Density of gun shops linked to areas’ suicides by firearm

Firearm suicides are more common in areas with more gun shops, a new study has found.

The finding suggests it might be possible to reduce firearm suicide deaths by reducing the number of gun shops in communities, or enlisting gun-shop owners to participate in suicide-prevention initiatives, said the study’s lead author. 

Julie Kafka conducted the study as a postdoctoral research fellow at the UW Medicine Firearm Injury & Policy Research Program in Seattle and remains affiliated with the program. She is an assistant professor of emergency medicine at the University of Colorado Anschutz School of Medicine.

The paper was published Sept. 9 in the American Journal of Preventive Medicine.

More than 49,000 Americans died by suicide in 2022, according to the U.S. Centers for Disease Control and Prevention. Firearms, the most common method used, accounted for more than half of suicide deaths. 

Researchers and others have raised the issue of gun shops’ role in the ongoing suicide epidemic.

“We do know that easy access to firearms can turn suicidal thoughts into tragic action,” said Kafka. “Firearms are highly lethal, and when someone attempts suicide with a firearm, they are more likely to die, compared to when people employ other methods. When other methods are used, there are better chances for resuscitation, recovery and for people to get the help and support that they need”

Although suicide is often described as the act of an individual, external factors can increase access to firearms and shape attitudes toward gun ownership. These factors might make it more likely for an individual to act on suicidal impulses by using a firearm, Kafka noted. 

In the study, Kafka and her colleagues mapped the number of federal firearm licensees per capita and number of firearm-related and other suicides by census tracts in Maryland, a state whose death certificate protocol provides  reliable information about the manner of death. Federal firearm licensees include firearm dealers, gun shops and pawnshops that sell guns. 

The researchers found that concentrated clusters of gun shops and suicides involving firearms tended to occur in the same neighborhoods and regions of the state. Firearm suicides and the gun shop clusters were more common in the state’s rural eastern and western regions, while non-firearm suicides were heavily concentrated in Maryland’s more urban core, where the concentrations of federal firearm licensees was lower. 

The investigators also found that, compared to other methods of suicide, the risk of firearm involvement was about 29% higher among men, and 26% higher for women, in neighborhoods with relatively higher densities of federal firearm licensees. 

“Our findings suggest that we should think about firearm dealers and gun shops as commercial determinants of health in a similar way that we think about how the density of alcohol outlets, cannabis dispensaries, smoke shops and fast-food outlets impact the health of communities,” she said. 

More research is needed, she said, to understand the mechanisms by which firearm availability at the community-level affects firearm suicide mortality. 

“The study supports the idea that federal firearm licensees may be suitable intervention points to prevent firearm suicides,” Kafka said.

Such interventions might include enlisting gun shop owners in projects that raise awareness of suicide-prevention services, and to train employees to identify and decline sales to customers who might be acutely suicidal. Interventions also could include consideration of zoning laws to reduce the density of gun shops in affected communities, in states where such changes are allowed by law.

The study was funded by the National Institute on Alcohol Abuse and Alcoholism (T32AA007240).

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