Risk of Suicide, Homicide Increases with Household Firearm Access

MedicalResearch.com Interview with:
Andrew Anglemyer, PhD, MPH; Clinical Pharmacy and Global Health Sciences University of California, San Francisco San Francisco, CAAndrew Anglemyer, PhD, MPH;
Clinical Pharmacy and Global Health Sciences
University of California, San Francisco
San Francisco, CA


MedicalResearch.com:  What are the main findings of the study?

 Dr. Anglemyer: Over all, you are more than 3 times more likely to commit suicide if you have access to a firearm than if you do not.  And,  among men only, they are nearly 4 times more likely to commit suicide if they have access to a firearm than if they do not.

Additionally, over all, you are 2 times more likely to be a victim of homicide if you have access to a firearm than if you do not.

We also found that females have a higher likelihood of being a victim of homicide, than males when considering firearm access.  And we know from empirical data that the majority of female victims knew their assailant—which, to us, suggests that they were victims of domestic violence.


MedicalResearch.com:   Were any of the findings unexpected?

 Dr. Anglemyer: What we as researchers do in a systematic review and meta-analysis is look at all the available data and synthesize that data–we pool the evidence.  So, what we found is not really new evidence; what IS new is that we have looked at ALL the available evidence to help understand the true risks.  So, if there were any ambiguity about the safety of firearms, at least in terms of suicide or being a victim of homicide, we hope we have provided evidence to clear this up.

Another important point is that most reviews summarize the body of evidence and find that there’s at least a little inconsistency between studies.  That’s not really what we see here.  Of 15 studies, 14 found significantly higher odds of suicide or homicide and 1 found a non-significantly higher odds of suicide.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Anglemyer:  To be clear, this isn’t a study about how “bad” guns are.  This is a study about understanding the risks with owning a gun—and not just the risk of accidental injury, but, at least in the present case, the risk of intentional harm.  And impulsivity seems to be a major player here.  What’s important to understand is that most of these studies controlled for a history of mental illnesses, which means that the risk of suicide was independent of any diagnosed history of mental illness in most cases.

Assuming impulsivity is the driving force here, what we’re seeing is some people are sometimes making very bad, impulsive decisions, the ramifications of those decisions are obviously very deadly.

In terms of patients and clinicians, our evidence can only help people make informed decisions about whether a firearm is right for them.  If there are members in a particular household who are depressed or if there is a volatile relationship, easy access to a firearm could be potentially dangerous.

MedicalResearch.com:  What recommendations do you have for future research as a result of this study?

Dr. Anglemyer: We feel that a gap in firearms research is in two areas in particular: studies of homicide perpetration (our study focused on homicide victimization) and studies determining the protective effect of firearms (e.g., how likely one is to use a firearm for protection versus use it for harms).

There are a number of studies out there we did not include.  They are different types of studies that collect data on a population level.  So, for example, the rates of homicide or the rates of firearm access in a given population, and the researcher will make inferences based off of those rates.  Though our review did not cover these types of studies, we feel that they have an important role in firearms research to examine the potential trends over time or potential impact of policies in different regions.

Citation:

Andrew Anglemyer, Tara Horvath, George Rutherford; The Accessibility of Firearms and Risk for Suicide and Homicide Victimization Among Household MembersA Systematic Review and Meta-analysis. Annals of Internal Medicine. 2014 Jan;160(2):101-110.

 

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