title: Firearms and suicide in US cities.
abstract: On an average day in the USA more than 100 Americans die by suicide-half use firearms. Suicide rates overall and by firearms are higher, on average, in states where household firearm ownership is more common. In general this means in states where a greater proportion of the population lives in rural areas. The current ecological study focuses on the relation between measures of household firearm prevalence and suicide mortality in urban areas (metropolitan statistical areas and divisions) using survey-based measures of firearm ownership. Suicide rates (1999-2010) for metropolitan statistical areas that are comprised of large US cities come from death certificate records; rates of household firearm ownership come from the 2002 and 2004 Behavioural Risk Factor Surveillance System. Higher rates of firearm ownership are strongly associated with higher rates of overall suicide and firearm suicide, but not with non-firearm suicide. Stratification by gender, age and race did not materially affect the association between firearms and suicide. This study provides evidence consistent with previous case-control work and extends evidence from previous state- and region-level ecological studies that firearms in the home impose suicide risk above and beyond baseline.
authors.affiliation: Harvard Injury Control Research Center, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Miller
authors.affiliation: Harvard Injury Control Research Center, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: Molly
authors.initials: M
authors.lastname: Warren
authors.affiliation: Harvard Injury Control Research Center, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: David
authors.initials: D
authors.lastname: Hemenway
authors.affiliation: Harvard Injury Control Research Center, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Azrael
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005389:Firearms / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010067:Ownership / Q000706:statistics & numerical data; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult