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After 19 children and two teachers were slaughtered by a gunman at Robb Elementary School in Uvalde, Texas, many Americans are asking, yet again, how to prevent future acts of senseless violence from occurring. What gun laws need to be changed? Why is it so difficult to pass regulations? How can Second Amendment rights be balanced with firearm safety? 

Stanford scholars have been studying these issues from a range of perspectives, including law, politics, economics, and medicine. Here are some of their findings.

Update: May 25, 2022: This story was originally published on Feb. 26, 2018, and has been updated to include new content.

Causes, impacts of gun violence

Uncovering the causes of gun violence has been a challenge, in part because research is limited by federal legislation that constrains research funding on the issue. Scholar Nigam Shah at the Stanford School of Medicine has written about how this has affected empirical study. But that has not deterred scholars from examining its impacts. David Studdert, also at the School of Medicine, has studied the devastating consequences of gun violence, particularly the risks it poses to public health.  

Maya Rossin-Slater, an associate professor of medicine and a senior fellow at the Stanford Institute for Economic Policy Research (SIEPR), has also looked at the long-term impact of gun violence, specifically among American children who experienced a shooting at their school. Rossin-Slater found that they have higher rates of absenteeism, lower high school and college graduation rates, and by their mid-twenties, earn lower incomes.

Below is some of that research. 

Californians living with handgun owners more than twice as likely to die by homicide, study finds

Residents who don’t own a handgun but live with someone who does are significantly more likely to die by homicide compared with those in gun-free homes, research shows.

New study of gun violence in schools identifies long-term harms

Research from SIEPR’s Maya Rossin-Slater finds that students exposed to school shootings face “lasting, persistent” adversity in their educational and long-term economic outcomes.

Shirin Sinnar on the Buffalo shooting, hate crimes, and domestic terrorism

In the wake of the Buffalo shooting, Stanford Law School’s Shirin Sinnar discusses the scale of white supremacist violence in the U.S. and the rise of hate crimes.

Disconnect: The gap between gun violence and research in numbers

Gun violence is much discussed but little studied, largely due to federal decisions governing research funding. A new analysis highlights just how big the gap between the violence and our knowledge of it is. The answer? It’s huge.

Supporting students exposed to school shootings

Maya Rossin-Slater talks about her research into the mental health impact of severe school violence.

Panel discusses how shootings affect those unscathed by bullets

A panel of faculty members at the School of Medicine said shootings can affect the mental health of people close to the violence.

California handgun sales spiked after two mass shootings

In the six weeks after the Newtown and San Bernardino mass shootings, handguns sales jumped in California, yet there is little research on why – or on the implications for public health, according to a Stanford researcher.

Mass shootings: Public face of a much larger epidemic

While mass shootings have become the public face of gun violence, they account for less than 1% of the 40,000 firearm deaths each year.  

Short-term hospital readmissions for gun injuries cost $86 million a year

A study from Stanford researchers has found that readmissions account for 9.5% of the $911 million spent annually on gun-injury hospitalizations.

Supporting children through loss

Rabbi Patricia Karlin-Neumann talks about how to help young people experiencing grief.

Firearm injuries in children, teens costly for U.S. health care system, Stanford study finds

The average cost of initial hospitalization to treat pediatric gun injuries is about $13,000 per patient and has risen in recent decades, a Stanford Medicine study found.

Investigating psychiatric illnesses of mass shooters

Ira Glick and his collaborators studied the psychiatric state of 35 mass shooters in the United States who survived the incidents, which took place between 1982 and 2019.

The silent cost of school shootings

SIEPR’s Maya Rossin-Slater finds the average rate of antidepressant use among youths under age 20 rose by 21 percent in the local communities where fatal school shootings occurred.

New study analyzes recent gun violence research

Consensus is growing in recent research evaluating the impact of right-to-carry concealed handgun laws, showing that they increase violent crime, despite what older research says.

Handgun ownership associated with much higher suicide risk

Men who own handguns are eight times more likely to die of gun suicides than men who don’t own handguns, and women who own handguns are 35 times more likely than women who don’t.

Advice on how to cope with the threat of school shootings

Victor Carrion offers advice on how families can cope with the stress of school safety.

Reducing gun violence

Many Americans are demanding practical steps to reduce gun crime. One way is to have more stringent gun safety policies, such as legislation requiring guns to be stored safely, more stringent background checks, or as President Biden announced Tuesday, a federal ban on assault weapons and high-capacity magazines. 

Research has shown that states with tighter policies save lives: One study by Stephanie Chao found that states with stricter gun laws have lower rates of gun deaths among children and teenagers, and states with child prevention access laws are linked with fewer gun suicides in this age group.

“If you put more regulations on firearms, it does make a difference,” said Chao, assistant professor of surgery and senior author of the study. “It does end up saving children’s lives.” Her analysis found that states with the strictest laws had a mortality rate of 2.6 per 100,000 and for states with the least strict laws, mortality rate was almost double at 5.0 per 100,000.  

John Donohue: One tragic week with two mass shootings and the uniquely American gun problem

In a Q&A, Stanford Law School gun law expert John J. Donohue III discusses mass shootings in the U.S., the challenges facing police when confronting powerful automatic weapons and the prospect of gun safety laws.

Lax state gun laws linked to more child gun deaths

States with strict gun laws have lower rates of gun deaths among children and teenagers, and laws to keep guns away from minors are linked with fewer gun suicides in this age group, a Stanford study found.

Improved gun buyer background checks would impede some mass shootings, Stanford expert says

Stanford Law Professor John Donohue says a background check system that was universal and effectively operated could impede gun acquisition by people who commit mass shootings.

How to solve more gun crimes without spending more money

Simple tweaks to how police process bullet casings could dramatically improve their forensic data.

Reducing civilian firepower would boost police and community safety, Stanford expert says

In addition to restricting the firepower a person can amass, Stanford law Professor John J. Donohue advocates efforts to build trust between communities and law enforcement agencies as a way to enhance both police and citizen safety.

Stricter gun laws reduce child and adolescent gun deaths, Stanford study finds

Laws that keep guns away from young people are especially strongly linked to lower rates of gun suicides in youth.

Gun legislation and policy

For nearly three decades, law Professor John Donohue III has studied what can be done to prevent gun violence in the United States. A lawyer and economist, Donohue explores how law and public policy are connected to gun violence, including how gun laws in the U.S. compare to other countries, as well as how legislation varies across the states, to better understand the effect that has on rates of violence. 

“The U.S. is by far the world leader in the number of guns in civilian hands,” Donohue explained . “The stricter gun laws of other ‘advanced countries’ have restrained homicidal violence, suicides and gun accidents – even when, in some cases, laws were introduced over massive protests from their armed citizens.” 

Here are some of his findings, and other research related to legislating gun safety in the U.S.

Stanford’s John Donohue on guns, mass shootings and the law in the U.S.

On Nov. 30, American students were once again the victims of a school shooting. Stanford law Professor John Donohue discusses the case and gun violence in the U.S.

How U.S. gun control compares to the rest of the world

While deaths from mass shootings are a relatively small part of the overall homicidal violence in America, they are particularly wrenching. The problem is worse in the U.S. than in most other industrialized nations. And it’s getting worse.

4 gun control steps U.S. needs now

John Donohue pens an opinion piece for CNN laying out four steps the United States should take to strengthen gun legislation.

Violent crime increases in right-to-carry states

Stanford Law School Professor John Donohue found that states that adopted right-to-carry concealed handgun laws have experienced a 13 to 15 percent increase in violent crime in the 10 years after enacting those laws.

Another mass shooting: An update on U.S. gun laws

In a Q&A, John Donohue discusses gun safety law and legislative developments.

Stanford GSE holds teach-in on research into gun violence in schools

Education scholars look at the evidence behind policy ideas to address school shootings.

Will Americans ever think differently about guns?

Stanford medicine and law professor David Studdert thinks more public health evidence is needed before cultural attitudes around gun safety and violence will change.

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Firearm Ownership, Defensive Gun Usage, and Support for Gun Control: Does Knowledge Matter?

• Published: 30 September 2021
• Volume 48 , pages 21–50, ( 2023 )

Cite this article

• Nathan E. Kruis   ORCID: orcid.org/0000-0002-2076-314X 1 ,
• Richard L. Wentling 2 ,
• Tyler S. Frye 1 &
• Nicholas J. Rowland 3  

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Recent incidents of gun violence have raised questions about public access to “military-style” firearms and the need for more-restrictive forms of gun control. Proponents of more-restrictive forms of gun regulation argue that such measures will help combat the disproportionately high rates of gun crime in the United States. Opponents believe that such measures infringe upon constitutional rights and hinder law-abiding citizens' abilities to adequately defend themselves. This project explores the characteristics of gun owners living in Pennsylvania and public perceptions of three different categories of gun control. Results indicate that most gun owners have received some form of training and take appropriate safety precautions with their firearms. Further, 1 in 4 gun owners reported using their firearm in self-defense at some point in their life. Regarding gun control, most participants favored strategies intended to keep guns away from dangerous and “at risk” people, such as required background checks for all types of gun purchases, mental health screenings, and mandatory gun education. However, most participants opposed complete firearm bans. Among those who are the least supportive of such polices are those who are the most knowledgeable about gun crime, gun legislation, and gun functioning. Policy implications are discussed within.

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Introduction

Gun reform was a key policy issue of the 2020 presidential general election. President Biden and Democratic leaders have advocated for the enactment of “common sense” gun reform efforts, such as assault weapon bans, universal background checks, and increased resources to enforce current gun laws (Lucey, 2021 ). They believe that such reforms will help reduce the disproportionately high rates of gun crime in America. As such, leading Democrats are expected to push to change gun laws in the coming years (Newburger, 2021 ; Phillips, 2021 ). However, while data suggests that many Republicans are generally supportive of gun reform efforts intended to keep guns away from dangerous and “at risk” people (Cook et al., 2011 ; Oliphant, 2017 ), many Republican leaders view the comprehensive reforms proposed by Democrats as arbitrary, infringing on constitutionally protected rights, and hindering American citizens’ abilities to adequately protect themselves, their families, and their properties. They believe that comprehensive legislation proposed by the Biden administration will only remove guns from the hands of law-abiding citizens and do little to combat gun crime. As such, legislators in many Republican-led jurisdictions have begun passing more-permissive gun policies aimed at limiting the scope of federal (“Democratic” enacted policies) gun control measures at the state level, such as pushing for “Constitutional Carry” laws, “Anti-red flag” legislation and creating “2nd Amendment Sanctuary” cities and states (Balemert, 2021 ; Friend, 2021 ).

The debate is not exclusively political, though. There is also a rift in support for gun control amongst scholars, with some favoring more-restrictive forms of gun control and others favoring less-restrictive forms of gun regulation (Morral et al., 2018 ). The legality and utility of gun regulation has promoted much discussion amongst academics (see Braga et al., 2021 ; Kleck et al., 2016 ; Winkler, 2018 ). Public support for gun control is also mixed and has varied across time, although current estimates suggest that a slight majority favor more-restrictive forms of gun control, but do not favor complete firearm bans (Gallup, 2020 ; Parker et al., 2017 ).

Prior research has attempted to examine correlates of attitudes toward gun polices. Generally, this work has found that those who are the least supportive of more-restrictive forms of gun regulation are those who identify as politically conservative (Kruis et al., 2020 ), whites (Merino, 2018 ), males (O’Brien et al., 2013 ), and gun owners (Merino, 2018 ), as well as those with greater familiarity with firearms (Rosen, 2000 ). A recent article published in the American Journal of Criminal Justice shifted this discussion to the relationship between gun knowledge and support for restrictive forms of gun control (see Kruis et al., 2020 ). In that work, the researchers found an inverse relationship between gun knowledge (i.e., broad “understanding” of gun policies, legislation, and crime) and support for stricter forms of gun control amongst college students. Findings indicated that students who knew more about guns and gun-related matters, reported being less supportive of more-restrictive forms of gun control than students who lacked such knowledge. Unfortunately, methodological limitations (e.g., cross-sectional research design, convenience sampling, student participants, etc.) precluded the authors from drawing firm conclusions about the relationship between gun knowledge and gun functioning. The current project seeks to extend this line of research by exploring the relationship between three types of gun knowledge (i.e., knowledge of gun crime, knowledge of gun legislation, and knowledge of gun functioning) and three different measures of gun control (i.e., general gun control, support for policies that reduce overall gun ownership, support for polices intended to keep guns away from dangerous and “at risk” people). The current project also extends Kruis et al.’s ( 2020 ) findings related to student gun owners to members of the general public, by exploring the demographic characteristics, training experiences, safety precautions, and defensive gun usage reported by gun owners obtained from a representative sample of Pennsylvania Residents ( N  = 522). In achieving these goals, the current study seeks to provide academics and policymakers alike with important information needed to be considered before making gun reforms.

Literature Review

Gun violence.

The United States has disproportionately high rates of gun violence for a developed country (Grinshteyn & Hemenway, 2019 ; Naghavi et al., 2018 ). The U.S. homicide rate is estimated to be about seven times higher than other high-income countries, which researchers suggest is primarily driven by a gun homicide rate that is about 25 times higher (Grinshteyn & Hemenway, 2019 ). In 2019 alone, there were approximately 39,707 firearm-related deaths in the United States, equating to a rate of about 12.1 per 100,000 persons (Centers for Disease Control and Prevention [CDC], 2020 )—which is about three times the rate of America’s northern neighbor (i.e., Canada, 4.1 per 100,000; Department of Justice, Government of Canada, n.d.). Among these firearm-related deaths, 23,941 were suicides and 14,414 were homicides (CDC, 2020 ). Guns, particularly handguns, are used to commit many violent crimes and most murders in the United States (National Institute of Justice, 2019 ). In total, guns were used to help commit more than 121,000 violent crimes in 2019 (Federal Bureau of Investigation [FBI], n.d.). According to data collected for the National Crime Victimization Survey (NCVS), guns were used in more than one in three aggravated assaults and about one in five robbery victimizations reported by Americans in 2019, but fewer than 1 in 100 rape and sexual assault victimizations (Bureau of Justice Statistics, 2020 ). In this regard, while guns are used to help commit many crimes, it would be an oversight to ignore that most violent victimizations in the United States do not involve guns (Braga et al., 2021 ). Further, whenever a gun is used during the commission of a violent crime it usually is not fired. In fact, when a gun is used in a crime it is predominately used as an instrument to gain victim compliance. Data suggest that only about one in four victims of nonfatal gun crimes suffer a gunshot wound (Planty & Truman, 2013 ) and overall injury rates for victims of gun crimes tend to be lower than rates for victims of crimes in which other weapons are used (Cook, 1980 ; Cook et al., 2011 ). However, whenever guns are used offenders are more likely to complete the criminal act (Cook et al., 2011 ; Libby & Corzine, 2007 ; Tillyer & Tillyer, 2014 ), and whenever they are fired, victim injuries are more likely to be lethal (Cook, 2018 ; Cook et al., 2011 ).

The Great American Gun Debate

Given high rates of gun crime, many progressives have demanded changes be made to American gun legislation. In a review of the extant literature on firearm instrumentality, Braga et al. ( 2021 ) suggest that there are two sides in the great American gun debate. On the one side of the debate are those who favor more-permissive forms of gun regulation. These advocates tend to conform to the adage endorsed by the National Rifle Association (NRA) “guns don’t kill people, people kill people” (Braga et al., 2021 ; Henigan, 2016 ; Shammas, 2019 ). This group believes that more-restrictive gun control will do little to reduce crime or to save lives (Kleck, 1997 ; Kleck et al., 2016 ; Wolfgang, 1958 ). On the other side of the debate are proponents of more-restrictive forms of gun regulation, or those who believe that “guns do kill people” (Braga et al., 2021 , p. 148). These advocates suggest that reducing firearm availability, especially to who they consider to be dangerous or “at risk” individuals (i.e., felons, the “mentally unstable,” Footnote 1 etc.) will help reduce violent gun crimes and suicides, and ultimately, save lives. In Braga et al.’s ( 2021 ) synopsis of propositions introduced by the two sides, the researchers argue that the key distinction between proponents and opponents of stricter forms of gun control relates to the instrumentality of weapons. Specifically, they write “The ‘people kill people’ perspective further suggests that gun control is futile in reducing homicides because determined killers will simply find another way. If guns are not available, assailants will substitute knives, blunt instruments, or other means” (p. 148). Similar sentiments are found within the general public as an increasing number of Americans have purchased firearms, specifically during the Covid-19 pandemic, citing self-defense as a primary driver of ownership (Gallup, 2020 ; Schaeffer, 2021 ). However, proponents of more-restrictive means of gun control assume that even if assailants choose to use other means (i.e., knife, blunt instrument) to carry out their attacks, such attacks will be less fatal (Cook, 1991 ; Cook et al., 2011 ; Henigan, 2016 ). Thus, Braga et al. ( 2021 ) argue that the crux of the debate centers on what researchers refer to “firearm instrumentality,” or whether the presence of firearms makes a criminal event more lethal.

While Braga et al. (2021 ) bring attention to an important point of contention within the debate, their brief synopsis of the two sides in the great debate overlooks arguments pertaining to the perceived ability, or inability, of gun legislation being able to effectively reduce firearm availability, particularly to dangerous and “at risk” people. This issue is a focal point in the debate and a common topic that is an important factor for the general public. Indeed, it is almost commonsensical to believe that if there were no guns, then there would be no gun crime; certainly, proponents of both sides know this to be true. The reality though is that there are a lot of guns. In fact, the United States civilian gun ownership rate is the highest in the world, with estimates suggesting that there are more than 350 million guns owned by Americans (Institute of Medicine & National Research Council, 2013 ). These instruments serve both legitimate (i.e., recreation, hunting, self-defense, etc.) and illegitimate purposes (i.e., criminal activities; Cook et al., 2011 ; Kleck et al.,  2016 ). Thus, the real questions in the debate are (1) will strict gun control policies be able to effectively keep guns away from dangerous and “at risk” individuals who may want to harm themselves or others? and (2) will restrictive gun control measures prevent law abiding citizens from defending their families, their properties, and their lives?

Opponents of restrictive forms of control believe that more-restrictive gun control policies will do little to disrupt illegal gun markets. They believe that such policies will merely take guns away from law abiding citizens who use firearms for legitimate purposes, including recreation, hunting, and self-defense. Current estimates suggest that there are about 15.2 million hunting license holders in the United States (U.S. Fish & Wildlife Services, 2020 ) and 9.4 million self-described “gun only” deer hunters (Schmidt, 2020 ). The data suggest that a significant portion of Americans use firearms as a source of legal recreation and food acquisition. Data also suggest that a significant number of Americans use guns for self-defense purposes. A 2017 report published by researchers at Pew Charitable trust estimated that approximately 1 in 6 gun owners had used their weapon to defend themselves, their families, or their possessions at some point in their life (Parker et al., 2017 ). While estimates vary greatly, it is speculated that the prevalence of defensive gun usage in the United States ranges from 60,000 to 2.5 million incidents annually (National Research Council, 2013 ), and whenever guns are used in self-defense, the odds of injury to potential victims is significantly reduced (Cook et al., 2011 ; Kleck & Gertz, 1995 ). As such, critics of more-restrictive gun control “argue that gun control laws could increase crime, by disarming prospective victims, reducing their ability to effectively defend themselves, and possibly reducing any deterrent effect that victim gun possession might have on offenders” (Kleck et al.,  2016 , p.489).

Opponents of more restrictive measures of gun control turn to research demonstrating that a majority of gun crimes are committed by offenders who illegally obtained the firearm used in the crime (Cook, 2018 ; Roth, 1994 ). Indeed, research suggests that most gun crimes are committed by individuals who are already, under current regulations, legally disqualified from possessing a firearm due to their age, criminal record, or some other characteristic (Cook, 2018 ). However, proponents of more-restrictive gun control use this same research to cite the reality that most firearms used to commit crime originate from a legal manufacturing or distribution supply chain (Cook, 2018 ). Thus, they believe that reducing the number of guns in such markets will ultimately reduce the number of guns available to be used in crimes (Cook et al., 2011 ).

A recent report published by the RAND Corporation found that members of the scholarly community also tend to conform to this “more-restrictive” or “more-permissive” dichotomy (Morral et al., 2018 ). Indeed, there is great disagreement among researchers about the extent to which crime can be reduced through gun control. While research has produced mixed results, evidence from more methodologically sound work has indicated that higher levels of firearm ownership has little, if any, effect on overall violent crime rates (Cook & Ludwig, 2006 ; Cook & Pollack, 2017 ; Cook et al., 2011 ) or suicides (Kleck, 2019a , 2019b ), and that more-restrictive gun control mechanisms are generally ineffective at reducing crime (Kleck & Patterson, 1993 ; Kleck et al., 2016 ; Kleck, 2019b ). Footnote 2 However, some research indicates that there may be an association between rates of community gun ownership and homicide rates (Braga et al., 2021 ), suggesting that firearm availability may increase the lethality of violent crimes—although Kleck ( 2021 ) argues that prior work in this area has produced mixed findings, been tautological, and that the data merely demonstrate a positive relationship between gun ownership and the firearm homicide rates (Kleck, 2021 ). There also is evidence suggesting that polices intended to restrict dangerous and/or “at-risk” individuals (i.e., felons, the mentally ill, and “alcoholics”) from accessing firearms may be associated with reductions in crime, suicides, and violence in the community (Andrés & Hempstead, 2011 ; Braga et al., 2021 ; Braga & Cook, 2018 ; Cook et al., 2011 ; Kleck, 2019b ; Kleck et al., 2016 ; Sen & Panjamapirom, 2012 ; Smith & Spiegler, 2020 ; Wright et al., 1999 ). However, there is more research needed in this area before firm conclusions can be drawn.

Types of Gun Control

Cook et al. ( 2011 ) argue that gun-control measures can be “usefully classified into three categories: those that are intended to reduce overall gun ownership; those that are intended to keep guns away from particularly dangerous people; [and] those that are intended to influence choices about how guns are used and to what effect” (p. 259). Mechanisms that are intended to reduce overall gun ownership are those that attempt to keep guns out of the hands of all citizens—law abiding or non-law abiding. Such policies include firearm bans, limited and restrictive licensing, gun buy-back programs, and policies designed to make firearms and ammunition more expensive, and subsequently, less affordable to the average citizen. Although research on public support for such strategies is limited, data suggest that a slight majority of the general public supports banning the manufacturing, possession, and sale of some types of firearms, such as assault rifles, from public use (Gallup, 2020 ), but few support policies banning other types of firearms, such as handguns, from public use (Brenan, 2020 ). Footnote 3 Mechanisms that are intended to keep guns away from dangerous or “at-risk” people refer to strategies aimed at keeping guns away from those who are likely to use them for criminal purposes, or to self-harm, such as felons, the untrained, and the mentally ill (Morrall, 2018 ). Measures within this category of gun control include increased screening and monitoring of buyers and dealers in legal gun markets, creating a national firearms database, and outlawing “straw” (i.e., secondary market) purchases. Generally, the public is more supportive of these types of gun control strategies, especially those aimed at barring gun sales to the mentally ill, and those on “no fly” or on law enforcement “watch lists” (Parker et al., 2017 Schaeffer, 2019 ). The third category of “usefully classified” gun control mechanisms are those intended to influence choices about how guns are used and to what effect. This category includes strategies aimed at increasing firearm design regulation (e.g., manufacturing more “smart guns”) and implementing various forms of “focused deterrence” policing strategies, such as “gun oriented patrol tactics” and “hot spots policing” (Cook et al., 2011 , p. 280) Recent research suggests that many members of the general public may have favorable views of smart guns as a safety and crime reduction tool by indicating that they would be inclined to purchase such weapons if they became readily available (Wallace, 2016 ). Controversial, research also indicates mixed public support for “gun oriented” policing tactics, such as stop, question, and frisk polices (Evans & Williams, 2017 ) which is further complicated by the recent surge in firearm purchases (Schaeffer, 2021 ).

Prior Research Assessing Correlates of Support for Gun Control

Trends in public polling tend to inform the direction of gun policies and the overall sentiment of potential voters toward certain restrictions or measures to be introduced. Much of this data is derived from national surveys which are administered through organizations such as Gallup, RAND, and similar organizations via cross-sectional designs. Wozniak ( 2017 ) notes that public opinion toward gun control has remained relatively consistent although support for more restrictive laws concerning the sales of firearms has declined since the 1990s. The most recent data collected by Gallup ( 2020 ) suggest that approximately 57 percent of Americans believe that the laws covering the sale of firearms should be made more strict, which is down more than 20 percentage points since when the organization first started tracking these data in the early 1990s, but up more than 10 percentage points from the start of the 2010s. One aspect that remains relatively high is the support for background checks and limiting access for dangerous or “at-risk” individuals. Barry et al. ( 2019 ) find similar support for the use of universal background checks and limiting access for dangerous or “at-risk” individuals regardless of ownership status to include knowledge and/or safety courses for first-time owners.

Researchers have spent considerable time examining correlates of support for gun control, finding mixed support across demographic groups. Due to this mixed support, an array of proposed gun control measures and policies have faced backlash amid American constituents (see Giffords Law Center for a review of state-specific measures). Generally, though, this work has found that men (Ellison, 1991 ; Kauder, 1993 ; Livingston & Lee, 1992 ; Marciniak & Loftin, 1991 ; Merino, 2018 ; O’Brien et al., 2013 ; Pederson et al., 2015 ; Tyler & Lavrakas, 1983 ), whites (Filindra & Kaplan, 2017 ; McClain, 1983 ; Merino, 2018 ; Secret & Johnson, 1989 ), those who are politically conservative (Filindra & Kaplan, 2017 ; Merino, 2018 ), those who live in rural communities (Brennan et al., 1993 ; Parker et al., 2017 ) and gun owners (Filindra & Kaplan, 2017 ; Merino, 2018 ) are less supportive of more-restrictive forms of gun control than those in reference groups. Additionally, there is evidence suggesting that those who have greater exposure to, and familiarity with firearms (Ellison, 1991 ; Hill et al., 1985 ; Kruis et al., 2020 ; Rosen, 2000 ; Tyler & Lavrakas, 1983 ) favor more-permissive forms of gun control. Recently, Filindra and Kaplan ( 2017 ) found that “drivers of support for gun control” were generally consistent for members of racial minority groups and whites (p. 413). The authors noted that fear, or concern, of crime was generally positively related to support for more-restrictive forms of gun control across racial groups, while political conservativism, being a crime victim, owning a gun, and racial prejudice (i.e., held by Whites and Latinos) were inversely related to support for more-restrictive forms of gun control. Their study, along with earlier work (see Filindra & Kaplan, 2016 ), shed light on a possible relationship between racial resentment and Whites’ and Latinos’ attitudes toward gun control, suggesting that racism, generally, is a correlate of support for less-restrictive forms of gun control among these groups. However, gun ownership among minority and BIPOC communities has continued to rise with the largest increases occurring during the social and civil unrest associated with 2020 (Curcuruto, 2020 ; Parker et al., 2017 ). Crifasi et al. ( 2021 ) extended this line of inquiry and found that minority and BIPOC communities tend to favor less-restrictive gun control measures especially when police or the criminal justice system is involved, but general support for reduced access to firearms remains mixed across group membership.

Other researchers have found that men, generally, are less supportive of more-restrictive forms of gun control (see Ellison, 1991 ; Merino, 2018 ; O’Brien et al., 2013 ; Pederson et al., 2015 ; Tyler & Lavrakas, 1983 ). Some scholars have suggested that guns and pro-gun attitudes serve as a way for men to demonstrate masculinity and to bond with other men. These scholars argue that gun control is perceived as a threat to “male intimacy” and male identity, thus men are more likely to be emersed in gun culture and have favorable views of guns (see Carlson et al., 2018 ). Research has also documented an inverse relationship between educational attainment and support for more-restrictive forms of gun control (Newman & Hartman, 2019 ). Kruis et al. ( 2020 ) recently extended this line of inquiry by examining the relationship between gun knowledge—operationally defined as “one’s understanding of gun legislation, gun policies, and firearm crime”—and support for general gun control using a convenience sample of college students (p. 33). The authors found an inverse relationship between gun knowledge and support for stricter forms of gun control, concluding that students who had greater understanding of gun legislation, gun crime, and gun functioning, were less likely to favor stricter forms of gun control than students with less knowledge in these areas. While informative, this study suffered from a few crucial methodological limitations that preclude the generalizability of the findings. Notably, findings were based on data collected from college students through convenience sampling at three universities. Additionally, the measures of gun control and gun knowledge were broad and prohibited the examination of specific types of gun knowledge and various categories of gun control. Accordingly, the authors called for more work to be done in this area.

Current Study

The goal of the current study was to help contribute to research in this area by exploring public perceptions of various types of gun control mechanisms. In many ways the current study serves as an extension of Kruis et al.’s ( 2020 ) research. Specifically, the methodology employed by Kruis et al. ( 2020 ) were applied to the general public, using a representative sample of Pennsylvania residents ( N  = 522) to help answer the following two overarching research questions:

R1: What are the training experiences, safety precautions, and defensive gun use reported by gun owners in Pennsylvania?

R2: What is the relationship between firearm knowledge and support for more-restrictive gun control policies?

Regarding our first research question, we were interested in assessing training experiences, safety precautions, and defensive gun usage reported by Pennsylvania gun owners. We were also interested in comparing demographic characteristics, victimization experiences, gun knowledge, and support for different types of gun control between gun owners and non-owners. Our second research question was concerned with testing the generalizability of Kruis et al.’s ( 2020 ) findings from students to members of the general public. Notably, we were interested in expanding upon Kruis et al.’s measures to better explore the relationship between different types of firearm knowledge (i.e., knowledge of gun crime, knowledge of gun policy, and knowledge of gTillyerun functioning) and various categories of gun control (i.e., general gun control, policies aimed at reducing overall gun ownership, and policies aimed at keeping guns away from dangerous and “at risk” people). We hypothesized that increased firearm knowledge would be inversely related to greater support for gun control.

Data for this project came from a larger study aimed at measuring public attitudes toward a variety of social phenomena, including school security measures, campus carry, and perceptions of the police. Specifically, data came from a 64-question original survey created by the authors and administered via the Qualtrics survey platform. The authors used the marketing research team at Qualtrics to locate and recruit a sample of 500+ English speaking residents of Pennsylvania aged 18 or older. Qualtrics maintains active market research panels of more than six million English speaking, non-institutionalized adults capable of giving consent. Participants join a panel through one of three different methods, including a “double opt-in,” direct recruitment by the marketing research team, or voluntary sign up. In exchange for their voluntary participation in surveys, panelists are compensated with small point-based incentives that can be redeemed in various forms, such as Sky Miles or gift cards.

In the Fall of 2020, Qualtrics sent an invitation link to panelists inviting them to participate in the survey. Interested panelists were first screened to determine eligibility. Efforts were made to ensure the representativeness of the sample in terms of race, age, and biological sex. That is, the marketing team was contracted to ensure that participants were screened in a way such that the final sample would be representative of the Pennsylvania general population in terms of race, age, and biological sex. Then, potential participants were shown an informed consent document specifying the goals of the study, potential risks and benefits, and contact information for the principal investigator and institutional review board. Those who consented were then directed to the online survey where they were presented with 64 Likert scale, text entry, and essay-based questions. In total, 680 panelists clicked on the invitation link and participated in the survey in some capacity. Data quality assurance tests revealed that 522 of these cases were valid and complete responses. Thus, all models specified below were based on the 522 cases with complete and valid data. It is important to note at the onset that our data collection strategy represent a convenience sampling approach. That said, comparisons with population estimates revealed that the data collected were generally representative of the Pennsylvania general population in terms of race and sex at the time of data collection, as well as income and geographical location (i.e., rural or urban). However, the median age of the sample (47) was slightly older than that of the general Pennsylvania population (41).

Support for Gun Control

The goal of this study was to assess residents’ support for various categories of gun control. Three different measures were used to capture participants’ disposition toward stricter forms of gun regulation. First, the 9-item measure used in Kruis et al.’s ( 2020 ) original study was used to capture respondents’ disposition toward broad forms of gun control. Items included: (1) “Strict gun legislation will stop future gun-related incidents/mass shootings,” (2) “Guns should not be used for recreational reasons (i.e., hunting, sporting, etc.),” (3) “Gun laws should differentiate between handguns and other guns,” (4) “Military type guns should be banned from public use,” (5) “Mental health screenings should be required to purchase any firearm,” (6) “I think all types of guns should be banned from public use,” (7) “I believe that the Second Amendment needs to be revised to reflect modern times,” (8) “Second Amendment rights allow more guns to be available to the public than necessary,” and (9) “I believe that current gun legislation is appropriate.” Response categories followed a 5-point Likert scale ranging from “Strongly Disagree” (1) to “Strongly Agree” (5). Item #9 was reverse coded and then responses were summed and averaged to create a continuous measure of broad support for gun control with higher numbers indicative of greater support for enhanced firearm regulation (α = 0.832).

To further assess differences in support for distinct types of gun control policies, two measures from Cook et al.’s ( 2011 ) gun control trichotomy were also created and included in analyses. The first measure was intended to capture support for gun control mechanisms aimed at reducing overall firearm ownership. Two items from the survey were used to capture this category of gun control strategies: (1) “Guns should not be used for recreational purposes (i.e., hunting, sporting, etc.)” and (2) “I think all types of guns should be banned from public use.” Responses followed a 5-point Likert scale ranging from “Strongly Disagree” (1) to “Strongly Agree” (5). The two items were combined and averaged to create a scale variable with higher scores reflective of greater support for policies intended to reduce overall firearm ownership (α = 0.797). The second specific type of gun control measured was support for policies intended to keep guns away from dangerous and/or “at-risk” individuals, such as criminals, the untrained, and the mentally ill. Three items for the survey were used to measure participants’ support for this category of gun control policies: (1) “I believe that mandatory gun education will lead to fewer gun related deaths in the U.S.,” (2) “There should be required background checks for all guns purchases,” and (3) “Mental health screenings should be required to purchase any firearm.” Responses followed a 5-point Likert scale ranging from “Strongly Disagree” (1) to “Strongly Agree” (5). The items were combined and averaged to create a scale variable with higher scores reflective of greater support for policies intended to keep guns out of the hands of dangerous and “at risk” people (α = 0.721).

For the purposes of this project, knowledge referred to a participant’s understanding of gun-related phenomena. To capture knowledge, participants were given a “Knowledge Test.” Three different domains of knowledge were assessed: (1) knowledge of gun crime, (2) knowledge of gun policy, and (3) knowledge of gun functioning. Knowledge of gun crime refers to participants' level of understanding of gun-related crime in the United States. Items used to capture this measure included: (1) “Gun related homicides have increased over the last 30 years throughout the U.S.,” (2) “In the last 10 years, most gun related deaths per year in the U.S. have been from suicides,” (3) “A majority of firearms used in criminal offenses were obtained illegally,” (4) “Military-style weapons (for example, “assault rifles”) are used in the majority of gun-related crimes,” (5) “Most firearm owners never commit a gun crime,” and (6) “Most mass shootings in the United states are done with legally obtained firearms.” Knowledge of gun policy refers to participants’ level of understanding of gun-related purchasing and ownership policies. Items used to capture this measure included: (1) “In the U.S., it is illegal to own a fully automatic firearm without a permit,” (2) “When purchasing a firearm from a retail store, a background check is NOT required,” (3) “When purchasing a firearm online from a retail store, one must go through a licensed firearm dealer to acquire it,” (4) “In the U.S., the legal purchasing age of rifles is lower than that of handguns,” (5) “In the U.S., felons cannot legally own a firearm,” and (6) “In the U.S., authorities can legally confiscate guns solely based on an individual’s mental illness.” Knowledge of gun functioning refers to a participant’s level of understanding of how guns work (i.e., gun-related functioning and operational procedures). Items used to capture this measure included: (1) “The “AR” in AR-15 stands for “Assault Rifle Footnote 4 ”, (2) “A semi-automatic firearm only fires one round of ammunition per single pull of the trigger,” (3) “The “magazine” is the area of the gun that feeds ammunition into the chamber of the gun,” (4) “An individual must manually engage the hammer on a double-action firearm before the weapon can fire a bullet,” (5) “A bolt-action rifle requires the user to manually cycle every round before the rifle can be fired,” and (6) “All firearms must legally have a safety setting to keep the firearm from firing.” Response categories to all questions included “True,” “False,” and “I Don’t” Know.” Correct answers were coded as a “1” and incorrect answers were coded as a “-1.” Participants were not penalized for selecting “I don’t know” (coded as “0”). Individual items were then combined to create an index measure ranging from − 6 to + 6 with greater scores indicating greater knowledge. See Appendix 1 for specific coding. Footnote 5

Experiences

Prior work has shown that experiences with firearms and crime can influence dispositions toward firearms (Ciomek et al., 2020 ; Kleck, 2019a ; Kruis et al., 2020 ). As such, five variables were used to capture participants’ experiences with firearms and crime, including (1) exposure to firearms, (2) perceived firearm familiarity, (3) criminal victimization experience, (4) vicarious criminal victimization experience, and (5) vicarious shooting victimization experience. Exposure was captured using Kruis et al.’s ( 2020 ) 10-item firearm exposure scale (α = 0.955), with items including “I regularly use guns for recreational purposes” and “I am around guns frequently.” Perceived familiarity was captured using Kruis et al.’s ( 2020 ) 3-item perceived familiarity scale (α = 0.872), with items including “I am familiar with current gun legislation in the United States” and “I am familiar with current gun legislation in my state of residence.” Participants were also asked to indicate whether they had ever been the victim of a crime (1 = “yes” and 0 = “no”), if someone close to them had ever been the victim of a crime (1 = “yes” and 0 = “no”), and if they knew someone who had ever been shot with a firearm (1 = “yes” and 0 = “no”).

