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This special collection brings together evidence and insights from nonprofits, foundations, and research organizations working to understand the full impact of firearm use and gun violence in the US. By providing us with analyses of current state and federal laws as well as valuable data on suicides, homicides, accidents, and mass shootings, these organizations seek to inform sound public policy and to curb this ongoing public health epidemic.

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"Gun Violence" by M+R Glasgow licensed under CC 2.0

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Extreme risk protection orders, race/ethnicity, and equity: Evidence from California

August 6, 2022

Extreme risk protection orders (ERPOs) provide a civil mechanism to temporarily remove firearm access from individuals at high risk of harming themselves or others. Evidence and theory suggest that ERPOs can prevent firearm-related harm, but the policy's impact on racial/ethnic equity is largely unknown. To examine potential inequities by race/ethnicity in public perceptions and use of California's ERPO law, we drew on two complementary data sources: 1) a 2020 state-representative survey of California adults, and 2) ERPO court documents for the first 3 years of policy implementation (2016–2018). Majorities (54–89%) of all racial/ethnic groups reported that ERPOs are at least sometimes appropriate, and 64–94% were willing to ask a judge for an ERPO for a family member. However, Black and Hispanic/Latinx survey participants less often perceived ERPOs as appropriate and were less willing to serve as petitioners, with Black participants citing lack of knowledge about ERPOs and not trusting the system to be fair as their top reasons for unwillingness. Similarly, review of ERPO court documents revealed that no family or household members served as petitioners for Black and Hispanic/Latinx ERPO respondents. Additionally, Black respondents were the least likely to have documented access to a firearm and legal representation in court. Racial/ethnic equity in ERPO use may be improved by reducing barriers to petitioning, incorporating non-law enforcement intervention professionals like behavioral health specialists into the ERPO process, providing legal assistance to respondents and petitioners, and investing in the social safety net.

Machine Learning Analysis of Handgun Transactions to Predict Firearm Suicide Risk

July 11, 2022

Importance  Evidence suggests that limiting access to firearms among individuals at high risk of suicide can be an effective means of suicide prevention, yet accurately identifying those at risk to intervene remains a key challenge. Firearm purchasing records may offer a large-scale and objective data source for the development of tools to predict firearm suicide risk.Objective  To test whether a statewide database of handgun transaction records, coupled with machine learning techniques, can be used to forecast firearm suicide risk.Design, Setting, and Participants  This prognostic study used the California database of 4 976 391 handgun transaction records from 1 951 006 individuals from January 1, 1996, to October 6, 2015. Transaction-level random forest classification was implemented to predict firearm suicide risk, and the relative predictive power of features in the algorithm was estimated via permutation importance. Analyses were performed from December 1, 2020, to May 19, 2022.Main Outcomes and Measures  The main outcome was firearm suicide within 1 year of a firearm transaction, derived from California death records (1996-2016). With the use of California's Dealer's Records of Sale (1996-2015), 41 handgun, transaction, purchaser, and community-level predictor variables were generated.Results  There are a total of 4 976 391 transactions in the California's Dealer's Record of Sale database representing 1 951 006 individuals (1 525 754 men [78.2% of individuals]; mean [SD] age, 43.4 [13.9] years). Firearm suicide within 1 year occurred in 0.07% of handgun transactions (3278 transactions among 2614 individuals). A total of 38.6% of observed firearm suicides were among transactions classified in the highest-risk ventile (379 of 983 transactions), with 95% specificity. Among the small number of transactions with a random forest score above 0.95, more than two-thirds (24 of 35 [68.6%]) were associated with a purchaser who died by firearm suicide within 1 year. Important features included known risk factors, such as older age at first purchase, and previously unreported predictors, including distance to firearms dealer and month of purchase.Conclusions and Relevance  This prognostic study presented the first large-scale machine learning analysis of individual-level handgun transaction records. The results suggested the potential utility of such records in identifying high-risk individuals to aid suicide prevention efforts. It also identified handgun, individual, and community characteristics that have strong predictive relationships with firearm suicide and may warrant further study.

Child Access Prevention Laws and Firearm Storage: Results From a National Survey

February 1, 2022

IntroductionChild Access Prevention Negligent Storage (CAP-NS) laws seek to reduce pediatric firearm injury by imposing sanctions on gun owners if children gain access to unlocked guns. Whether these laws affect the storage behavior they aim to encourage is not known because historical panel data on firearm storage do not exist. As a result, assessing how much, if at all, firearm storage changed because of CAP-NS laws requires an indirect approach.MethodsData for this study came from a web-based survey conducted by the research firm Ipsos from July 30, 2019 to August 11, 2019. Respondents were adult gun owners drawn from an online sampling frame comprising approximately 55,000 U.S. adults recruited using address-based sampling methods to be representative of the U.S. population. The primary outcome was the proportion of gun owners in CAP-NS versus non-CAP-NS states who had ≥1 unlocked firearm. Estimates are presented by CAP-NS status, for gun owners overall and for those who live with children, before and after adjusting for potential confounders. Data were analyzed in 2021.ResultsIn adjusted analyses, gun owners in CAP-NS states were no more likely to lock firearms than were those in states without these laws. In addition, most gun owners reported not knowing whether they lived in a state with a CAP-NS law.ConclusionsCAP-NS laws have at best modest effects on firearm storage. If the storage effect is as small as this study indicates, the mortality benefits previously attributed to CAP-NS laws are overstated. As such, developing interventions that effectively reduce firearm mortality by reducing access to firearms remains an urgent clinical and public policy priority.

Implementation and perceived effectiveness of gun violence restraining orders in California: A qualitative evaluation

October 19, 2021

BackgroundUptake of gun violence restraining orders (GVROs), which temporarily prohibit the possession and purchase of firearms and ammunition from individuals at particularly high risk of harming themselves or others with a firearm, has been slow and heterogenous across California. Insights into the implementation process and perceived effectiveness of the law could guide implementation in California and the many states that have enacted or are considering enacting such a law.MethodsWe conducted 21 semi-structured interviews with 27 key informants, including judges, law enforcement officers, city and district attorneys, policy experts, and firearm violence researchers. Analysis of transcripts was guided by grounded theory and the Consolidated Framework for Implementation Research (CFIR).FindingsThe following constructs emerged within 4 CFIR domains as salient features of implementation: 1) implementation characteristics: risk of violence, cost, and adaptability; 2) outer setting: interagency coordination and local firearm ideology; 3) inner setting: readiness for implementation and law enforcement firearm culture; and 4) implementation process: planning and engaging with those involved in implementation. Key informants perceived the law to be effective, particularly for preventing firearm suicide, but agreed that more research was needed. While most indicated that the law resulted in positive outcomes, concerns about the potential for class- and race-based inequities were also raised.ConclusionsImplementation of the GVRO law in California was hampered by a lack of funding to support local proactive implementation efforts. This resulted in ad hoc policies and procedures, leading to inconsistent practices and widespread confusion among those responsible for implementation. In states that have not begun implementation, we recommend dedicating funding for implementation and creating local procedures statewide prior to the law's rollout. In California, recommendations include providing training on the GVRO law—including an explication of agency-specific roles, responsibilities, and procedures—to officers, city attorneys, and civil court judges.

Whose Guns are Stolen? The Epidemiology of Gun Theft Victims

April 10, 2017

This study is the first to explore the association between gun-related characteristics and gun theft victimization. The study shows that owning many guns, owning guns for protection, carrying guns, and storing guns unsafely are associated with having guns stolen. Storing guns in the car also appears to increase the risk. Owning many guns appears to be a risk factor for gun theft, perhaps because burglars see firearms as loot.