36 of 54 suicides were committed with a gun

• 24 used a gun form home, 2 a non resident parent’s gun, 2 a relative’s, 4 a friend, neighbor or acquaintance, 4 unknown

• 42% used a handgun

• Only 25% of the guns were stored locked

Adolescent Suicide in Colorado 1991-1993

Variable Cases Controls P value

A gun in the home

72% 50% .05

An unlocked gun

58% 35% .05

> 1 gun 56% 28% .02

Conduct problem

64% 25% <.01

Mental Health Rx

47% 19% .01

Ever drank alcohol

54% 34% <.01

Independent Factors predicting the risk of suicide in adolescents

Variable Adjusted Odds Ratio

Conduct Disorder Related Behaviors

7.45

Past Mental Health Problem 4.84

Household access to a gun 3.91

Ever drank Alcohol 1.86

Does Storage Matter?

• Grossman et al studied 106 suicide and gun injury cases from Washington, Oregon and Missouri in individuals less than 20 years old

• 82 Suicide attempts, 95% fatal• 24 unintentional injuries, 50% fatal• Control gun owning households were found by

random telephone dialing and matched by age group of a household member and county

Does Storage Matter?

Storage Practice /Safety Device

CasesN=106

ControlsN=480

Gun loaded 34% 9%

Gun unloaded 66% 91%

Gun and Ammo stored separately

41% 65%

Both accessible 56% 28%

Gun locked 32% 58%

Ammunition locked 24% 48%

Both locked 17% 35%

Does Storage Matter?

Storage Practice Odds Ratio

Gun and Ammunition Accessible

1.0

Gun Accessible, Ammunition Not

0.47

Ammunition Accessible, Gun Not

0.34

Neither Accessible 0.22

Figure 7: Indiana Suicide Deaths by Gender and Age, 2001-2005

0

100

200

300

400

500

600

700

10-1

4

15-1

9

20-2

4

25-3

4

35-4

4

45-5

4

55-6

4

65-7

4

75-8

485

+

Ages

De

ath

s

White Males

Black Males

White Females

Black Females

(Source: Indiana State Department of Health, Suicide Report, 2001-2005)

Figure 8: Indiana Suicide Rates by Race and Age, 2001-2005

0

5

10

15

20

25

30

35

Age

Ag

e-A

dju

ste

d R

ate

pe

r 1

00

,00

0

White Males 1.57 14.11 21.3 25.66 27.79 29.14 22.39 31.48

Black Males 1.56 4.41 27.89 24.07 17.62 13.16 12.83 7.97

White Females 0.73 3.07 3.2 5.57 7.97 7.63 6.23 2.85

10-14 15-19 20-24 25-34 35-44 45-54 55-64 65+

(Source: Indiana State Department of Health, Suicide Report, 2001-2005)*Black Females not included due to all age categories having less than 20 deaths and therefore unstable rates.

Table 4: Indiana Suicide Rates by Mechanism, Race and Gender, 2001-2005

Mechanism White Males

Black Males

White Females

All

NumberDeath Rate*

Number Death Rate*

Number Death Rate*

Number (%)

Firearms 168812.71

998.14

2341.66

2021(60%)

Suffocation 6074.49

352.70

900.65

732(22%)

Poisoning 3382.49

** 2611.87

599(18%)

Indiana Gun Ownership

• 44.2% of families reported owning a gun*

• 25.8% reported owning a handgun*• 9.6% store guns loaded**• 6% store guns loaded and unlocked**

Good News in Indiana

Year Gun in the Household

Handgun in the Household

2000 48.6% 29.5%

2004 44.2% 25.8%

Guns and Suicide Answered

• This is a problem usually involving legal guns accessed by people at risk from mental illness, substance abuse, physical illness, old age, etc.

• Simply removing guns from the community on a large scale is the simplest and probably most effective measure.

• Regulation of gun storage could limit the risk to the actual owner.

• Enforced waiting periods under Brady led to a decrease in suicide.

• Educational campaigns may be helpful.

Finally

• If Indiana were to somehow become a low gun ownership state, we might expect little change in non gun suicides but gun suicides to go from 60% to 33% of all suicides

• For an average year this would decrease the number of suicides from about 700 to about 420. The decrease would come preferentially from suicides in younger males

We don’t have more crime in our country, just much more lethal violence.

Country CarTheft

Burglary Robbery SexualIncident

Assault orThreat

11 Crimes

United States

0.5 1.8 0.6 1.5 3.4 21.1

Australia 1.9 3.9 1.2 4.0 6.4 23.8

Canada 1.4 2.3 0.9 2.1 5.3 30.0

17 Industrial-izedNations

1.0 1.8 0.8 1.7 3.5 21.3

Guns and Crime

Guns and Crime

Nation Fire ArmHomicide Rate

Non-FirearmHomicideRate

TotalHomicideRate

Households with guns

United States

4.0 2.2 6.1 41%

Canada 0.6 1.2 1.8 26%

Australia 0.4 1.4 1.8 16%

New Zealand

0.2 1.5 1.7 20%

Gun Ownership and Homicide

• Homicide Deaths in High Ownership States, 1988-1997

• Person Years at Risk 158 million

• Gun-related 15283• Non-gun related

5865• Total 21148

• Homicide Deaths in Low Ownership States, 1988-1997

• Person Years at Risk 160 million

• Gun –related 3668• Non-gun related 3598• Total 7266

Guns and Crime

• Guns don’t kill people, but they make it so darn easy– The use of a gun in the commission of a crime