Training, Safety Precautions, and Gun Use

As the first research question for this project was concerned with examining the characteristics of gun owners, participants were asked to indicate whether they owned a firearm (1 = “yes” and 0 = “no”). Those who indicated that they owned a gun were then presented with a series of questions intended to capture their experiences with firearm-related training. Specifically, gun owners were asked if they (1) had taken a formal gun safety course, such as a basic hunter safety education course (1 = “yes” and 0 = “no”), (2) received informal gun safety training, through a friend or family member (1 = “yes” and 0 = “no”), and/or (3) taken a gun self-defense course (1 = “yes” and 0 = “no”). Owners were also asked to report whether or not they took various safety precautions with their firearms, such as using a gun safe or gun lock, keeping their guns unloaded, and/or storing ammunition away from their firearm(s) (1 = “yes” and 0 = “no”). Additionally, gun owners were also asked to report if they had ever used their gun to defend themselves Footnote 6 (1 = “yes” and 0 = “no”).

Demographics

Measures of sex (1 = “male,” 0 = “female”), race (1 = white, 0 = non-white), age (0–max), geographical background (1 = “Urban,” 2 = “Suburban,” and 3 = “Rural”), income (1 = “Less than $10,000” through 12 = “More than $150,000”) and political affiliation (1 = “Republican,” 2 = “Democrat,” and 3 = “Other”) were also captured and included as control variables in the analyses.

Analytic Strategy

Data were analyzed using SPSS version 27. The analysis consisted of 3 main steps. First, all data were cleaned, coded, and preliminary analyses run to assess measures of central tendency and dispersion. Factor analyses (i.e., Principal Component Analysis and Principal Axis Factor Analysis) were used along with reliability estimations to help construct scale variables during the initial data screening process. Support for individual gun control measures were estimated by combining “strongly agree” with “agree” responses and then ranked to help illustrate public support for specific types of gun control strategies. Second, bivariate analyses were conducted to examine differences in mean scores and response categories between gun owners and non-owners. Third, a series of OLS regression models were estimated to explore the relationship between knowledge of gun crime, gun legislation, gun functioning and support for gun control, controlling for relevant “predictors. Footnote 7 ” All assumptions of OLS regression were checked prior to constructing the final models reported below. All variables inputted into the regression model had tolerances above 0.1 and Variance Inflation Scores (VIFs) below 10 (Pallant, 2016 ). Normal Quantile–Quantile and Probability-Probability plots indicated the presence of relatively normal distributions, and skewness and kurtosis values for the dependent variables fell within the acceptable range for analyses (− 2.00 and + 2.00, Field, 2016 ).

Descriptive Statistics

Table 1 displays participant demographic information and descriptive statistics. As indicated in Table 1 , a majority of participants were white (76.4%) and female (50.4%). Participants were fairly evenly distributed in their political affiliation, with about 41 percent identifying as “Democrat,” 37 percent identifying as “Republican,” and 22 percent identifying as “Other.” The mean age of the sample was 49.03 years old. More participants indicated suburban backgrounds (42.1%) than urban (37.2%) and rural (20.7%) backgrounds. In terms of income, the mean score reported was 6.70, suggesting an average household income between $50,000 and $70,000. A little more than a quarter of the sample (27.8%) indicated being a gun owner. Approximately 40 percent of the sample knew a victim of a crime (40.6%) or indicated being the victim of a crime themselves (39.7%). Nearly a third of the sample reported knowing someone who had been shot (32.4%). Regarding gun-related experiences, most participant’s indicated moderate firearm exposure (M = 2.51, SD = 1.25) and a slightly elevated estimate of their perceived familiarity (M = 3.40, SD = 1.00) with current firearm legislation. In terms of actual gun knowledge, participants had more knowledge of gun policy (M = 2.00, SD = 2.16) than gun crime (M = 0.64, SD = 2.08) and gun functioning (M = 0.04, SD = 1.86). In the aggregate, participants expressed moderate support for our general measure of broad gun control policies (M = 3.28, SD = 0.90). However, participants were more supportive of policies intended to keep guns away from dangerous and “at risk” people (M = 4.10, SD = 0.88) than they were of policies intended to reduce overall ownership (M = 2.48, SD = 1.31).

Comparing Owners to Non-Owners

Table 2 displays the results from bivariate analyses (i.e., t-tests and chi-square tests) comparing gun owners (N = 145) to non-owners (N = 377). With the exception of age, gun owners were different from non-owners in all other demographic measures assessed. On average, gun owners were more likely to be male, white, and republican (p ≤ 0.001). They were also more likely to have rural backgrounds ( Χ 2  = 6.315, p ≤ 0.05) and reported higher incomes (t = − 3.481, p ≤ 0.01). Results also show that gun owners were different from non-owners in terms of gun-related experiences, gun knowledge, and support for gun control. Specifically, compared to non-owners, gun owners were more likely to report being the victim of a crime ( Χ 2  = 6.235, p ≤ 0.05) and to know someone who has been shot ( Χ 2  = 5.331, p ≤ 0.05). Owners also reported greater gun exposure (t = − 11.810, p ≤ 0.001) and familiarity (t = − 5.330, p ≤ 0.05) than non-owners. Gun owners were found to have greater knowledge of gun crime (t = − 2.831, p ≤ 0.01), gun policy (t = − 5.317, p ≤ 0.001), and gun functioning (t = − 5.116, p ≤ 0.001) than non-owners, and indicated less support for general gun control mechanisms (t = 5.346, p ≤ 0.001), policies that seek to reduce overall gun ownership (t = 3.318, p ≤ 0.05), and policies intended to keep guns away from dangerous and “at risk” people (t = 1.991, p ≤ 0.05).

Training, Safety, and Defensive Gun Usage

Our first overarching research question was concerned with examining training experiences, safety precautions taken, and defensive gun usage reported by gun owners. Table 3 displays characteristics of the gun owners in our sample. As indicated in Table 3 , most owners indicated receiving some form of gun training (89.7%). Nearly three-quarters of the gun owners in our sample reported completing a formal safety training course, such as a basic hunter safety education course (72.4%). A little more than 70 percent indicated receiving informal safety training from a friend or family member, and 42.8 percent reported taking a gun self-defense course. Interestingly, 10.3 percent of all the gun owners in our sample noted that they had not received any form of safety training—formal or informal—nor had they taken a gun self-defense class. In terms of safety precautions taken, most gun owners indicated taking one of measures included in the survey (95.9%). Specifically, 62.1 percent indicated using a gun safe for storage purposes, 39.3 percent reported using gun locks, 50.3 percent expressed that they stored ammunition away from firearms, and 54.4 percent indicated that they kept their guns unloaded. Just six of the 145 gun owners in our sample (4.1%) reported that they did not use any of the safety precautions assessed in our survey. Regarding defensive gun usage, more than a quarter of gun owners (26.9%) reported that they had used a firearm to defend themselves at some point in their life.

Our second overarching research question was concerned with assessing public support for gun control. Two different analyses were used to answer this research question. First, descriptive statistics were assessed for individual measures of support for gun control and then ranked by level of support. Table 4 displays the findings from these analyses in order of rank. As noted in Table 4 , the most publicly supported gun control policy was requiring background checks for all types of gun purchases (86.0%), followed by requiring mental health screenings (79.7%), banning military-style weapons from public use (69.7%), mandating gun education (62.5%), and differentiating laws between handguns and other guns (59.4%). Slightly more than half of the sample also felt that the Second Amendment needed revised “to reflect modern times” (52.7%) and believed that strict gun legislation could stop future gun-related incidents and mass shootings (51.3%). However, most participants did not support completely banning firearms from public use (72.6%) Footnote 8 or banning guns for recreational purposes, such as hunting and sport shooting (74.1%).

Second, we estimated a series of OLS regression models to examine variables associated with support for gun control. Table 5 displays results from those analyses. Regarding our general measure of gun control, results indicated that the model fit the data well and explained approximately 31 percent of the variance in general support for gun control ( F  = 14.901, p = 0.000, R 2  = 0.312). Nine of the independent variables in that model were found to be statistically significantly related to support for general gun control (p ≤ 0.05). Regarding demographic variables, results showed that compared to Republicans, Democrats (b = 0.589, p ≤ 0.001) indicated more support for gun control. Findings also suggest a marginally significant relationship between identifying as having a “Other” political affiliation (b = 0.176, p ≤ 0.010) and greater support for gun control, compared to identifying as a Republican. Further, results showed that compared to those with rural backgrounds, those with urban backgrounds (b = 0.234, p ≤ 0.05) were more supportive of gun control. Income was also statistically significant (b = 0.045, p ≤ 0.001), with findings suggesting that wealthier individuals were more supportive of gun control. Conversely, gun ownership (b = − 0.234, p ≤ 0.01) was found to be negatively associated with support for increased gun control. In terms of experiences, findings indicated that those who had been the victim of a gun crime (b = 0.188, p ≤ 0.05) and those who perceived having greater familiarity with current gun legislation (b = 0.151, p ≤ 0.001) were more supportive of policies associated with increased gun control. Findings also showed that those who indicated greater firearm exposure (b = − 0.119, p ≤ 0.01) held less support for general gun control mechanisms. Two measures of gun knowledge were also statistically significant in that model. Results showed that knowledge of gun crime (b = − 0.080, p p ≤ 0.001) and knowledge of gun functioning (b = − 0.079, p ≤ 0.001) were inversely related to support for general gun control.

The model estimating support for gun control policies intended to reduce overall gun ownership was also statistically significant ( F  = 14.992, p = 0.000). The predictors in that model explained approximately 31 percent of the variance in the dependent measure ( R 2  = 0.313). Nine of the independent variables in that model were found to be statistically significant (p ≤ 0.05) and two exhibited a marginally significant association (p ≤ 0.10). Regarding demographic variables, results showed that age (b = − 0.017, p ≤ 0.001) and gun ownership (b = − 0.325, p ≤ 0.01) were negatively associated with the dependent measure, whereas being a Democrat (b = 0.441, p < 0.001), income (b = 0.033, p ≤ 0.05), and having an Urban background (b = 0.560, p ≤ 0.001) were significantly and positively associated with the dependent measure. In terms of experiences, findings indicated that those who had been the victim of a crime (b = 0.208, p ≤ 0.10) were more supportive of policies associated with reducing overall gun ownership. Interestingly, findings also showed that those who indicated greater firearm exposure (b = 0.139, p ≤ 0.05) held more support for such policies, which is opposite the direction for this variable noted in the first model. Knowing a crime victim was found to exhibit a negative, albeit marginally, significant relationship (b = − 0.216, p ≤ 0.10) with support for policies intended to reduce overall ownership. All measures of gun knowledge were statistically significantly related to support for policies aimed at reducing overall gun ownership. Results showed that knowledge of gun crime (b = − 0.110, p ≤ 0.001), knowledge of gun policy (b = − 0.059, p ≤ 0.05), and knowledge of gun functioning (b = − 0.068, p ≤ 0.05) were inversely related to support for policies intended to reduce overall gun ownership.

The last column in Table 5 shows results from the OLS modeling estimating support for gun control policies intended to keep guns away from dangerous and “at risk” people. Results indicated that the model fit the data well and explained approximately 14 percent of the variance in gun control mechanisms aimed at keeping guns out of the hands of dangerous people (F = 6.059, p = 0.000, R 2  = 0.142). Six of the independent variables in that model were found to be statistically significant. Regarding demographic variables, results showed that being male (b = − 0.163, p < 0.05) and younger (b = .008, p ≤ 0.01) were negatively related to the dependent measure, whereas income (b = 0.033, p ≤ 0.01) was positively associated with support for policies intended to keep guns away from dangerous individuals. In terms of experiences, findings suggested that greater familiarity with current gun legislation (b = 0.235, p ≤ 0.001) was associated with more support for policies intended to keep guns away from dangerous people, whereas greater exposure was associated with less support (b = − 0.182, p ≤ 0.001). Only one measure of gun knowledge was statistically significant in the model. Results showed that knowledge of gun functioning (b = − 0.077, p ≤ 0.01) was inversely related to support for policies intended to keep guns away from dangerous and “at risk” people. Footnote 9

This study was concerned with exploring public perceptions of gun control. Specifically, data collected from a representative sample of 522 Pennsylvania residents were used to (1) explore the training experiences, safety practices, and defensive gun usage reported by gun owners, and (2) to examine the correlates of public support for various types of gun control. There are a few findings from analyses that warrant further discussion.

First, there were several notable findings related to training experiences, safety precautions, and defensive gun usage indicated by the gun owners in our sample. Consistent with previous findings, we found that more than 25 percent of the gun owners in our sample had never taken a formal gun safety course, including a basic hunter safety education course (Parker et al., 2017 ; Kruis et al., 2020 ). To expand upon prior work, we also attempted to assess gun training through cultural transmission by asking participants if they had received informal gun training, such as training through a family member or friend. We found that approximately 70 percent of gun owners in our sample had received informal training through a family member or friend. In all, a majority of our sampled gun owners reported receiving some form of gun safety training (i.e., 90 percent). However, collectively, findings revealed that about 10 percent of the gun owners in our sample had received no formal or informal training. This estimate is concerning, given that firearm training courses tend to focus on teaching novice gun handlers how to safely use, transport, and store their firearms, as well as introduce them to relevant gun laws (Rowhani-Rahbar et al., 2018 ). Ill-trained gun owners may be at a greater risk of using their firearms in an unsafe manner or storing them in ways that permit “unauthorized” persons to access and use their weapons, which can result in more firearm-related injuries.

Unfortunately, due to data limitations (i.e., sample size), we were unable to effectively explore the relationship between gun training and safety precautions taken by gun owners. We did find that more than half of the gun owners in our sample reported using gun safes, kept their firearms unloaded at all times, and/or stored ammunition away from firearms in an attempt to prevent others from accessing and/or using their firearms, which helps to prevent accidental discharges. In fact, just six of the 145 gun owners in our sample (4.1%) reported that they took “no safety” precautions, suggesting that most— “trained” and “untrained” gun owners—took some form of gun safety precaution. Supplementary analyses did reveal that two of the six gun owners who indicated they took none of the listed safety precautions also indicated that they had received no formal or informal gun safety training. These data indicate that there was a higher proportion of non-trained gun owners (13.3%) who suggested taking no safety precaution than there were trained gun owners (3.1%). We do want to caution when interpreting these results for two reasons. First, our measures do not capture the “quality” of training received. Second, as noted above, the number of non-trained gun owners and owners who take no-safety precautions was so small that we were unable to conduct any type of meaningful comparison. As such, we encourage future researchers to explore the relationship between gun training and gun safety more thoroughly. We will note, however, that, in synthesizing prior research in this area, scholars at RAND Corporation ( 2020 ) concluded that child access prevention laws, defined as laws that attempt to influence how guns are stored, are effective at reducing unintentional injuries and deaths, as well as suicides, and may be effective at helping to reduce violent crime. Thus, it appears that there may be a relationship between gun storing patterns and rates of firearm-related injuries. As such, if more owners store their weapons properly, then we may see fewer firearm related injuries, suicides, and violent crime.

Another interesting finding emerging from the data was the proportion of defensive gun usage reported by gun owners in our sample. Nearly 27 percent of gun owners in our sample indicated that they had used their gun to defend themselves at some point in their life. This suggests that more than 1 in 4 gun owners in our sample had used their firearm to defend their life, liberty, or property—which, although a slightly higher estimate, mirrors findings reported by the Pew Research Center in 2017 (i.e., 1 in 6 gun owners; see Parker et al., 2017 ). Other research has found that the prevalence of defensive gun usage in the United States ranges from 60,000 to 2.5 million incidents annually (Institute of Medicine & National Research Council, 2013 ). Collectively, these findings indicate that a significant portion of gun owners use—or at least perceive that they use—their firearm(s) for self-defense purposes. As such, any efforts aimed at reforming gun policies in the United States should consider this “utility,” or using firearms as a tool, prior to implementation. While firearms may currently help contribute to a high number of injuries (CDC, 2020 ) and crimes (National Institute of Justice, 2019 ) committed every year in the United States, it is possible that gun control efforts that take guns out of the hands of law-abiding citizens could further exacerbate these numbers by removing a viable protection mechanism from individuals who otherwise may be unable to adequately defend themselves. Prior research has been mixed in findings related to this hypothesis with some work suggested that arming potential victims may be associated with reductions in injuries and loss of property (see Cook et al., 2011 ; Cook, 1991 ; Kleck & Gertz, 1995 ; Southwick, 2000 ) and other research questioning such claims (Hemenway, & Solnick, 2015 ). Similarly, and more broadly, prior research on the effects of gun control related to patterns of gun ownership on patterns of violence and crime have produced mixed results, with some research findings indicating little to no effect (Kleck, 2019a ; Kleck et al.,  2016 ; Lott, 2013 ) and others suggesting a positive relationship between gun ownership and gun crime (Billings, 2020 ; Ciomek et al., 2020 ). Accordingly, more research is needed before firm conclusions related to defensive gun usage can be drawn. That said, our data show that gun owners in Pennsylvania may use their weapons in self-defense at a fairly high rate.

Second, there were several interesting findings related to participants’ support for various forms of gun control. In the aggregate, the top three supported gun control measures were: (1) required background checks for all types of gun purchases (86.0%), (2) required mental health screenings for gun purchases (79.7%), and (3) banning military type firearms (i.e., AR or AK platforms) from public use (69.7%). Using prior research (see Cook, 2011 and Kruis et al., 2020 ) we also examined “correlates” of support for gun control measured in three different ways: (1) support for general gun control mechanisms, (2) support for policies aimed at reducing overall gun ownership, and (3) support for policies aimed at keeping firearms away from dangerous people. There were several interesting findings that emerge from those analyses. Notably, most participants seemed to favor polices aimed at keeping guns away from dangerous and “at risk” individuals, such as the untrained, the mentally ill, and justice-involved persons. However, most did not support policies aimed at reducing overall gun ownership (i.e., restricting public gun use and use for recreational purposes)—which is consistent with prior research (Parker et al., 2017 ).

These findings are important to consider in relation to the efficacy of such policies. The dominate research suggests that gun control intended to keep guns away from dangerous and “at risk” people may be effective at reducing serious violence (Braga & Cook, 2018 ; Kleck et al., 2016 ; RAND, 2020 ), while gun control strategies aimed at reducing community firearm ownership may have little to no effect on overall violent crime rates (Cook & Ludwig, 2006 ; Cook & Pollack, 2017 ; Kleck, 2019b ).

Similarly, several interesting findings emerged in multivariable modeling. Generally, we found that those who are more supportive of gun control were Democrats, those who had Urban backgrounds, those who had less exposure to firearms, and those with larger annual incomes. We also found a significant relationship between specific types of gun knowledge and support for categories of gun control. Participants who had greater knowledge of gun crime and gun functioning were less supportive of general forms of gun control, and those who had greater knowledge of gun functioning were less supportive of restrictive policies. Consistent with findings reported by Kruis et al. ( 2020 ), we found a general inverse relationship between gun knowledge and support for various types of gun control, with a few caveats. We found that those who were more knowledgeable in the areas of gun crime, gun policy, and gun functioning, did not favor more restrictive gun control measures, particularly those aimed at reducing overall gun ownership. However, excluding knowledge of gun functioning, there was no relationship between gun knowledge and support for policies aimed at keeping firearms away from dangerous people, suggesting that both the “knowledgeable” and “non-knowledgeable” are equally likely to support restricted access for potentially dangerous and “at risk” individuals.

Collectively, this research shows that the same gun control strategies with the most public support—and those supported by those with the most gun “knowledge”—are also those with the most empirical support. Similarly, those with the least public support are those that seem to have the least or, at least, questionable empirical support. As such, policymakers may want to direct gun “reform” efforts toward policies intended to keep guns away from persons who are considered to be dangerous or “at risk,” such as felons, the untrained, and those who are mentally ill. At the same time, policymakers need to consider the effects that such actions will have on legal acquisition and take efforts to strengthen law abiding citizens’ abilities to obtain and use firearms legally. For instance, based on the available scholarly literature, we argue that complete firearm bans will likely have little if any positive effect of crime, and our research shows that such policies are largely unsupported by members of the general public. Related, we also suggest that gun control strategies discussed by Cook and Leitzel ( 1996 ) aimed at increasing the price of firearms and ammunition may only prevent law abiding citizens from obtaining weapons and merely increase black market sales or thefts of weapons, which is how most criminals obtain their firearms (Cook, 2018 ; Roth, 1994 ). Thus, better approaches to gun regulation will prevent dangerous and “at risk” people from obtaining firearms, while also protecting law-abiding citizens abilities to access firearms. Unfortunately, as noted by Braga et al. ( 2021 ) the current research provides us with little guidance on how best to achieve this goal. As such, more scholarly work is needed in this area.

Limitations and Directions for Future Research

The most concerning limitation of this study is that it utilized a cross-sectional research design. As such, the temporal relationship between variables remains unknown. Related, data were collected from a sample of Pennsylvania residents and findings are not generalizable beyond those parameters. Additionally, our measures of gun control overlooked an entire category of gun control mechanisms—those that are intended to influence choices about how guns are used and to what effect. Accordingly, we encourage future researchers to use longitudinal research designs, to examine these findings in other populations, and better attempt to capture all categories of gun control mechanisms in instrumentation.

Despite these limitations, this work contributes to the extant literature in several ways. Notably, findings from this study suggest that most gun owners in Pennsylvania have received some form of safety training and take appropriate safety precautions with their firearms. Moreover, findings reveal that many gun owners use guns for self-defense purposes. Regarding gun control, findings reveal that members of the general public tend to be supportive of policies aimed at keeping guns away from dangerous and “at risk” individuals, such as required background checks for all types of gun purchases, mental health screenings, and mandatory gun education. However, members of the general public are not supportive of gun control mechanisms aimed at reducing overall firearm ownership, such as public gun bans. Among those who are the least supportive of such polices are those who are the most knowledgeable about gun crime, gun legislation, and gun functioning.

The long-standing debate of gun rights and ownership tends to center around the concept of “needs” and “wants” in relation to the types of firearms available to the public and the measures used to control the access to these firearms. Much of the empirical literature has produced mixed results when assessing the importance of preventative policies and the associated crimes that can be reduced. This study adds to the growing body of literature seeking more information to adequately inform policymakers regarding gun ownership and public opinions toward restrictive gun laws.

Research suggests that those who are mentally ill are at a higher odds of committing suicide, especially with a gun, but have relatively low rates of violent crime commission, including firearm violence. In fact, this work suggests that those who are mentally ill are more likely to be the victim of a crime than the perpetrator of a crime. Although, given the extent of under-diagnosis among the mentally ill, the relationship between these variables has been difficult to establish. See Swanson et al. ( 2015 ) and Ramchand and Ayer ( 2021 ).

See Kleck ( 2021 ) for a discussion of the quality of research in this area.

Research has found that question wording may influence whether people indicate support for a proposed assault weapons ban (Newport, 2019 ). Still, the available data suggest a slight majority of the public supports banning assault weapons.

The term “AR” is commonly mistaken to mean “assault rifle” or “automatic rifle” (Palma, 2019 ).

At the request of reviewers, we have included informational sources after each question to verify our coding. Efforts were made to include sources with commentary to help readers better understand subject matter. We also tried to incorporate informational sources with a Pennsylvania focus, when available, given that our sample is of Pennsylvania residents.

Gun owners were asked, “Have you ever used your gun to defend yourself?”.

Here, we refer to “predictor” in the linear manner.

As noted in Table 4 , approximately 27 percent of our sample indicated that they felt all guns should be banned from public use. A reviewer suggested that it would be interesting to explore the relationship between political affiliation and support for public gun bans. Results from chi-square test revealed a statistically significant relationship between political affiliation and support for public gun bans ( Χ 2  = 56.840, p < .001). Specifically, analysis revealed that about 1 in 3 democrats supported such a policy, compared to approximately 1 in 4 Republicans and 1 in 5 individuals who identified as having a “Other” political affiliation.

While we are confident that our measures of gun knowledge are valid and reliable measures, at the requests of the reviewers, we also ran a series of supplemental analyses that omitted “questionable” variables within the indices. For instance, we omitted the variables “Gun related homicides have increased over the last 30 years throughout the U.S.” and “A majority of firearms used in criminal offenses were obtained illegally” from knowledge of gun crime. We also omitted “In the U.S., authorities can legally confiscate guns solely based on an individual’s mental illness” from knowledge of gun policy, and “The “AR” in AR-15 stands for “Assault Rifle” from knowledge of gun functioning. Results were similar to the final models reported in the manuscript and are available upon request.

Andrés, A. R., & Hempstead, K. (2011). Gun control and suicide: The impact of state firearm regulations in the United States, 1995–2004. Health Policy, 101 (1), 95–103.

Article   Google Scholar  

ATF. (2015) Does a customer have to be a certain age to buy firearms or ammunition from a licensee? Retrieved July 25, 2021, from https://www.atf.gov/firearms/qa/does-customer-have-be-certain-age-buy-firearms-or-ammunition-licensee

Balmert, J. (2021). As Biden enters white house, Ohio GOP lawmaker pushes ‘Second Amendment sanctuary state’ . The Enquirer. Retrieved February 15, 2021, from https://www.cincinnati.com/story/news/politics/2021/01/29/ohio-gop-second-amendment-sanctuary-state-biden/4274810001/

Barry, C. L., Stone, E. M., Crifasi, C. K., Vernick, J. S., Webster, D. W., & McGinty, E. E. (2019). Trends in public opinion on US gun laws: Majorities of gun owners and non-gun owners support a range of measures. Health Affairs, 38 (10), 1727–1734.

Billings, S. B. (2020). Smoking gun? Linking gun ownership to crime victimization and neighborhood crime. Linking Gun Ownership to Crime Victimization and Neighborhood Crime (April 29, 2020) .

Braga, A. A., & Cook, P. J. (2018). The association of firearm caliber with likelihood of death from gunshot injury in criminal assaults. JAMA Network Open, 1 (3), e180833–e180833.

Braga, A. A., Griffiths, E., Sheppard, K., & Douglas, S. (2021). Firearm instrumentality: Do guns make violent situations more lethal? Annual Review of Criminology, 4 , 147–164.

Brenan, M. (2020). Support for stricter U.S. gun laws at lowest level since 2016. Gallup. Retrieved February 15, 2021, from https://news.gallup.com/poll/325004/support-stricter-gun-laws-lowest-level-2016.aspx

Brennan, P. G., Lizotte, A. J., & McDowall, D. (1993). Guns, southerness, and gun control. Journal of Quantitative Criminology, 9 (3), 289–307.

Bureau of Justice Statistics. (2020). NCVS Victimization Analysis Tool (NVAT). Retrieved February 15, 2021, from https://www.bjs.gov/index.cfm?ty=nvat

Carlson, J., Goss, K. A., & Shapira, H. (Eds.). (2018). Gun studies: Interdisciplinary approaches to politics, policy, and practice . Routledge.

Google Scholar  

Centers for Disease Control and Prevention (2020). Underlying cause of death 1999–2019 on CDC WONDER online database, Retrieved from https://wonder.cdc.gov/controller/datarequest/D76;jsessionid=8547021C770390B83510480403DA

Ciomek, A., Braga, A., & Papachristos, A. (2020). The influence of firearms trafficking on gunshots injuries in a co-offending network. Social Science and Medicine, 259 , 113114.

Clark, D. (2018). Is most gun crime committed by those who illegally possess guns? Politifact. Retrieved July 25, 2021, from https://www.politifact.com/factchecks/2018/mar/12/john-faso/do-illegal-gun-owners-commit-most-gun-crime-rep-fa/

Cook, P. J. (1980). Reducing injury and death rates in robbery. Policy Analysis , 21–45.

Cook, P. J. (1991). The technology of personal violence. Crime and Justice, 14 , 1–71.

Cook, P.J. (2017). How dangerous people get their guns in America . CBS News: The conversation. Retrieved July 25, 2021, from https://www.cbsnews.com/news/gun-sales-how-dangerous-people-get-weapons/

Cook, P. J. (2018). Gun markets. Annual Review of Criminology, 1 , 359–377.

Cook, P. J., Braga, A. A., & Moore, M. H. (2011). Gun Control. In J. Q. Wilson & J. Petersilia (Eds.), Crime and public policy (pp. 257–292). Oxford University Press.

Cook, P. J., & Leitzel, J. A. (1996). Perversity, futility, jeopardy: An economic analysis of the attack on gun control. Law and Contemporary Problems, 59 , 91–118.

Cook, P. J., & Ludwig, J. (2006). The social costs of gun ownership. Journal of Public Economics, 90 (1–2), 379–391.

Cook, P. J., & Pollack, H. A. (2017). Reducing access to guns by violent offenders. RSF: the Russell Sage Foundation Journal of the Social Sciences, 3 (5), 2–36.

Crifasi, C. K., Ward, J. A., McGinty, E. E., Webster, D. W., & Barry, C. L. (2021). Public opinion on gun policy by race and gun ownership status. Preventive Medicine, 149 , 106607.

Curcuruto, J. (2020). NSSF survey reveals broad demographic appeal for firearm purchases during sales surge of 2020. National Shooting Sports Foundation. Retrieved July 25, 2021, from https://www.nssf.org/articles/nssf-survey-reveals-broad-demographic-appeal-for-firearm-purchases-during-sales-surge-of-2020/

Department of Justice, Government of Canada. (n.d.). Firearms, accidental deaths, suicides and violent crime: An updated review of the literature with special reference to the Canadian situation. Retrieved February 15, 2021, from https://www.justice.gc.ca/eng/rp-pr/csj-sjc/jsp-sjp/wd98_4-dt98_4/p3.html#a32

Ellison, C. G. (1991). Southern culture and firearms ownership. Social Science Quarterly, 72 (2), 267–283.

Evans, D. N., & Williams, C. L. (2017). Stop, question, and frisk in New York City: A study of public opinions. Criminal Justice Policy Review, 28 (7), 687–709.

Fabio, A., Duell, J., Creppage, K., O’Donnell, K., & Laporte, R. (2016). Gaps continue in firearm surveillance: Evidence from a large US city bureau of police. Social Medicine, 10 (1), 13–21.

Federal Bureau of Investigation. (n.d.). Crime data explorer. Retrieved February 15, 2021, from https://crime-data-explorer.fr.cloud.gov/explorer/national/united-states/crime

Field, A. (2016). Discovering statistics using IBM SPSS statistics (4th ed). Los Angeles, CA; Sage.

Filindra, A., & Kaplan, N. J. (2016). Racial resentment and whites’ gun policy preferences in contemporary America. Political Behavior, 38 (2), 255–275.

Filindra, A., & Kaplan, N. J. (2017). Testing theories of gun policy preferences among Blacks, Latinos, and Whites in America. Social Science Quarterly, 98 (2), 413–428.

Follman, M., Aronsen, G., & Pan, D. (2021). US mass shootings, 1982–2021: Data from mother jones’ investigation. MotherJones. Retrieved July 25, 2021, from https://www.motherjones.com/politics/2012/12/mass-shootings-mother-jones-full-data/

Friend, D. (2021). Constitutional carry, 2nd amendment sanctuary, and anti-red flag laws: A look at pro-gun bills in Texas . The Texan. Retrieved February 15, 2021, from https://thetexan.news/a-look-at-the-pro-gun-bills-filed-in-the-texas-legislature/

Frontline. (n.d.). Hot guns. PBS. Retrieved July 25, 2021, from https://www.pbs.org/wgbh/pages/frontline/shows/guns/more/faq.html

Gallup. (2020). Guns. Retrieved February 15, 2021, from https://news.gallup.com/poll/1645/guns.aspx

Giffords Law Center. (2021a). Statistics. Retrieved July 25, 2021, from https://giffords.org/lawcenter/gun-violence-statistics/

Giffords Law Center. (2021b). Mental health reporting in Pennsylvania . Retrieved July 25, 2021, from https://giffords.org/lawcenter/state-laws/mental-health-reporting-in-pennsylvania/

Giffords Law Center. (2021c). Firearm prohibitions in Pennsylvania. Retrieved July 25, 2021, from https://giffords.org/lawcenter/state-laws/firearm-prohibitions-in-pennsylvania/

Giffords Law Center. (n.d.) Machine guns and 50 caliber . Retrieved July 25, 2021, from https://giffords.org/lawcenter/gun-laws/policy-areas/hardware-ammunition/machine-guns-50-caliber/#footnote_0_5658

Gramlich, J. (2019). What the data says about gun deaths in the U.S. Pew Research Center. Retrieved July 25, 2021, from https://www.pewresearch.org/fact-tank/2019/08/16/what-the-data-says-about-gun-deaths-in-the-u-s/

Grinshteyn, E., & Hemenway, D. (2019). Violent death rates in the US compared to those of the other high-income countries, 2015. Preventive Medicine, 123 , 20–26.

Gun News Daily. (n.d.). Single action vs. double action: A guide for beginners. Retrieved from https://gunnewsdaily.com/single-action-vs-double-action/

Gun Violence Archive. (2021). Past summary ledgers . Retrieved July 25, 2021, from https://www.gunviolencearchive.org/past-tolls

Hemenway, D., & Solnick, S. J. (2015). The epidemiology of self-defense gun use: Evidence from the National Crime Victimization Surveys 2007–2011. Preventive Medicine, 79 , 22–27.

Henigan, D. A. (2016). Guns don’t kill people, people kill people: And other myths about guns and gun control . Beacon Press.

Hill, G. D., Howell, F. M., & Driver, E. T. (1985). Gender, fear, and protective handgun ownership. Criminology, 23 (3), 541–552.

Huntingsmart. (n.d.). The firing cycle of a bolt action rifle. Retrieved July 25, 2021, from https://www.thecampfirecollective.com/knowledge-base/us/huntingsmart/03/09/

Institute of Medicine and National Research Council. (2013). Priorities for research to reduce the threat of firearm-related violence . National Academies Press.

Kauder, N. B. (1993). One-gun-a-month: Measuring public opinion concerning a gun control initiative. Behavioral Sciences and the Law, 11 (4), 353–360.

Kleck, G. (1997). Point blank: Guns and gun violence in America . Aldine de Gruyter.

Kleck, G. (2021). The continuing vitality of flawed research on guns and violence: A comment on Fridel (2020). Justice Quarterly , 1–9.

Kleck, G. (2019a). Macro-level research on the effect of firearms prevalence on suicide rates: A systematic review and new evidence. Social Science Quarterly, 100 (3), 936–950.

Kleck, G. (2019b). Regulating guns among young adults. American Journal of Criminal Justice, 44 (5), 689–704.

Kleck, G., & Gertz, M. (1995). Armed resistance to crime: The prevalence and nature of self-defense with a gun. The Journal of Criminal Law and Criminology, 86 , 150–187.

Kleck, G., & Patterson, E. B. (1993). The impact of gun control and gun ownership levels on violence rates. Journal of Quantitative Criminology, 9 (3), 249–287.

Kleck, G., Kovandzic, T., & Bellows, J. (2016). Does gun control reduce violent crime? Criminal Justice Review, 41 (4), 488–513.

Koper, C. S., Johnson, W. D., Nichols, J. L., Ayers, A., & Mullins, N. (2018). Criminal use of assault weapons and high-capacity semiautomatic firearms: An updated examination of local and national sources. Journal of Urban Health, 95 (3), 313–321.

Kruis, N. E., Wentling, R. L., Heirigs, M. H., & Ishoy, G. A. (2020). Assessing the impact of knowledge and location on college students’ perceptions of gun control and campus carry policies: A multisite comparison. American Journal of Criminal Justice, 45 (1), 25–47.

Libby, N. E., & Corzine, J. (2007). Lethal weapons: Effects of firearm types on the outcome of violent encounters. Justice Research and Policy, 9 (2), 113–137.

Livingston, M. M., & Lee, M. W. (1992). Attitudes toward firearms and reasons for firearm ownership among nonurban youth: Salience of sex and race. Psychological Reports, 71 (2), 576–578.

Lott, J. R. (2013). More guns, less crime: Understanding crime and gun control laws . University of Chicago Press.

Lott, J. R. (2016). Concealed carry permit holders across the United States: 2016. Available at SSRN 2814691.

Lucey, C. (2021). Biden’s gun-policy plans start to take shape . The Wall Street Journal. Retrieved February 15, 2021, from https://www.wsj.com/articles/bidens-gun-policy-plans-start-to-take-shape-11613135990

Malcom, J & Swearer, A. (2018). Here are 8 stubborn facts on gun violence in America . The Heritage Foundation. Retrieved July 25, 2021, from https://www.heritage.org/crime-and-justice/commentary/here-are-8-stubborn-facts-gun-violence-america

Marciniak, L. M., & Loftin, C. (1991). Measuring protective handgun ownership. Criminology, 29 (3), 531–540.

