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Journal ArticleDOI

What Are the Risks and Benefits of Keeping a Gun in the Home

05 Aug 1998-JAMA (American Medical Association)-Vol. 280, Iss: 5, pp 473-475
TL;DR: It appears that gun ownership is associated with a net increase in the risk of death for a typical individual, and clinicians might advise their patients accordingly.
Abstract: the evidence from comparative observational studies appears consistent with the inference that owning a gun increases the risk of suicide. Most studies show a moderately strong association, the biological mechanism is plausible, the exposure precedes the outcome, the association has been replicated in several populations, and there is evidence of a dose response (greater risk with more or more available guns). Evidence that a gun in the home increases the risk of homicide comes from only 2 studies and seems weaker; however, these studies offer no support for the view that gun ownership confers a net benefit in terms of protection against homicide. Based on the evidence currently available, it appears that gun ownership is associated with a net increase in the risk of death for a typical individual. Clinicians might advise their patients accordingly.
Citations
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Journal ArticleDOI
TL;DR: Having a gun at home is a risk factor for adults to be shot fatally (gun homicide) or commit suicide with a firearm and Physicians should continue to discuss with patients the implications of keeping guns at home.

225 citations

Journal ArticleDOI
TL;DR: Results show that regardless of storage practice, type of gun, or number of firearms in the home, having a gun in the Home was associated with an increased risk of firearm homicide and firearm suicide in theHome.
Abstract: Data from a US mortality follow-back survey were analyzed to determine whether having a firearm in the home increases the risk of a violent death in the home and whether risk varies by storage practice, type of gun, or number of guns in the home. Those persons with guns in the home were at greater risk than those without guns in the home of dying from a homicide in the home (adjusted odds ratio = 1.9, 95% confidence interval: 1.1, 3.4). They were also at greater risk of dying from a firearm homicide, but risk varied by age and whether the person was living with others at the time of death. The risk of dying from a suicide in the home was greater for males in homes with guns than for males without guns in the home (adjusted odds ratio = 10.4, 95% confidence interval: 5.8, 18.9). Persons with guns in the home were also more likely to have died from suicide committed with a firearm than from one committed by using a different method (adjusted odds ratio = 31.1, 95% confidence interval: 19.5, 49.6). Results show that regardless of storage practice, type of gun, or number of firearms in the home, having a gun in the home was associated with an increased risk of firearm homicide and firearm suicide in the home.

217 citations

Journal ArticleDOI
TL;DR: On average, guns did not protect those who possessed them from being shot in an assault, and such users should reconsider their possession of guns or, at least, understand that regular possession necessitates careful safety countermeasures.
Abstract: Objectives. We investigated the possible relationship between being shot in an assault and possession of a gun at the time.Methods. We enrolled 677 case participants that had been shot in an assault and 684 population-based control participants within Philadelphia, PA, from 2003 to 2006. We adjusted odds ratios for confounding variables.Results. After adjustment, individuals in possession of a gun were 4.46 (P < .05) times more likely to be shot in an assault than those not in possession. Among gun assaults where the victim had at least some chance to resist, this adjusted odds ratio increased to 5.45 (P < .05).Conclusions. On average, guns did not protect those who possessed them from being shot in an assault. Although successful defensive gun uses occur each year, the probability of success may be low for civilian gun users in urban areas. Such users should reconsider their possession of guns or, at least, understand that regular possession necessitates careful safety countermeasures.

135 citations


Cites background from "What Are the Risks and Benefits of ..."

  • ...That is, someone may have a gun in their home, may have purchased a gun, or may own a gun, but without knowledge of whether that gun was in their possession at the time they were shot, the possibility that they have been misclassified as being exposed to a gun when in fact they were not is a potential bias.(43,62,63) This bias erodes the ability to speculate on plausible causal mechanisms other than to say that general access to a gun, over some amount of space or time, is a risk factor....

