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TOPLINE: Among veterans and demographically matched nonveterans from 2002 to 2019, higher state household firearm ownership was associated with higher rates of deaths by suicide, while greater state firearm law restrictiveness was associated with lower rates of deaths by suicide. In 2017 to 2019 models, these associations were seen for both veterans and matched nonveterans and driven primarily by firearm deaths by suicide rates.
METHODOLOGY:
US state-level data across 6 consecutive 3-year periods from 2002-2019, stratified suicide rates by veteran status (veteran vs matched nonveterans) and method (firearm vs nonfirearm).
Data sources included US Department of Veterans Affairs (VA) Office of Mental Health and Suicide Prevention counts matched to the National Death Index, plus Centers for Disease Control suicide counts and population estimates by sex and age.
Participants included veterans with state- and period-specific death suicide counts and population denominators from the VetPop model, and a matched nonveteran comparison created by comparing state deaths by suicide data to veterans’ age and gender distributions.
Exposure measures included annual state household firearm ownership rate estimates carried forward to 2017-2019, and a 7-item state firearm policy restrictiveness index derived from the RAND Corporation state firearm law database.
TAKEAWAY:
Average death by suicide rates from 2002-2019 were 28.2 per 100,000 for veterans and 27.5 per 100,000 for matched nonveterans, with most deaths involving a firearm.
Across states, the maximum average death by suicide rate was about 3 times the minimum over the study period, and veteran and matched nonveteran state patterns aligned closely.
Higher household firearm ownership was associated with higher firearm death by suicide rates for veterans and matched nonveterans from 2017-2019.
Greater firearm law restrictiveness, equivalent to 3 additional restrictive laws, was associated with fewer firearm deaths by suicide for veterans and matched nonveterans from 2017-2019.
IN PRACTICE: “The results suggest that changes to state firearm laws and policies should be investigated as a possibly cost-effective primary prevention strategy for reducing suicide rates among veterans and nonveterans,” the authors wrote.
SOURCE:The study was led by Andrew R. Morral, PhD, RAND Corporation in Arlington, Virginia, and Terry L. Schell, PhD, and Adam Scherling, RAND Corporation in Santa Monica, California and published online in Injury Prevention.
LIMITATIONS: The estimates are correlational and should not be interpreted as causal effect estimates, as most interstate variation in gun ownership and firearm laws predates the beginning of the available VA death by suicide data, limiting the analytical approach to identify causal effects. VA does not share microdata on veteran suicide, requiring construction of a matched comparison sample of nonveterans by estimating veteran decedent removal from general population suicide totals within cells of a 5-way table based on publicly released 3-way tables, introducing imprecision. Veteran suicide counts are known to undercount suicides among veterans who separated from the military prior to 1974, likely resulting in a slight underestimate of veteran suicide rates for the oldest cohort of veterans, particularly in earlier study periods. Restricting analysis to identify modeled effects solely through limited changes in state firearm ownership and policies during the study period yields imprecise effect estimates.
DISCLOSURES: This work received support from a grant provided by The RAND Epstein Family Veterans Policy Research Institute, established through a contribution from Daniel J. Epstein via the Epstein Family Foundation. Neither the Institute, the Foundation, nor Mr. Epstein participated in the design, conduct, analysis, or drafting of this report. The authors disclosed no relevant conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
TOPLINE: Among veterans and demographically matched nonveterans from 2002 to 2019, higher state household firearm ownership was associated with higher rates of deaths by suicide, while greater state firearm law restrictiveness was associated with lower rates of deaths by suicide. In 2017 to 2019 models, these associations were seen for both veterans and matched nonveterans and driven primarily by firearm deaths by suicide rates.
METHODOLOGY:
US state-level data across 6 consecutive 3-year periods from 2002-2019, stratified suicide rates by veteran status (veteran vs matched nonveterans) and method (firearm vs nonfirearm).
Data sources included US Department of Veterans Affairs (VA) Office of Mental Health and Suicide Prevention counts matched to the National Death Index, plus Centers for Disease Control suicide counts and population estimates by sex and age.
Participants included veterans with state- and period-specific death suicide counts and population denominators from the VetPop model, and a matched nonveteran comparison created by comparing state deaths by suicide data to veterans’ age and gender distributions.
Exposure measures included annual state household firearm ownership rate estimates carried forward to 2017-2019, and a 7-item state firearm policy restrictiveness index derived from the RAND Corporation state firearm law database.
TAKEAWAY:
Average death by suicide rates from 2002-2019 were 28.2 per 100,000 for veterans and 27.5 per 100,000 for matched nonveterans, with most deaths involving a firearm.
Across states, the maximum average death by suicide rate was about 3 times the minimum over the study period, and veteran and matched nonveteran state patterns aligned closely.
Higher household firearm ownership was associated with higher firearm death by suicide rates for veterans and matched nonveterans from 2017-2019.