McClain, P. D. (1983). Determinants of black and white attitudes toward gun regulation: A research note. Journal of Criminal Justice, 11 (1), 77–81.

Merino, S. M. (2018). God and guns: Examining religious influences on gun control attitudes in the United States. Religions, 9 (6), 189. https://doi.org/10.3390/rel9060189

Morral, A. R., Schell, T.L., & Tankard, M. (2018). The magnitude and sources of disagreement among gun policy experts. RAND Corporation. Retrieved February 15, 2021, from https://www.rand.org/pubs/research_reports/RR2088z1.html . Also available in print form.

Morrall, A. (2018). The science of gun policy: A critical synthesis of research evidence on the effects of gun policies in the United States. Rand Health Quarterly . https://doi.org/10.7249/RR2088

Naghavi, M., Marczak, L. B., Kutz, M., Shackelford, K. A., Arora, M., Miller-Petrie, M., & Tran, B. X. (2018). Global mortality from firearms, 1990–2016. JAMA, 320 (8), 792–814.

National Institute of Justice. (2019). Gun violence in America. Retrieved February 15, 2021, from https://nij.ojp.gov/topics/articles/gun-violence-america

National Shooting Sports Foundation. (n.d.). Modern sporting rifle: Introduction. Retrieved July 25, 2021, from https://www.nssf.org/msr/

Newburger, E. (2021). Biden calls for congress to pass stricter gun laws on anniversary of Parkland mass shooting . CNBC. Retrieved February 15, 2021, from https://www.cnbc.com/2021/02/14/biden-calls-on-congress-to-reform-gun-laws-on-anniversary-of-parkland-shooting.html

Newman, B. J., & Hartman, T. K. (2019). Mass shootings and public support for gun control. British Journal of Political Science, 49 (4), 1527–1553.

Newport, F. (2019). Analyzing surveys on banning assault weapons . Gallup. Retrieved February 15, 2021, from https://news.gallup.com/opinion/polling-matters/268340/analyzing-surveys-banning-assault-weapons.aspx

NRA-ILA. (n.d.) Background checks for guns . Retrieved July 25, 2021, from https://www.nraila.org/get-the-facts/background-checks-nics/

O’Brien, K., Forrest, W., Lynott, D., & Daly, M. (2013). Racism, gun ownership, and gun control: Biased attitudes in US whites may influence policy decisions. PLoS ONE, 8 (10), e77552. https://doi.org/10.1371/journal.pone.0077552

Oliphant, B.J. (2017). Bipartisan support for some gun proposals, stark partisan divisions on many others. Pew Charitable Trust. Retrieved February 15, 2021, from https://www.pewresearch.org/fact-tank/2017/06/23/bipartisan-support-for-some-gun-proposals-stark-partisan-divisions-on-many-others/

Pallant, J. (2016). SPSS Survival Manual: A Step by Step Guide to Data Analysis Using IBM SPSS, 6th Edn Crows Nest . NSW: Allen &Unwin.

Palma, B. (2019). Does ‘AR’ in AR-15 Stand for ‘Assault Rifle’? A frequent misconception centers on what the term “AR-15” literally means. Snopes. Retrieved July 25, 2021, from https://www.snopes.com/fact-check/meaning-of-ar-in-ar-15-firearm/

Parker, K., Horowitz, J., Igielnik, R., Oliphant, J.B., & Brown, A. (2017). America’s complex relationship with guns. Pew Charitable Trust. Retrieved February 15, 2021, from https://www.pewresearch.org/social-trends/2017/06/22/views-on-gun-policy/

Pederson, J., Hall, T. L., Foster, B., & Coates, J. E. (2015). Gun ownership and attitudes toward gun control in older adults: Re-examining self-interest theory. American Journal of Social Science Research, 1 (5), 273–281.

Phillips, M. (2021). How Biden could tighten gun control without congress. Fox News . Retrieved February 18, 2021, from https://www.foxnews.com/politics/how-could-biden-tighten-gun-control-without-congress-approval

Planty, M., & Truman, J. L. (2013). Firearm violence, 1993–2011 . Washington, DC: US Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.

Ramchand, R. & Ayer, L. (2021). Is mental illness a risk factor for gun violence? RAND. Retrieved July 25, 2021, from https://www.rand.org/research/gun-policy/analysis/essays/mental-illness-risk-factor-for-gun-violence.html

RAND. (2020). What science tells us about the effects of gun policies . Retrieved February 18, 2021, from https://www.rand.org/research/gun-policy/key-findings/what-science-tells-us-about-the-effects-of-gun-policies.html

Rosen, G. (2000). Yes and no to gun control. Commentary, 110 (2), 47–53.

Roth, J. A. (1994). Firearms and violence . US Department of Justice, Office of Justice Programs, National Institute of Justice.

Rowhani-Rahbar, A., Lyons, V. H., Simonetti, J. A., Azrael, D., & Miller, M. (2018). Formal firearm training among adults in the USA: Results of a national survey. Injury Prevention, 24 (2), 161–165.

Schaeffer, K. (2019). Share of Americans who favor stricter gun laws has increased since 2017 . Pew Charitable Trust. Retrieved from https://www.pewresearch.org/fact-tank/2019/10/16/share-of-americans-who-favor-stricter-gun-laws-has-increased-since-2017/

Schaeffer, K. (2021). Key facts about Americans and guns. Pew Charitable Trust. Retrieved July 25, 2021, from https://www.pewresearch.org/fact-tank/2021/05/11/key-facts-about-americans-and-guns/

Schmidt, D. (2020). How many deer hunters in the United States? Deer and Deer Hunting. Retrieved February 15, 2021, from https://www.deeranddeerhunting.com/content/blogs/dan-schmidt-deer-blog-whitetail-wisdom/how-many-deer-hunters-in-the-united-states

Secret, P. E., & Johnson, J. B. (1989). Racial differences in attitudes toward crime control. Journal of Criminal Justice, 17 (5), 361–375.

Sen, B., & Panjamapirom, A. (2012). State background checks for gun purchase and firearm deaths: An exploratory study. Preventive Medicine, 55 (4), 346–350.

Shammas, M. (2019). It’s time to retire the guns don’t kill people—People kill people argument. Guns do kill people. Guns Do Kill People (November 24, 2019) .

Smith, J., & Spiegler, J. (2020). Explaining gun deaths: Gun control, mental illness, and policymaking in the American states. Policy Studies Journal, 48 (1), 235–256.

Southwick, L., Jr. (2000). Self-defense with guns: The consequences. Journal of Criminal Justice, 28 (5), 351–370.

Statista Research Department (2021). Mass shootings in the U.S.: Legality of shooter’s weapons, as of May 2021 . Retrieved July 25, 2021, from https://www.statista.com/statistics/476461/mass-shootings-in-the-us-by-legality-of-shooters-weapons/

Swanson, J. W., McGinty, E. E., Fazel, S., & Mays, V. M. (2015). Mental illness and reduction of gun violence and suicide: Bringing epidemiologic research to policy. Annals of Epidemiology, 25 (5), 366–376.

Tillyer, M. S., & Tillyer, R. (2014). Violence in context: A multilevel analysis of victim injury in robbery incidents. Justice Quarterly, 31 (4), 767–791.

Tyler, T. R., & Lavrakas, P. J. (1983). Support for gun control: The influence of personal, sociotropic, and ideological concerns. Journal of Applied Social Psychology, 13 (5), 392–405.

U.S. Fish and Wildlife Services (2020). National hunting license data. Retrieved February 15, 2021, from https://www.fws.gov/wsfrprograms/Subpages/LicenseInfo/Natl%20Hunting%20License%20Report%202020.pdf

Wallace, L. N. (2016). American preferences for “smart” guns versus traditional weapons: Results from a nationwide survey. Preventive Medicine Reports, 4 , 11–16.

Winkler, A. (2018). Is the second amendment becoming irrelevant. Indian Law Journal, 93 , 253–265.

Wintersteen. (2018). 9 Common misused gun terms. Guns and Ammo. Retrieved July 25, 2021, from https://www.gunsandammo.com/editorial/9-misused-gun-terms/249625

Wolfgang, M. E. (1958). Patterns in criminal Homicide . University of Pennsylvania Press.

Book   Google Scholar  

Wozniak, K. H. (2017). Public opinion about gun control post-Sandy Hook. Criminal Justice Policy Review, 28 (3), 255–278.

Wright, M. A., Wintemute, G. J., & Rivara, F. P. (1999). Effectiveness of denial of handgun purchase to persons believed to be at high risk for firearm violence. American Journal of Public Health, 89 (1), 88–90.

Yablon, A. (2020). Internet gun sales and background checks, explained . The Trace. Retrieved July 25, 2021, from https://www.thetrace.org/2016/01/internet-gun-sales-background-checks/

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Appendix 1 knowledge “answers”, knowledge of gun crime.

Gun related homicides have increased over the last 30 years throughout the U.S. (False, see Gramlich, 2019 ; Gun Violence Archive, 2021 ; and National Institute of Justice, 2019 ).

In the last 10 years, most gun related deaths per year in the U.S. have been from suicides (True, see Giffords Law Center, 2021a , 2021b , 2021c and Gramlich, 2019 ).

A majority of firearms used in criminal offenses were obtained illegally (True, see Cook, 2017 , Clark, 2018 , and Fabio et al., 2016 ).

Military-style weapons (for example, “assault rifles”) are used in the majority of gun-related crimes (False, see Koper et al., 2018 ).

Most firearm owners never commit a gun crime (True, see Lott, 2016 and Malcom & Swearer, 2018 )

Most mass shootings in the United States are done with legally obtained firearms (True, see Follman et al., 2021 and Statista Research Department, 2021 )

Knowledge of Gun Policy

In the U.S., it is illegal to own a fully automatic firearm without a permit. (True, see Giffords Law Center, n.d.)

When purchasing a firearm from a retail store, a background check is NOT required. (False, see NRA-ILA, n.d. and Yablon, 2020 ).

When purchasing a firearm online from a retail store, one must go through a licensed firearm dealer to acquire it. (True, see NRA-ILA, n.d. and Yablon, 2020 )

In the U.S., the legal purchasing age of rifles is lower than that of handguns. (True, see ATF, 2015 ).

In the U.S., felons cannot legally own a firearm. (True, see Giffords Law Center, 2021 )

In the U.S., authorities can legally confiscate guns solely based on an individual’s mental illness. (True, see Giffords Law Center, 2021 ).

Knowledge of Gun Functioning

The “AR” in AR-15 stands for “Assault Rifle.” (False, see National Shooting Sports Foundation, n.d.)

A semi-automatic firearm only fires one round of ammunition per single pull of the trigger. (True, see Frontline, n.d.)

The “magazine” is the area of the gun that feeds ammunition into the chamber of the gun. (True, see Wintersteen, 2018 )).

An individual must manually engage the hammer on a double-action firearm before the weapon can fire a bullet. (False, see Gun News Daily, n.d.)

A bolt-action rifle requires the user to manually cycle every round before the rifle can be fired. (True, see Huntingsmart, n.d.)

All firearms must legally have a safety setting to keep the firearm from firing. (False, Giffords Law Center, n.d.)

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Kruis, N.E., Wentling, R.L., Frye, T.S. et al. Firearm Ownership, Defensive Gun Usage, and Support for Gun Control: Does Knowledge Matter?. Am J Crim Just 48 , 21–50 (2023). https://doi.org/10.1007/s12103-021-09644-7

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The psychology of guns: risk, fear, and motivated reasoning

• Joseph M. Pierre 1  

Palgrave Communications volume  5 , Article number:  159 ( 2019 ) Cite this article

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The gun debate in America is often framed as a stand-off between two immutable positions with little potential to move ahead with meaningful legislative reform. Attempts to resolve this impasse have been thwarted by thinking about gun ownership attitudes as based on rational choice economics instead of considering the broader socio-cultural meanings of guns. In this essay, an additional psychological perspective is offered that highlights how concerns about victimization and mass shootings within a shared culture of fear can drive cognitive bias and motivated reasoning on both sides of the gun debate. Despite common fears, differences in attitudes and feelings about guns themselves manifest in variable degrees of support for or opposition to gun control legislation that are often exaggerated within caricatured depictions of polarization. A psychological perspective suggests that consensus on gun legislation reform can be achieved through understanding differences and diversity on both sides of the debate, working within a common middle ground, and more research to resolve ambiguities about how best to minimize fear while maximizing personal and public safety.

Discounting risk

Do guns kill people or do people kill people? Answers to that riddle draw a bright line between two sides of a caricatured debate about guns in polarized America. One side believes that guns are a menace to public safety, while the other believes that they are an essential tool of self-preservation. One side cannot fathom why more gun control legislation has not been passed in the wake of a disturbing rise in mass shootings in the US and eyes Australia’s 1996 sweeping gun reform and New Zealand’s more recent restrictions with envy. The other, backed by the Constitutional right to bear arms and the powerful lobby of the National Rifle Association (NRA), fears the slippery slope of legislative change and refuses to yield an inch while threatening, “I’ll give you my gun when you pry it from my cold, dead hands”. With the nation at an impasse, meaningful federal gun legislation aimed at reducing firearm violence remains elusive.

Despite the 1996 Dickey Amendment’s restriction of federal funding for research on gun violence by the Centers for Disease Control and Prevention (Rostron, 2018 ), more than 30 years of public health research supports thinking of guns as statistically more of a personal hazard than a benefit. Case-control studies have repeatedly found that gun ownership is associated with an increased risk of gun-related homicide or suicide occurring in the home (Kellermann and Reay, 1986 ; Kellermann et al., 1993 ; Cummings and Koepsell, 1998 ; Wiebe, 2003 ; Dahlberg et al., 2004 ; Hemenway, 2011 ; Anglemeyer et al., 2014 ). For homicides, the association is largely driven by gun-related violence committed by family members and other acquaintances, not strangers (Kellermann et al., 1993 , 1998 ; Wiebe, 2003 ).

If having a gun increases the risk of gun-related violent death in the home, why do people choose to own guns? To date, the prevailing answer from the public health literature has been seemingly based on a knowledge deficit model that assumes that gun owners are unaware of risks and that repeated warnings about “overwhelming evidence” of “the health risk of a gun in the home [being] greater than the benefit” (Hemenway, 2011 ) should therefore decrease gun ownership and increase support for gun legislation reform. And yet, the rate of US households with guns has held steady for two decades (Smith and Son, 2015 ) with owners amassing an increasing number of guns such that the total civilian stock has risen to some 265 million firearms (Azrael et al., 2017 ). This disparity suggests that the knowledge deficit model is inadequate to explain or modify gun ownership.

In contrast to the premise that people weigh the risks and benefits of their behavior based on “rational choice economics” (Kahan and Braman, 2003 ), nearly 50 years of psychology and behavioral economics research has instead painted a picture of human decision-making as a less than rational process based on cognitive short-cuts (“availability heuristics”) and other error-prone cognitive biases (Tversky and Kahneman, 1974 ; Kunda, 1990 ; Haselton and Nettle, 2006 ; Hibert, 2012 ). As a result, “consequentialist” approaches to promoting healthier choices are often ineffective. Following this perspective, recent public health efforts have moved beyond educational campaigns to apply an understanding of the psychology of risky behavior to strike a balance between regulation and behavioral “nudges” aimed at reducing harmful practices like smoking, unhealthy eating, texting while driving, and vaccine refusal (Atchley et al., 2011 ; Hansen et al., 2016 ; Matjasko et al., 2016 ; Pluviano et al., 2017 ).

A similar public health approach aimed at reducing gun violence should take into account how gun owners discount the risks of ownership according to cognitive biases and motivated reasoning. For example, cognitive dissonance may lead those who already own guns to turn a blind eye to research findings about the dangers of ownership. Optimism bias, the general tendency of individuals to overestimate good outcomes and underestimate bad outcomes, can likewise make it easy to disregard dangers by externalizing them to others. The risk of suicide can therefore be dismissed out of hand based on the rationale that “it will never happen to me,” while the risk of homicide can be discounted based on demographic factors. Kleck and Gertz ( 1998 ) noted that membership in street gangs and drug dealing might be important confounds of risk in case control studies, just as unsafe storage practices such as keeping a firearm loaded and unlocked may be another (Kellerman et al., 1993 ). Other studies have found that the homicide risk associated with guns in the home is greater for women compared to men and for non-whites compared to whites (Wiebe, 2003 ). Consequently, white men—by far the largest demographic that owns guns—might be especially likely to think of themselves as immune to the risks of gun ownership and, through confirmation bias, cherry-pick the data to support pre-existing intuitions and fuel motivated disbelief about guns. These testable hypotheses warrant examination in future research aimed at understanding the psychology of gun ownership and crafting public health approaches to curbing gun violence.

Still, while the role of cognitive biases should be integrated into a psychological understanding of attitudes towards gun ownership, cognitive biases are universal liabilities that fall short of explaining why some people might “employ” them as a part of motivated reasoning to support ownership or to oppose gun reform. To understand the underlying motivation that drives cognitive bias, a deeper analysis of why people own guns is required. In the introductory essay to this journal’s series on “What Guns Mean,” Metzl ( 2019 ) noted that public health efforts to reduce firearm ownership have failed to “address beliefs about guns among people who own them”. In a follow-up piece, Galea and Abdalla ( 2019 ) likewise suggested that the gun debate is complicated by the fact that “knowledge and values do not align” and that “these values create an impasse, one where knowing is not enough” (Galea and Abdalla, 2019 ). Indeed, these and other authors (Kahan and Braman, 2003 ; Braman and Kahan, 2006 ; Pierre, 2015 ; Kalesan et al., 2016 ) have enumerated myriad beliefs and values, related to the different “symbolic lives” and “social meanings” of firearms both within and outside of “gun culture” that drive polarized attitudes towards gun ownership in the US. This essay attempts to further explore the meaning of guns from a psychological perspective.

Fear and gun ownership

Modern psychological understanding of human decision-making has moved beyond availability heuristics and cognitive biases to integrate the role of emotion and affect. Several related models including the “risk-as-feelings hypothesis” (Loewenstein et al., 2001 ), the “affect heuristic” (Slovic et al., 2007 ); and the “appraisal-tendency framework” (Lerner et al., 2015 ) illustrate how emotions can hijack rational-decision-making processes to the point of being the dominant influence on risk assessments. Research has shown that “perceived risk judgments”—estimates of the likelihood that something bad will happen—are especially hampered by emotion (Pachur et al., 2012 ) and that different types of affect can bias such judgments in different ways (Lerner et al., 2015 ). For example, fear can in particular bias assessments away from rational analysis to overestimate risks, as well as to perceive negative events as unpredictable (Lerner et al., 2015 ).

Although gun ownership is associated with positive feelings about firearms within “gun culture” (Pierre, 2015 ; Kalesan et al., 2016 ; Metzl, 2019 ), most research comparing gun owners to non-gun owners suggests that ownership is rooted in fear. While long guns have historically been owned primarily for hunting and other recreational purposes, US surveys dating back to the 1990s have revealed that the most frequent reason for gun ownership and more specifically handgun ownership is self-protection (Cook and Ludwig, 1997 ; Azrael et al., 2017 ; Pew Research Center, 2017 ). Research has likewise shown that the decision to obtain a firearm is largely motivated by past victimization and/or fears of future victimization (Kleck et al., 2011 ; Hauser and Kleck, 2013 ).

A few studies have reported that handgun ownership is associated with past victimization, perceived risk of crime, and perceived ineffectiveness of police protection within low-income communities where these concerns may be congruent with real risks (Vacha and McLaughlin, 2000 , 2004 ). However, gun ownership tends to be lower in urban settings and in low-income families where there might be higher rates of violence and crime (Vacha and McLaughlin, 2000 ). Instead, the largest demographic of gun owners in the US are white men living in rural communities who are earning more than $100K/year (Azrael et al., 2017 ). Mencken and Froese ( 2019 ) likewise reported that gun owners tend to have higher incomes and greater ratings of life happiness than non-owners. These findings suggest a mismatch between subjective fear and objective reality.

Stroebe and colleagues ( 2017 ) reported that the specific perceived risk of victimization and more “diffuse” fears that the world is a dangerous place are both independent predictors of handgun ownership, with perceived risk of assault associated with having been or knowing a victim of violent crime and belief in a dangerous world associated with political conservatism. These findings hint at the likelihood that perceived risk of victimization can be based on vicarious sources with a potential for bias, whether through actual known acquaintances or watching the nightly news, conducting a Google search or scanning one’s social media feed, or reading “The Armed Citizen” column in the NRA newsletter The American Rifleman . It also suggests that a general fear of crime, independent of actual or even perceived individual risk, may be a powerful motivator for gun ownership for some that might track with race and political ideology.

Several authors have drawn a connection between gun ownership and racial tensions by examining the cultural symbolism and socio-political meaning of guns. Bhatia ( 2019 ) detailed how the NRA’s “disinformation campaign reliant on fearmongering” is constructed around a narrative of “fear and identity politics” that exploits current xenophobic sentiments related to immigrants. Metzl ( 2019 ) noted that during the 1960s, conservatives were uncharacteristically in favor of gun control when armed resistance was promoted by Malcolm X, the Black Panther Party, and others involved in the Black Power Movement. Today, Metzl argues, “mainstream society reflexively codes white men carrying weapons in public as patriots, while marking armed black men as threats or criminals.” In support of this view, a 2013 study found that having a gun in the home was significantly associated with racism against black people as measured by the Symbolic Racism Scale, noting that “for each 1 point increase in symbolic racism, there was a 50% greater odds of having a gun in the home and a 28% increase in the odds of supporting permits to carry concealed handguns” (O’Brien et al., 2013 ). Hypothesizing that guns are a symbol of hegemonic masculinity that serves to “shore up white male privilege in society,” Stroud ( 2012 ) interviewed a non-random sample of 20 predominantly white men in Texas who had licenses for concealed handgun carry. The men described how guns help to fulfill their identities as protectors of their families, while characterizing imagined dangers with rhetoric suggesting specific fears about black criminals. These findings suggest that gun ownership among white men may be related to a collective identity as “good guys” protecting themselves against “bad guys” who are people of color, a premise echoed in the lay press with headlines like, “Why Are White Men Stockpiling Guns?” (Smith, 2018 ), “Report: White Men Stockpile Guns Because They’re Afraid of Black People” (Harriott, 2018 ), and “Gun Rights Are About Keeping White Men on Top” (Wuertenberg, 2018 ).

Connecting the dots, the available evidence therefore suggests that for many gun owners, fears about victimization can result in confirmation, myside, and optimism biases that not only discount the risks of ownership, but also elevate the salience of perceived benefit, however remote, as it does when one buys a lottery ticket (Rogers and Webley, 2001 ). Indeed, among gun owners there is widespread belief that having a gun makes one safer, supported by published claims that where there are “more guns”, there is “less crime” (Lott, 1998 , 1999 ) as well as statistics and anecdotes about successful defensive gun use (DGU) (Kleck and Gertz, 1995 , 1998 ; Tark and Kleck, 2004 ; Cramer and Burnett, 2012 ). Suffice it to say that there have been numerous debates about how to best interpret this body of evidence, with critics claiming that “more guns, less crime” is a myth (Ayres and Donohue, 2003 ; Moyer, 2017 ) that has been “discredited” (Wintemute, 2008 ) and that the incidence of DGU has been grossly overestimated and pales in comparison to the risk of being threatened or harmed by a gun in the home (Hemenway, 1997 , 2011 ; Cook and Ludwig, 1998 ; Azrael and Hemenway, 2000 ; Hemenway et al., 2000 ). Attempts at objective analysis have concluded that surveys to date have defined and measured DGU inconsistently with unclear numbers of false positives and false negatives (Smith, 1997 ; McDowall et al., 2000 ; National Research Council, 2005 ; RAND, 2018 ), that the causal effects of DGU on reducing injury are “inconclusive” (RAND, 2018 ), and that “neither side seems to be willing to give ground or see their opponent’s point of view” (Smith, 1997 ). With the scientific debate about DGU mirrored in the lay press (Defilippis and Hughes, 2015 ; Kleck, 2015 ; Doherty, 2015 ), a rational assessment of whether guns make owners safer is hampered by a lack of “settled science”. With no apparent consensus, motivated reasoning can pave the way to the nullification of opposing arguments in favor of personal opinions and ideological stances.

For gun owners, even if it is acknowledged that on average successful DGU is much less likely than a homicide or suicide in the home, not having a gun at all translates to zero chance of self-preservation, which are intolerable odds. The bottom line is that when gun owners believe that owning a gun will make them feel safer, little else may matter. Curiously however, there is conflicting evidence that gun ownership actually decreases fears of victimization (Hauser and Kleck, 2013 ; Dowd-Arrow et al., 2019 ). That gun ownership may not mitigate such fears could help to account for why some individuals go on to acquire multiple guns beyond their initial purchase with US gun owners possessing an average of 5 firearms and 8% of owners having 10 or more (Azrael et al., 2017 ).

Gun owner diversity

A psychological model of the polarized gun debate in America would ideally compare those for or against gun control legislation. However, research to date has instead focused mainly on differences between gun owners and non-gun owners, which has several limitations. For example, of the nearly 70% of Americans who do not own a gun, 36% report that they can see themselves owning one in the future (Pew Research Center, 2017 ) with 11.5% of all gun owners in 2015 having newly acquired one in the previous 5 years (Wertz et al., 2018 ). Gun ownership and non-ownership are therefore dynamic states that may not reflect static ideology. Personal accounts such as Willis’ ( 2010 ) article, “I Was Anti-gun, Until I Got Stalked,” illustrate this point well.

With existing research heavily reliant on comparing gun owners to non-gun owners, a psychological model of gun attitudes in the US will have limited utility if it relies solely on gun owner stereotypes based on their most frequent demographic characteristics. On the contrary, Hauser and Kleck ( 2013 ) have argued that “a more complete understanding of the relationship between fear of crime and gun ownership at the individual level is crucial”. Just so, looking more closely at the diversity of gun owners can reveal important details beyond the kinds of stereotypes that are often used to frame political debates.

Foremost, it must be recognized that not all gun owners are conservative white men with racist attitudes. Over the past several decades, women have comprised 9–14% of US gun owners with the “gender gap” narrowing due to decreasing male ownership (Smith and Son, 2015 ). A 2017 Pew Survey reported that 22% of women in the US own a gun and that female gun owners are just as likely as men to belong to the NRA (Pew Research Center, 2017 ). Although the 36% rate of gun ownership among US whites is the highest for any racial demographic, 25% of blacks and 15% of Hispanics report owning guns with these racial groups being significantly more concerned than whites about gun violence in their communities and the US as a whole (Pew Research Center, 2017 ). Providing a striking counterpoint to Stroud’s ( 2012 ) interviews of white gun owners in Texas, Craven ( 2017 ) interviewed 11 black gun owners across the country who offered diverse views on guns and the question of whether owning them makes them feel safer, including if confronted by police during a traffic stop. Kelly ( 2019 ) has similarly offered a self-portrait as a female “left-wing anarchist” against the stereotype of guns owners as “Republicans, racist libertarians, and other generally Constitution-obsessed weirdos”. She reminds us that, “there is also a long history of armed community self-defense among the radical left that is often glossed over or forgotten entirely in favor of the Fox News-friendly narrative that all liberals hate guns… when the cops and other fascists see that they’re not the only ones packing, the balance of power shifts, and they tend to reconsider their tactics”.

Although Mencken and Froese ( 2019 ) concluded that “white men in economic distress find comfort in guns as a means to reestablish a sense of individual power and moral certitude,” their study results actually demonstrated that gun owners fall into distinguishable groups based on different levels of “moral and emotional empowerment” imparted by guns. For example, those with low levels of gun empowerment were more likely to be female and to own long guns for recreational purposes such as hunting and collecting. Other research has shown that the motivations to own a gun, and the degree to which gun ownership is related to fear and the desire for self-protection, also varies according to the type of gun (Stroebe et al., 2017 ). Owning guns, owning specific types of guns (e.g. handguns, long guns, and so-called “military style” semi-automatic rifles like AR-15s), carrying a gun in public, and keeping a loaded gun on one’s nightstand all have different psychological implications. A 2015 study reported that new gun owners were younger and more likely to identify as liberal than long-standing gun owners (Wertz et al., 2018 ). Although Kalesan et al. ( 2016 ) found that gun ownership is more likely among those living within a “gun culture” where ownership is prevalent, encouraged, and part of social life, it would therefore be a mistake to characterize gun culture as a monolith.

It would also be a mistake to equate gun ownership with opposition to gun legislation reform or vice-versa. Although some evidence supports a strong association (Wolpert and Gimpel, 1998 ), more recent studies suggest important exceptions to the rule. While only about 30% of the US population owns a gun, over 70% believes that most citizens should be able to legally own them (Pew Research Center, 2017 ). Women tend to be more likely than men to support gun control, even when they are gun owners themselves (Kahan and Braman, 2003 ; Mencken and Froese, 2019 ). Older (age 70–79) Americans likewise have some of the highest rates of gun ownership, but also the highest rates of support for gun control (Pederson et al., 2015 ). In Mencken and Froese’s study ( 2019 ), most gun owners reporting lower levels of gun empowerment favored bans on semi-automatic weapons and high-capacity magazines and opposed arming teachers in schools. Kahan and Braman ( 2003 ) theorized that attitudes towards gun control are best understood according to a “cultural theory of risk”. In their study sample, those with “hierarchical” and “individualist” cultural orientations were more likely than those with “egalitarian” views to oppose gun control and these perspectives were more predictive than other variables including political affiliation and fear of crime.

In fact, both gun owners and non-owners report high degrees of support for universal background checks; laws mandating safe gun storage in households with children; and “red flag” laws restricting access to firearms for those hospitalized for mental illness or those otherwise at risk of harming themselves or others, those convicted of certain crimes including public display of a gun in a threatening manner, those subject to temporary domestic violence restraining orders, and those on “no-fly” or other watch lists (Pew Research Center, 2017 ; Barry et al., 2018 ). According to a 2015 survey, the majority of the US public also opposes carrying firearms in public spaces with most gun owners opposing public carry in schools, college campuses, places of worship, bars, and sports stadiums (Wolfson et al., 2017 ). Despite broad public support for gun legislation reform however, it is important to recognize that the threat of gun restrictions is an important driver of gun acquisition (Wallace, 2015 ; Aisch and Keller, 2016 ). As a result, proposals to restrict gun ownership boosted gun sales considerably under the Obama administration (Depetris-Chauvin, 2015 ), whereas gun companies like Remington and United Sporting Companies have since filed for bankruptcy under the Trump administration.

A shared culture of fear

Developing a psychological understanding of attitudes towards guns and gun control legislation in the US that accounts for underlying emotions, motivated reasoning, and individual variation must avoid the easy trap of pathologizing gun owners and dismissing their fears as irrational. Instead, it should consider the likelihood that motivated reasoning underlies opinion on both sides of the gun debate, with good reason to conclude that fear is a prominent source of both “pro-gun” and “anti-gun” attitudes. Although the research on fear and gun ownership summarized above implies that non-gun owners are unconcerned about victimization, a closer look at individual study data reveals both small between-group differences and significant within-group heterogeneity. For example, Stroebe et al.’s ( 2017 ) findings that gun owners had greater mean ratings of belief in a dangerous world, perceived risk of victimization, and the perceived effectiveness of owning a gun for self-defense were based on inter-group differences of <1 point on a 7-point Likert scale. Fear of victimization is therefore a universal fear for gun owners and non-gun owners alike, with important differences in both quantitative and qualitative aspects of those fears. Kahan and Braham ( 2003 ) noted that the gun debate is not so much a debate about the personal risks of gun ownership, as it is a one about which of two potential fears is most salient—that of “firearm casualties in a world with insufficient gun control or that of personal defenselessness in a world with excessive control”.

Although this “shared fear” hypothesis has not been thoroughly tested in existing research, there is general support for it based on evidence that fear is an especially potent influence on risk assessment and decision-making when considering low-frequency catastrophic events (Chanel et al., 2009 ). In addition, biased risk assessments have been linked to individual feelings about a specific activity. Whereas many activities in the real world have both high risk and high benefit, positive attitudes about an activity are associated with biased judgments of low risk and high benefit while negative attitudes are associated with biased judgments of high risk and low benefit (Slovic et al., 2007 ). These findings match those of the gun debate, whereby catastrophic events like mass shootings can result in “probability neglect,” over-estimating the likelihood of risk (Sunstein, 2003 ; Sunstein and Zeckhauser, 2011 ) with polarized differences regarding guns as a root cause and gun control as a viable solution. For those that have positive feelings about guns and their perceived benefit, the risk of gun ownership is minimized as discussed above. However, based on findings from psychological research on fear (Loewenstein et al., 2001 ; Slovic et al., 2007 ), the reverse is also likely to be true—those with negative feelings about guns who perceive little benefit to ownership may tend to over-estimate risks. Consistent with this dichotomy, both calls for legislative gun reform, as well as gun purchases increase in the wake of mass shootings (Wallace, 2015 ; Wozniak, 2017 ), with differences primarily predicted by the relative self-serving attributional biases of gun ownership and non-ownership alike (Joslyn and Haider-Markel, 2017 ).

Psychological research has shown that fear is associated with loss of control, with risks that are unfamiliar and uncontrollable perceived as disproportionately dangerous (Lerner et al., 2015 ; Sunstein, 2003 ). Although mass shootings have increased in recent years, they remain extremely rare events and represent a miniscule proportion of overall gun violence. And yet, as acts of terrorism, they occur in places like schools that are otherwise thought of as a suburban “safe spaces,” unlike inner cities where violence is more mundane, and are often given sensationalist coverage in the media. A 2019 Harris Poll found that 79% of Americans endorse stress as a result of the possibility of a mass shooting, with about a third reporting that they “cannot go anywhere without worrying about being a victim” (American Psychological Association, 2019 ). While some evidence suggests that gun owners may be more concerned about mass shootings than non-gun owners (Dowd-Arrow et al., 2019 ), this is again a quantitative difference as with fear of victimization more generally. There is little doubt that parental fears about children being victims of gun violence were particularly heightened in the wake of Columbine (Altheide, 2019 ) and it is likely that subsequent school shootings at Virginia Tech, Sandy Hook Elementary, and Stoneman Douglas High have been especially impactful in the minds of those calling for increasing restrictions on gun ownership. For those privileged to be accustomed to community safety who are less worried about home invasion and have faith in the police to provide protection, fantasizing about “gun free zones” may reflect a desire to recreate safe spaces in the wake of mass shootings that invoke feelings of loss of control.

Altheide ( 2019 ) has argued that mass shootings in the US post-Columbine have been embedding within a larger cultural narrative of terrorism, with “expanded social control and policies that helped legitimate the war on terror”. Sunstein and Zeckhauser ( 2011 ) have similarly noted that following terrorist attacks, the public tends to demand responses from government, favoring precautionary measures that are “not justified by any plausible analysis of expected utility” and over-estimating potential benefits. However, such responses may not only be ineffective, but potentially damaging. For example, although collective anxieties in the wake of the 9/11 terrorist attacks resulted in the rapid implementation of new screening procedures for boarding airplanes, it has been argued that the “theater” of response may have done well to decrease fear without any evidence of actual effectiveness in reducing danger (Graham, 2019 ) while perhaps even increasing overall mortality by avoiding air travel in favor of driving (Sunstein, 2003 ; Sunstein and Zeckhauser, 2011 ).

As with the literature on DGU, the available evidence supporting the effectiveness of specific gun laws in reducing gun violence is less than definitive (Koper et al., 2004 ; Hahn et al., 2005 ; Lee et al., 2017 ; Webster and Wintemute, 2015 ), leaving the utility of gun reform legislation open to debate and motivated reasoning. Several authors have argued that even if proposed gun control measures are unlikely to deter mass shooters, “doing something is better than nothing” (Fox and DeLateur, 2014 ) and that ineffective counter-terrorism responses are worthwhile if they reduce public fear (Sunstein and Zeckhauser, 2011 ). Crucially however, this perspective fails to consider the impact of gun control legislation on the fears of those who value guns for self-protection. For them, removing guns from law-abiding “good guys” while doing nothing to deter access to the “bad guys” who commit crimes is illogical anathema. Gun owners and gun advocates likewise reject the concept of “safe spaces” and regard the notion of “gun free zones” as a liability that invites rather than prevents acts of terrorism. In other words, gun control proposals designed to decrease fear have the opposite of their intended effect on those who view guns as symbols of personal safety, increasing rather than decreasing their fears independently of any actual effects on gun violence. Such policies are therefore non-starters, and will remain non-starters, for the sizeable proportion of Americans who regard guns as essential for self-preservation.

In 2006, Braman and Kahan noted that “the Great American Gun Debate… has convulsed the national polity for the better part of four decades without producing results satisfactory to either side” and argued that consequentialist arguments about public health risks based on cost–benefit analysis are trumped by the cultural meanings of guns to the point of being “politically inert” (Braman and Kahan, 2006 ). More than a decade later, that argument is iterated in this series on “What Guns Mean”. In this essay, it is further argued that persisting debates about the effectiveness of DGU and gun control legislation are at their heart trumped by shared concerns about personal safety, victimization, and mass shootings within a larger culture of fear, with polarized opinions about how to best mitigate those fears that are determined by the symbolic, cultural, and personal meanings of guns and gun ownership.

Coming full circle to the riddle, “Do guns kill people or do people kill people?”, a psychologically informed perspective rejects the question as a false dichotomy that can be resolved by the statement, “people kill people… with guns”. It likewise suggests a way forward by acknowledging both common fears and individual differences beyond the limited, binary caricature of the gun debate that is mired in endless arguments over disputed facts. For meaningful legislative change to occur, the debate must be steered away from its portrayal as two immutable sides caught between not doing anything on the one hand and enacting sweeping bans or repealing the 2nd Amendment on the other. In reality, public attitudes towards gun control are more nuanced than that, with support or opposition to specific gun control proposals predicted by distinct psychological and cultural factors (Wozniak, 2017 ) such that achieving consensus may prove less elusive than is generally assumed. Accordingly, gun reform proposals should focus on “low hanging fruit” where there is broad support such as requiring and enforcing universal background checks, enacting “red flag” laws balanced by guaranteeing gun ownership rights to law-abiding citizens, and implementing public safety campaigns that promote safe firearm handling and storage. Finally, the Dickey Amendment should be repealed so that research can inform public health interventions aimed at reducing gun violence and so that individuals can replace motivated reasoning with evidence-based decision-making about personal gun ownership and guns in society.

Aisch G, Keller J (2016). What happens after calls for new gun restrictions? Sales go up. New York Times. https://www.nytimes.com/interactive/2015/12/10/us/gun-sales-terrorism-obama-restrictions.html . Accessed 19 Nov 2019.

Altheide DL (2019) The Columbine shootings and the discourse of fear. Am Behav Sci 52:1354–1370

Article   Google Scholar  

American Psychological Association (2019). One-third of US adults say fear of mass shootings prevents them from going to certain places or events. Press release, 15 August 2019. https://www.apa.org/news/press/releases/2019/08/fear-mass-shooting . Accessed 19 Nov 2019

Anglemeyer A, Horvath T, Rutherford G (2014) The accessibility of firearms and risk for suicide and homicide victimization among household members: a systematic review and meta-analysis. Ann Int Med 160:101–110

Google Scholar  

Atchley P, Atwood S, Boulton A (2011) The choice to text and drive in younger drivers: behavior may shape attitude. Accid Anal Prev 43:134–142

Article   PubMed   Google Scholar  

Ayres I, Donohue III JJ (2003) Shooting down the more guns, less crime hypothesis. Stanf Law Rev 55:1193–1312

Azrael D, Hemenway D (2000) ‘In the safety of your own home’: results from a national survey on gun use at home. Soc Sci Med 50:285–291

Article   CAS   PubMed   Google Scholar  

Azrael D, Hepburn L, Hemenway D, Miller M (2017) The stock and flow of U.S. firearms: results from the 2015 National Firearms Survey. Russell Sage Found J Soc Sci 3:38–57

Barry CL, Webster DW, Stone E, Crifasi CK, Vernick JS, McGinty EE (2018) Public support for gun violence prevention policies among gun owners and non-gun owners in 2017. Am J Public Health 108:878–881

Article   PubMed   PubMed Central   Google Scholar  

Bhatia R (2019). Guns, lies, and fear: exposing the NRA’s messaging playbook. Center for American Progress. https://www.americanprogress.org/issues/guns-crime/reports/2019/04/24/468951/guns-lies-fear/ . Accessed 19 Nov 2019

Braman D, Kahan DM (2006) Overcoming the fear of guns, the fear of gun control, and the fear of cultural politics: constructing a better gun debate. Emory Law J 55:569–607

Cook PJ, Ludwig J (1997). Guns in America: National survey on private ownership and use of firearms. National Institute of Justice. https://www.ncjrs.gov/pdffiles/165476.pdf . Accessed 19 Nov 2019

Chanel O, Chichilnisky G(2009) The influence of fear in decisions: Experimental evidence. J Risk Uncertain 39(3):271–298

Article   MATH   Google Scholar  

Cook PJ, Ludwig J (1998) Defensive gun use: new evidence from a national survey. J Quant Criminol 14:111–131

Cramer CE, Burnett D (2012). Tough targets: when criminals face armed resistance from citizens. Cato Institute https://object.cato.org/sites/cato.org/files/pubs/pdf/WP-Tough-Targets.pdf . Accessed 19 Nov 2019

Craven J (2017). Why black people own guns. Huffington Post. https://www.huffpost.com/entry/black-gun-ownership_n_5a33fc38e4b040881bea2f37 . Accessed 19 Nov 2019

Cummings P, Koepsell TD (1998) Does owning a firearm increase or decrease the risk of death? JAMA 280:471–473

Dahlberg LL, Ikeda RM, Kresnow M (2004) Guns in the home and risk of a violent death in the home: findings from a national study. Am J Epidemiol 160:929–936

Defilippis E, Hughes D (2015). The myth behind defensive gun ownership: guns are more likely to do harm than good. Politico. https://www.politico.com/magazine/story/2015/01/defensive-gun-ownership-myth-114262 . Accessed 19 Nov 2019

Depetris-Chauvin E (2015) Fear of Obama: an empirical study of the demand for guns and the U.S. 2008 presidential election. J Pub Econ 130:66–79

Doherty B (2015). How to count the defensive use of guns: neither survey calls nor media and police reports capture the importance of private gun ownership. Reason. https://reason.com/2015/03/09/how-to-count-the-defensive-use-of-guns/ . Accessed 19 Nov 2019

Dowd-Arrow B, Hill TD, Burdette AM (2019) Gun ownership and fear. SSM Pop Health 8:100463

Fox JA, DeLateur MJ (2014) Mass shootings in America: moving beyond Newtown. Homicide Stud 18:125–145

Galea S, Abdalla SM (2019) The public’s health and the social meaning of guns. Palgrave Comm 5:111

Graham DA. The TSA doesn’t work—and never has. The Atlantic. https://www.theatlantic.com/politics/archive/2015/06/the-tsa-doesnt-work-and-maybe-it-doesnt-matter/394673/ . Accessed 19 Nov 2019

Hahn RA, Bilukha O, Crosby A, Fullilove MT, Liberman A, Moscicki E, Synder S, Tuma F, Briss PA, Task Force on Community Preventive Services (2005) Firearms laws and the reduction of violence: a systematic review. Am J Prev Med 28:40–71

Hansen PG, Skov LR, Skov KL (2016) Making healthy choices easier: regulation versus nudging. Annu Rev Public Health 37:237–51

Harriott M (2018). Report: white men stockpile guns because they’re afraid of black people. The Root. https://www.theroot.com/report-white-men-stockpile-guns-because-they-re-afraid-1823779218 . Accessed 19 Nov 2019

Haselton MG, Nettle D (2006) The paranoid optimist: an integrative evolutionary model of cognitive biases. Pers Soc Psychol Rev 10:47–66

Hauser W, Kleck G (2013) Guns and fear: a one-way street? Crime Delinquency 59:271–291

Hemenway (1997) Survey research and self-defense gun use: an explanation of extreme overestimates. J Crim Law Criminol 87:1430–1445

Hemenway D, Azrael D, Miller M (2000) Gun use in the United States: results from two national surveys. Inj Prev 6:263–267

Article   CAS   PubMed   PubMed Central   Google Scholar  

Hemenway D (2011) Risks and benefits of a gun in the home. Am J Lifestyle Med 5:502–511

Hibert M (2012) Toward a synthesis of cognitive biases: how noisy information processing can bias human decision making. Psychol Bull 138:211–237

Joslyn MR, Haider-Markel DP (2017) Gun ownership and self-serving attributions for mass shooting tragedies. Soc Sci Quart 98:429–442

Kahan DM, Braman D (2003) More statistics, less persuasion: a cultural theory of gun-risk perceptions. Univ Penn Law Rev 151:1291–1327

Kalesan B, Villarreal MD, Keyes KM, Galea S (2016) Gun ownership and social gun culture. Inj Prev 22:216–220

Kellermann AL, Reay DT (1986) Protection or peril? An analysis of fire-arm related deaths in the home. N Engl J Med 314:1557–1560

Kellermann AL, Rivara FP, Rushforth NB, Banton JG, Reay DT, Francisco JT, Locci A, Prodzinski J, Hackman BB, Somes G (1993) Gun ownership as a risk factor for homicide in the home. N Engl J Med 329:1084–1091

Kellerman AL, Somes G, Rivara F, Lee R, Banton J (1998) Injuries and deaths due to firearms in the home. J Trauma Inj Infect Crit Care 45:263–267

Kelly K (2019) I’m a left-wing anarchist. Guns aren’t just for right-wingero. Vox. https://www.vox.com/first-person/2019/7/1/18744204/guns-gun-control-anarchism . Accessed 19 Nov 2019

Kleck G (2015) Defensive gun use is not a myth: why my critics still have it wrong. Politico. https://www.politico.com/magazine/story/2015/02/defensive-gun-ownership-gary-kleck-response-115082 . Accessed 19 Nov 2019

Kleck G, Kovandzic T, Saber M, Hauser W (2011) The effect of perceived risk and victimization on plans to purchase a gun for self-protection. J Crim Justice 39:312–319

Kleck G, Gertz M (1995) Armed resistance to crime: the prevalence and nature of self-defense with a gun. J Crim Law Criminol 86:150–187

Kleck G, Gertz M (1998) Carrying guns for protection: results from the national self-defense survey. J Res Crime Delinquency 35:193–224

Koper CS, Woods DJ, Roth JA (2004) An updated assessment of the federal assault weapons ban: impacts on gun markets and gun violence, 1994–2003. https://www.ncjrs.gov/pdffiles1/nij/grants/204431.pdf . Accessed 19 Nov 2019

Kunda Z (1990) The case for motivated reasoning. Psychol Bull 108:480–498

Lee LK, Fleegler EW, Farrell C, Avakame E, Srinivasan S, Hemenway D, Monuteaux MC (2017) Firearm laws and firearm homicides: a systematic review. JAMA Int Med 177:106–119

Lerner JS, Li Y, Valdesolo P, Kassam KS (2015) Emotion and decision making. Ann Rev Psychol 66:799–823

Loewenstein GF, Weber EU, Hsee CK, Welch N (2001) Risk as feelings. Psychol Bull 127:267–286

Lott JR (1998) More guns, less crime. University of Chicago Press, Chicago

Lott JR (1999) More guns, less crime: a response to Ayres and Donohue. Yale Law & Economics Research paper no. 247 https://papers.ssrn.com/sol3/papers.cfm?abstract_id=248328 . Accessed 19 Nov 2019

Matjasko JL, Cawley JH, Baker-Goering M, Yokum DV (2016) Applying behavioral economics to public health policy: illustrative examples and promising directions. Am J Prev Med 50:S13–S19

McDowall D, Loftin C, Presser S (2000) Measuring civilian defensive firearm use: a methodological experiment. J Quant Criminol 16:1–19

Mencken FC, Froese P (2019) Gun culture in action. Soc Prob 66:3–27

Metzl J (2019) What guns mean: the symbolic lives of firearms. Palgrave Comm 5:35

Article   ADS   Google Scholar  

Moyer MW (2017). More guns do not stop more crimes, evidence shows. Sci Am https://www.scientificamerican.com/article/more-guns-do-not-stop-more-crimes-evidence-shows/ . Accessed 19 Nov 2019.

National Research Council (2005) Firearms and violence: a critical review. The National Academies Press, Washington, DC

O’Brien K, Forrest W, Lynott D, Daly M (2013) Racism, gun ownership and gun control: Biased attitudes in US whites may influence policy decisions. PLoS ONE 8(10):e77552

Article   ADS   PubMed   PubMed Central   CAS   Google Scholar  

Pachur T, Hertwig R, Steinmann F (2012) How do people judge risks: availability heuristic, affect heuristic, or both? J Exp Psychol Appl 18:314–330

Pederson J, Hall TL, Foster B, Coates JE (2015) Gun ownership and attitudes toward gun control in older adults: reexamining self interest theory. Am J Soc Sci Res 1:273–281

Pew Research Center (2017) America’s complex relationship with guns. https://www.pewsocialtrends.org/wp-content/uploads/sites/3/2017/06/Guns-Report-FOR-WEBSITE-PDF-6-21.pdf . Accessed 19 Nov 2019

Pierre JM (2015) The psychology of guns. Psych Unseen. https://www.psychologytoday.com/us/blog/psych-unseen/201510/the-psychology-guns . Accessed 19 Nov 2019

Pluviano S, Watt C, Della Salla S (2017) Misinformation lingers in memory: failure of three pro-vaccination strategies. PLoS ONE 23(7):e0811640

RAND (2018) The challenges of defining and measuring defensive gun use. https://www.rand.org/research/gun-policy/analysis/essays/defensive-gun-use.html . Accessed 19 Nov 2019

Rogers P, Webley P (2001) “It could be us!”: cognitive and social psychological factors in UK National Lottery play. Appl Psychol Int Rev 50:181–199

Rostron A (2018) The Dickey Amendment on federal funding for research on gun violence: a legal discussion. Am J Public Health 108:865–867

Slovic P, Finucane ML, Peters E, MacGregor DG (2007) The affect heuristic. Eur J Oper Res 177:1333–1352

Smith TW (1997) A call for a truce in the DGU war. J Crim Law Criminol 87:1462–1469

Smith JA (2018) Why are white men stockpiling guns? Sci Am Blogs. https://blogs.scientificamerican.com/observations/why-are-white-men-stockpiling-guns/ . Accessed 19 Nov 2019

Smith TW, Son J (2015). General social survey final report: Trends in gun ownership in the United States, 1972–2014. http://www.norc.org/PDFs/GSS%20Reports/GSS_Trends%20in%20Gun%20Ownership_US_1972-2014.pdf . Accessed 19 Nov 2019

Stroebe W, Leander NP, Kruglanski AW (2017) Is it a dangerous world out there? The motivational biases of American gun ownership. Pers Soc Psychol Bull 43:1071–1085

Stroud A (2012) Good guys with guns: hegemonic masculinity and concealed handguns. Gend Soc 26:216–238

Sunstein CR (2003) Terrorism and probability neglect. J Risk Uncertain 26:121–136

Sunstein CR, Zeckhauser R (2011) Overreaction to fearsome risks. Environ Resour Econ 48:435–449

Tark J, Kleck G (2004) Resisting crime: the effects of victim action on the outcomes of crimes. Criminol 42:861–909

Tversky A, Kahneman D (1974) Judgment under uncertainty: heuristics and biases. Science 185:1124–1131

Article   ADS   CAS   PubMed   Google Scholar  

Vacha EF, McLaughlin TF (2000) The impact of poverty, fear of crime, and crime victimization on keeping firearms for protection and unsafe gun-storage practices” A review and analysis with policy recommendations. Urban Educ 35:496–510

Vacha EF, McLaughlin TF (2004) Risky firearms behavior in low-income families of elementary school children: the impact of poverty, fear of crime, and crime victimization on keeping and storing firearms. J Fam Violence 19:175–184

Wallace LN (2015) Responding to violence with guns: mass shootings and gun acquisition. Soc Sci J 52:156–167

Webster DW, Wintemute GJ (2015) Effects of policies designed to keep firearms from high-risk individuals. Ann Rev Public Health 36:21–37

Wertz J, Azrael D, Hemenway D, Sorenson S, Miller M (2018) Differences between new and long-standing US gun owners: results from a National Survey. Am J Public Health 108:871–877

Wiebe DJ (2003) Homicide and suicide risks associated with firearms in the home: a national case-control study. Ann Emerg Med 47:771–782

Willis J (2010). I was anti-gun, until I got stalked. Salon. https://www.salon.com/2010/10/21/buying_gun_protect_from_stalker/ . Accessed 19 Nov 2019

Wintemute GJ (2008) Guns, fear, the constitution, and the public’s health. N. Engl J Med 358:1421–1424

Wolfson JA, Teret SP, Azrael D, Miller M (2017) US public opinion on carrying firearms in public places. Am J Public Health 107:929–937

Wolpert RM, Gimpel JG (1998) Self-interest, symbolic politics, and public attitudes toward gun control. Polit Behav 20:241–262

Wozniak KH (2017) Public opinion about gun control post-Sandy Hook. Crim Just Pol Rev 28:255–278

Wuertenberg N (2018). Gun rights are about keeping white men on top. Washington Post. https://www.washingtonpost.com/news/made-by-history/wp/2018/03/09/gun-rights-are-about-keeping-white-men-on-top . Accessed 19 Nov 2019

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Article Contents

Introduction, the burden of firearm violence, understanding and reducing firearm violence is complex and multi-factorial, interventions and recommendations, conclusions, research ethics.

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Firearm Violence in the United States: An Issue of the Highest Moral Order

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Chisom N Iwundu, Mary E Homan, Ami R Moore, Pierce Randall, Sajeevika S Daundasekara, Daphne C Hernandez, Firearm Violence in the United States: An Issue of the Highest Moral Order, Public Health Ethics , Volume 15, Issue 3, November 2022, Pages 301–315, https://doi.org/10.1093/phe/phac017

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Firearm violence in the United States produces over 36,000 deaths and 74,000 sustained firearm-related injuries yearly. The paper describes the burden of firearm violence with emphasis on the disproportionate burden on children, racial/ethnic minorities, women and the healthcare system. Second, this paper identifies factors that could mitigate the burden of firearm violence by applying a blend of key ethical theories to support population level interventions and recommendations that may restrict individual rights. Such recommendations can further support targeted research to inform and implement interventions, policies and laws related to firearm access and use, in order to significantly reduce the burden of firearm violence on individuals, health care systems, vulnerable populations and society-at-large. By incorporating a blended public health ethics to address firearm violence, we propose a balance between societal obligations and individual rights and privileges.

Firearm violence poses a pervasive public health burden in the United States. Firearm violence is the third leading cause of injury related deaths, and accounts for over 36,000 deaths and 74,000 firearm-related injuries each year ( Siegel et al. , 2013 ; Resnick et al. , 2017 ; Hargarten et al. , 2018 ). In the past decade, over 300,000 deaths have occurred from the use of firearms in the United States, surpassing rates reported in other industrialized nations ( Iroku-Malize and Grissom, 2019 ). For example, the United Kingdom with a population of 56 million reports about 50–60 deaths per year attributable to firearm violence, whereas the United States with a much larger population, reports more than 160 times as many firearm-related deaths ( Weller, 2018 ).

Given the pervasiveness of firearm violence, and subsequent long-term effects such as trauma, expensive treatment and other burdens to the community ( Lowe and Galea, 2017 ; Hammaker et al. , 2017 ; Jehan et al. , 2018 ), this paper seeks to examine how various evidence-based recommendations might be applied to curb firearm violence, and substantiate those recommendations using a blend of the three major ethics theories which include—rights based theories, consequentialism and common good. To be clear, ours is not a morally neutral paper wherein we weigh the merits of an ethical argument for or against a recommendation nor is it a meta-analysis of the pros and cons to each public health recommendation. We intend to promote evidence-based interventions that are ethically justifiable in the quest to ameliorate firearm violence.

It is estimated that private gun ownership in the United States is 30% and an additional 11% of Americans lived with someone who owed a gun in 2017 ( Gramlich and Schaeffer, 2019 ). Some of the reported motivations for carrying a firearm include protection against people (anticipating future victimization or past victimization experience) and hunting or sport shooting ( Schleimer et al. , 2019 ). A vast majority of firearm-related injuries and death occur from intentional harm (62% from suicides and 35% from homicides) versus 2% of firearm-related injuries and death occurring from unintentional harm or accidents (e.g. unsafe storage) ( Fowler et al. , 2015 ; Lewiecki and Miller, 2013 ; Monuteaux et al. , 2019 ; Swanson et al. , 2015 ).

Rural and urban differences have been noted regarding firearms and its related injuries and deaths. In one study, similar amount of firearm deaths were reported in urban and rural areas ( Herrin et al. , 2018 ). However, the difference was that firearm deaths from homicides were higher in urban areas, and deaths from suicide and unintentional deaths were higher in rural areas ( Herrin et al. , 2018 ). In another study, suicides accounted for about 70% of firearm deaths in both rural and urban areas ( Dresang, 2001 ). Hence, efforts to implement these recommendations have the potential to prevent most firearm deaths in both rural and urban areas.

The burden of firearm injuries on society consists of not only the human and economic costs, but also productivity loss, pain and suffering. Firearm-related injuries affect the health and welfare of all and lead to substantial burden to the healthcare industry and to individuals and families ( Corso et al. , 2006 ; Tasigiorgos et al. , 2015 ). Additionally, there are disparities in firearm injuries, whereby firearm injuries disproportionately affect young people, males and non-White Americans ( Peek-Asa et al. , 2017 ). The burden of firearm also affects the healthcare system, racial/ethnic minorities, women and children.

Burden on Healthcare System

Firearm-related fatalities and injuries are a serious public health problem. On average more than 38 lives were lost every day to gun related violence in 2018 ( The Education Fund to Stop Gun Violence (EFSGV), 2020 ). A significant proportion of Americans suffer from firearm non-fatal injuries that require hospitalization and lead to physical disabilities, mental health challenges such as post-traumatic stress disorder, in addition to substantial healthcare costs ( Rattan et al. , 2018 ). Firearm violence and related injuries cost the U.S. economy about $70 billion annually, exerting a major effect on the health care system ( Tasigiorgos et al. , 2015 ).

Victims of firearm violence are also likely to need medical attention requiring high cost of care and insurance payouts which in turn raises the cost of care for everyone else, and unavoidably becomes a financial liability and source of stress on the society ( Hammaker et al. , 2017 ). Firearm injuries also exert taxing burden on the emergency departments, especially those in big cities. Patients with firearm injuries who came to the emergency departments tend to be overwhelmingly male and younger (20–24 years old) and were injured in an assault or unintentionally ( Gani et al. , 2017 ). Also, Carter et al. , 2015 found that high-risk youth (14–24 years old) who present in urban emergency departments have higher odds of having firearm-related injuries. In fact, estimates for firearm-related hospital admission costs are exorbitant. In 2012, hospital admissions for firearm injuries varied from a low average cost of $16,975 for an unintentional firearm injury to a high average cost of $32,237 for an injury from an assault weapon ( Peek-Asa et al. , 2017 ) compared with an average cost of $10,400 for a general hospital admission ( Moore et al. , 2014 ).

Burden on Racial/Ethnic Minorities, Women and Children

Though firearm violence affects all individuals, racial disparities exist in death and injury and certain groups bear a disproportionate burden of its effects. While 77% of firearm-related deaths among whites are suicides, 82% of firearm-related deaths among blacks are homicides ( Reeves and Holmes, 2015 ). Among black men aged 15–34, firearm-related death was the leading cause of death in 2012 ( Cerdá, 2016 ). The racial disparity in the leading cause of firearm-related homicide among 20- to 29-year-old adults is observed among blacks, followed by Hispanics, then whites. Also, victims of firearms tend to be from lower socioeconomic status ( Reeves and Holmes, 2015 ). Understanding behaviors that underlie violence among young adults is important. Equally important is the fiduciary duty of public health officials in creating public health interventions and policies that would effectively decrease the burden of gun violence among all Americans regardless of social, economic and racial/ethnic backgrounds.

Another population group that bears a significant burden of firearm violence are women. The violence occurs in domestic conflicts ( Sorenson and Vittes, 2003 ; Tjaden et al. , 2000 ). Studies have shown that intimate partner violence is associated with an increased risk of homicide, with firearms as the most commonly used weapon ( Leuenberger et al. , 2021 ; Gollub and Gardner, 2019 ). However, firearm threats among women who experience domestic violence has been understudied ( Sullivan and Weiss, 2017 ; Sorenson, 2017 ). It is estimated that nearly two-thirds of women who experience intimate partner violence and live in households with firearms have been held at gunpoint by intimate partners ( Sorenson and Wiebe, 2004 ). Firearms are used to threaten, coerce and intimidate women. Also, the presence of firearms in a home increases the risk of women being murdered ( Campbell et al. , 2015 ; Bailey et al. , 1997 ). Further, having a firearm in the home is strongly associated with more severe abuse among pregnant women in a study by McFarlane et al. (1998) . About half of female intimate partner homicides are committed with firearms ( Fowler, 2018 ; Díez et al. , 2017 ). Some researchers reported that availability of firearms in areas with fewer firearms restrictions has led to higher intimate partner homicides ( Gollub and Gardner, 2019 ; Díez et al. , 2017 ).

In the United States, children are nine times more likely to die from a firearm than in most other industrialized nations ( Krueger and Mehta, 2015 ). Children here include all individuals under age 18. These statistics highlight the magnitude of firearm injuries as well as firearms as a serious pediatric concern, hence, calls for appropriate interventions to address this issue. Unfortunately, children and adolescents have a substantial level of access to firearms in their homes which contributes to firearm violence and its related injuries ( Johnson et al. , 2004 ; Kim, 2018 ). About half of all U.S. households are believed to have a firearm, making firearms one of the most pervasive products consumed in the United States ( Violano et al. , 2018 ). Consequently, most of the firearms used by children and youth to inflict harm including suicides are obtained in the home ( Johnson et al. , 2008 ). Beyond physical harm, children experience increased stress, fear and anxiety from direct or indirect exposure to firearms and its related injuries. These effects have also been reported as predictors of post-traumatic stress disorders in children and could have long-term consequences that persist from childhood to adulthood ( Holly et al. , 2019 ). Additionally, the American Psychological Association’s study on violence in the media showed that witnessing violence leads to fear and mistrust of others, less sensitivity to pain experienced by others, and increases the tendency of committing violent acts ( Branas et al. , 2009 ; Calvert et al. , 2017 ).

As evidenced from the previous sections, firearm violence is a complex issue. Some argue that poor mental health, violent video games, substance abuse, poverty, a history of violence and access to firearms are some of the reasons for firearm violence ( Iroku-Malize and Grissom, 2019 ). However, the prevalence and incidence of firearm violence supersedes discrete issues and demonstrates a complex interplay among a variety of factors. Therefore, a broader public health analysis to better understand, address and reduce firearm violence is warranted. Some important factors as listed above should be taken into consideration to more fully understand firearm violence which can consequently facilitate processes for mitigation of the frequency and severity of firearm violence.

Lack of Research Prevents Better Understanding of Problem of Firearm Violence

A major stumbling block to understanding the prevalence and incidence of firearm related violence exists from a lack of rigorous scientific study of the problem. Firearm violence research constitutes less than 0.09% of the Centers for Disease Control and Prevention’s annual budget ( Rajan et al. , 2018 ). Further research on firearm violence is greatly limited by the Dickey Amendment, first passed in 1996 and annually thereafter in budget appropriations, which prohibits use of federal funds to advocate or promote firearm control ( Rostron, 2018 ). As such, the Dickey Amendment impedes future federally funded research, even as public health’s interest in firearm violence prevention increased ( Peetz and Haider, 2018 ; Rostron, 2018 ). In the absence of rigorous research, a deeper understanding and development of evidence-based prevention measures continue to be needed.

Lack of a Public Health Ethical Argument Against Firearm Use Impedes Violence Prevention

We make an argument that gun violence is a public health problem. While some might think that public health is primarily about reducing health-related externalities, it is embedded in key values such as harm reduction, social justice, prevention and protection of health and social justice and equity ( Institute of Medicine, 2003 ). Public health practice is also historically intertwined with politics, power and governance, especially with the influence of the states decision-making and policies on its citizens ( Lee and Zarowsky, 2015 ). According to the World Health Organization, health is a complete physical, mental and social well-being that is not just the absence of injury or disease ( Callahan, 1973 ). Health is fundamental for human flourishing and there is a need for public health systems to protect health and prevent injuries for individuals and communities. Public health ethics, then, is the practical decision making that supports public health’s mandate to promote health and prevent disease, disability and injury in the population. It is imperative for the public health community to ask what ought to be done/can be done to curtail firearm violence and its related burdens. Sound public health ethical reasoning must be employed to support recommendations that can be used to justify various public policy interventions.

The argument that firearm violence is a public health problem could suggest that public health methods (e.g. epidemiological methods) can be used to study gun violence. Epidemiological approaches to gun violence could be applied to study its frequency, pattern, distribution, determinants and measure the effects of interventions. Public health is also an interdisciplinary field often drawing on knowledge and input from social sciences, humanities, etc. Gun violence could be viewed as a crime-related problem rather than public health; however, there are, of course, a lot of ways to study crime, and in this case with public health relevance. One dominant paradigm in criminology is the economic model which often uses natural experiments to isolate causal mechanisms. For example, it might matter whether more stringent background checks reduce the availability of guns for crime, or whether, instead, communities that implement more stringent background checks also tend to have lower rates of gun ownership to begin with, and stronger norms against gun availability. Therefore, public health authorities and criminologists may tend to have overlapping areas of expertise aimed to lead to best practices advice for gun control.

Our paper draws on three major theories: (1) rights-based theories, (2) consequentialism and (3) the common good approach. These theories make a convergent case for firearm violence, and despite their significant divergence, strengthen our public health ethics approach to firearm. The key aspects of these three theories are briefly reviewed with respect to how one might use a theory to justify an intervention or recommendation to reduce firearm injuries.

Rights-Based Theories

The basic idea of the rights framework is that people have certain rights, and that therefore it is impermissible to treat people in certain ways even if doing so would promote the overall good. People have rights to safety, security and an environment generally free from risky pitfalls. Conversely, people also have a right to own a gun especially as emphasized in the U.S.’s second amendment. Another theory embedded within our discussion of rights-based theories is deontology. Deontological approaches to ethics hold that we have moral obligations or duties that are not reducible to the need to promote some end (such as happiness or lives saved). These duties are generally thought to specify what we owe to others as persons ( rights bearers ). There are specific considerations that define moral behaviors and specific ways in which people within different disciplines ought to behave to effectively achieve their goals.

Huemer (2003) argued that the right to own a firearm has both a fundamental (independent of other rights) and derivative justification, insofar as the right is derived from another right - the right to self-defense ( Huemer, 2003 ). Huemer gives two arguments for why we have a right to own a gun:

People place lots of importance on owning a gun. Generally, the state should not restrict things that people enjoy unless doing so imposes substantial risk of harm to others.

People have a right to defend themselves from violent attackers. This entails that they have a right to obtain the means necessary to defend themselves. In a modern society, a gun is a necessary means to defend oneself from a violent attacker. Therefore, people have a right to obtain a gun.

Huemer’s first argument could be explained that it would be permissible to violate someone’s right to own or use a firearm in order to promote some impersonal good (e.g. number of lives saved). Huemer’s second argument also justifies a fundamental right to gun ownership. According to Huemer, gun restrictions violate the right of individual gun owners to defend themselves. Gun control laws will result in coercively stopping people to defend themselves when attacked. To him, the right to self-defense does seem like it would be fundamental. It seems intuitive to argue that, at some level, if someone else attacks a person out of the blue, the person is morally required to defend themselves if they cannot escape. However, having a right to self-defense does not entail that your right to obtain the means necessary to that thing cannot be burdened at all.

While we have a right to own a gun, that right is weaker than other kinds of rights. For example, gun ownership seems in no way tied to citizenship in a democracy or being a member of the community. Also, since other nations/democracies get along fine without a gun illustrates that gun ownership is not important enough to be a fundamental right. Interestingly, the UK enshrines a basic right to self-defense, but explicitly denies any right to possess any particular means of self-defense. This leads to some interesting legal peculiarities where it can be illegal to possess a handgun, but not illegal to use a handgun against an assailant in self-defense.

In the United States, implementing gun control policies to minimize gun related violence triggers the argument that such policies are infringements on the Second Amendment, which states that the rights to bear arms shall not be infringed. The constitution might include a right to gun ownership for a variety of reasons. However, it is not clear from the text itself that the right to bear arms is supposed to be as fundamental as the right to freedom of expression. Further, one could argue, then, that any form of gun regulation is borne from the rationale to retain our autonomy. Protections from gun violence are required to treat others as autonomous agents or as bearers of dignity. We owe others certain protections and affordances at least in part because these are necessary to respect their autonomy (or dignity, etc.). We discuss potential recommendations to minimize gun violence while protecting the rights of individuals to purchase a firearm if they meet the necessary and reasonable regulatory requirements. Most of the gun control regulations discussed in this article could provide an opportunity to ensure the safety of communities without unduly infringing on the right to keep a firearm.

Consequentialism

Consequentialism is the view that we should promote the common good even if doing so infringes upon some people’s (apparent) rights. The case for gun regulation under this theory is made by showing how many lives it would save. Utilitarianism, a part of consequentialist approach proposes actions which maximize happiness and the well-being for the majority while minimizing harm. Utilitarianism is based on the idea that a consequence should be of maximum benefit ( Holland, 2014 ) and that actions are right in proportion as they tend to promote happiness as the ultimate moral norm. If one believes that the moral purpose of public health is to make decisions that will produce maximal benefits for most affected, remove or prevent harm and ensure equitable distribution of burdens and benefits ( Bernheim and Childress, 2013 ), they are engaging in a utilitarian theory. Rights, including the rights to bear arms, are protected so long as they preserve the greater good. However, such rights can be overridden or ignored when they conflict with the principle of utility; that is to say, if greater harm comes from personal possession of a firearm, utilitarianism is often the ethical theory of choice to restrict access to firearms, including interventions that slow down access to firearms such as requiring a gun locker at home. However, it is important to note that utilitarians might also argue that one has to weigh how frustrating a gun locker would be to people who like to go recreationally hunting. Or how much it would diminish the feeling of security for someone who knows that if a burglar breaks in, it might take several minutes to fumble while inputting the combination on their locker to access their gun.

Using a utilitarian approach, current social statistics show that firearm violence affects a great number of people, and firearm-related fatalities and injuries threaten the utility, or functioning of another. Therefore, certain restrictions or prohibitions on firearms can be ethically justifiable to prevent harm to others using a utilitarian approach. Similarly, the infringement of individual freedom could be warranted as it protects others from serious harm. However, one might argue that a major flaw in the utilitarian argument is that it fails to see the benefit of self-defense as a reasonable benefit. Utilitarianism as a moral theory would weigh the benefits of proposed restrictions against its costs, including its possible costs to a felt sense of security on the part of gun owners. A utilitarian argument that neglects some of the costs of regulations wouldn’t be a very good argument.

One might legitimately argue that if an individual is buying a firearm, whether for protection or recreation, they are morally responsible to abide by the laws and regulations regarding purchasing that firearm and ensuring the safety of others in the society. Additionally, vendors and licensing/enforcement authorities would have the responsibility to ensure the safety of the rest of the society by ensuring that the firearm purchase does not compromise the safety of the community. Most people who own firearms would not argue against this position. However, arguments in support of measures that will reduce the availability of firearms center around freedom and liberty and are not as well tolerated by those who argue from a libertarian starting point. Further, this would stipulate that measures against firearm purchase or use impinge upon the rights of individuals who have the freedom to pursue what they perceive as good ( Holland, 2014 ). However, it seems as though the state has a fundamental duty to help ensure an adequate degree of safety for its citizens, and it seems that the best way to do that is to limit gun ownership.

Promoting the Common Good

A well-organized society that promotes the common good of all is to everyone’s advantage ( Ruger, 2015 ). In addition, enabling people to flourish in a society includes their ability to be healthy. The view of common good consists of ensuring the welfare of individuals considered as a group or the public. This group of people are presumed to have a common interest in protection and preservation from harms to the group ( Beauchamp, 1985 ). Health and security are shared by members of a community, and guns are an attempt to privatize public security and safety, and so is antithetical to the common good. Can one really be healthy or safe in a society where one’s neighbors are subject to gun violence? Maybe not, and so then this violence is a threat to one’s life too. If guns really are an effective means of self-defense, they help one defend only oneself while accepting that others in one’s community might be at risk. One might also argue that the more guns there are, the more that society accepts the legitimacy of gun ownership and the more that guns have a significant place in culture etc., and consequently, the more that there is likely to be a problem.

Trivigno (2018) suggests that the willingness to carry a firearm indicates an intention to use it if the need arises and Branas et al (2009) argue that perpetually carrying a firearm might affect how individuals behave ( Trivigno, 2018 ; Branas et al. , 2009 ). When all things are equal, will prudence and a commitment to the flourishing of others prevail? Trivigno (2013) wonders if such behaviors as carrying or having continual access to a firearm generates mistrust or triggers fear of an unknown armed assailant, allowing for aggression or anger to build; the exact opposite of flourishing ( Trivigno, 2013 ). One could suggest, then, that the recreational use of firearms is also commonly vicious. Many people use firearms to engage in blood sport, killing animals for their own amusement. For example, someone who kicks puppies or uses a magnifying glass to fry ants with the sun seems paradigmatically vicious; why not think the same of someone who shoots deer or rabbits for their amusement?. Firearm proponents might suggest that the fidelity (living out one’s commitments) or justice, which Aristotle holds in high regard, could justify carrying a firearm to protect one’s life, livelihood, or loved ones insofar as it would be just of a person to defend and protect the life of another or even one’s own life when under threat by one who means to do harm. Despite an argument justifying the use of a firearm against another for self-defense after the fact, the action might not have been right when evaluated through the previous rationale, or applying the doctrine of double effect as described by Aquinas’ passage in the Summa II-II, which mentions that self-defense is quite different than taking it upon one’s self to mete out justice ( Schlabach, n.d. ). The magistrate is charged with seeing that justice is done for the common good. At best, if guns really are an effective means of self-defense, they help one defend only oneself while accepting that others in one’s community might be at risk. They take a common good, the health and safety of the community, and make it a private one. For Aquinas and many other modern era ethicists, intention plays a critical part in judgment of an action. Accordingly, many who oppose any ownership of firearms do so in both a paternalistic fashion (one cannot intend harm if they don’t have access to firearms) and virtuous fashion (enabling human flourishing).

Classical formulations of the double doctrine effect include necessity and proportionality conditions. So, it’s wrong to kill in self-defense if you could simply run away (without giving up something morally important in doing so), or to use deadly force in self-defense when someone is trying to slap you. One thing the state can do, in its role of promoting the common good, is to reduce when it is necessary to use self-defense. If there were no police at all, then anyone who robs you without consequence will probably be back, so there’s a stronger reason to use deadly force against them to feel secure. That’s bad, because it seems to allow violence that truly isn’t necessary because no one is providing the good of public security. So, one role of the state is to reduce the number of cases in which the use of deadly force is necessary for our safety. Since most homicides in the United State involve a firearm, one way to reduce the frequency of cases in which deadly force is necessary for self-defense is to reduce the instances of gun crime.

We have attempted to lay the empirical and ethical groundwork necessary to support various interventions, and the recommendations aimed at curbing firearm violence that will be discussed in this next section. Specifically, by discussing the burden of the problem in its various forms (healthcare costs, disproportionate violence towards racial/ethnic minority groups, women, children, vulnerable populations and the lack of research) and the ethics theories public health finds most accessible, we can now turn our attention to well-known, evidence-based recommendations that could be supported by the blended ethics approach: rights-based theories, consequentialism and the common-good approach discussed.

Comprehensive, Universal Background Checks for Firearm Sales

Of the 17 million persons who submitted to a background check to purchase or transfer possession of a firearm in 2010, less than 0.5% were denied approval of purchase ( Federal Bureau of Investigation, 2014 ). At present, a background check is required only when a transfer is made by a licensed retailer, and nearly 40% of firearm transfers in recent years were private party transfers ( Miller et al. , 2017 ). As such, close to one-fourth of individuals who acquired a firearm within the last two years obtained their firearm without a background check ( Miller et al. , 2017 ). Anestis et al. , (2017) and Siegel et al. , (2019) evaluated the relationship between the types of background information required by states prior to firearm purchases and firearm homicide and suicide deaths ( Anestis et al. , 2017 ; Siegel et al. , 2019 ). Firearm homicide deaths appear lower in states checking for restraining orders and fugitive status as opposed to only conducting criminal background checks ( Sen and Panjamapirom, 2012 ). Similarly, suicide involving firearm were lower in states checking for a history of mental illness, fugitive status and misdemeanors ( Sen and Panjamapirom, 2012 ).

Research supports the evidence that comprehensive universal background checks could limit crimes associated with firearms, and enforcement of such laws and policies could prevent firearm violence ( Wintemute, 2019 ; Lee et al. , 2017 ). Comprehensive, universal background check policies that are applicable to all firearm transactions, including private party transfers, sales by firearm dealers and sales at firearm shows are justifiable using a blend of the ethics theories we have previously discussed. With the rights-based approach, one could still honor the right to own a firearm by a competent person while also enforcing the obligation of the firearm vendor to ensure only a qualified individual purchased the firearm. To further reduce gun crime, rather than ensure only the right people own guns, we can just reduce the number of guns owned overall. Consequentialism could be employed to ensure the protection of the most vulnerable such as victims of domestic violence and allowing a firearm vendor to stop a sale to an unqualified individual if they had a history of suspected or proven domestic violence. Also, having universal background checks that go beyond the bare minimum of assessing if a person has a permit, the legally required training, etc., but delving more deeply into a person’s past, such as the inclusion of a red flag ( Honberg, 2020 ), would be promoting the common good approach by creating the conditions for persons to be good and do good while propelling community safety.

Renewable License Before Buying and After Purchase of Firearm and Training Firearm Owners

At present, federal law does not require licensing for firearm owners or purchasers. However, state licensing laws fall into four categories: (1) permits to purchase firearms, (2) licenses to own firearms, (3) firearm safety certificates and (4) registration laws that impose licensing requirements ( Anestis et al. , 2015 ; Giffords Licensing, n.d. ). A study conducted in urban U.S. counties with populations greater than 200,000 indicated that permit-to-purchase laws were associated with 14% reduction in firearm homicides ( Crifasi et al. , 2018 ). In Connecticut, enforcing a mandatory permit-to-purchase law making it illegal to sell a hand firearm to anyone who did not have an eligible certificate to purchase firearms was associated with a reduction in firearm associated homicides ( Rudolph et al. , 2015 ). This also resulted in a significant reduction in the rates of firearm suicide rates in Connecticut ( Crifasi et al. , 2015 ). Conversely, the permit-to-purchase law was repealed in Missouri in 2007, which resulted in an increase of homicides with firearms and firearm suicides ( Crifasi et al. , 2015 ; Webster et al. , 2014 ). Similarly, two large Florida counties indicated that 72% of firearm suicides involved people who were legally permitted to have a firearm ( Swanson et al. , 2016 ). According to the study findings, a majority of those who were eligible to have firearms died from firearm-related suicide, and also had records of previous short-term involuntary holds that were not reportable legal events.

In addition to comprehensive, universal background checks for firearm purchases, licensing with periodic review requires the purchaser to complete an in-person application at a law enforcement agency, which could (1) minimize fraud or inaccuracies and (2) prevent persons at risk of harming themselves or others to purchase firearms ( Crifasi et al. , 2019 ). Subsequent periodic renewal could further reduce crimes and violence associated with firearms by helping law enforcement to confirm that a firearm owner remains eligible to possess firearms. More frequent licensure checks through periodic renewals could also facilitate the removal of firearms from individuals who do not meet renewal rules.

Further, including training on gun safety and shooting with every firearm license request could also be beneficial in reducing gun violence. In Japan, if you are interested in acquiring a gun license, you need to attend a one-day gun training session in addition to mental health evaluation and background check ( Alleman, 2000 ). This training teaches future firearm owners the steps they would need to follow and the responsibilities of owning a gun. The training completes with passing a written test and achieving at least a 95% accuracy during a shooting-range test. Firearm owners need to retake the class and initial exam every three years to continue to have their guns. This training and testing have contributed to the reduction in gun related deaths in Japan. Implementing such requirements could reduce gun misuses. Even though, this is a lengthy process, it could manage and reduce the risks associated with firearm purchases and will support a well-regulated firearm market. While some may argue that other forms of weapons could be used to inflict harm, reduced access to firearms would lead to a significant decrease in the number of firearm-related injuries in the United States.

From an ethics perspective, again, all three theories could be applied to the recommendation for renewable licenses and gun training. From a rights-based perspective, renewable licensure and gun training would still allow for the right to bear arms but would ensure that the right belongs with qualified persons and again would allow the proper state agency to exercise its responsibility to its citizens. Additionally, a temporary removal of firearms or prohibiting firearm purchases by people involuntarily detained in short-term holds might be an opportunity to ensure people’s safety and does so without unduly infringing on the Second Amendment rights. Renewable licenses and gun training create opportunities for law enforcement to step in periodically to ascertain if a licensee remains competent, free from criminal behavior or mental illness, which reduces the harm to the individual and to the community—a tidy application of consequentialism. Again, by creating the conditions for people to be good, we see an exercise of the common good.

Licensing Firearm Dealers and Tracking Firearm Sales

In any firearm transfer or purchase, there are two parties involved: the firearm vendor and the individual purchaser. Federal law states that “it shall be unlawful for any person, except for a licensed importer, licensed manufacturer, or licensed dealer, to engage in the business of importing, manufacturing, or dealing in firearms, or in the course of such business to ship, transport, or receive any firearm in interstate or foreign commerce” (18 U.S.C. 1 922(a)(1)(A)(2007). All firearm sellers must obtain a federal firearm license issued by the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF). However, ATF does not have the complete authority to inspect firearm dealers for license, revoke firearm license, or take legal actions against sellers providing firearms to criminals ( Vernick and Webster, 2007 ). Depending on individual state laws, typically the firearm purchaser maintains responsibility in obtaining the proper license for each firearm purchase whereas the justice system has the responsibility to enforce laws regulating firearm sales. Firearm manufacturers typically sell their products through licensed distributors and dealers, or a primary market (such as a retail store). Generally, firearms used to conduct a crime (including homicide) or to commit suicide are the product of secondary markets ( Institute of Medicine, 2003 ) such as retail secondhand sales or private citizen transfers/sales. Such secondary firearm transfers are largely unregulated and allow for illegal firearm purchases by persons traditionally prohibited from purchasing in the primary market ( Vernick and Webster, 2007 ; Chesnut et al. , 2017 ).

According to evidence from Irvin et al. (2014) in states that require licensing for firearm dealers and/or allow inspections, the reported rates of homicides were lower ( Irvin et al. , 2014 ). Specifically, after controlling for race, urbanicity, poverty level, sex, age, education level, drug arrest rate, burglary rates and firearm ownership proxy, the states that require licensing for firearm dealers reported ~25% less risk of homicides, and the states that allow inspection reported ~35% less risk of homicides ( Irvin et al. , 2014 ). This protective effect against homicides was stronger in states that require both licensing and inspections compared to states that require either alone. The record keeping of all firearm sales is important as it facilitates police or other authorized inspectors to compare a dealer’s inventory with their records to identify any secondary market transactions or other discrepancies ( Vernick et al. , 2006 ). According to Webster et al. (2006) , a change in firearm sales policy in the firearm store that sold more than half of the firearms recovered from criminals in Milwaukee, resulted in a 96% reduction in the use of recently sold firearms in crime and 44% decrease in the flow of new trafficked firearms in Milwaukee ( Webster et al. , 2006 ).

The licensing of firearm vendors and tracking of firearm sales sits squarely as a typical public health consequentialist argument; in order to protect the community, an individual’s right is only minimally infringed upon. An additional layer, justifiable by consequentialism, includes a national repository of all firearm sales which can be employed to minimize the sale of firearms on the secondary market and dealers could be held accountable for such ‘off-label’ use ( FindLaw Attorney Writers, 2016 ). Enforcing laws, mandating record keeping, retaining the records for a reasonable time and mandating the inspection of dealers could help to control secondary market firearm transfers and minimize firearm-related crimes and injuries.

One could argue from a rights perspective that routine inspections and record keeping are the responsibility of both firearms vendors and law enforcement, and in doing so, still ensure that competent firearm owners can maintain their rights to bear arms. In Hume’s discussion of property rights, he situates his argument in justice; and that actions must be virtuous and the motive virtuous ( Hume, 1978 ). Hume proposes that feelings of benevolence don’t form our motivation to be just. We tend (perhaps rightly) to feel stronger feelings of benevolence to those who deserve praise than to those who have wronged us or who deserve the enmity of humanity. However, justice requires treating the property rights or contracts of one’s enemies, or of a truly loathsome person, as equally binding as the property rights of honest, decent people. Gun violence disproportionately impacts underserved communities, which are same communities impacted by social and economic injustice.

Standardized Policies on Safer Storage for Firearms and Mandatory Education

Results from a cross-sectional study by Johnson and colleagues showed that about 14-30% of parents who have firearms in the home keep them loaded, while about 43% reported an unlocked firearm in the home ( Johnson et al. , 2006 ; Johnson et al. , 2008 ). The risk for unintentional fatalities from firearms can be prevented when all household firearms are locked ( Monuteaux et al. , 2019 ). Negligent storage of a firearm carries various penalties based on the individual state ( RAND, 2018 ). For example, negligent storage in Massachusetts is a felony. Mississippi and Tennessee prohibit reckless or knowingly providing firearms to minors through a misdemeanor charge, whereas Missouri and Kentucky enforce a felony charge. Also, Tennessee makes it a felony for parents to recklessly or knowingly provide firearms to their children ( RAND, 2018 ).

While a competent adult may have a right to bear arms, this right does not extend to minors, even in recreational use. Many states allow for children to participate in hunting. Wisconsin allows for children as young as 12 to purchase a hunting license, and in 2017 then Governor Scott Walker signed into law a no age minimum for a child to participate in a mentored hunt and to carry a firearm in a hunt when accompanied by an adult ( Wisconsin Department of Natural Resources, 2020 ). The minor’s ‘right’ to use a firearm is due in part to the adult taking responsibility for the minor’s safety. As such, some have argued that children need to know how to be safe around firearms as they continue to be one of the most pervasive consumer products in the United States ( Violano et al. , 2018 ).

In addition to locking firearms, parents are also encouraged to store firearms unloaded in a safe locked box or cabinet to prevent children’s access to firearms ( Johnson et al. , 2008 ). It follows then that reducing children and youth’s access to firearm injuries involves complying with safe firearm storage practices ( McGee et al. , 2003 ). In addition to eliminating sources of threat to the child, it is also important for children to be trained on how to safely respond in case they encounter a firearm in an unsupervised environment. Education is one of the best strategies for firearm control, storage and reduction of firearm-related injuries via development of firearm safety trainings and programs ( Jones, 1993 ; Holly et al. , 2019 ). Adults also need firearm safety education and trainings; as such, inclusion of firearm safety skills and trainings in the university-based curriculum and other avenues were adults who use guns are likely to be, could also mitigate firearm safety issues ( Puttagunta et al. , 2016 ; Damari et al. , 2018 ). Peer tutoring could also be utilized to provide training in non-academic and social settings.

Parents have a duty to protect their children and therefore mandating safe firearm storage, education and training for recreational use and periodic review of those who are within the purview of the law. Given that someone in the U. S. gets shot by a toddler a little more frequently than once a week ( Ingraham, 2017 ), others might use a utilitarian argument that limiting a child’s access to firearms minimizes the possibility of accidental discharge or intentional harm to a child or another. Again, the common good approach could be employed to justify mandatory safe storage and education to create the conditions for the flourishing of all.

Firearm and Ammunition Buy-Back Programs

Firearm and ammunition buy-back programs have been implemented in several cities in the United States to reduce the number of firearms in circulation with the ultimate goal of reducing gun violence. The first launch in Baltimore, Maryland was in 1974. The Los Angeles Police Department (LAPD) has conducted a gun buy-back program for nearly eight years to remove more guns off the streets and improve security in communities. Currently there is a plan for a federal gun buy-back program in the United States. The objective of such programs is to reduce gun violence through motivating marginal criminals to sell their firearms to local governments, encourage law-abiding individuals to sell their firearms available for theft by would-be criminals, and to reduce firearm related suicide resulting from easy access to a gun at a time of high emotion ( Barber and Miller, 2014 ).

According to Kuhn et al. (2002) and Callahan et al. (1994) , gun buy-back programs are ineffective in reducing gun violence due to two main facts: 1- the frequently surrendered types of firearms are typically not involved in gun-related violence and 2- the majority of participants in gun buyback programs are typically women and older adults who are not often involved in interpersonal violence ( Kuhn et al. , 2002 ; Callahan et al. , 1994 ). However, as a result of implementation of the ‘‘good for guns’’ program in Worcester, Massachusetts, there has been a decline in firearm related injuries and mortality in Worcester county compared to other counties in Massachusetts ( Tasigiorgos et al. , 2015 ). Even though, there is limited research indicating a direct link between gun buy-back programs and reduction in gun violence in the United States, a gun buy-back program implemented in Australia in combination with other legislations to reduce household ownership of firearms, firearm licenses and licensed shooters was associated with a rapid decline in firearm related deaths in Australia ( Bartos et al. , 2020 ; Ozanne-Smith et al. , 2004 ).

The frequency of disparities in firearm-related violence, injuries and death makes it a central concern for public health. Even though much has been said about firearms and its related injuries, there continues to be an interest towards its use. Some people continue to desire guns due to fear, feeling of protection and safety, recreation and social pressure.

Further progress on reforms can be made through understanding the diversity of firearm owners, and further research is needed on ways to minimize risks while maximizing safety for all. Although studies have provided data on correlation between firearm possession and violence ( Stroebe, 2013 ), further research is needed to evaluate the interventions and policies that could effectively decrease the public health burden of firearm violence. Evidence-based solutions to mitigating firearm violence can be justified using three major public health ethics theories: rights-based theories, consequentialism and common good. The ethical theories discussed in this paper can direct implementation of research, policies, laws and interventions on firearm violence to significantly reduce the burden of firearm violence on individuals, health care systems, vulnerable populations and the society-at-large. We support five major steps to achieve those goals: 1. Universal, comprehensive background checks; 2. Renewable license before and after purchase of firearm; 3. Licensing firearm dealers and tracking firearm sales; 4. Standardized policies on safer storage for firearms and mandatory education; and 5. Firearm buy-back programs. For some of the goals we propose, there might be a substantial risk of non-compliance. However, we hope that through education and sensibilization programs, overtime, these goals are not met with resistance. By acknowledging the proverbial struggle of individual rights and privileges paired against population health, we hope our ethical reasoning can assist policymakers, firearm advocates and public health professionals in coming to shared solutions to eliminate unnecessary, and preventable, injuries and deaths due to firearms.

The conducted research is not related to either human or animal use.

Alleman , M. ( 2000 ). The Japanese Firearm and Sword Possession Control Law: Translator’s Introduction . Washington International Law Journal , 9 , 165 .

Google Scholar

Anestis , M. D. , Khazem , L. R. , Law , K. C. , Houtsma , C. , LeTard , R. , Moberg , F. and Martin , R. ( 2015 ). The Association Between State Laws Regulating Handgun Ownership and Statewide Suicide Rates . American Journal of Public Health , 105 , 2059 – 2067 .

Anestis , M. D. , Anestis , J. C. and Butterworth , S. E. ( 2017 ). Handgun Legislation and Changes in Statewide Overall Suicide Rates . American Journal of Public Health , 107 , 579 – 581 .

Bailey , J. E. , Kellermann , A. L. , Somes , G. W. , Banton , J. G. , Rivara , F. P. and Rushforth , N. P. ( 1997 ). Risk factors for violent death of women in the home . Archives of Internal Medicine , 157 , 777 – 782 .

Barber , C. W. and Miller , M. J. ( 2014 ). Reducing a suicidal person’s access to lethal means of suicide: a research agenda . American Journal of Preventive Medicine , 47 , S264 – S272 .

Bartos , B. J. , McCleary , R. , Mazerolle , L. and Luengen , K. ( 2020 ). Controlling Gun Violence: Assessing the Impact of Australia’s Gun Buyback Program Using a Synthetic Control Group Experiment . Prevention Science: The Official Journal of the Society for Prevention Research , 21 , 131 – 136 .

Beauchamp , D. E. ( 1985 ). Community: the neglected tradition of public health . The Hastings Center Report , 15 , 28 – 36 .

Bernheim , R.G. , Childress , J.F. ( 2013 ). Introduction: A Framework for Public Health Ethics. In Essentials of Public Health Ethics . Burlington, MA : Jones & Bartlett .

Google Preview

Branas , C. C. , Richmond , T. S. , Culhane , D. P. , Ten Have , T. R. and Wiebe , D. J. ( 2009 ). Investigating the Link Between Gun Possession and Gun Assault . American Journal of Public Health , 99 , 2034 – 2040 .

Callahan , D. ( 1973 ). The WHO definition of ‘health’ . Studies - Hastings Center , 1 , 77 – 88 .

Callahan , C. M. , Rivara , F. P. and Koepsell , T. D. ( 1994 ). Money for Guns: Evaluation of the Seattle Gun Buy-Back Program . Public Health Reports , 109 , 472 – 477 .

Calvert , S. L. , Appelbaum , M. , Dodge , K. A. , Graham , S. , Nagayama Hall , G. C. , Hamby , S. , Fasig-Caldwell , L. G. , Citkowicz , M. , Galloway , D. P. and Hedges , L. V. ( 2017 ). The American Psychological Association Task Force Assessment of Violent Video Games: Science in the Service of Public Interest . The American Psychologist , 72 , 126 – 143 .

Campbell , D. J. T. , O’Neill , B. G. , Gibson , K. and Thurston , W. E. ( 2015 ). Primary healthcare needs and barriers to care among Calgary’s homeless populations . BMC Family Practice , 16( 1 ), 139 .

Carter , P. M. , Walton , M. A. , Roehler , D. R. , Goldstick , J. , Zimmerman , M. A. , Blow , F. C. and Cunningham , R. M. ( 2015 ). Firearm Violence Among High-Risk Emergency Department Youth After an Assault Injury . Pediatrics , 135 , 805 – 815 .

Cerdá , M. ( 2016 ). Editorial: Gun Violence—Risk, Consequences, and Prevention . American Journal of Epidemiology , 183 , 516 – 517 .

Chesnut , K. Y. , Barragan , M. , Gravel , J. , Pifer , N. A. , Reiter , K. , Sherman , N. and Tita , G. E. ( 2017 ). Not an ‘iron pipeline’, but many capillaries: regulating passive transactions in Los Angeles’ secondary, illegal gun market . Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention , 23 , 226 – 231 .

Corso , P. , Finkelstein , E. , Miller , T. , Fiebelkorn , I. and Zaloshnja , E. ( 2006 ). Incidence and lifetime costs of injuries in the United States . Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention , 12 , 212 – 218 .

Crifasi , C. K. , Meyers , J. S. , Vernick , J. S. and Webster , D. W. ( 2015 ). Effects of changes in permit-to- purchase handgun laws in Connecticut and Missouri on suicide rates . Preventive Medicine , 79 , 43 – 49 .

Crifasi , C. K. , Merrill-Francis , M. , McCourt , A. , Vernick , J. S. , Wintemute , G. J. and Webster , D. W. ( 2018 ). Association between Firearm Laws and Homicide in Urban Counties . Journal of Urban Health: Bulletin of the New York Academy of Medicine , 95 , 383 – 390 .

Crifasi , C.K. , McCourt , A.D. , Webster , D.W. ( 2019 ). The Impact of Handgun Purchaser Licensing on Gun Violence . Johns Hopkins Bloomberg School of Public Health, Center for Gun Policy and Research .

Damari , N. D. , Ahluwalia , K. S. , Viera , A. J. and Goldstein , A. O. ( 2018 ). Continuing Medical Education and Firearm Violence Counseling . AMA Journal of Ethics , 20 , 56 – 68 .

Díez , C. , Kurland , R. P. , Rothman , E. F. , Bair-Merritt , M. , Fleegler , E. , Xuan , Z. , Galea , S. , Ross , C. S. , Kalesan , B. , Goss , K. A. and Siegel , M. ( 2017 ). State Intimate Partner Violence-Related Firearm Laws and Intimate Partner Homicide Rates in the United States, 1991 to 2015 . Annals of Internal Medicine , 167 , 536 – 543 .

Dresang , L. T. ( 2001 ). Gun deaths in rural and urban settings: recommendations for prevention . The Journal of the American Board of Family Practice , 14 , 107 – 115 .

Federal Bureau of Investigation ( 2014 ). National Instant Criminal Background Check System (NICS) Operations 2014 . Washington, DC : U.S. Department of Justice .

FindLaw Attorney Writers ( 2016 ). Responsibility of Firearm Owners and Dealers for Their Second Amendment Right to Bear Arms: A Survey of the Caselaw . Findlaw , available from: https://corporate.findlaw.com/litigation-disputes/responsibility-of-firearm-owners-and-dealers-for-their-second.html [accessed June 23, 2021 ].

Fowler , K. A. ( 2018 ). Surveillance for Violent Deaths — National Violent Death Reporting System, 18 States, 2014 . MMWR. Surveillance Summaries , 67 , 1 – 36 .

Fowler , K. A. , Dahlberg , L. L. , Haileyesus , T. and Annest , J. L. ( 2015 ). Firearm injuries in the United States . Preventive Medicine , 79 , 5 – 14 .

Gani , F. , Sakran , J. V. and Canner , J. K. ( 2017 ). Emergency Department Visits For Firearm-Related Injuries In The United States, 2006–14 . Health Affairs , 36 , 1729 – 1738 .

Giffords Law Center ( n.d .) Licensing. Available from https://giffords.org/lawcenter/gun-laws/policy-areas/owner-responsibilities/licensing/

Gollub , E. L. and Gardner , M. ( 2019 ). Firearm Legislation and Firearm Use in Female Intimate Partner Homicide Using National Violent Death Reporting System Data . Preventive Medicine , 118 , 216 – 219 .

Gramlich , J. , Schaeffer , K. ( 2019 ). 7 Facts About Guns in the U.S . Pew Research Center , available from: https://www.pewresearch.org/fact-tank/2019/10/22/facts-about-guns-in-united-states/ [accessed September 23, 2020 ].

Hammaker , D.K. , Knadig , T.M. , Tomlinson , S.J. ( 2017 ). Environmental Safety and Gun Injury Prevention. In Health care ethics and the law . Jones & Bartlett Learning , pp. 319 – 335 .

Hargarten , S. W. , Lerner , E. B. , Gorelick , M. , Brasel , K. , deRoon-Cassini , T. and Kohlbeck , S. ( 2018 ). Gun Violence: A Biopsychosocial Disease . Western Journal of Emergency Medicine , 19 , 1024 – 1027 .

Herrin , B. R. , Gaither , J. R. , Leventhal , J. M. and Dodington , J. ( 2018 ). Rural Versus Urban Hospitalizations for Firearm Injuries in Children and Adolescents . Pediatrics , 142 ( 2 ), e20173318 .

Holland , S. ( 2014 ). Public Health Ethics . 2nd ed. Malden, MA : Polity Press .

Holly , C. , Porter , S. , Kamienski , M. and Lim , A. ( 2019 ). School-Based and Community-Based Gun Safety Educational Strategies for Injury Prevention . Health Promotion Practice , 20 , 38 – 47 .

Honberg , R. S. ( 2020 ). Mental Illness and Gun Violence: Research and Policy Options . The Journal of Law, Medicine & Ethics , 48 , 137 – 141 .

Huemer , M. ( 2003 ). Is There a Right to Own a Gun? Social Theory and Practice , 29 , 297 – 324 .

Hume , D. ( 1978 ). David Hume: A Treatise of Human Nature . 2nd edn. New York, United States : Oxford University Press .

Ingraham , C. ( 2017 ). Analysis | American Toddlers Are Still Shooting People on a Weekly Basis This Year . Washington Post . https://www.washingtonpost.com/news/wonk/wp/2017/09/29/american-toddlers-are-still-shooting-people-on-a-weekly-basis-this-year/

Institute of Medicine ( 2003 ). Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century .

Iroku-Malize , T. and Grissom , M. ( 2019 ). Violence and Public and Personal Health: Gun Violence . FP Essentials , 480 , 16 – 21 .

Irvin , N. , Rhodes , K. , Cheney , R. and Wiebe , D. ( 2014 ). Evaluating the Effect of State Regulation of Federally Licensed Firearm Dealers on Firearm Homicide . American Journal of Public Health , 104 , 1384 – 1386 .

Jehan , F. , Pandit , V. , O’Keeffe , T. , Azim , A. , Jain , A. , Tai , S. A. , Tang , A. , Khan , M. , Kulvatunyou , N. , Gries , L. and Joseph , B. ( 2018 ). The Burden of Firearm Violence in the United States: Stricter Laws Result in Safer States . Journal of Injury and Violence Research , 10 , 11 – 16 .

Johnson , R. M. , Coyne-Beasley , T. and Runyan , C. W. ( 2004 ). Firearm Ownership and Storage Practices, U.S. Households, 1992-2002. A Systematic Review . American Journal of Preventive Medicine , 27 , 173 – 182 .

Johnson , R. M. , Miller , M. , Vriniotis , M. , Azrael , D. and Hemenway , D. ( 2006 ). Are Household Firearms Stored Less Safely in Homes With Adolescents? Archives of Pediatrics & Adolescent Medicine , 160 , 788 – 792 .

Johnson , R. M. , Runyan , C. W. , Coyne-Beasley , T. , Lewis , M. A. and Bowling , J. M. ( 2008 ). Storage of Household Firearms: An Examination of the Attitudes and Beliefs of Married Women With Children . Health Education Research , 23 , 592 – 602 .

Jones , J. P. ( 1993 ). Gun Control: Education Is the Best Control . Texas Medicine , 89 , 8 .

Kim , J. ( 2018 ). Beyond the Trigger: The Mental Health Consequences of In-Home Firearm Access Among Children of Gun Owners . Social Science & Medicine (1982) , 203 , 51 – 59 .

Krueger , C. A. and Mehta , S. ( 2015 ). Trends in Firearm Safety—Do They Correlate With Fewer Injuries . Current Reviews in Musculoskeletal Medicine , 8 , 272 – 275 .

Kuhn , E. M. , Nie , C. L. , O’Brien , M. E. , Withers , R. L. , Wintemute , G. J. and Hargarten , S. W. ( 2002 ). Missing the Target: A Comparison of Buyback and Fatality Related Guns . Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention , 8 , 143 – 146 .

Lee , L. M. and Zarowsky , C. ( 2015 ). Foundational Values for Public Health . Public Health Reviews , 36 , 2 .

Lee , K. H. , Jun , J. S. , Kim , Y. J. , Roh , S. , Moon , S. S. , Bukonda , N. and Hines , L. ( 2017 ). Mental Health, Substance Abuse, and Suicide Among Homeless Adults . Journal of Evidence-Informed Social Work , 14 , 229 – 242 .

Leuenberger , L. , Lehman , E. and McCall-Hosenfeld , J. ( 2021 ). Perceptions of Firearms in a Cohort of Women Exposed to Intimate Partner Violence (IPV) in Central Pennsylvania . BMC Women’s Health , 21 , 20 .

Lewiecki , E. M. and Miller , S. A. ( 2013 ). Suicide, Guns, and Public Policy . American Journal of Public Health , 103 , 27 – 31 .

Lowe , S. R. and Galea , S. ( 2017 ). The Mental Health Consequences of Mass Shootings . Trauma, Violence & Abuse , 18 , 62 – 82 .

McFarlane , J. , Soeken , K. , Campbell , J. , Parker , B. , Reel , S. and Silva , C. ( 1998 ). Severity of Abuse to Pregnant Women and Associated Gun Access of the Perpetrator . Public Health Nursing , 15 , 201 – 206 .

McGee , K. S. , Coyne-Beasley , T. and Johnson , R. M. ( 2003 ). Review of Evaluations of Educational Approaches to Promote Safe Storage of Firearms . Injury Prevention , 9 , 108 – 111 .

Miller , M. , Hepburn , L. and Azrael , D. ( 2017 ). Firearm Acquisition Without Background Checks: Results of a National Survey . Annals of Internal Medicine , 166 , 233 .

Monuteaux , M. C. , Azrael , D. and Miller , M. ( 2019 ). Association of Increased Safe Household Firearm Storage With Firearm Suicide and Unintentional Death Among US Youths . JAMA Pediatrics , 173 , 657 – 662 .

Moore , B. , Levit , K. , Elixhauser , A. ( 2014 ). Costs for Hospital Stays in the United States, 2012 , available from: https://www.hcup-us.ahrq.gov/reports/statbriefs/sb181-Hospital-Costs-United-States-2012.jsp [accessed September 23, 2020 ].

Ozanne-Smith , J. , Ashby , K. , Newstead , S. , Stathakis , V. Z. and Clapperton , A. ( 2004 ). Firearm related deaths: the impact of regulatory reform . Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention , 10 , 280 – 286 .

Peek-Asa , C. , Butcher , B. and Cavanaugh , J. E. ( 2017 ). Cost of Hospitalization for Firearm Injuries by Firearm Type, Intent, and Payer in the United States . Injury Epidemiology , 4 ( 1 ), 20 .

Peetz , A. B. and Haider , A. ( 2018 ). Gun Violence Research and the Profession of Trauma Surgery . AMA Journal of Ethics , 20 , 475 – 482 .

Puttagunta , R. , Coverdale , T. R. and Coverdale , J. ( 2016 ). What is Taught on Firearm Safety in Undergraduate, Graduate, and Continuing Medical Education? A Review of Educational Programs . Academic Psychiatry: The Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry , 40 , 821 – 824 .

Rajan , S. , Branas , C. C. , Hargarten , S. and Allegrante , J. P. ( 2018 ). Funding for Gun Violence Research Is Key to the Health and Safety of the Nation . American Journal of Public Health , 108 , 194 – 195 .

RAND Corporation ( 2018 ). The Effects of Child-Access Prevention Laws , available from: https://www.rand.org/research/gun-policy/analysis/child-access-prevention.html [accessed March 6, 2020 ].

Rattan , R. , Parreco , J. , Namias , N. , Pust , G. D. , Yeh , D. D. and Zakrison , T. L. ( 2018 ). Hidden Costs of Hospitalization After Firearm Injury: National Analysis of Different Hospital Readmission . Annals of Surgery , 267 , 810 – 815 .

Reeves , R.V. , Holmes , S. ( 2015 ) Guns and Race: The Different Worlds of Black and White Americans . Brookings . https://www.brookings.edu/blog/social-mobility-memos/2015/12/15/guns-and-race-the-different-worlds-of-black-and-white-americans/

Resnick , S. , Smith , R. N. , Beard , J. H. , Holena , D. , Reilly , P. M. , Schwab , C. W. and Seamon , M. J. ( 2017 ). Firearm Deaths in America: Can We Learn From 462,000 Lives Lost? Annals of Surgery , 266 , 432 – 440 .

Rostron , A. ( 2018 ). The Dickey Amendment on Federal Funding for Research on Gun Violence: A Legal Dissection . American Journal of Public Health , 108 , 865 – 867 .

Rudolph , K. E. , Stuart , E. A. , Vernick , J. S. and Webster , D. W. ( 2015 ). Association Between Connecticut’s Permit-to-Purchase Handgun Law and Homicides . American Journal of Public Health , 105 , e49 – e54 .

Ruger , J. P. ( 2015 ). Governing for the Common Good . Health Care Analysis: HCA: Journal of Health Philosophy and Policy , 23 , 341 – 351 .

Schlabach , G.W. ( n.d .) Aquinas on Warfare and Self-defense , available from: https://www.geraldschlabach.net/misc/aquinas-on-warfare-and-self-defense/ [accessed June 23, 2022 ].

Schleimer , J.P. , Kravitz-Wirtz , N. , Pallin , R. , Charbonneau , A.K. , Buggs , S.A. , and Wintemute , G.J. ( 2019 ). Firearm Ownership in California: A Latent Class Analysis . Injury Prevention , injuryprev-2019-043412.

Sen , B. and Panjamapirom , A. ( 2012 ). State Background Checks for Gun Purchase and Firearm Deaths: An Exploratory Study . Preventive Medicine , 55 , 346 – 350 .

Siegel , M. , Ross , C. S. and King , C. ( 2013 ). The Relationship Between Gun Ownership and Firearm Homicide Rates in the United States, 1981–2010 . American Journal of Public Health , 103 , 2098 – 2105 .

Siegel , M. , Pahn , M. , Xuan , Z. , Fleegler , E. and Hemenway , D. ( 2019 ). The Impact of State Firearm Laws on Homicide and Suicide Deaths in the USA, 1991-2016: A Panel Study . Journal of General Internal Medicine , 34 , 2021 – 2028 .

Sorenson , S. B. ( 2017 ). Guns in Intimate Partner Violence: Comparing Incidents by Type of Weapon . Journal of Women’s Health (2002) , 26 , 249 – 258 .

Sorenson , S. B. and Vittes , K. A. ( 2003 ). Buying a Handgun for Someone Else: Firearm Dealer Willingness to Sell . Injury Prevention , 9 , 147 – 150 .

Sorenson , S. B. and Wiebe , D. J. ( 2004 ). Weapons in the Lives of Battered Women . American Journal of Public Health , 94 , 1412 – 1417 .

Stroebe , W. ( 2013 ). Firearm Possession and Violent Death: A Critical Review . Aggression and Violent Behavior , 18 , 709 – 721 .

Sullivan , T. P. and Weiss , N. H. ( 2017 ). Is Firearm Threat in Intimate Relationships Associated with Posttraumatic Stress Disorder Symptoms Among Women? Violence and Gender , 4 , 31 – 36 .

Swanson , J. W. , McGinty , E. E. , Fazel , S. and Mays , V. M. ( 2015 ). Mental Illness and Reduction of Gun Violence and Suicide: Bringing Epidemiologic Research to Policy . Annals of Epidemiology , 25 , 366 – 376 .

Swanson , J. W. , Easter , M. M. , Robertson , A. G. , Swartz , M. S. , Alanis-Hirsch , K. , Moseley , D. , Dion , C. and Petrila , J. ( 2016 ). Gun Violence, Mental Illness, And Laws That Prohibit Gun Possession: Evidence From Two Florida Counties . Health Affairs (Project Hope) , 35 , 1067 – 1075 .

Tasigiorgos , S. , Economopoulos , K. P. , Winfield , R. D. and Sakran , J. V. ( 2015 ). Firearm Injury in the United States: An Overview of an Evolving Public Health Problem . Journal of the American College of Surgeons , 221 , 1005 – 1014 .

The Education Fund to Stop Gun Violence (EFSGV) ( 2020 ). Gun violence in America an analysis of 2018 CDC data .

Tjaden , P. , Thoennes , N. , US Department of Justice: Office to Justice Programs: National Institute of Justice ( 2000 ). Extent, Nature, and Consequences of Intimate Partner Violence: (300342003-001).

Trivigno , F. V. ( 2013 ). Guns and Virtue: The Virtue Ethical Case Against Gun Carrying . Public Affairs Quarterly , 27 , 289 – 310 .

Trivigno , F.V. ( 2018 ). Plato . The Oxford Handbook of Virtue , available from: https://academic.oup.com/edited-volume/28109/chapter-abstract/212218916?redirectedFrom=fulltext [accessed June 23, 2021 ].

Vernick , J. S. and Webster , D. W. ( 2007 ). Policies to Prevent Firearm Trafficking . Injury Prevention , 13 , 78 – 79 .

Vernick , J. S. , Webster , D. W. , Bulzacchelli , M. T. and Mair , J. S. ( 2006 ). Regulation of Firearm Dealers in the United States: An Analysis of State Law and Opportunities for Improvement . The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics , 34 , 765 – 775 .

Violano , P. , Bonne , S. , Duncan , T. , Pappas , P. , Christmas , A. B. , Dennis , A. , Goldberg , S. , Greene , W. , Hirsh , M. , Shillinglaw , W. , Robinson , B. and Crandall , M. ( 2018 ). Prevention of Firearm Injuries With Gun Safety Devices and Safe Storage: An Eastern Association for the Surgery of Trauma Systematic Review . The Journal of Trauma and Acute Care Surgery , 84 , 1003 – 1011 .

Webster , D. W. , Vernick , J. S. and Bulzacchelli , M. T. ( 2006 ). Effects of a Gun Dealer’s Change in Sales Practices on the Supply of Guns to Criminals . Journal of Urban Health , 83 , 778 – 787 .

Webster , D. W. , Crifasi , C. K. and Vernick , J. S. ( 2014 ). Effects of the Repeal of Missouri’s Handgun Purchaser Licensing Law on Homicides . Journal of Urban Health , 91 , 293 – 302 .

Weller , C. ( 2018 ). These 4 Countries Have Nearly Eliminated Gun Deaths—Here’s What the US Can Learn . The Independfent , available from: https://www.independent.co.uk/news/world/americas/gun-deaths-eliminated-america-learn-japan-australia-uk-norway-florida-shooting-latest-news-a8216301.html [accessed June 4, 2021 ].

Wintemute , G. J. ( 2019 ). Background Checks For Firearm Purchases: Problem Areas And Recommendations To Improve Effectiveness . Health Affairs (Project Hope) , 38 , 1702 – 1710 .

Wisconsin Department of Natural Resources ( 2020 ). Mentored Hunting | Wisconsin DNR , available from: https://dnr.wisconsin.gov/Education/OutdoorSkills/mentor [accessed June 23, 2021 ].

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May 26, 2022

The Science Is Clear: Gun Control Saves Lives

By enacting simple laws that make guns safer and harder to get, we can prevent killings like the ones in Uvalde and Buffalo

By The Editors

Adam Gault/Getty Images

Editor’s Note (5/24/23): One year ago, on May 24, 2022, 19 students and two teachers were fatally shot at Robb Elementary School in Uvalde, Tex . This piece by Scientific American's editors presents the case that simple gun laws can prevent future tragedies.

Some editorials simply hurt to write. This is one.

At least 19 elementary school children and two teachers are dead, many more are injured, and a grandmother is fighting for her life in Uvalde, Tex., all because a young man, armed with an AR-15-style rifle, decided to fire in a school.

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By now, you know these facts: This killing spree was the largest school shooting since Sandy Hook. Law enforcement couldn’t immediately subdue the killer. In Texas, it’s alarmingly easy to buy and openly carry a gun . In the immediate hours after the shooting, President Biden demanded reform , again. Legislators demanded reform , again. And progun politicians turned to weathered talking points: arm teachers and build safer schools.

But rather than arm our teachers (who have enough to do without keeping that gun away from students and having to train like law enforcement to confront an armed attacker), rather than spend much-needed school dollars on more metal detectors instead of education, we need to make it harder to buy a gun. Especially the kind of weapons used by this killer and the white supremacist who killed 10 people grocery shopping in Buffalo . And we need to put a lasting stop to the political obstruction of taxpayer-funded research into gun-related injuries and deaths.

The science is abundantly clear: More guns do not stop crime . Guns kill more children each year than auto accidents. More children die by gunfire in a year than on-duty police officers and active military members. Guns are a public health crisis , just like COVID, and in this, we are failing our children, over and over again.

In the U.S., we have existing infrastructure that we could easily emulate to make gun use safer: the National Highway Traffic Safety Administration . Created by Congress in 1970, this federal agency is tasked, among other things, with helping us drive a car safely. It gathers data on automobile deaths. It’s the agency that monitors and studies seat belt usage . While we track firearm-related deaths, no such safety-driven agency exists for gun use.

During the early 1990s, the Centers for Disease Control and Prevention began to explore gun violence as a public health issue. After studies tied having a firearm to increased homicide risk , the National Rifle Association took action , spearheading the infamous Dickey Amendment, diverting gun research dollars and preventing federal funding from being used to promote gun control. For more than 20 years, research on gun violence in this country has been hard to do.

What research we have is clear and grim. For example, in 2017, guns overtook 60 years of cars as the biggest injury-based killer of children and young adults (ages one to 24) in the U.S. By 2020, about eight in every 100,000 people died of car crashes. About 10 in every 100,000 people died of gun injuries.

While cars have become increasingly safer (it’s one of the auto industry’s main talking points in marketing these days), the gun lobby has thwarted nearly all attempts to make it harder to fire a weapon. With federal protection against some lawsuits , the financial incentive of a giant tort payout to make guns safer is virtually nonexistent.

After the Uvalde killings, the attorney general of Texas, Ken Paxton , said he’d “rather have law-abiding citizens armed and trained so that they can respond when something like this happens.” Sen. Ted Cruz emphasized “armed law enforcement on the campus.” They are two of many conservatives who see more guns as the key to fighting gun crime. They are wrong.

A study comparing gun deaths the U.S. to other high-income countries in Europe and Asia tells us that our homicide rate in teens and young adults is 49 times higher. Our firearm suicide rate is eight times higher. The U.S. has more guns than any of the countries in the comparison.

As we previously reported , in 2015, assaults with a firearm were 6.8 times more common in states that had the most guns, compared to the least. More than a dozen studies have revealed that if you had a gun at home, you were twice as likely to be killed as someone who didn’t. Research from the Harvard School of Public Health tells us that states with higher gun ownership levels have higher rates of homicide . Data even tells us that where gun shops or gun dealers open for business, killings go up . These are but a few of the studies that show the exact opposite of what progun politicians are saying. The science must not be ignored.

Science points to laws that would work to reduce shootings, to lower death. Among the simplest would be better permitting laws with fewer loopholes. When Missouri repealed its permit law, gun-related killings increased by 25 percent . Another would be to ban people who are convicted of violent crime from buying a gun. In California, before the state passed such a law, people convicted of crimes were almost 30 percent more likely to be arrested again for a gun or violent crime than those who, after the law, couldn’t buy a gun.

Such laws, plus red flag laws and those taking guns out of the hands of domestic abusers and people who abuse alcohol, would lower our gun violence rate as a nation. But it would require elected officials to detach themselves from the gun lobby. There are so many issues to consider when voting, but in this midterm election year, we believe that protection from gun violence is one that voters could really advance. Surveys routinely show that gun control measures are extremely popular with the U.S. population.

In the meantime, there is some hope. Congress restored funding for gun-related research in 2019, and there are researchers now looking at ways to reduce gun deaths. But it’s unclear if this change in funding is permanent. And what we’ve lost is 20 years of data on gun injuries, death, safety measures and a score of other things that could make gun ownership in this country safer.

Against all this are families whose lives will never be the same because of gun violence. Who must mourn children and adults lost in domestic violence, accidental killings and mass shootings that are so common, we are still grieving one when the next one occurs.

We need to become the kind of country that looks at guns for what they are: weapons that kill. And treat them with the kind of respect that insists they be harder to get and safer to use.

And then we need to become the kind of country that says the lives of children are more valuable than the right to weapons that have killed them, time and again. Since Columbine. Since Sandy Hook. Since always.

Gun Violence: Prediction, Prevention, and Policy

• Gun Violence and Crime

Gun violence is an urgent, complex, and multifaceted problem. It requires evidence-based, multifaceted solutions. Psychology can make important contributions to policies that prevent gun violence. Toward this end, in February 2013 the American Psychological Association commissioned this report by a panel of experts to convey research-based conclusions and recommendations (and to identify gaps in such knowledge) on how to reduce the incidence of gun violence — whether by homicide, suicide, or mass shootings — nationwide.

Following are chapter-by-chapter highlights and short summaries of conclusions and recommendations of the report’s authors. More information and supporting citations can be found within the chapters themselves.

Antecedents to Gun Violence: Developmental Issues

A complex and variable constellation of risk and protective factors makes persons more or less likely to use a firearm against themselves or others. For this reason, there is no single profile that can reliably predict who will use a gun in a violent act. Instead, gun violence is associated with a confluence of individual, family, school, peer, community, and sociocultural risk factors that interact over time during childhood and adolescence. Although many youths desist in aggressive and antisocial behavior during late adolescence, others are disproportionately at risk for becoming involved in or otherwise affected by gun violence. The most consistent and powerful predictor of future violence is a history of violent behavior.  P revention efforts guided by research on developmental risk can reduce the likelihood that firearms will be introduced into community and family conflicts or criminal activity.  Prevention efforts can also reduce the relatively rare occasions when severe mental illness contributes to homicide or the more common circumstances when depression or other mental illness contributes to suicide. Reducing incidents of gun violence arising from criminal misconduct or suicide is an important goal of broader primary and secondary prevention and intervention strategies. Such strategies must also attend to redirecting developmental antecedents and larger sociocultural processes that contribute to gun violence and gun-related deaths.

Antecedents to Gun Violence: Gender and Culture

Any account of gun violence in the United States must be able to explain both why males are perpetrators of the vast majority of gun violence and why the vast majority of males never perpetrate gun violence. Preliminary evidence suggests that changing perceptions among males of social norms about behaviors and characteristics associated with masculinity may reduce the prevalence of intimate partner and sexual violence. Such interventions need to be further tested for their potential to reduce gun violence. The skills and knowledge of psychologists are needed to develop and evaluate programs and settings in schools, workplaces, prisons, neighborhoods, clinics, and other relevant contexts that aim to change gendered expectations for males that emphasize self-sufficiency, toughness, and violence, including gun violence.

What Works: Gun Violence Prediction and Prevention at the Individual Level

Although it is important to recognize that most people suffering from a mental illness are not dangerous, for those persons at risk for violence due to mental illness, suicidal thoughts, or feelings of desperation, mental health treatment can often prevent gun violence. Policies and programs that identify and provide treatment for all persons suffering from a mental illness should be a national priority. Urgent attention must be paid to the current level of access to mental health services in the United States; such access is woefully insufficient. Additionally, it should be noted that behavioral threat assessment is becoming a standard of care for preventing violence in schools, colleges, and the workplace and against government and other public officials. Threat assessment teams gather and analyze information to assess if a person poses a threat of violence or self-harm, and if so, take steps to intervene.

What Works: Gun Violence Prevention at the Community Level

Prevention of violence occurs along a continuum that begins in early childhood with programs to help parents raise emotionally healthy children and ends with efforts to identify and intervene with troubled individuals who are threatening violence. The mental health community must take the lead in advocating for community-based collaborative problem-solving models to address the prevention of gun violence. Such models should blend prevention strategies in an effort to overcome the tendency within many community service systems to operate in silos. There has been some success with community-based programs involving police training in crisis intervention and with community members trained in mental health first aid. These programs need further piloting and study so they can be expanded to additional communities as appropriate. In addition, public health messaging campaigns on safe gun storage are needed. The practice of keeping all firearms appropriately stored and locked must become the only socially acceptable norm.

What Works: Policies to Reduce Gun Violence

The use of a gun greatly increases the odds that violence will lead to a fatality: This problem calls for urgent action. Firearm prohibitions for high-risk groups — domestic violence offenders, persons convicted of violent misdemeanor crimes, and individuals with mental illness who have been adjudicated as being a threat to themselves or to others — have been shown to reduce violence. The licensing of handgun purchasers, background check requirements for all gun sales, and close oversight of retail gun sellers can reduce the diversion of guns to criminals. Reducing the incidence of gun violence will require interventions through multiple systems, including legal, public health, public safety, community, and health. Increasing the availability of data and funding will help inform and evaluate policies designed to reduce gun violence.

Dewey Cornell, PhD, and Nancy G. Guerra, EdD

Gun violence is an important national problem leading to more than 31,000 deaths and 78,000 nonfatal injuries every year. Although the rate of gun homicides in the United States has declined in recent years, U.S. rates remain substantially higher than those of almost every other nation in the world and are at least seven times higher than those of Australia, Canada, France, Germany, India, Italy, Japan, South Korea, Spain, Sweden, the United Kingdom, and many others (see Alpers & Wilson).

Guns are not a necessary or sufficient cause of violence and can be used legally for a variety of sanctioned activities. Still, they are especially lethal weapons that are used in approximately two thirds of the homicides and more than half of all suicides in the United States. Every day in the United States, approximately 30 persons die of homicides and 53 persons die of suicides committed by someone using a gun (Centers for Disease Control and Prevention [CDC], 2013a). Guns also provide individuals with the capacity to carry out multiple-fatality shootings that inflict great trauma and grief on our society, and the public rightly insists on action to make our communities safer.

Gun violence demands special attention. At the federal level, President Barack Obama announced a new “Now Is the Time” plan (White House, 2013) to address firearm violence to better protect children and communities and issued 23 related executive orders to federal agencies. The importance of continued research to address firearm violence is reflected in the 2013 report of the Institute of Medicine (IOM) and the National Research Council (NRC) "Priorities for Research to Reduce the Threat of Firearm-Related Violence. "  This report calls for a public health approach that emphasizes the importance of accurate information on the number and distribution of guns in the United States, including risk factors and motivations for acquisition and use, the association between exposure to media violence and any subsequent perpetration of gun violence, and how new technology can facilitate prevention. The report also outlines a research agenda to facilitate programs and policies that can reduce the occurrence and impact of firearm-related violence in the United States.

Psychology can make an important contribution to policies that prevent gun violence. Rather than debate whether “people” kill people or “guns” kill people, a reasonable approach to facilitate prevention is that “people with guns kill people.” The problem is more complex than simple slogans and requires careful study and analysis of the different psychological factors, behavioral pathways, social circumstances, and cultural factors that lead to gun violence. Whether prevention efforts should focus on guns because they are such a powerful tool for violence, on other factors that might have equal or greater impact, or on some combination of factors should be a scientific question settled by evidence.

Toward this end, the American Psychological Association (APA) commissioned this report, with three goals. First, this report is intended to focus on gun violence, recognizing that knowledge about gun violence must be related to a broader understanding of violence. Second, the report reviews what is known from the best current science on antecedents to gun violence and effective prevention strategies at the individual, community, and national levels. Finally, the report identifies policy directions, gaps in the literature, and suggestions for continued research that can help address unresolved questions about effective strategies to reduce gun violence. For over a decade, research on gun violence has been stifled by legal restrictions, political pressure applied to agencies not to fund research on certain gun-related topics, and a lack of funding. The authors of this report believe the cost of gun violence to our society is too great to allow these barriers to remain in place.

The Role of Mental Health and Mental Illness

An important focus of this report is the role that mental health and mental illness play in why individuals commit firearm-related violence and how this can inform preventive efforts. This focus undoubtedly brings to mind shootings such as those in Newtown, Conn., Aurora, Colo., and Tucson, Ariz. However, it is important to realize that mass fatality incidents of this type, although highly publicized, are extremely rare, accounting for one tenth of 1 percent of all firearm-related homicides in the United States (CDC, 2013a). Moreover, serious mental illness affects a significant percentage of the U.S. population, with prevalence estimates in the general population as high as 5 percent (Substance Abuse and Mental Health Services Administration [SAMHSA], 2012). This is quite significant, given that the term serious mental illness is typically reserved for the most debilitating kinds of mental disorder, such as schizophrenia, bipolar disorder, and the most severe forms of depression, but can include other mental disorders that result in acute functional impairment.

Although many highly publicized shootings have involved persons with serious mental illness, it must be recognized that persons with serious mental illness commit only a small proportion of firearm-related homicides; the problem of gun violence cannot be resolved simply through efforts focused on serious mental illness (Webster & Vernick, 2013a). Furthermore, the overwhelming majority of people with serious mental illness do not engage in violence toward others and should not be stereotyped as dangerous (Sirotich, 2008).

It also is important to recognize that for the small proportion of individuals whose serious mental illness does predispose them to violence, there are significant societal barriers to treatment. Psychiatric hospitalization can be helpful, but treatment can be expensive, and there may not be appropriate follow-up services in the community. Civil commitment laws, which serve to protect individuals from being unreasonably detained or forced into treatment against their will, can also prevent professionals from treating someone who does not recognize his or her need for treatment.

Other kinds of mental disorders that do not rise to the level of serious mental illness also are associated with gun violence and criminal behavior generally. For example, conduct disorder and antisocial personality disorder are associated with increased risk for violence. (This link is not surprising because violent behavior is counted as one of the symptoms that helps qualify someone for the diagnosis.) Nevertheless, there are well-established, scientifically validated mental health treatment programs for individuals with these disorders, such as multisystemic therapy, that can reduce violent recidivism (Henggeler, 2011). Substance abuse is another form of mental disorder that is a risk factor for violence in the general population and also increases the risk for violence among persons with serious mental illness (Van Dorn, Volavka, & Johnson, 2012).

These observations reflect the complexity of relationships among serious mental illness, mental disorders, and violence. In contrast to homicide, suicide accounts for approximately 61 percent of all firearm fatalities in the United States (CDC, 2013a), and more than 90 percent of persons who commit suicide have some combination of depression, symptoms of other mental disorders, and/or substance abuse (Moscicki, 2001). This suggests that mental health and mental illness are especially relevant to understanding and preventing suicide, the leading type of firearm-related death.

Prediction and Prevention

The prediction of an individual’s propensity for violence is a complex and challenging task for mental health professionals, who often are called upon by courts, correctional authorities, schools, and others to assess the risk of an individual’s violence. Mental health professionals are expected to take action to protect potential victims when they judge that their patient or client poses a danger to others. However, decades of research have established that there is only a moderate ability to identify individuals likely to commit serious acts of violence. Much depends on the kind of violence and the time frame for prediction. For example, there are specialized instruments for the assessment of violence risk among sex offenders, civilly committed psychiatric patients, and domestic violence offenders. However, the time frame and focus for these predictions often are broadly concerned with long-term predictions that someone will ever be violent with anyone rather than whether a person will commit a particular act of targeted violence.

Research has moved the field beyond the assessment of “dangerousness” as a simple individual characteristic applicable in all cases to recognize that predictive efforts must consider a range of personal, social, and situational factors that can lead to different forms of violent behavior in different circumstances. Moreover, risk assessment has expanded to include concepts of risk management and interventions aimed at reducing risk.

In making predictions about the risk for mass shootings, there is no consistent psychological profile or set of warning signs that can be used reliably to identify such individuals in the general population. A more promising approach is the strategy of behavioral threat assessment , which is concerned with identifying and intervening with individuals who have communicated threats of violence or engaged in behavior that clearly indicates planning or preparation to commit a violent act. A threat assessment approach recognizes that individuals who threaten targeted violence are usually troubled, depressed, and despondent over their circumstances in life. A threat assessment leads to interventions intended to reduce the risk of violence by taking steps to address the problem that underlies the threatening behavior. Such problems can range from workplace conflicts to schoolyard bullying to serious mental illness. One of the most influential threat assessment models was developed by the U.S. Secret Service (Fein et al., 2002; Vossekuil, Fein, Reddy, Borum, & Modzelski, 2002) and has been adapted for use in schools, colleges, business settings, and the U.S. military.

The limited ability to make accurate predictions of violence has led some to question whether prevention is possible. This is a common misconception, because prevention does not require prediction of a specific individual’s behavior . For example, public health campaigns have reduced problems ranging from lung cancer to motor vehicle accidents by identifying risk factors and promoting safer behaviors even though it is not possible to predict whether a specific individual will develop lung cancer or have a motor vehicle accident (Mozaffarian, Hemenway, & Ludwig, 2013). A substantial body of scientific evidence identifies important developmental, familial, and social risk factors for violence. In addition, an array of rigorously tested psychological and educational interventions facilitate healthy social development and reduce aggressive behavior by teaching social skills and problem-solving strategies. It is important that policymakers and stakeholders recognize the value of prevention.

Prevention measures also should be distinguished from security measures and crisis response plans. Prevention must begin long before a gunman comes into a school or shopping center. Prevention efforts are often conceptualized as taking place on primary, secondary, and tertiary levels:

• Primary prevention (also called universal prevention) consists of efforts to promote healthy development in the general population. An example would be a curriculum to teach all children social skills to resist negative peer influences and resolve conflicts peacefully.
• Secondary prevention (also called selective prevention) involves assistance for individuals who are at increased risk for violence. Mentoring programs and conflict-mediation services are examples of such assistance.
• Tertiary prevention (also called indicated prevention) consists of intensive services for individuals who have engaged in some degree of aggressive behavior and could benefit from efforts to prevent a recurrence or escalation of aggression. Programs to rehabilitate juvenile offenders are examples.

Throughout this report, we discuss evidence-based prevention programs relevant to the issue of firearm-related violence.

Research can help us understand and prevent gun violence. The psychological research summarized in this report can inform public policy and prevention efforts designed to promote public safety and reduce violence. Gun violence is not a simple, discrete category of crime; it shares characteristics with other forms of violence, and it can be a product of an array of cultural, social, psychological, and situational factors. Nevertheless, there is valuable psychological knowledge that can be used to make our communities safer.

Robert Kinscherff, PhD, JD; Nancy G. Guerra, EdD; and Ariel A. Williamson, MA

Youth gun violence is often sensationalized and misunderstood by the general public, in part because of increasingly public acts of violence and related media coverage (Snyder & Sickmund, 2006; Williams, Tuthill, & Lio, 2008). In truth, only a small number of juvenile offenders commit the majority of violent juvenile crimes in the United States (Williams et al., 2008). Most juvenile offenders commit “nonperson” offenses, usually in terms of property and technical (parole) violations (Sickmund, Sladky, Kang, & Puzzanchera, 2011). For example, in 2010, the majority of juvenile offenses were nonperson offenses such as property offenses (27.2 percent), drug offenses (8.4 percent), public order offenses (10.7 percent), technical violations (14.4 percent), and status offenses (4.6 percent) — that is, crimes defined by minor (under age 18) status, such as alcohol consumption, truancy, and running away from home (Sickmund et al., 2011). Additionally, young adults between the ages of 18 and 34 are the most likely to commit violent crimes like homicide and to do so using a gun, compared with individuals under 18 (Cooper & Smith, 2011).

A subgroup of youth is particularly vulnerable to violence and victimization. Minority males constitute a disproportionate number of youths arrested and adjudicated, with 60 percent of all arrested youths identifying as part of a racial/ethnic minority group (Sickmund et al., 2011). Males also outnumber females in arrest rates for every area except status offenses and technical violations. Urban African American males are at substantially greater risk for involvement in gun-related homicides as perpetrators and as victims (CDC, 2013a; Spano, Pridemore, & Bolland, 2012). However, the majority of the infrequent but highly publicized shootings with multiple fatalities, such as those at Sandy Hook Elementary School or the Aurora, Colo., movie theater, have been committed by young White males.

This presents a picture of a small number of youths and young adults who are at an increased risk for involvement in gun violence. In the United States, these youths are somewhat more likely to be males of color growing up in urban areas. But it also is important to understand that most young males of all races and ethnicities — and most people in general — are not involved in serious violence and do not carry or use guns inappropriately.

How did this small subset of youths and young adults come to be involved in serious gun violence? Is there a “cradle-to-prison” pipeline, particularly for youths of color living in poverty and in disadvantaged urban areas, that triggers a cascade of events that increase the likelihood of gun violence (Children’s Defense Fund, 2009)? A developmental perspective on antecedents to youth gun violence can help us design more effective prevention programs and strategies.

This chapter describes the biological and environmental risk factors that begin early in development and continue into adolescence and young adulthood. Developmental studies that link children’s aggressive behavior to more serious involvement in the criminal justice system suggest the accumulation and interaction of many risks in multiple contexts (Dodge, Greenberg, Malone, & Conduct Problems Prevention Research Group, 2008; Dodge & Pettit, 2003). There is no single biological predisposition, individual trait, or life experience that accounts for the development and continuity of violent behavior or the use of guns. Rather, violence is associated with a confluence of individual, family, school, peer, community, and sociocultural risk factors that interact over time during childhood and adolescence (Brennan, Hall, Bor, Najman, & Williams, 2003; Dodge & Pettit, 2003). Risk for gun violence involves similar risk processes, although the complexity and variability of individuals means there is no meaningful profile that allows reliable prediction of who will eventually engage in gun violence. Nevertheless, developmental factors beginning in utero may increase the risk of aggressive behavior and lead to gun violence — especially when guns are readily available and part of an aggressive or delinquent peer culture.

Early-Onset Aggression

Early onset of aggressive behavior significantly increases risk for later antisocial behavior problems. The most consistent and powerful predictor of future violence is a history of violent behavior, and risk increases with earlier and more frequent incidents. Longitudinal work has shown that having a first arrest between 7 and 11 years of age is associated with patterns of long-term adult offending (Loeber, 1982). Children who are highly aggressive throughout childhood and continue to have serious conduct problems during adolescence have been identified as “life-course persistent” (LCP) youths (Moffitt, 1993). Examining longitudinal data from a large birth cohort in New Zealand, Moffitt (1993) created a taxonomy of antisocial behavior that differentiates LCP youths from an “adolescence-limited” subgroup. The latter subgroup characterizes those who engage in antisocial behaviors during adolescence and usually desist by adulthood. By contrast, LCP youths display more severe early aggression in childhood and develop a pattern of chronic violence during adolescence and into adulthood.

Both biological and environmental risks during prenatal development, infancy, and early childhood contribute to the development of early-onset aggression and the LCP developmental trajectory (Brennan et al., 2003; Dodge & Pettit, 2003; Moffitt, 2005). Pre- and postnatal risks associated with early-onset aggression include maternal substance abuse during pregnancy, high levels of prenatal stress, low birth weight, birth complications and injuries (especially those involving anoxia), malnutrition, and exposure to environmental toxins like lead paint (Brennan et al., 2003; Dodge & Pettit, 2003). According to Moffitt (1993), these early developmental risks disrupt neural development and are associated with neuropsychological deficits, particularly in executive functioning and verbal abilities.

Along with neuropsychological deficits, poor behavioral control and a difficult temperament are associated with the development of early-onset aggression (Dodge & Pettit, 2003; Moffitt, 1993). Children with difficult temperaments are typically irritable, difficult to soothe, and highly reactive. These patterns of behavior often trigger negative and ineffective reactions from parents and caregivers that can escalate into early aggressive behavior (Dodge & Pettit, 2003; Wachs, 2006). Family influences, such as familial stress and negative parent–child interactions, can interact with a child’s individual characteristics, leading to increased aggressive behavior during childhood.

Family Influences

Highly aggressive children who engage in serious acts of violence during later childhood and adolescence also are exposed to continued environmental risks throughout development (Dodge et al., 2008). The family context has been found to be quite influential in the development and continuity of antisocial behavior. Particularly for early-onset aggressive youths raised in families that are under a high degree of environmental stress, aggressive child behavior and negative parenting practices interact to amplify early-onset aggression. Examples of family risk factors include low parent–child synchrony and warmth, poor or disrupted attachment, harsh or inconsistent discipline (overly strict or permissive), poor parental monitoring, the modeling of antisocial behavior, pro-violent attitudes and criminal justice involvement, and coercive parent–child interaction patterns (Dodge & Pettit, 2003; Farrington, Jolliffe, Loeber, Stouthamer-Loeber, & Kalb, 2001; Hill, Howel, Hawkins, & Battin-Pearson, 1999; Patterson, Forgatch, & DeGarmo, 2010).

Coercive parent–child interactions have been associated with the emergence of aggressive behavior problems in children (Patterson et al., 2010). In these interactions, children learn to use coercive behaviors such as temper tantrums to escape parental discipline. When parents acquiesce to these negative behaviors, they inadvertently reward children for coercive behaviors, reinforcing the idea that aggression or violence is adaptive and can be used instrumentally to achieve goals. These interaction patterns tend to escalate in their severity (e.g., from whining, to temper tantrums, to hitting, etc.) and frequency, leading to increased aggression and noncompliance (Patterson et al., 2010). Such behaviors also generalize across contexts to children’s interactions with others outside the home, including with teachers, other adults, and peers. Indeed, prevention research has shown that intervening with at-risk families to improve parenting skills can disrupt the pathway from early-onset aggressive behavior to delinquency in adolescence (Patterson et al., 2010).

Other family risk factors for youths with early predispositions to aggression may be especially relevant to increased risk for gun violence. For instance, research has shown that many families with children own firearms and do not keep them safely stored at home (Johnson, Miller, Vriniotis, Azrael, & Hemenway, 2006). Although keeping firearms at home is not a direct cause of youth gun violence, the rates of suicides, homicides, and unintentional firearm fatalities are higher for 5–14-year-olds who live in states or regions in which rates of gun ownership are more prevalent (Miller, Azrael, & Hemenway, 2002). Poor parental monitoring and supervision, which are more general risk factors for involvement in aggression and violent behaviors (Dodge et al., 2008), may be especially salient in risk for gun violence. For example, impulsive or aggressive children who are often unsupervised and live in a home with access to guns may be at risk.

The family also is an important context for socialization and the development of normative beliefs or perceptions about appropriate social behavior that become increasingly stable during early development and are predictive of later behavior over time (Huesmann & Guerra, 1997). These beliefs shape an individual’s social-cognitive understanding about whether and under what circumstances threatened or actual violence is justified. Children who develop beliefs that aggression is a desirable and effective way to interact with others are more likely to use coercion and violence instrumentally to achieve goals or solve problems (Huesmann & Guerra, 1997). Antisocial attitudes and social-cognitive distortions (e.g., problems in generating nonviolent solutions, misperceiving hostile/aggressive intent by others, justifying acts of violence that would be criminal) can also increase risk for violence (Borum & Verhaagen, 2006; Dodge & Pettit, 2003).

Families can play a role in establishing and maintaining normative beliefs about violence and gun usage. For example, pro-violence attitudes and the criminality of parents and siblings during childhood have been found to predict adolescent gang membership and delinquency (Farrington et al., 2001; Hill et al., 1999). Youths from families that encourage the use of guns for solving problems also may be exposed to such attitudes in other contexts (in communities, with peers, and in the media) and may perceive firearms to be an appropriate means to solve problems and protect themselves.

School and Peer Influences

The school setting is another important context for child socialization. Children who enter school with high levels of aggressive behavior, cognitive or neurobiological deficits, and poor emotional regulation may have difficulty adjusting to the school setting and getting along with peers (Dodge et al., 2008; Dodge & Pettit, 2003). Highly aggressive children who have learned to use aggression instrumentally at home will likely use such behavior with teachers, increasing the chances that they will have poor academic experiences and low school engagement (Patterson et al., 2010). Academic failure, low school interest, truancy, and school dropout are all correlated with increased risk for problem behavior and delinquency, including aggression and violence (Dodge & Pettit, 2003). This risk is strongest when poor academic achievement begins in elementary school and contributes to school underachievement and the onset of adolescent problem behaviors, such as substance use and drug trafficking, truancy, unsafe sexual activity, youth violence, and gang involvement (Dodge et al., 2008; Guerra & Bradshaw, 2008).

Involvement in these risk behaviors also is facilitated by affiliation with deviant peers, particularly during adolescence (Dodge et al., 2008). Research has shown that children who are aggressive, victimized, and academically marginalized from the school setting may suffer high levels of peer rejection that amplify preexisting aggressive behaviors (Dodge et al., 2008; Dodge & Pettit, 2003). Longitudinal work indicates that experiences of academic failure, school marginalization, and peer rejection interact to produce affiliations with similarly rejected, deviant, and/or gang-involved peers. Friendships between deviant peers provide youths with “training” in antisocial behaviors that reinforce and exacerbate preexisting aggressive tendencies (Dishion, Véronneau, & Meyers, 2010; Dodge et al., 2008). Peer deviancy training is a primary mechanism in the trajectory from overt, highly aggressive behaviors during childhood to more covert processes during adolescence, such as lying, stealing, substance use, and weapon carrying (Dishion et al., 2010; Patterson et al., 2010).

The larger school context also can interact with youths’ experiences of academic failure, peer rejection, and deviant peer affiliations to influence the continuity of antisocial behavior. Poorly funded schools located in low-income neighborhoods have fewer resources to address the behavioral, academic, mental health, and medical needs of their students. In addition, these schools tend to have stricter policies toward discipline, are less clinically informed about problem behaviors, and have stronger zero tolerance policies that result in more expulsions and suspensions (Edelman, 2007). This contextual factor is important, as youths who are attending and engaged in school are less likely to engage in delinquent or violent behavior, whereas marginalized and rejected youths, particularly in impoverished schools, are at increased risk for aggression and violence at school and in their communities. Schools that provide safe environments that protect students from bullying or criminal victimization support student engagement, reduce incidents of student conflict that could result in volatile or violent behavior, and diminish risks that students will bring weapons to school.

Although few homicides (< 2 percent) and suicides occur at school or during transportation to and from school (Roberts, Zhang, & Truman, 2012) and widely publicized mass school shootings are rare, research indicates that a small number of students do carry guns or other weapons. In 2011, 5.1 percent of high school students in Grades 9–12 reported carrying a gun in the 30 days prior to the survey, and 5.4 percent of students had carried a weapon (gun, knife, or club) on school grounds at least once in the 30 days prior to the survey (Eaton et al., 2012). Studies show that youths who carry guns are more likely to report involvement in multiple problem behaviors, to be affiliated with a gang, to overestimate how many of their peers carry guns, and to have a high need for interpersonal safety. For instance, student reports of involvement in and exposure to risk behaviors at school such as physical fighting, being threatened, using substances, or selling drugs on school grounds have been positively correlated with an increased likelihood of carrying weapons to school (Furlong, Bates, & Smith, 2001).

In another study of high school students, 5.5 percent of urban high school students reported that they carried a gun in the year prior to the study, but students estimated that 32.6 percent of peers in their neighborhoods carried guns, a substantial overestimation of the actual gun-carrying rates. Lawful, supervised gun carrying by juveniles is not the concern of this line of research; however, when unsupervised youths carry guns in high-violence neighborhoods, they may be more likely to use guns to protect themselves and resolve altercations. Gun-carrying youths in this study had higher rates of substance use, violence exposure, gang affiliation, and peer victimization (Hemenway, Vriniotis, Johnson, Miller, & Azrael, 2011). Additionally, many gun-carrying youths had lower levels of perceived interpersonal safety (Hemenway et al., 2011). Research has also revealed that deviant peer group affiliations during specific periods of adolescent development may increase the risk for gun violence. For example, research findings have shown that gang membership in early adolescence is significantly associated with increased gun carrying over time. This changes somewhat in late adolescence and young adulthood, when gun carrying is linked more to involvement in drug dealing and having peers who illegally own guns (Lizotte, Krohn, Howell, Tobin, & Howard, 2000).

Communities Matter

The community context is an additional source of risk for the development and continuity of antisocial behavior. Living in extremely disadvantaged, underresourced communities with high levels of crime and violence creates serious obstacles to healthy development. Recent estimates show that currently in the United States, 16.4 million children live in poverty and 7.4 million of those live in extreme poverty (i.e., an annual income of less than half of the federal poverty level; Children’s Defense Fund, 2012). One in four children under 5 years of age is poor during the formative years of brain development. In addition, 22 percent of children who have lived in poverty do not graduate from high school, compared with 6 percent of children who have never been poor (Children’s Defense Fund, 2012). For families and youths, living in poverty is associated with high levels of familial stress, poor child nutrition, elevated risks of injury, and limited access to adequate health care (Adler & Steward, 2010; Patterson et al., 2010). Ethnic minority youth in the United States are overrepresented in economically struggling communities. These environmental adversities can, in turn, compromise children’s health status and functioning in other environments and increase the risk for involvement in violent behaviors, contributing significantly to ethnic and cultural variations in the rates of violence (Borum & Verhaagen, 2006).