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Journal ArticleDOI
TL;DR: The gun assault risk to individuals who are near off-premise alcohol outlets is about the same as or statistically greater than the risk they incur from heavy drinking, while light drinkers were not at significantly greater risk of being shot in an assault when compared with nondrinkers.
Abstract: Background: We conducted a population-based case–control study to better delineate the relationship between individual alcohol consumption, alcohol outlets in the surrounding environment, and being assaulted with a gun. Methods: An incidence density sampled case–control study was conducted in the entire city of Philadelphia from 2003 to 2006. We enrolled 677 cases that had been shot in an assault and 684 population-based controls. The relationships between 2 independent variables of interest, alcohol consumption and alcohol outlet availability, and the outcome of being assaulted with a gun were analyzed. Conditional logistic regression was used to adjust for numerous confounding variables. Results: After adjustment, heavy drinkers were 2.67 times as likely to be shot in an assault when compared with nondrinkers (p < 0.10) while light drinkers were not at significantly greater risk of being shot in an assault when compared with nondrinkers. Regression-adjusted analyses also demonstrated that being in an area of high off-premise alcohol outlet availability significantly increased the risk of being shot in an assault by 2.00 times (p < 0.05). Being in an area of high on-premise alcohol outlet availability did not significantly change this risk. Heavy drinkers in areas of high off-premise alcohol outlet availability were 9.34 times (p < 0.05) as likely to be shot in an assault. Conclusions: This study finds that the gun assault risk to individuals who are near off-premise alcohol outlets is about the same as or statistically greater than the risk they incur from heavy drinking. The combination of heavy drinking and being near off-premise outlets resulted in greater risk than either factor alone. By comparison, light drinking and being near on-premise alcohol outlets were not associated with increased risks for gun assault. Cities should consider addressing alcohol-related factors, especially off-premise outlets, as highly modifiable and politically feasible approaches to reducing gun violence.

95 citations

Journal ArticleDOI
TL;DR: In 1995, the American College of Physicians issued its first statement that raised concern about the epidemic of firearm violence in the United States and advocated for policies to reduce the rate of violence.
Abstract: In 1995, the American College of Physicians issued its first statement that raised concern about the epidemic of firearm violence in the United States and advocated for policies to reduce the rate ...

57 citations

References
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Journal ArticleDOI
TL;DR: Owners of firearms should weigh their reasons for keeping a gun in the home against the possibility that it might someday be used in a suicide, and be aware of the potential risks to their health.
Abstract: Background. It has been suggested that limiting access to firearms could prevent many suicides, but this belief is controversial. To assess the strength of the association between the availability of firearms and suicide, we studied all suicides that took place in the homes of victims in Shelby County, Tennessee, and King County, Washington, over a 32-month period. Methods. For each suicide victim (case subject), we obtained data from police or the medical examiner and interviewed a proxy. Their answers were compared with those of control subjects from the same neighborhood, matched with the victim according to sex, race, and age range. Crude and adjusted odds ratios were calculated with matched-pairs methods. Results. During the study period, 803 suicides occurred in the two counties, 565 of which (70 percent) took place in the home of the victim. Fifty-eight percent (326) of these suicides were committed with a firearm. After excluding 11 case subjects for various reasons, we were able to inter...

655 citations

Journal ArticleDOI
TL;DR: To study risk factors for homicide in the home, homicides occurring in the homes of victims in three metropolitan counties were identified and data obtained from the police or medical examiner and interviewed a proxy for the victim.
Abstract: Background It is unknown whether keeping a firearm in the home confers protection against crime or, instead, increases the risk of violent crime in the home. To study risk factors for homicide in the home, we identified homicides occurring in the homes of victims in three metropolitan counties. Methods After each homicide, we obtained data from the police or medical examiner and interviewed a proxy for the victim. The proxies' answers were compared with those of control subjects who were matched to the victims according to neighborhood, sex, race, and age range. Crude and adjusted odds ratios were calculated with matched-pairs methods. Results During the study period, 1860 homicides occurred in the three counties, 444 of them (23.9 percent) in the home of the victim. After excluding 24 cases for various reasons, we interviewed proxy respondents for 93 percent of the victims. Controls were identified for 99 percent of these, yielding 388 matched pairs. As compared with the controls, the victims more often ...

600 citations

Journal ArticleDOI
TL;DR: It is found that keeping a gun in the home was strongly and independently associated with an increased risk of homicide (adjusted odds ratio, 2.7; 95 percent confidence interval, 1.6 to 4.4).

273 citations

Journal ArticleDOI
TL;DR: Legal purchase of a handgun appears to be associated with a long-lasting increased risk of violent death.
Abstract: OBJECTIVES: The purpose of this study was to determine whether purchase of a handgun from a licensed dealer is associated with the risk of homicide or suicide and whether any association varies in relation to time since purchase. METHODS: A case-control study was done among the members of a large health maintenance organization. Case subjects were the 353 suicide victims and 117 homicide victims among the members from 1980 through 1992. Five control subjects were matched to each case subject on age, sex, and zip code of residence. Handgun purchase information was obtained from the Department of Licensing. RESULTS: The adjusted relative risk of suicide was 1.9 (95% confidence interval [CI] = 1.4, 2.5) for persons with a history of family handgun purchase from a registered dealer. The adjusted relative risk for homicide, given a history of family handgun purchase, was 2.2 (95% CI = 1.3, 3.7). For both suicide and homicide, the elevated relative risks persisted for more than 5 years after the purchase. CONCL...

220 citations

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Is owning a gun a risk factor for suicide?

the evidence from comparative observational studies appears consistent with the inference that owning a gun increases the risk of suicide.