greatly increases the likelihood of a homicide– Most gun homicides are not premeditated or

planned, but occur in the context of another crime or dispute

Guns and Crime

• Homicides in Robberies and Assaults are:– 3-5 times more likely with guns than

knives– 6-10 times more likely with guns than with

other weapons (clubs, bats, bottles, etc.)– 40 times more likely than with no weapon

Circumstances of Gun Assault and Violence in Indianapolis, 2002-2004*

• Robbery or Burglary 153 (14%)• Argument 146 (14%)• Domestic Violence 29 (3%)• Drive By 44 (4%)• Other 118 (11%)• Unknown 547 (54%)• When known, a handgun was used in 85%

of cases.

Gun Violence in Indiana

• 6-7 homicides per 100,000 from 1999-2001• 68% are done with firearms• Firearm homicide was the leading cause of

injury death for black males from 1999-2001, accounting for 478 or 38% of 1264 deaths

Gun Violence Marion Cty. 2004

• 392 injuries, 83 of which were fatal (21%)• Males were 89% of the victims• 90% were black (139/100,000)• 72% were younger than 35• 38% in a home, 35% a road or vehicle, 27%

other location

Gun Violence, Marion Cty. 2004

• For 83 firearm homicides, the shooter was– An acquaintance 24 % – A stranger 11% – A family member or intimate 10%– Other or Unknown 56%

• Handguns accounted for 89 % of the firearms when the firearm was known

Gun violence is costly

• Medical care costs are increased by about $2 billion per year

• Increased costs to the criminal justice system of $2.4 billion per year for longer incarcerations, trials, etc.

• Increased costs of law enforcement, preventive actions by schools, airports, etc. of more than $1 billion dollars.

• Costs of decreased willingness to work evenings estimated at $3-7 billion per year

• Costs of depopulation of central cities, decline in property values, problems delivering services, etc. are in the billions but difficult to quantify

Gun Violence Costs as Willingness to Pay

• Would you be willing to pay more taxes to decrease gun violence?

• Cook and Ludwig review several studies that suggest Americans would be willing to pay $80 billion to eliminate the use of guns in crime

Guns and Crime, Answers If locking up criminals is the answer, we should be the safest country in the world:The US has the highest rate of incarceration in the developed world.

Country Prisoners* Prisoners/100,000*

HomicideRate/100,000**

United States 2,053,331 701 4.28

Canada 36,024 116 1.4

England 74,452 141 1.4

Australia 22,492 115 1.5

Guns and Crime, Answers

• If guns were the answer to crime, we should be remarkably safe. We have 290 million guns in circulation, nine guns for every 10 people. No other country has more than six guns for ten people.

• Responsible gun ownership does not protect from crime. Guns in home are rarely useful in defense and increase likelihood of suicide or homicide.

• Gun carry laws have little effect on crime.

Guns and Crime, Answers

• Acknowledge Guns are the problem . –The governor, mayor, and key

legislators need to address guns as a threat to the community

–Key community leaders to need to denounce guns and gun violence• Different Communities need different speakers

Guns and Crime, Answers

For Crime Guns, the problem is the migration of guns, mainly hand guns, from legal sales to criminal users.

This can happen at the point of sale through straw man purchasers.

This can happen in secondary markets where no records are kept.

This can happen through theft.

Guns and Crime, Answers

• Better regulation of the gun market– One handgun per month requirment– No unscreened sales or transfers– Registration requirement, with required reporting of

loss or theft– Storage requirements– Improvements in manufacture that restrict use to the

gun’s owner– Increased support for the ATF and better distribution

of information to states and localities

Guns and Crime, Answers

• Recognition that gun violence is not the same threat in the city and rural areas. Allow municipalities to set different rules for gun ownership and use.

• Focused policing aimed at literally getting guns off the street– Stop and frisk laws– Focus on violence associated with drug trafficking,

getting sellers off the streets

Measures Favored By a Majority of Hoosiers, 2004

• Background checks at gun shows 87%• Waiting period to buy a handgun 85%• Raise age to 21 for purchase of a long gun 63%• Storage requirements for guns 73%• Child Access Prevention Law 73%• Safety Training for New Owners 83%• Recognition device for new handguns 75%

Reasons For Hope

• “At one time, the United States had the worst traffic fatality rate in the developed world. The automobile industry wanted to blame the problem on bad driving, no regulation needed. Progress was made when we were convinced that the problem was not only bad driving, but unsafe cars and roads. Despite fierce industry opposition, great progress has been made now that that traffic safety is recognized as a public health issue. Traffic fatalities per mile driven are down 80%.”

• Hemenway, Private Guns, Public Health, 2004

Hoosiers Concerned About Gun Violence

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