Greater firearm law restrictiveness, equivalent to 3 additional restrictive laws, was associated with fewer firearm deaths by suicide for veterans and matched nonveterans from 2017-2019.
IN PRACTICE: “The results suggest that changes to state firearm laws and policies should be investigated as a possibly cost-effective primary prevention strategy for reducing suicide rates among veterans and nonveterans,” the authors wrote.
SOURCE:The study was led by Andrew R. Morral, PhD, RAND Corporation in Arlington, Virginia, and Terry L. Schell, PhD, and Adam Scherling, RAND Corporation in Santa Monica, California and published online in Injury Prevention.
LIMITATIONS: The estimates are correlational and should not be interpreted as causal effect estimates, as most interstate variation in gun ownership and firearm laws predates the beginning of the available VA death by suicide data, limiting the analytical approach to identify causal effects. VA does not share microdata on veteran suicide, requiring construction of a matched comparison sample of nonveterans by estimating veteran decedent removal from general population suicide totals within cells of a 5-way table based on publicly released 3-way tables, introducing imprecision. Veteran suicide counts are known to undercount suicides among veterans who separated from the military prior to 1974, likely resulting in a slight underestimate of veteran suicide rates for the oldest cohort of veterans, particularly in earlier study periods. Restricting analysis to identify modeled effects solely through limited changes in state firearm ownership and policies during the study period yields imprecise effect estimates.
DISCLOSURES: This work received support from a grant provided by The RAND Epstein Family Veterans Policy Research Institute, established through a contribution from Daniel J. Epstein via the Epstein Family Foundation. Neither the Institute, the Foundation, nor Mr. Epstein participated in the design, conduct, analysis, or drafting of this report. The authors disclosed no relevant conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
TOPLINE: Among veterans and demographically matched nonveterans from 2002 to 2019, higher state household firearm ownership was associated with higher rates of deaths by suicide, while greater state firearm law restrictiveness was associated with lower rates of deaths by suicide. In 2017 to 2019 models, these associations were seen for both veterans and matched nonveterans and driven primarily by firearm deaths by suicide rates.
METHODOLOGY:
US state-level data across 6 consecutive 3-year periods from 2002-2019, stratified suicide rates by veteran status (veteran vs matched nonveterans) and method (firearm vs nonfirearm).
Data sources included US Department of Veterans Affairs (VA) Office of Mental Health and Suicide Prevention counts matched to the National Death Index, plus Centers for Disease Control suicide counts and population estimates by sex and age.
Participants included veterans with state- and period-specific death suicide counts and population denominators from the VetPop model, and a matched nonveteran comparison created by comparing state deaths by suicide data to veterans’ age and gender distributions.
Exposure measures included annual state household firearm ownership rate estimates carried forward to 2017-2019, and a 7-item state firearm policy restrictiveness index derived from the RAND Corporation state firearm law database.
TAKEAWAY:
Average death by suicide rates from 2002-2019 were 28.2 per 100,000 for veterans and 27.5 per 100,000 for matched nonveterans, with most deaths involving a firearm.
Across states, the maximum average death by suicide rate was about 3 times the minimum over the study period, and veteran and matched nonveteran state patterns aligned closely.
Higher household firearm ownership was associated with higher firearm death by suicide rates for veterans and matched nonveterans from 2017-2019.
Greater firearm law restrictiveness, equivalent to 3 additional restrictive laws, was associated with fewer firearm deaths by suicide for veterans and matched nonveterans from 2017-2019.
IN PRACTICE: “The results suggest that changes to state firearm laws and policies should be investigated as a possibly cost-effective primary prevention strategy for reducing suicide rates among veterans and nonveterans,” the authors wrote.
SOURCE:The study was led by Andrew R. Morral, PhD, RAND Corporation in Arlington, Virginia, and Terry L. Schell, PhD, and Adam Scherling, RAND Corporation in Santa Monica, California and published online in Injury Prevention.
LIMITATIONS: The estimates are correlational and should not be interpreted as causal effect estimates, as most interstate variation in gun ownership and firearm laws predates the beginning of the available VA death by suicide data, limiting the analytical approach to identify causal effects. VA does not share microdata on veteran suicide, requiring construction of a matched comparison sample of nonveterans by estimating veteran decedent removal from general population suicide totals within cells of a 5-way table based on publicly released 3-way tables, introducing imprecision. Veteran suicide counts are known to undercount suicides among veterans who separated from the military prior to 1974, likely resulting in a slight underestimate of veteran suicide rates for the oldest cohort of veterans, particularly in earlier study periods. Restricting analysis to identify modeled effects solely through limited changes in state firearm ownership and policies during the study period yields imprecise effect estimates.
DISCLOSURES: This work received support from a grant provided by The RAND Epstein Family Veterans Policy Research Institute, established through a contribution from Daniel J. Epstein via the Epstein Family Foundation. Neither the Institute, the Foundation, nor Mr. Epstein participated in the design, conduct, analysis, or drafting of this report. The authors disclosed no relevant conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.