Article Summary: Associations among state youth firearm protection laws and youth suicide rates in U.S.
Citation: Webster, DW, Vernick, JS, Zeoli, AM & Manganello, JA. Association between youth-focused firearm laws and youth suicides. JAMA 2004;292:594-601.
In 2001, suicide was the third leading cause of death among U.S. youth ages 10 to 19; half of these suicides involved firearms. This study examined the association between state laws designed to restrict child and adolescent access to firearms and suicide among youth aged 14 years to 20 years between 1976 and 2001.
This study used a quasi-experimental design to compare changes in youth suicide rates between states with laws that restricted youth access to firearms and states without these laws. The three categories of laws were minimum purchase age laws, minimum possession age laws, and child access protection (CAP) laws. The number of total, firearm, and non-firearm suicides in each state were obtained from death certificate data. The authors used negative binomial regression and rate ratios in order to express the effects of these laws as percentage changes in suicide rates. The models also included within-state suicide rates among a comparison group (individuals aged 22 to 24 years), per capita beer consumption, a proxy for the prevalence of gun ownership, and demographic characteristics.
During the 1976-2001 study period, there were nearly 64,000 youth suicides, 62% of which were completed with firearms. The authors found no significant associations between suicides among youth aged 14 to 17 years and minimum firearm purchase or possession laws; however, state CAP laws were associated with an 8.3% reduction in overall suicide rates and a 10.8% reduction in firearm suicide rates. Among youth aged 18 to 20 years, state laws that raised the minimum firearm purchase age to 21 years were associated with a 12.9% increase in overall suicide rates and state CAP laws were associated with an 11.1% decrease in overall suicide rates and a 12.9% decrease in firearm suicide rates.
There are several reasons to question the validity of the finding that minimum-age laws are associated with increased youth suicide rates: This result was based on only three states and there was no equivalent rise in suicide rates among youth aged 14 to 17 years. One limitation of this study was that the suicide rates were based on death certificate data, which may not be a valid measure of suicide deaths. The authors were also unable to directly measure whether CAP laws changed gun storage behavior.
This study found the implementation of state child access protection (CAP) laws between 1976 and 2001 were associated with declines in firearm suicide rates and overall suicide rates among youth aged 14 to 20 years. During the same period, state laws that raised the minimum age to purchase a firearm to 21 years were associated with an increase in overall suicide rates among youth aged 18 to 20 years.