In a community context, the degree to which children have access to adequate positive resources (e.g., in terms of health, finances, nutrition, education, peers, and recreation), have prosocial and connected relationships with others, and feel safe in their environment can significantly affect their risk for involvement in violent behaviors. Aggressive children and adolescents who are living in neighborhoods with high levels of community violence, drug and firearm trafficking, gang presence, and inadequate housing may have increased exposure to violence and opportunities for involvement in deviant behavior. Compared with communities that have better resources, disenfranchised and impoverished communities may also lack social, recreational, and vocational opportunities that contribute to positive youth development. Youths with high levels of preexisting aggressive behavior and emerging involvement with deviant or gang-involved peers may be especially at risk for increased violent behavior and subsequent criminal justice involvement when exposed to impoverished and high-crime communities.

Exposure to violence in one’s community, a low sense of community safety, unsupervised access to guns, and involvement in risky community behaviors such as drug dealing all contribute to youths’ involvement in gun carrying and gun violence. Decreased community perceptions of neighborhood safety and higher levels of social (e.g., loitering, public substance use, street fighting, prostitution, etc.) and physical (e.g., graffiti, gang signs, and discarded needles, cigarettes, and beer bottles) neighborhood disorder have been associated with increased firearm carrying among youths (Molnar, Miller, Azrael, & Buka, 2004). A study of African American youths living in poverty found that those who had been exposed to violence prior to carrying a gun were 2.5 times more likely than nonexposed youths to begin carrying a gun at the next time point, even when controlling for gang involvement (Spano et al., 2012). This study also indicated that after exposure to violence, youths were more likely to start carrying guns in their communities (Spano et al., 2012).

Studies have shown that apart from characteristics like conduct problems and prior delinquency, youths who are involved in gang fighting and selling drugs are also more likely to use a gun to threaten or harm others (e.g., Butters, Sheptycki, Brochu, & Erikson, 2011). Involvement in drug dealing in one’s community appears to be particularly risky for gun carrying during later adolescence and early adulthood, possibly due to an increased need for self-protection (Lizotte et al., 2000). Taken together, these studies show that firearm possession may be due to interactions between the need for self-protection in violent communities and increased involvement in delinquent behaviors.

Sociocultural Context: Exposure to Violent Media

Child and adolescent exposure to violent media, a more distal, sociocultural influence on behavior, is also important when considering developmental risks for gun violence. Decades of experimental, cross-sectional, and longitudinal research have documented that exposure to violent media, in movies and television, is associated with increased aggressive behaviors, aggressive thoughts and feelings, increased physiological arousal, and decreased prosocial behaviors (e.g., Anderson et al., 2003; Anderson & Bushman, 2001; Huesmann, 2010; Huesmann, Moise-Titus, Podolski, & Eron, 2003). In light of ongoing advances in technology, research has been expanded to include violent content in video games, music, social media, and the Internet (Anderson et al., 2010; IOM & NRC, 2013).

Findings on associations between violent media exposure and aggressive behavior outcomes have held across differences in culture, gender, age, socioeconomic status, and intellect (e.g., Anderson et al., 2010; Huesmann et al., 2003). Social-cognitive theory on violent media exposure suggests that these images are part of children’s socialization experiences, similar to violence exposure in interpersonal and community contexts (Huesmann, 2010). The viewing of violent images can serve to desensitize children to violence and normalize violent behavior, particularly when children have previously developed beliefs that aggression and violence are an acceptable means of achieving goals or resolving conflicts.

It is important to note that the link between violent media exposure and subsequent violent behaviors does not demonstrate a direct causal effect but instead shows how some children may be more susceptible to this risk factor than others. For instance, Huesmann et al. (2003) found that identification with aggressive characters on television and the perception that television violence was real were robust predictors of later aggression over time. Additionally, there is no established link between violent media exposure and firearm usage in particular. However, given the substantial proportion of media that includes interactions around firearms (e.g., in video games, movies, and television shows), the IOM and NRC (2013) recently identified a crucial need to examine specific associations between exposure to violent media and use of firearms. Exposure to violent media, especially for youths with preexisting aggressive tendencies and poor parental monitoring, may be an important contextual factor that amplifies risk for violent behavior and gun use.

Summary and Conclusions

The relatively small number of youths most likely to persist in serious acts of aggression (including increased risk of gun violence) have often experienced the following:

• Early childhood onset of persistent rule-breaking and aggression
• Socialization into criminal attitudes and behaviors by parents and caretakers who themselves are involved in criminal activities
• Exposure in childhood to multiple adverse experiences in their families and communities
• Social dislocation and reduced opportunities due to school failure or underachievement
• Persisting affiliation with deviant peers or gangs engaged in delinquent/criminal misconduct and with attitudes and beliefs that support possession and use of guns
• Broad exposure to sociocultural influences such as mass media violence and depictions of gun violence as an effective means of achieving goals or status

Most youths — even those with chronic and violent delinquent misconduct — desist in aggressive and antisocial behavior during late adolescence, and no single risk factor is sufficient to generate persisting violent behavior. Still, many are disproportionately at risk for becoming perpetrators or victims of gun violence. Homicide remains the second leading cause of death for teens and young adults between the ages of 15 and 24. In 2010, there were 2,711 infant, child, and adolescent victims of firearm deaths. In that year, 84 percent of homicide victims between the ages of 10 and 19 were killed with a firearm, and 40 percent of youths who committed suicide between the ages 15 and 19 did so with a gun (CDC, 2013a). 1

There is no one developmental trajectory that specifically leads to gun violence. However, prevention efforts guided by research on developmental risk can reduce the likelihood that firearms will be introduced into community and family conflicts or criminal activity. Prevention efforts can also reduce the relatively rare occasions when severe mental illness contributes to homicide or the more common circumstances when depression or other mental illness contributes to suicide.

Reducing incidents of gun violence arising from criminal misconduct or suicide is an important goal of broader primary and secondary prevention and intervention strategies. Such strategies must also attend to redirecting developmental antecedents and larger sociocultural processes that contribute to gun violence and gun-related deaths.

1 The 2010 data shown here are available online .

Eric Mankowski, PhD

Any account of gun violence in the United States must consider both why males are the perpetrators of the vast majority of gun violence and why the vast majority of males never perpetrate gun violence. An account that explains both phenomena focuses, in part, on how boys and men learn to demonstrate and achieve manhood through violence, as well as the differences in opportunities to demonstrate manhood among diverse groups of males. Although evidence exists for human biological and social-environmental systems interacting and contributing to aggressive and violent behavior, this review focuses on the sociocultural evidence that explains males’ higher rates of gun violence.

Reducing the propensity for some males to engage in violence will involve both social and cultural change. Hence, this section reviews existing research on the relationships between sex, gender (i.e., masculinity), and the perpetration and victimization of gun violence in the United States. The intersection of gender, race/ethnicity, and economic disadvantage is also considered in explaining the rates of gun violence across diverse communities. Finally, the relationships between masculinity, gender socialization, and gun violence are analyzed to identify gender-related risk factors for gun violence that can be targeted for prevention strategies and social policy.

Sex Differences in Gun Violence

Prevalence and Risk Men represent more than 90 percent of the perpetrators of homicide in the United States and are also the victims of the large majority (78 percent) of that violence (Bureau of Justice Statistics, 2008; Federal Bureau of Investigation [FBI], 2007). Homicide by gun is the leading cause of death among Black youth, the second leading cause of death among all male youth, and the second or third leading cause of death among female youth (depending on the specific age group) (e.g., Miniño, 2010; Webster, Whitehill, Vernick, & Curriero, 2012). In addition, roughly four times as many youths visit hospitals for gun-induced wounds as are killed each year (CDC, 2013a).

Even more common than homicide, suicide is another leading cause of death in the United States, and most suicides are completed with a firearm. Males complete the large majority of suicides; depending on the age group, roughly four to six times as many males as females kill themselves with firearms (CDC, 2013a). Among youth, suicide ranks especially high as a cause of death. It is the third leading cause of death of 15–24-year-olds and the sixth leading cause of death for 5–14-year-olds. However, the rate of suicide and firearm suicide gradually increases over the lifespan. In addition to gender and age differences in prevalence, sizable differences also exist among ethnic groups. Firearm suicide generally is at least twice as high among Whites than among Blacks and other racial groups from 1980 to 2010 (CDC, 2013a), and White males over the age of 65 have rates that far exceed all other major groups.

Perpetrator–Victim Relationship and Location The prevalence of gun violence strongly depends not only on the sex of the offender but also on the offender’s relationship to the victim and the location of the violence (Sorenson, 2006). Both men and women are more likely to be killed with firearms by someone they know than by a stranger. Specifically, men are most likely to be killed in a public place by an acquaintance, whereas women are most likely to be killed in the home by a current or former spouse or dating partner (i.e., “intimate partner”). Women compared with men are especially likely to be killed by a firearm used by an intimate partner.

Women are killed by current or former intimate partners four to five times more often than men (Campbell, Glass, Sharps, Laughon, & Bloom, 2007), including by firearm. These sex differences in victimization do not appear to hold in the limited data available on same-sex intimate partner homicide; it is more common for men to kill their male partners than for women to kill their female partners (Campbell et al., 2007). Notably, these sex differences in gun violence, as a function of the type of perpetrator–victim relationships, are also found in nonfatal gun violence when emergency room visits are examined (Wiebe, 2003).

A disproportionate number of gun homicides occur in urban areas. Conversely, a disproportionate number of firearm suicides occur in rural (compared with urban) areas (Branas, Nance, Elliott, Richmond, & Schwab, 2004). Although they are highly publicized, less than 2 percent of the homicides of children occur in schools (Borum, Cornell, Modzeleski, & Jimerson, 2010; CDC, 2008, 2013b). There are even fewer “random” or “mass” school shootings in which multiple victims are killed at the same time.

Gun Access and Possession A person must own or obtain a gun to be able to commit gun violence. Research shows that there are sex differences in access to and carrying a gun. Males are roughly two to four times as likely as females to have access to a gun in the home or to possess a gun (Swahn, Hamming, & Ikeda, 2002; Vaughn et al., 2012). In turn, gun carrying is a key risk factor for gun violence perpetration and victimization. For example, gun carrying is associated with dating violence victimization among adolescents, with boys more likely to be victimized than girls (Yan, Howard, Beck, Shattuck, & Hallmark-Kerr, 2010).

Conclusions based on sex differences in access to guns should be drawn with some caution, given that there also appear to be sex differences in the reporting of guns in the home. Men report more guns in the home than do women from the same household (e.g., Ludwig, Cook, & Smith, 1998; Sorenson & Cook, 2008), a sex difference that appears to stem specifically from the substantially higher level of contact with and experience in handling and using guns among boys than girls in the same household (Cook & Sorenson, 2006). Nonetheless, the presence of guns in the home remains predictive of gun violence.

Gender and Gun Violence

Robust sex and race differences in firearm violence have been established. Examined next is how the socialization of men as well as differences in living conditions and opportunities among diverse groups of boys and men help explain why these differences occur.

Making Gender Visible in the Problem of Gun Violence Gender remains largely invisible in research and media accounts of gun violence. In particular, gender is not used to explain the problem of “school shootings,” despite the fact that almost every shooting is perpetrated by a young male. Newspaper headlines and articles describe “school shooters,” “violent adolescents,” and so forth, but rarely call attention to the fact that nearly all such incidents are perpetrated by boys and young men. Studies of risk factors for school shootings may refer accurately to the perpetrators generally as “boys” but largely fail to analyze gender (e.g., Verlinden, Hersen, & Thomas, 2000).

The large sex differences in gun violence should not be overlooked simply because the vast majority of boys and men do not perpetrate gun violence or excused as “boys will be boys.” The size of sex differences in the prevalence of gun violence differs substantially within regions of the United States (Kaplan & Geling, 1998) and across countries (e.g., Ahn, Park, Ha, Choi, & Hong, 2012), which further suggests that gender differences in sociocultural environments are needed to explain sex differences in gun violence.

Masculinity, Power, and Guns Status as a “man” is achieved by the display of stereotypically masculine characteristics, without which one’s manhood is contested. Although the particular characteristics defining manhood and the markers of them can vary across subcultural contexts (Connell, 1995), masculinity has, historically, generally been defined by aggressive and risk-taking behavior, emotional restrictiveness (particularly the vulnerable emotions of fear and sadness, and excepting anger), heterosexuality, and successful competition (Brannon, 1976; Kimmel, 1994; O’Neil, 1981). Such normative characteristics of traditional masculinity are in turn directly related to numerous factors that are associated with gun violence. For example, risk taking is associated with adolescent males’ possession of and access to guns (Vittes & Sorenson, 2006).

Social expectations and norms, supported by social and organizational systems and practices, privilege boys who reject or avoid in themselves anything stereotypically feminine, act tough and aggressive, suppress emotions (other than anger), distance themselves emotionally and physically from other men, and strive competitively for power. Men of color, poor men, gay men, and men from other marginalized groups differ substantially in their access to opportunities to fulfill these manhood ideals and expectations in socially accepted ways. For example, men with less formal educational and economic opportunity, who in the United States are disproportionately Black and Latino, cannot fulfill expectations to be successful breadwinners in socially acceptable ways (e.g., paid, legal employment) as easily as White men, and gay men have less ability to demonstrate normative heterosexual masculinity where they cannot legally marry or have children.

At the same time, higher levels of some forms of violence victimization and perpetration (including suicide) are found among these disadvantaged groups. For example, gay youth are more likely than heterosexual males to commit suicide, and African American male youth are disproportionately the victims of gun violence. Such structural discrimination can be seen reflected in implicit cognitive biases against these group members. Virtual simulations of high-threat incidents, such as those used to train police officers, reliably demonstrate a “shooter bias” in which actors are more likely to shoot Black male targets than those from other race-gender groups (i.e., Black women, White men, and White women) (Plant, Goplen, & Kunstman, 2011).

Even to the extent that it is achieved, manhood status is theorized as precarious, needing to be protected and defended through aggression and violence, including gun violence, in order to avoid victimization from (mostly) male peers (Connell, 1995). Paradoxically, as in all competition, the more convincingly manhood is achieved, the more vulnerable it becomes to challenges or threats and thus requires further defending, often with increasing levels and displays of toughness and violence. The dynamic of these expectations of manhood and their enforcement is like a tight box (Kivel, 1998). Boys and men are either trapped inside this box or, in violating the expectations by stepping out of the box, risk being targeted by threats, bullying, and other forms of violence.

Adherence to stereotypic masculinity, in turn, is commonly associated with stress and conflict, poor health, poor coping and relationship quality, and violence (Courtenay 2000; Hong, 2000). Men’s gender role stress and conflict are directly associated with various forms of interpersonal aggression and violence, including the perpetration of intimate partner violence and suicide (Feder, Levant, & Dean, 2010; Moore & Stuart, 2005; O’Neil, 2008). Men with more restricted emotionality and more restricted affection with other men are more likely to be aggressive, coercive, or violent (O’Neil, 2008). These dimensions of masculinity also are related to a number of other harmful behaviors that are, in turn, associated directly with gun violence and other forms of aggression (see O’Neil, 2008, for a review). For example, the effect of alcohol consumption on intimate partner violence is greater among men than women (Moore, Elkins, McNulty, Kivisto, & Handsel, 2011), and alcohol consumption may be associated with lethal male-to-male violence at least partly because it is associated with carrying a gun (Phillips, Matusko, & Tomasovic, 2007).

In addition, accumulating research evidence indicates a relationship between gender and many of the factors that are associated with suicide (e.g., substance abuse, unemployment; Payne, Swami, & Stanistreet, 2008). Beliefs in traditional masculinity are related to suicidal thoughts, although differently across age cohorts (Hunt, Sweeting, Keoghan, & Platt, 2006). Men’s historic role as economic providers in heterosexual families typically ends with their retirement from the workforce. Suicide rates, including firearm suicide, increase dramatically at precisely this point in the life course (i.e., age 65 and older), whereas they decrease among women this age. The increase in suicide rates among White men at age 65 and older does not occur among Black men, who as a group have much higher levels of unemployment throughout their lives and consequently may not experience the same sense of loss of meaning or entitlement. Male firearm suicide also increases dramatically in adolescence and early adulthood, precisely the years during which young men’s sense of manhood is developing.

Beliefs about gender and sexual orientation also help explain sex differences in fatal hate crimes involving guns. Key themes in male gender role expectations are anti-femininity (Brannon, 1976) and homophobia (Kimmel, 1994). Boys are expected to rid themselves of stereotypically feminine characteristics (e.g., “you throw like a girl,” “big boys don’t cry”). Gun violence against lesbian, gay, bisexual, and transgendered persons can be understood in this context. One explanation of these hate crimes is that they are perpetrated to demonstrate heterosexual masculinity to male peer group members. These homicides, compared with violent crimes in which the victim is (or is perceived to be) heterosexual, often are especially brutal and are more commonly perpetrated by groups of men rather than individual men or women. However, such homicides appear to be perpetrated less often using firearms, which suggests motives beyond a desire to kill — for example, expressing intense hatred or transferring negative affect directly onto the victim (Gruenwald, 2012).

Male role expectations for achievement of success and power, combined with restricted emotionality, may have dangerous consequences, particularly for boys who suffer major losses and need help. A majority of the males who have completed homicides at schools had trouble coping with a recent major loss. Many had also experienced bullying or other harassment (Vossekuil et al., 2002). Such characteristics cannot and should not be used to develop risk profiles of attackers because school shootings are such rare events, and so many men who share these same characteristics never will perpetrate gun violence. However, when male gender and characteristics associated with male gender are highly common among attackers, it is responsible to ask how male gender contributes to school shootings and other forms of gun violence.

In their case studies of male-perpetrated homicide-suicides at schools, Kalish and Kimmel (2010) speculated that a sense of “aggrieved entitlement” may be common among the shooters. In this view, the young men see suicide and revenge as appropriate, even expected, responses for men to perceived or actual victimization. Related findings emerged from a similar analysis of all “random” school shootings (those with multiple, nontargeted victims) from 1982 to 2001 (Kimmel & Mahler, 2003). With a small number of exceptions, the vast majority were committed by White boys (26 of 28) in suburban or rural (not urban) areas (27 of 28). Many of these boys also had experienced homophobic bullying.

Masculinity and Beliefs About Guns Sex differences in beliefs about guns may begin at an early age as a function of parental socialization and attitudes. Fathers, particularly White fathers, are more permissive than mothers of their children, particularly sons, playing with toy guns (Cheng et al., 2003). Through the socialization of gender, boys and men may come to believe that displaying a gun will enhance their masculine power. Carrying a weapon is, in fact, instrumental in fulfilling male gender role expectations. Estimates of a person’s physical size and muscularity are greater when they display a gun (or large knife) than other similarly sized and shaped objects (e.g., drill, saw), even when the person is only described and not visible. This perception persists despite no apparent correlation between actual gun ownership and size or muscularity (Fessler, Holbrook, & Snyder, 2012). Guns symbolically represent some key elements of hegemonic masculinity — power, hardness, force, aggressiveness, coldness (Connell, 1995; Stroud, 2012).

Implications for Prevention and Policy

Sex Differences in Attitudes Toward Gun Policies Policies and laws addressing the manufacture, purchase, and storage of guns have been advocated in response to the prevalence of gun violence. Perhaps reflecting their differential access to firearms and differential perpetration and victimization rates, men and women hold different attitudes about such gun control policies. Females are generally much more favorable toward gun restriction and control policies (e.g., Vittes, Sorenson, & Gilbert, 2003).

Prevention Programs Addressing Gender The foregoing analysis of the link between gender and gun violence suggests the potential value of addressing gender in efforts to define the problem of gun violence and develop preventive responses. Preliminary evidence suggests that correcting and changing perceptions among men of social norms regarding beliefs about behaviors and characteristics that are associated with stereotypic masculinity may reduce the prevalence of intimate partner and sexual violence (Fabiano, Perkins, Berkowitz, Linkenbach, & Stark, 2003; Neighbors et al., 2010). However, the effect of such interventions in specifically reducing gun violence remains to be tested. The skills and knowledge of psychologists are needed to develop and evaluate programs and settings in schools, workplaces, prisons, neighborhoods, clinics, and other relevant contexts that aim to change gendered expectations for males that emphasize self-sufficiency, toughness, and violence, including gun violence.

Robert Kinscherff, PhD, JD; Arthur C. Evans Jr., PhD; Marisa R. Randazzo, PhD; and Dewey Cornell, PhD

A natural starting point for the prevention of gun violence is to identify individuals who are at risk for violence and in need of assistance. Efforts focused on at-risk individuals are considered secondary prevention because they are distinguished from primary or universal prevention efforts that address the general population. Secondary prevention strategies for gun violence can include such actions as providing prompt mental health treatment for an acutely depressed and suicidal person or conducting a threat assessment of a person who has threatened gun violence against a spouse or work supervisor.

To be effective, strategies to prevent gun violence should be tailored to different kinds of violence. One example is the distinction between acts of impulsive violence (i.e., violence carried out in the heat of the moment, such as an argument that escalates into an assault) and acts of targeted or predatory violence (i.e., acts of violence that are planned in advance of the attack and directed toward an identified target). The incidents of mass casualty gun violence that have garnered worldwide media attention, such as the shootings at Sandy Hook Elementary School in Newtown, Conn., at a movie theater Aurora, Colo., at the Fort Hood military base, and at a political rally in a shopping center in Tucson, Ariz., are all examples of targeted or predatory violence. Distinguishing between impulsive violence, targeted/predatory violence, and other types of violence is important because they are associated with different risk factors and require different prevention strategies.

Predicting and Preventing Impulsive Gun Violence

Research on impulsive violence has enabled scientists to develop moderately accurate predictive models that can identify individuals who are more likely than other persons to engage in this form of violence. These models cannot determine with certainty whether a particular person will engage in violence — just whether a person is at greater likelihood of doing so. This approach is known as a violence risk assessment or clinical assessment of dangerousness . A violence risk assessment is conducted by a licensed mental health professional who has specific training in this area. The process generally involves comparing the person in question with known base rates for those of the same age/gender who have committed impulsive violence and then determining whether the person in question has individual risk factors that would increase that person’s likelihood of engaging in impulsive violence. In addition, the process involves examining individual protective factors that would decrease the person’s overall likelihood of engaging in impulsive violence. Research that has identified risk and protective factors for impulsive violence is limited in that more research has been conducted on men than women and on incarcerated or institutionalized individuals than on those in the general population. Nevertheless, this approach can be effective for determining someone’s relative likelihood of engaging in impulsive violence.

Some risk factors for impulsive violence are static — for example, race and age — and cannot be changed. But those factors that are dynamic — for example, unmet mental health needs for conditions linked with violence to self (such as depression) or others (such as paranoia), lack of mental health care, abuse of alcohol — are more amenable to intervention and treatment that can reduce the risk for gun violence. Secondary prevention strategies to prevent impulsive gun violence can include having a trained psychologist or other mental health professional treat the person’s acute mental health needs or substance abuse needs. There must be a vigorous and coordinated response to persons whose histories include acts of violence, threatened or actual use of weapons, and substance abuse, particularly if they have access to a gun. This response should include a violence risk assessment by well-trained professionals and referral for any indicated mental health treatment, counseling and mediation services, or other forms of intervention that can reduce the risk of violence.

Youths and young adults who are experiencing an emerging psychosis should be referred for prompt assessment by mental health professionals with sufficient clinical expertise with psychotic disorders to craft a clinical intervention plan that includes risk management. In some cases, secondary prevention measures may include a court-ordered emergency psychiatric hospitalization where a person can receive a psychiatric evaluation and begin treatment. Criteria for allowing such involuntary evaluations vary by state but typically can occur only when someone is experiencing symptoms of a serious mental illness and, as a result, potentially poses a significant danger to self or others. There is an urgent need to improve the effectiveness of emergency commitment procedures because of concerns that they do not provide sufficient services and follow-up care.

Predicting and Preventing Targeted or Predatory Gun Violence

Acts of targeted or predatory violence directed at multiple victims, including crimes sometimes referred to as rampage shootings and mass shootings, 2 occur far less often in the United States than do acts of impulsive violence (although targeted violence garners far more media attention). Acts of targeted violence have not been subject to study that has developed statistical models like those used for estimating a person’s likelihood of impulsive violence. Although it seems appealing to develop checklists of warning signs to construct a profile of individuals who commit these kinds of crimes, this effort, sometimes described as psychological profiling, has not been successful. Research has not identified an effective or useful psychological profile of those who would engage in multiple casualty gun violence. Moreover, efforts to use a checklist profile to identify these individuals fail in part because the characteristics used in these profiles are too general to be of practical value; such characteristics are also shared by many nonviolent individuals.

Because of the limitations of a profiling approach, practitioners have developed the behavioral threat assessment model as an alternative means of identifying individuals who are threatening, planning, or preparing to commit targeted violence. Behavioral threat assessment also emphasizes the need for interventions to prevent violence or harm when a threat has been identified, so it represents a more comprehensive approach to violence prevention. The behavioral threat assessment model is an empirically based approach that was developed largely by the U.S. Secret Service to evaluate threats to the president and other public figures and has since been adapted by the U.S. Secret Service and U.S. Department of Education (Fein et al., 2002; Vossekuil et al., 2002) and others (Cornell, Allen, & Fan, 2012) for use in schools, colleges and universities, workplaces, and the U.S. military. Threat assessment teams are typically multidisciplinary teams that are trained to identify potentially threatening persons and situations. They gather and analyze additional information, make an informed assessment of whether the person is on a pathway to violence — that is, determine whether the person poses a threat of interpersonal violence or self-harm — and if so, take steps to intervene, address any underlying problem or treatment need, and reduce the risk for violence.

Behavioral threat assessment is seen as the emerging standard of care for preventing targeted violence in schools, colleges, and workplaces, as well as against government officials and other public figures. The behavioral threat assessment approach is the model currently used by the U.S. Secret Service to prevent violence to the U.S. president and other public officials, by the U.S. Capitol Police to prevent violence to members of Congress, by the U.S. State Department to prevent violence to dignitaries visiting the United States, and by the U.S. Marshals Service to prevent violence to federal judges (see Fein & Vossekuil, 1998). The behavioral threat assessment model also is recommended in two American national standards: one for higher education institutions (which recommends that all colleges and universities operate behavioral threat assessment teams; see ASME-Innovative Technologies Institute, 2010) and one for workplaces (which recommend s similar teams to prevent workplace violence; see ASIS International and Society for Human Resource Management, 2011). In addition, a comprehensive review conducted by a U.S. Department of Defense (2010) task force following the Fort Hood shooting concluded that threat assessment teams or threat management units (i.e., teams trained in behavioral threat assessment and management procedures) are the most effective tool currently available to prevent workplace violence or insider threats like the attack at Fort Hood.

Empirical research on acts of targeted violence has shown that many of those attacks were carried out by individuals motivated by personal problems who were at a point of desperation. In their troubled state of mind, these individuals saw no viable solution to their problems and could envision no future. The behavioral threat assessment model is used not only to determine whether a person is planning a violent attack but also to identify personal or situational problems that could be addressed to alleviate desperation and restore hope. In many cases, this includes referring the person to mental health services and other sources of support. In some of these cases, psychiatric hospitalization may be needed to address despondence and suicidality. Nonpsychiatric resources also can help alleviate the individual’s problems or concerns. Resources such as conflict resolution, credit counseling, job placement assistance, academic accommodations, veterans’ services, pastoral counseling, and disability services all can help address personal problems and reduce desperation. When the underlying personal problems are alleviated, people who may have posed a threat of violence to others no longer see violence as their best or only option.

Predicting and Preventing Violence by Those With Acute Mental Illness

When treating a person with acute or severe mental illness, mental health professionals may encounter situations in which they need to determine whether their patient (or client) is at risk for violence. Typically, they would conduct a violence risk assessment if the clinician’s concern is about risk for impulsive violence, as discussed previously. Clinicians also can conduct — or work with a team to help conduct — a threat assessment if their concern involves targeted violence. The available research suggests that mental health professionals should be concerned when a person with acute mental illness makes an explicit threat to harm someone or is troubled by delusions or hallucinations that encourage violence, but even in these situations, violence is far from certain. Although neither a violence risk assessment nor a threat assessment can yield a precise prediction of someone’s likelihood of violence, it can identify high-risk situations and guide efforts to reduce risk. It is important to emphasize that prevention does not require prediction; interventions to reduce risk can be beneficial even if it is not possible to determine who would or would not have committed a violent act.

When their patients (or clients) pose a risk of violence to others, mental health professionals have a legal and ethical obligation to take appropriate action to protect potential victims of violence. This obligation is not easily carried out for several reasons. First, mental health professionals have only a modest ability to predict violence, even when assisted by research-validated instruments. Mental health professionals who are concerned that a patient is at high risk for violence may be unable to convince their patient to accept hospitalization or some other change in treatment. They can seek involuntary hospitalization or treatment, but civil commitment laws (that vary from state to state) generally require convincing evidence that a person is imminently dangerous to self or others. There is considerable debate about the need to reform civil commitment laws in a manner that both protects individual liberties and provides necessary protection for society.

There is no guarantee that voluntary or involuntary treatment of a potentially dangerous individual will be effective in reducing violence risk, especially when the risk for violence does not arise from a mental illness but instead from intense desperation resulting from highly emotionally distressing circumstances or from antisocial orientation and proclivities for criminal misconduct. When individuals with prior histories of violence are released from treatment facilities, they typically need continued treatment and monitoring for potential violence until they stabilize in community settings. Jurisdictions vary widely in the resources available to achieve stability in the community and in the legal ability to impose monitoring or clinical care on persons who decline voluntary services.

Furthermore, if unable to obtain civil commitment to a protective setting, mental health professionals must consider other protective actions permitted in their jurisdictions, which may include warning potential victims that they are in danger or alerting local law enforcement, family members, employers, or others. Whether their particular jurisdiction mandates a response to “warn or protect” potential victims or leaves this decision to the discretion of the clinician, mental health professionals are often reluctant to take such actions because they are concerned that doing so might damage the therapeutic relationship with their patient and drive patients from treatment or otherwise render effective treatment impossible.

Another post-hospitalization strategy is to prohibit persons with mental illness from acquiring a firearm. The Gun Control Act of 1968 prohibited persons from purchasing a firearm if they had been involuntarily committed to a psychiatric inpatient unit. The Brady Handgun Violence Act (1994), known as the Brady Law, began the process of background checks to identify individuals who might attempt to purchase a firearm despite prohibitions. There is some evidence that rates of gun violence are reduced when these procedures are adequately implemented, but research, consistent implementation, and refinement of these procedures are needed (Webster & Vernick, 2013a).

Predicting and Preventing Gun-Based Suicide

Suicide accounts for approximately 61 percent of all firearm fatalities in the United States — 19,393 of the 31,672 firearm deaths reported by the CDC for 2010 (Murphy, Xu, & Kochanek, 2013). When there is concern that a person may be suicidal, mental health professionals can conduct suicide screenings and should rely on structured assessment tools to assess that person’s risk to self. Behavioral threat assessment also may be indicated in such situations if the potentially suicidal individual may also pose a threat to others.

More than half of suicides are accomplished by firearms and most commonly with a firearm from the household (Miller, Azrael, Hepburn, Hemenway, & Lippmann, 2006). More than 90 percent of persons who commit suicide had some combination of symptoms of depression, symptoms of other mental disorders, and/or substance abuse (Moscicki, 2001). Ironically, although depression is the condition most closely associated with attempted or completed suicide, it is also less likely than schizophrenia or other disorders to prompt an involuntary civil commitment or other legal triggers that can prevent some persons with mental illness from possessing firearms. As in behavioral threat assessment, suicide risk may be reduced through identifying and providing support in solving the problems that are driving a person to consider suicide. In many cases the person may need a combination of psychological treatment and psychiatric medication.

Tragic shootings like the ones at Sandy Hook Elementary School and the movie theater in Aurora, Colo., spark intense debate as to whether specific gun control policies would significantly diminish the number of mass shooting incidents. This debate includes whether or how to restrict access to firearms, especially with regard to persons with some mental illnesses. Another line of debate concerns whether to limit access to certain types of firearms (e.g., reducing access to high-capacity magazines). Empirical evidence documents the efficacy of some firearms restrictions, but because the restrictions often are not well implemented and have serious limitations, it is difficult to conduct the kind of rigorous research needed to fairly evaluate their potential for reducing gun violence.

The often-debated Brady Law (1994) does not consistently prevent persons with mental illness from acquiring a firearm. The prohibition applies only to persons with involuntary commitments and omits both persons with voluntary admissions and those with no history of inpatient hospitalization. The law does not prevent a person with a history of involuntary commitment from obtaining a previously owned firearm or one possessed by a friend or relative. Additional problems with implementing the Brady Law include incomplete records of involuntary commitments, background checks limited to purchases from licensed gun dealers, and exceptions from background checks for firearms purchased during gun shows.

Despite these limitations and gaps, there is some scientific evidence that background checks reduce the rate of violent gun crimes by persons whose mental health records disqualify them from legally obtaining a firearm. A study of one state (Connecticut) found that the risk of violent criminal offending among persons with a history of involuntary psychiatric commitment declined significantly after the state began reporting these individuals to the National Instant Criminal Background Check System (Swanson et al., 2013). This study supports the value of additional research to investigate strategies for limiting access to firearms by persons with serious mental illness.

In contrast, access to appropriate mental health treatment can work to reduce violence at the individual level. For example, one major finding of the MacArthur Risk Assessment study (Monahan et al., 2001) was that getting continued mental health treatment in the community after release from a psychiatric hospitalization reduced the number of violent acts by those who had been hospitalized. In other studies, outpatient mental health services, including mandated services, have been effective in preventing or reducing violent and harmful behavior (e.g., New York State Office of Mental Health, 2005; N.Y. Mental Hygiene Law [Kendra’s Law], 1999; O’Keefe, Potenza, & Mueser, 1997; Swanson et al., 2000).

There is abundant scientific research demonstrating the effectiveness of treatment for persons with severe mental illness such as schizophrenia and bipolar disorder. However, there are social, economic, and legal barriers to treatment. First, there is a persistent social stigma associated with mental illness that deters individuals from seeking treatment for themselves or for family members. Public education to increase understanding of and support for persons with serious mental illness and to encourage access to treatment is needed.

Second, mental health treatment, especially inpatient hospitalization, is expensive, and persons with mental illness often cannot access this level of care or afford it. Commercial insurers often have limitations on hospital care or do not cover intensive services that are alternatives to inpatient admission. Public sector facilities such as community mental health centers and state-operated psychiatric hospitals have experienced many years of shrinking government support; demand for their services exceeds their capacity. Many mental health providers limit their services to the most acute cases and cannot extend services after the immediate crisis has resolved.

Third, there are complex legal barriers to the provision of mental health services when an individual does not desire treatment or does not believe he or she is in need of treatment. A severe mental illness can impair an individual’s understanding of his or her condition and need for treatment, but a person with mental illness may make a rational decision to refuse treatment that he or she understandably regards as ineffective, aversive, or undesirable for some reason (e.g., psychiatric medications can produce unpleasant side effects and hospitalization can be a stressful experience).

When an individual refuses to seek treatment, it may be difficult to determine whether this decision is rational or irrational. To protect individual liberties, laws throughout the United States permit involuntary treatment only under stringent conditions, such as when an individual is determined to be imminently dangerous to self or others due to a mental illness. People who refuse treatment but are not judged to be imminently dangerous (a difficult and ambiguous standard) fall into a “gray zone” (Evans, 2013). Some individuals with serious mental illness pose a danger to self or others that is not imminent, and often it is not possible to monitor them adequately or determine precisely when they become dangerous and should be hospitalized on an involuntary basis. In other situations, the primary risk posed by the individual does not arise from mental illness but from his or her willingness to engage in criminal misconduct for personal gain.

Furthermore, when a person is committed to a psychiatric hospital on an involuntary basis, treatment is limited in scope. Once the person is no longer regarded as imminently dangerous (the criteria differ across states), he or she must be released from treatment even if not fully recovered; that person may be vulnerable to relapse into a dangerous state. In some cases of mass shootings, persons who committed the shooting were known to have a serious mental illness, but authorities could not require treatment when it was needed. In other cases, authorities were not aware of an individual’s mental illness before the attempted or actual mass shooting incident.

A related problem is that the onset or recurrence of serious mental illness can be difficult to detect. Symptoms of mental illness may emerge slowly, often in late adolescence or early adulthood, and may not be readily apparent to family members and friends. A person hearing voices or experiencing paranoid delusions may hide these symptoms and simply seem preoccupied or distressed but not seriously ill. A person who has been treated successfully for a serious mental illness may experience a relapse that is not immediately recognized. There is a great need for public education about the onset of serious mental illness, recognition of the symptoms of mental illness, and increased emphasis on the importance of seeking prompt treatment.

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2 The FBI (n.d.) defines mass murder as incidents that occur in one location (or in closely related locations during a single attack) and that result in four or more casualties. Mass murder shootings are much less common than other types of gun homicides. They are also not a new phenomenon. Historically, most mass murder shootings occurred within families or in criminal activities such as gang activity and robberies. Rampage killings is a term used to describe some mass murders that involve attacks on victims in unprotected settings (such as schools and colleges, workplaces, places of worship) and public places (such as theaters, malls, restaurants, public gatherings). However, these shootings are often planned well in advance and carried out in a methodical manner, so the term rampage is a misnomer.

Ellen Scrivner, PhD, ABPP; W. Douglas Tynan, PhD, ABPP; and Dewey Cornell, PhD

Prevention of violence occurs along a continuum that begins in early childhood with programs to help parents raise healthy children and ends with efforts to identify and intervene with troubled individuals who threaten violence. A comprehensive community approach recognizes that no single program is sufficient and there are many opportunities for effective prevention. Discussion of effective prevention from a community perspective should include identification of the community being examined. Within the larger community, many stakeholders are affected by gun violence that results in a homicide, suicide, or mass shooting.

Such stakeholders include community and public safety officials, schools, workplaces, neighborhoods, mental health and public health systems, and faith-based groups. When it comes to perpetrating gun violence, however, a common thread that exists across community groups is the recognition that someone, or possibly several people, may have heard something about an individual’s thoughts and/or plans to use a gun. Where do they go with that information? How do they report it so that innocent people are not targeted or labeled unfairly — and how can their information initiate a comprehensive and effective crisis response that prevents harm to the individual of concern and the community?

To date, there is little research to help frame a comprehensive and effective prevention strategy for gun violence at the community level. One of the most authoritative reviews of the body of gun violence research comes from the National Research Council of the National Academy of Sciences (see Wellford, Pepper, & Petrie, 2004). In reviewing a range of criminal justice initiatives designed to reduce gun violence, such as gun courts, enhanced sentencing, and problem-based policing, Wellford et al. concluded that problem-oriented policing, also known as place-based initiatives or target policing, holds promise, particularly when applied to “hot spots” — areas in the community that have high crime rates. They included studies on programs such as the Boston Gun Project (see Kennedy, Braga, & Piehl, 2001), more commonly known as Operation Ceasefire, in their review and concluded that although many of these programs may have reduced youth homicides, there is only modest evidence to suggest that they effectively lowered rates of crime and violence, given the confounding factors that influence those rates and are difficult to control. In other words, the variability in the roles of police, prosecutors, and the community creates complex interactions that can confound the levels of intervention and affect sustainability.

Wellford et al.’s (2004) conclusions were supported by the findings of the 2011 Firearms and Violence Research Working Group (National Institute of Justice, 2011), which also questioned whether rigorous evaluations are possible given the reliability and validity of the data. Wellford et al. advocated for continued research and development of models that include collaboration between police and community partners and for examination of different evaluation methodologies.

There are varied prevention models that address community issues. When it comes to exploring models that specifically address preventing the recent episodes of gun violence that have captured the nation’s attention, however, the inevitable conclusion is that there is a need to develop a new model that would bring community stakeholders together in a collaborative, problem-solving mode, with a goal of preventing individuals from engaging in gun violence, whether directed at others or self-inflicted. This model would go beyond a single activity and would blend several strategies as building blocks to form a workable systemic approach. It would require that community service systems break their tendencies to operate in silos and take advantage of the different skill sets already available in the community — for example:

• Police are trained in crisis intervention skills with a primary focus on responding to special populations such as those with mental illness.
• Community members are trained in skilled interventions such as Emotional CPR  and Mental Health First Aid — consumer-based initiatives that use neighbor-to-neighbor approaches that direct people in need of care to appropriate mental health treatment.
• School resource officers are trained to show a proactive presence in schools.

Each group may provide a solution to a piece of the problem, but there is nothing connecting the broad range of activities to the type of collaborative system needed to implement a comprehensive, community-based strategy to prevent gun violence. From a policy and practice perspective, no one skill set or one agency can provide the complete answer when it comes to developing a prevention methodology. However, some models developed through the community policing reform movement may be relevant because they are generally acknowledged to have been useful in reducing violence against women and domestic violence and in responding to children exposed to violence. These community policing models involve collaborative problem solving as a way to safeguard the community as opposed to relying only on arrest procedures. Moreover, they engage the community in organized joint efforts to produce public safety (Peak, 2013).

Another initiative, Project Safe Neighborhoods ( PSN ), is also relevant. PSN, a nationwide program that began in 2001 and was designed specifically to reduce gun violence, has some similarity to the community policing model. PSN involved the 94 U.S. attorneys in cities across the country in a prominent leadership role, ensured flexibility across jurisdictions, and required cross-agency buy-in, though there seems to have been less formalized involvement with mental health services. Nevertheless, it used a problem-solving approach that was aimed at getting guns off the streets, and the results of varied outcome assessments demonstrate that it was successful in reducing gun violence, particularly when the initiatives were tailored to the gun violence needs of specific communities (McGarrell et al., 2009).

A common approach used by PSN involved engaging the community to establish appropriate stakeholder partnerships, formulating strategic planning on the basis of identification and measurement of the community problem, training those involved in PSN, providing outreach through nationwide public service announcements, and ensuring accountability through various reporting mechanisms. The PSN problem-solving steps, with some adaptations, could provide a useful strategy for initiating collaborative problem solving with relevant community stakeholders in the interest of reducing gun violence and victimization through prevention.

The models discussed here illustrate how community engagement and collaboration helped break new ground in response to identified criminal justice problems, but they could be strengthened considerably by incorporating the involvement of professional psychology. The need for collaboration was again highlighted at a Critical Issues in Policing meeting (Police Executive Research Forum, 2012) as part of a discussion on connecting agency silos by building bridges across systems. Because police and mental health workers often respond to the same people, there is a need for collaboration on the best way to do this without compromising their roles. This emphasis takes the discussion beyond the student/school focus and expands it to include the use of crisis intervention teams (CIT) and community advocacy groups as additional resources for achieving the goal of preventing violence in the community.

The CIT model was another result of community policing reform that brought police and mental health services together to provide a more effective response to the needs of special populations, particularly mental health-related cases. Developed in Memphis in 1988 but now deployed in many communities across the country, the CIT model trains CIT officers to deescalate situations involving people in crises and to use jail diversion options, if available, rather than arrests. Although research on the effectiveness of CITs is generally limited to outcome studies in select cities, the model continues to gain prominence. In fact, the National Alliance on Mental Illness ( NAMI ) has established a NAMI CIT Center and is promoting the expansion of CIT nationwide. Studies by Borum (2000), Steadman, Deane, Borum, and Morrissey (2000), and Teller, Munetz, Gil, and Ritter (2006) have illustrated that high-risk encounters between individuals with mental illness and police can be substantially improved through CIT training, particularly when there are options such as drop-off centers, use of diversion techniques, and collaborations between law enforcement, mental health, and family members. Each plays a significant role in ensuring that city or county jails do not become de facto institutions for those in mental health crises.

Crisis intervention teams were also a major focus of a 2010 policy summit (International Association of Chiefs of Police [IACP], 2012). The summit, hosted by SAMHSA, the Bureau of Justice Assistance, and IACP, produced a 23-item action agenda. Although the summit focused on decriminalizing the response to persons with mental illness and was not directed specifically at dealing with people who perpetrate gun violence, some of their recommendations did apply. The central theme of the agenda encouraged law enforcement and mental health service systems to engage in mutually respectful working relationships, collaborate across partner agencies, and establish local multidisciplinary advisory groups. These partnerships would develop policy, protocols, and guidelines for informing law enforcement encounters with persons with mental illness who are in crisis, including a protocol that would enable agencies to share essential information about those individuals and whether the nature of the crisis could provoke violent behavior. They further recommended that these types of protocols be established and maintained by the multidisciplinary advisory group and that training be provided in the community to sensitize community members to signs of potential danger and how to intervene in a systematic way.

A Police Foundation (2013) roundtable on gun violence and mental health reported that some police departments have reached out to communities and offered safe storage of firearms when community members have concern about a family member’s access to firearms in the home. As a service to the community, the police would offer to keep guns secured in accessible community locations until the threat has subsided and the community member requests the return. The police would also confer with mental health practitioners regarding a designated family or community member on an as-needed basis. This strategy is consistent with a community threat assessment approach in which law enforcement authorities engage proactively with the community to reduce the risk of violence when an individual poses a risk.

Gun Violence in Schools

Gun violence in schools has been a national concern for more than two decades. Although school shootings are highly traumatic events and have brought school safety to the forefront of public attention, schools are very safe environments compared with other community settings (Borum et al., 2010). Less than 2 percent of homicides of school-aged children occur in schools. Over a 20-year period, there have been approximately 16 shooting deaths in U.S. schools each year (Fox & Burstein, 2010), compared with approximately 32,000 shooting deaths annually in the nation as a whole (Hoyert & Xu, 2012).

The Gun-Free Schools Act of 1994 made federal education funding contingent upon states requiring schools to expel for at least one year any student found with a firearm at school. This mandate strengthened the emerging philosophy of zero tolerance as a school disciplinary policy. According to the APA Zero Tolerance Task Force (2008), this policy was predicated on faulty assumptions that removing disobedient students would motivate them to improve their behavior, deter misbehavior by other students, and generate safer school conditions. The task force found no scientific evidence to support these assumptions and, on the contrary, concluded that the practice of school suspension had negative effects on students and a disproportionately negative impact on students of color and students with disabilities.

After the 1999 shooting at Columbine High School, both the FBI (O’Toole, 2000) and the U.S. Secret Service (Vossekuil et al., 2002) conducted studies of school shootings and concluded that schools should not rely on student profiling or checklists of warning signs to identify potentially violent students. They cautioned that school shootings were statistically too rare to predict with accuracy and that the characteristics associated with student shooters lacked specificity, which means that numerous nonviolent students would be misidentified as dangerous. Both law enforcement agencies recommended that schools adopt a behavioral threat assessment approach, which, as noted earlier, involves assessment of students who threaten violence or engage in threatening behavior and then individualized interventions to resolve any problem or conflict that underlies the threat. One of the promising features of threat assessment is that it provides schools with a policy alternative to zero tolerance. Many schools across the nation have adopted threat assessment practices. Controlled studies of the "Virginia Student Threat Assessment Guidelines" have shown that school-based threat assessment teams are able to resolve student threats safely and efficiently and to reduce school suspension rates (Cornell et al., 2012; Cornell, Gregory, & Fan, 2011; Cornell, Sheras, Gregory, & Fan, 2009).

The Role of Health and Mental Health Providers in Gun Violence Prevention

The health care system is an important point of contact for families regarding the issue of gun safety. Physicians’ counseling of individuals and families about firearm safety has in some cases proven to be an effective prevention measure and is consistent with other health counseling about safety. According to the 2012 policy statement of the American Academy of Pediatrics (AAP):

The AAP supports the education of physicians and other professionals interested in understanding the effects of firearms and how to reduce the morbidity and mortality associated with their use. HHS should establish a program to support gun safety training and counseling programs among physicians and other medical professionals. The program should also provide medical and community resources for families exposed to violence.

The AAP’s Bright Futures practice guide urges pediatricians to counsel parents who possess guns that storing guns safely and preventing access to guns reduce injury by as much as 70 percent and that the presence of a gun in the home increases the risk for suicide among adolescents. A randomized controlled trial indicates that health care provider counseling, when linked with the distribution of cable locks, has been demonstrated to increase safer home storage of firearms (Barkin et al., 2008). The removal of guns or the restriction of access should be reinforced for children and adolescents with mood disorders, substance abuse (including alcohol), or a history of suicide attempts (Grossman et al., 2005). Research is needed to identify the best ways to avoid unintended consequences while achieving intended outcomes.

In recent years, legal and legislative challenges have emerged that test the ability of physicians and other medical professionals to provide guidance on firearms. For example, in 2011 the state of Florida enacted the Firearm Owners’ Privacy Act, which prevented physicians from providing such counsel under threat of financial penalty and potential loss of licensure. The law has been permanently blocked from implementation by a U.S. district court. Similar policies have been introduced in six other states: Alabama, Minnesota, North Carolina, Oklahoma, Tennessee, and West Virginia. The fundamental right of all health and mental health care providers to provide counseling to individuals and families must be protected to mitigate risk of injury to people where they live, work, and play.

It is apparent that long before the events at Sandy Hook Elementary School, many public health and public safety practitioners were seeking strategies to improve responses to violence in their communities and have experienced some success through problem-solving projects such as PSN and CIT. Yet there is still a need to rigorously evaluate and improve these efforts. In the meantime, basic safety precautions must be emphasized to parents by professionals in health, education, and mental health.

Public health messaging campaigns around safe storage of firearms are needed. The practice of keeping firearms stored and locked must be encouraged, and the habit of keeping loaded, unlocked weapons available should be recognized as dangerous and rendered socially unacceptable. To keep children and families safe, good safety habits have to become the only socially acceptable norm.

Susan B. Sorenson, PhD, and Daniel W. Webster, ScD, MPH

The use of a gun greatly increases the odds that violence will result in a fatality. In 2010, the most recent year for which data are available, an estimated 17.1 percent of the interpersonal assaults with a gunshot wound resulted in a homicide, and 80.7 percent of the suicide attempts in which a gun was used resulted in death (CDC, 2013a). By contrast, the most common methods of assault (hands, fists, and feet) and suicide attempt (ingesting pills) in 2010 resulted in death in only 0.009 percent and 2.5 percent of the incidents, respectively (CDC, 2013a). 3

As shown in Figure 1, in the past 30 years, the percentage of deaths caused by gunfire has stabilized to about 68 percent for homicides and, as drug overdoses have increased, dropped to 50 percent for suicide. There are more gun suicides than gun homicides in the United States. In 2010, 61.2 percent (19,392) of the 31,672 gun deaths in the United States were suicides (CDC, 2013a).

Figure 1. Deaths Attributed to Firearms, 1981–2010

Note: Data are from the Web-Based Injury Statistics Query and Reporting System (WISQARS™), Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 2013. Retrieved from http://www.cdc.gov/injury/wisqars/fatal.html.

Much of the public concern about guns and gun violence focuses on interpersonal violence, and public policy mirrors this emphasis. Although there is no standard way to enumerate each discrete gun law, most U.S. gun laws focus on the user of the gun. Relatively few focus on the design, manufacture, distribution, advertising, or sale of firearms (Teret & Wintemute, 1993). Fewer yet address ammunition.

The focus herein is on the lifespan of guns — from design and manufacture to use — and the policies that could address the misuse of guns. It is critical to understand how policies create conditions that affect access to and use of guns. Because they constitute the largest portion of guns used in homicides (FBI, 2012a), handguns are the focus of most laws. Despite the substantial human and economic costs of gun violence in the United States and the ongoing debate about the effectiveness of gun regulations, scientifically rigorous evaluations are not available for many of these policies (Wellford et al., 2004). The dearth of such research on gun policies is due, in part, to the lack of government funding on this topic because of the political influences of the gun lobby (e.g., Kellermann & Rivara, 2013).

Design and Manufacture

The type of handguns manufactured in the United States has changed. Pistols overtook revolvers in manufacturing in the mid-1980s. In addition, the most widely sold pistol went from a .22 caliber in 1985 to a 9 mm or larger (e.g., .45 caliber pistols) by 1994 (Wintemute, 1996), with smaller, more concealable pistols favored by permit holders as well as criminals. This shift has been described as increasing the lethality of handguns, although, according to our review, no research has examined whether the change in weapon design has led to an increased risk of death. Such research may not be feasible given that the aforementioned weapons — that is, small, concealable pistols — still likely constitute a small portion of the estimated 283 million guns in civilian hands in the United States (Hepburn, Miller, Azrael, & Hemenway, 2007). The disproportionate appearance of such pistols among guns that were traced by law enforcement following their use in a crime has been attributed to the ease with which smaller guns can be concealed and their low price point (Koper, 2007; Wright, Wintemute, & Webster, 2010).

Ammunition, by contrast, is directly related to lethality. Hollow-point bullets are used by hunters because, in part, they are considered a more humane way to kill. The physics of hollow-point bullets are such that, upon impact, they will tumble inside the animal and take it down. Some bullets have been designed to be frangible, that is, to break apart upon impact and thus cause substantial internal damage. By contrast, the physics of full metal jacket bullets are such that, unless they hit a bone, they are likely to continue on a straight trajectory and pass through the animal, leaving it wounded and wandering. Hollow-point bullets are used by law enforcement to reduce over-penetration (i.e., when a bullet passes through its intended target and, thus, risks striking others).

Some design features would substantially reduce gun violence. One of the most promising ideas is that of “smart guns” that can be fired only by an authorized user. For example, young people, who are prohibited due to their age from legally purchasing a firearm, typically use a gun from their own home to commit suicide (Johnson, Barber, Azrael, Clark, & Hemenway, 2010; Wright, Wintemute, & Claire, 2008) and to carry out a school shooting (CDC, 2003). If personalized to an authorized adult in the home, the gun could not be operated by the adolescent or others in the home, thus rendering it of little use to the potential suicide victim or school shooter. During the Clinton administration, the federal government made a modest investment in the research and development of personalized firearms. There also was considerable private investment in technologies that would prevent unauthorized users from being able to fire weapons. Efforts to create these “smart guns” have resulted in multiple patent applications. Armatix GmbH, a German company, has designed and produced a personalized pistol that is being sold in several Western European nations and has been approved for importation to the United States. Although the cost of this new personalized gun is very high, it is believed that personalized guns can be produced at a cost that would be affordable by many (Teret & Merritt, 2013).

The assault weapons ban (the Violent Crime Control and Law Enforcement Act), enacted for a 10-year period beginning in 1994, provided a good opportunity to assess the effectiveness of restricting the manufacturing, sale, and possession of a certain class of weapons. “Assault weapons,” however, are difficult to conceal and are used rarely in most street crime or domestic violence. Assault weapons are commonly used in mass shootings in which ammunition capacity can determine the number of victims killed or wounded. Because multiple bullets are not an issue in suicide, one would not expect changes in such deaths either. Perhaps not surprisingly, an effect of the ban could not be detected on total gun-related homicides (Koper, 2013; Koper & Roth, 2001).

Unfortunately, prior research on the effects of the federal assault weapons ban did not focus on the law’s effects on mass shootings or the number of persons shot in such shootings. Assault weapons or guns with large-capacity ammunition feeding devices account for half of the weapons used in mass shootings such as at Sandy Hook Elementary School (see Follman & Aronson , 2013). Mass shootings with these types of weapons result in about 1.5 times as many fatalities as those committed with other types of firearms (Roth & Koper, 1997).

Distribution

The distribution of guns is largely the responsibility of a network of middlemen between gun manufacturers and gun dealers. When a gun is recovered following its use (or suspected use) in a crime, law enforcement routinely requests that the gun be traced — that is, the serial number is reported to the manufacturer, who then contacts the distributor and/or dealer who, in turn, reviews records to determine the original purchaser of a specific weapon. The number of gun traces is such that the manufacturers get many calls about their guns each day. One researcher estimated that Smith and Wesson, with about 10 percent of market share, received a call every seven to eight minutes about one of their guns (Kairys, 2008). Thus, one could reasonably expect that manufacturers would have some knowledge of which distributors sell guns that are disproportionately used in crime, and distributors would, in turn, know which retailers disproportionately sell guns used in crime.

Following in the footsteps of cities and states that had successfully sued the tobacco industry under state consumer protection and antitrust laws for costs the public incurred in caring for smokers, beginning in the late 1990s cities and states began to file claims against firearm manufacturers in an attempt to recover the costs of gun violence they incurred. In response, in 2005, Congress enacted and President George W. Bush signed the Protection of Lawful Commerce in Arms Act, which prohibits civil liability lawsuits against “manufacturers, distributors, dealers, or importers of firearms or ammunition for damages, injunctive or other relief resulting from the misuse of their products by others” ( 15 U.S.C. §§ 7901-7903 ). Thus, the option of using litigation, a long-standing and sometimes controversial tool by which to address entrenched public health problems (e.g., Lytton, 2004), was severely restricted.

Advertising

Advertisements for guns have largely disappeared from classified ads in newspapers. By contrast, advertising in magazines, specifically gun magazines, is strong (Saylor, Vittes, & Sorenson, 2004). Such advertising is subject to the same Federal Trade Commission (FTC) regulations as other consumer products. In 1996, several organizations filed a complaint with the FTC after documenting multiple cases of what they asserted to be false and misleading claims about home protection (for specific examples, see Vernick, Teret, & Webster, 1997). As of November 1, 2013, the FTC had not ruled on the complaint. However, the firearm industry changed its practices such that by 2002, self-protection was an infrequent theme in advertisements for guns (Saylor et al., 2004). To our knowledge, current advertising has not been studied. New issues relevant to the advertising of guns include online advertisements by private sellers who are not obligated to verify that purchasers have passed a background check, online ads from prohibited purchasers seeking to buy firearms, the marketing of military-style weapons to civilians, and the marketing of firearms to underage youth (for examples and more information, see Kessler & Trumble, 2013; Mayors Against Illegal Guns, 2013; McIntire, 2013; Violence Policy Center, 2011).

Sales and Purchases

Gun sales have been increasing in the United States. The FBI reported a substantial jump in background checks (a proxy for gun sales) in the days following the Sandy Hook Elementary School shootings. In fact, of the 10 days with the most requests for background checks since the FBI started monitoring such information, 7 of them were within 8 days of Sandy Hook (FBI, 2013). Guns can be purchased from federally licensed firearm dealers or private, unlicensed sellers in a variety of settings, including gun shows, flea markets, and the Internet.

Responsible sales practices (for examples, see Mayors Against Illegal Guns, n.d.) rely heavily on the integrity of the seller. And usually that responsibility is well placed: Over half (57 percent) of the guns traced (i.e., submitted by law enforcement, usually in association with a crime, to determine the original purchaser of the weapon) were originally sold by only 1.2 percent of federally licensed firearm dealers (Bureau of Alcohol, Tobacco and Firearms [ATF], 2000). However, there are problems. Sometimes a person who is prohibited from purchasing a gun engages someone else, who is not so prohibited, to purchase a gun for him or her. The person doing the buying is called a “straw purchaser.” Straw purchase attempts are not uncommon; in a random sample of 1,601 licensed dealers and pawnbrokers in 43 states, two thirds reported experiencing straw purchase attempts (Wintemute, 2013b).

Two studies tested the integrity of licensed firearm dealers by calling the dealers and asking whether they could purchase a handgun on behalf of someone else (in the studies, a boyfriend or girlfriend), a straw purchase transaction that is illegal. In the study of a sample of gun dealers listed in telephone directories of the 20 largest U.S. cities, the majority of gun dealers indicated a willingness to sell a handgun under the illegal straw purchase scenario (Sorenson & Vittes, 2003). In a similar study of licensed gun dealers in California, a state with relatively strong regulation and oversight of licensed gun dealers, one in five dealers expressed a willingness to make the illegal sale (Wintemute, 2010). Programs such as the ATF and National Sports Shooting Council’s “Don’t Lie for the Other Guy,” which provides posters and educational materials to display in gun stores as well as tips for gun dealers on how to identify and respond to straw purchase attempts, have not been evaluated.

It is important to be able to identify high-risk dealers because, in 2012, the ATF had insufficient resources to monitor federally licensed gun dealers (Horwitz, 2012); there were 134,997 unlicensed gun dealers in April 2013 (ATF, 2013). Some states have recognized the limited capacity of the ATF and the weaknesses of federal laws regulating gun dealers and enacted their own laws requiring the licensing, regulation, and oversight of gun dealers (Vernick, Webster, & Bulzacchelli, 2006) and, when enforced, these laws appear to reduce the diversion of guns to criminals shortly after a retail sale (Webster, Vernick, & Bulzacchelli, 2009). Undercover stings and lawsuits against gun dealers who facilitate illegal straw sales have also been shown to reduce the diversion of guns to criminals (Webster, Bulzacchelli, Zeoli, & Vernick, 2006; Webster & Vernick, 2013b).

To help ensure that guns are not sold to those who are prohibited from purchasing them, the National Instant Criminal Background Check System ([NICS], part of the Brady Law) was developed so that the status of a potential purchaser could be checked immediately by a federally licensed firearm dealer. Prohibited purchasers include, but are not limited to, convicted felons, persons dishonorably discharged from the military, those under a domestic violence restraining order, and, in the language of the federal law, persons who have been adjudicated as mentally defective or have been committed to any mental institution (see 18 U.S.C. § 922(g) (1)-(9) and (n)). About 0.6% of sales have been denied on the basis of these criteria since NICS was established in 1998 (FBI, 2012b).

A substantial portion of firearm sales and transfers, however, is not required to go through a federally licensed dealer or a background check requirement; this includes, in most U.S. states, private party sales including those that are advertised on the Internet and those that take place at gun shows where licensed gun dealers who could process background checks are steps away. Some evidence suggests that state policies regulating private handgun sales reduce the diversion of guns to criminals (Vittes, Vernick, & Webster, 2013; Webster et al., 2009; Webster, Vernick, McGinty, & Alcorn, 2013).

The ability to check the background of a potential purchaser nearly instantly means that in many states, someone who is not a prohibited purchaser can purchase a gun within a matter of minutes. Ten states and the District of Columbia have a waiting period (sometimes referred to as a “cooling-off” period) for handguns ranging from 3 (Florida and Iowa) to 14 (Hawaii) days (Law Center to Prevent Gun Violence, 2012). The efficacy of waiting periods has received little direct research attention.

With the exception of misdemeanor domestic violence assault, federal law and laws in most states prohibit firearm possession of those convicted of a crime only if the convictions are for felony offenses in adult courts. Research has shown that misdemeanants who were legally able to purchase handguns committed crimes involving violence following those purchases at a rate 2–10 times higher than that of handgun purchasers with no prior convictions (Wintemute, Drake, Beaumont, & Wright, 1998). Wintemute and colleagues (Wintemute, Wright, Drake, & Beaumont, 2001) examined the impact of a California law that expanded firearm prohibitions to include persons convicted of misdemeanor crimes of violence. In their study of legal handgun purchasers with criminal histories of misdemeanor violence before and after the law, denial of handgun purchases due to a prior misdemeanor conviction was associated with a significantly lower rate of subsequent violent offending.

Persons who are legally determined to be a danger to others or to themselves as a result of mental illness are prohibited by federal law from purchasing and possessing firearms. A significant impediment to successful implementation of this law is that the firearm disqualifications due to mental illness often are not reported to the FBI’s background check system. As mentioned earlier, in 2007 Connecticut began reporting these disqualifications to the background check system. In a ground-breaking study, Swanson and colleagues (2013) studied the effects of this policy change on individuals who would most likely be affected — that is, those who were legally prohibited from possessing firearms due solely to the danger posed by their mental illnesses. They found that the rate of violent crime offending was about half as high among those whose mental illness disqualification was reported to the background system compared with those whose mental illness disqualification was not reported.

Federal law allows an individual to buy several guns, even hundreds, at once; the only requirement is that a multiple-purchase form be completed (18 U.S.C. § 923(g)(3)(A)(2009)). Large bulk purchases have been linked to gun trafficking (Koper, 2005). Policies such as one-handgun-a-month have rarely been enacted. Evaluations of these laws document mixed findings (Webster et al., 2009, 2013;Weil & Knox, 1996).

The United States was one of the signers of the Geneva Convention, which prohibits the use of hollow-point bullets in war (the goal being to wound but not kill wartime enemies), but hollow-point bullets are available to civilians in the United States. A hunting license is not a prerequisite for the purchase of hollow-point bullets in the United States. California passed a law requiring a thumbprint for ammunition purchases; the law was ruled “unconstitutionally vague” by a Superior Court judge in 2011, but some municipalities (e.g., Los Angeles, Sacramento) have similar local ordinances in effect.

In 2004, a national survey found that 20 percent of the U.S. adult population reported they own one or more long-guns (shotguns or rifles), and 16 percent reported they own a handgun (Hepburn et al., 2007). Self-protection was the primary reason for owning a gun. Most people who have a gun have multiple guns, and half of gun owners reported owning four or more guns. In fact, 4 percent of the population is estimated to own 65 percent of the guns in the nation.

Nationally representative studies suggest that the mental health of gun owners is similar to that of individuals who do not own guns (Miller, Barber, Azrael, Hemenway, & Molnar, 2009; Sorenson & Vittes, 2008). However, gun owners are more likely to binge drink and drink and drive (Wintemute, 2011).

In perhaps the methodologically strongest study to date to examine handgun ownership and mortality, Wintemute and colleagues found a strong association between the purchase of a handgun and suicide: “In the first year after the purchase of a handgun, suicide was the leading cause of death among handgun purchasers, accounting for 24.5 percent of all deaths” (Wintemute, Parham, Beaumont, Wright, & Drake, 1999). The risk of suicide remained elevated (nearly twofold and sevenfold, respectively, for male and female handgun purchasers) at the end of the 6-year study period. Men’s handgun purchase was associated with a reduced risk of becoming a homicide victim (0.69); women’s handgun purchase, by contrast, was associated with a 55 percent increase in risk of becoming a homicide victim. A waiting period may reduce immediate risk but appears not to eliminate short- or long-term risk for suicide.

Risk can extend to others in the home. Efforts to educate children about guns (largely to stay away from them), when tested with field experiments, indicate they are generally ineffective (e.g., Hardy, 2002). Child Access Prevention (CAP) laws focus on the responsibilities of adults; adults are held criminally liable for unsafe storage of firearms around children. CAP laws have been associated with modest decreases in unintentional shootings of children and the suicides of adolescents (Webster & Starnes, 2000; Webster, Vernick, Zeoli, & Manganello, 2004).

Most gun-related laws focus on the user of the gun (e.g., increased penalties for using a gun in the commission of a crime). Some research suggests that having been threatened with a gun, as well as the perpetrator’s having access to a gun and using a gun during the fatal incident, is associated with increased risk of women becoming victims of intimate partner homicide (Campbell et al., 2003). Regarding sales, note that persons with a domestic violence misdemeanor or under a domestic violence restraining order are prohibited by federal law from purchasing and possessing a firearm and ammunition. Research to date indicates that firearm restrictions for persons subject to such laws have reduced intimate partner homicides by 6 percent to 19 percent (Vigdor & Mercy, 2006; Zeoli & Webster, 2010).

As with initial discussions about motor vehicle safety, which focused on what was then referred to as the “nut behind the wheel,” current discussions about gun users sometimes involve terms such as “good guys” and “bad guys.” Although intuitively appealing, such categories seem to assume a static label and do not take into account the fact that “good guys” can become “bad guys” and “bad guys” can become “good guys.” One way an armed “good guy” can become a “bad guy” is to use a gun in a moment of temporary despondence or rage (Bandeira, 2013; Wintemute, 2013a).

Research on near-miss suicide attempts among young adults indicates that impulsivity is of concern. About one fourth of those whose suicide attempt was so severe they most likely would have died reported first thinking about suicide five minutes before attempting it (Simon et al., 2001). Although an estimated 90 percent of those who attempt suicide go on to die of something else (i.e., they do not subsequently kill themselves; for a review, see Bostwick & Pankratz, 2000), for those who use a gun, as noted in opening paragraph of this chapter, there generally is not a second chance.

Given the complexity of the issue, a multifaceted approach will be needed to reduce firearm-related violence (see, for example, Chapman & Alpers, 2013). Not all ideas that on the surface seem to be useful actually are. For example, gun buyback programs may raise awareness of guns and gun violence in a community but have not been shown to reduce mortality (Makarios & Pratt, 2012). Such data can inform policy. President Obama’s January 2013 executive orders about gun violence include directing the CDC to research the causes and prevention of gun violence. The federal government has since announced several funding opportunities for research related to gun violence. And the recent Institute of Medicine and National Research Council (2013) report called for lifting access restrictions on gun-related administrative data (e.g., data related to dealers’ compliance with firearm sales laws, gun trace data) that could be used to identify potential intervention and prevention points and strategies. So perhaps more data will be available to inform and evaluate policies designed to reduce gun violence.

The focus of this section has largely been on mortality. The scope of the problem is far greater, however. For every person who dies of a gunshot wound, there are an estimated 2.25 people who are hospitalized or receive emergency medical treatment for a nonfatal gunshot wound (Gotsch, Annest, Mercy, & Ryan, 2001). And guns are used in the street and in the home to intimidate and coerce (e.g., Sorenson & Wiebe, 2004; Truman, 2011).

Single policies implemented by themselves have been shown to reduce certain forms of gun violence in the United States. Adequate implementation and enforcement as well as addressing multiple intervention points simultaneously may improve the efficacy of these laws even more. After motor vehicle safety efforts expanded to include the vehicle, roadways, and other intervention points (vs. a focus on individual behavior), motor vehicle deaths dropped precipitously and continue to decline (CDC, 1999, 2013a). A multifaceted approach to reducing gun violence will serve the nation well.

3 The 2010 data used to calculate current rates shown here are available at http://www.cdc.gov/injury/wisqars/ .

Adler, N. E., & Steward, J. (2010). Health disparities across the lifespan: Meaning, methods, and mechanisms. In N. E. Adler & J. Steward (Eds.), Annals of the New York Academy of Sciences: Vol. 1186. The biology of disadvantage: Socioeconomic status and health (pp. 5–23). New York, NY: New York Academy of Sciences.

Ahn, M. H., Park, S., Ha, K., Choi, S. H., & Hong, J. P. (2012). Gender ratio comparisons of the suicide rates and methods in Korea, Japan, Australia, and the United States. Journal of Affective Disorders, 142, 161–165. doi: 10.1016/j.jad.2012.05.008

Alpers, P., & Wilson, M. (2013, August 14). Global impact of gun violence: Firearms, public health and safety. Retrieved from http://www.gunpolicy.org/firearms/region

American Academy of Pediatrics, Council on Injury, Violence, and Poison Prevention Executive Committee. (2012). Firearm-related injuries affecting the pediatric population. Pediatrics, 130 (5), e1416–e1423. doi:10.1542/peds.2012-2481

American Psychological Association, Zero Tolerance Task Force. (2008). Are zero tolerance policies effective in the schools? An evidentiary review and recommendations. American Psychologist, 63, 852–862. doi: 10.1037/0003-066X.63.9.852

Anderson, C. A., Berkowitz, L., Donnerstein, E., Huesmann, L. R., Johnson, J. D., Linz, D., . . . Wartella, E. (2003). The influence of media violence on youth. Psychological Science in the Public Interest, 4 (3) , 81–110. doi:10.1111/j.1529-1006.2003.pspi_1433.x

Anderson, C. A., & Bushman, B. J. (2001). Effects of violent video games on aggressive behavior, aggressive cognition, aggressive affect, physiological arousal, and prosocial behavior: A meta-analytic review of the scientific literature. Psychological Science, 12, 353–359. doi:10.1111/1467-9280.00366

Anderson, C. A., Shibuya, A., Ihori, N., Swing, E. L., Bushman, B. J., Sakamoto, A., . . . Saleem, M. (2010). Violent video game effects on aggression, empathy, and prosocial behavior in Eastern and Western countries: A meta-analytic review. Psychological Bulletin, 136, 151–173. doi:10.1037/a0018251

ASIS International and Society for Human Resource Management. (2011). Workplace violence prevention and intervention: An American standard (ASIS/SHRM WVP.1-2011). New York, NY: American National Standards Institute.

ASME-Innovative Technologies Institute. (2010). A risk analysis standard for natural and man-made hazards to higher education: A standard for academia . New York, NY: American National Standards Institute.

Bandeira, A. R. (2013). Brazil: Gun control and homicide reduction. In D. Webster & J. Vernick (Eds.), Reducing gun violence in America: Informing policy with evidence and analysis (pp. 213–223). Baltimore, MD: Johns Hopkins University Press.

Barkin, S. L., Finch, S. A., Ip, E. H., Scheindlin, B., Craig, J. A., Steffes, J., . . . Wasserman, R. C. (2008). Is office-based counseling about media use, timeouts, and firearm storage effective? Results from a cluster-randomized, controlled trial. Pediatrics, 122 (1), e15–e25. Retrieved from http://pediatrics.aappublications.org/content/122/1/e15.full

Borum, R. (2000). Improving high risk encounters between people with mental illness and police. Journal of the American Academy of Psychiatry and the Law, 28, 332–337.

Borum, R., Cornell, D., Modzeleski, W., & Jimerson, S. R. (2010). What can be done about school shootings? A review of the evidence. Educational Researcher, 39, 27–37. doi:10.3102/0013189X09357620

Borum, R., & Verhaagen, D. (2006). Assessing and managing violence risk in juveniles. New York, NY: Guilford Press.

Bostwick, J. M., & Pankratz, V. S. (2000). Affective disorders and suicide risk: A reexamination. American Journal of Psychiatry, 157 (12), 1925–1932. doi:10.1176/appi.ajp.157.12.1925

Brady Handgun Violence Act, 18 U.S.C. § 921 et seq. (1994).

Branas, C. C., Nance, M. L., Elliott, M. R., Richmond, T. S., & Schwab, C. W. (2004). Urban–rural shifts in intentional firearm death: Different causes, same results. American Journal of Public Health, 94, 1750–1755. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448529/

Brannon, R. (1976). The male sex role: Our culture’s blueprint for manhood, what it’s done for us lately. In D. David & R. Brannon (Eds.), The forty-nine percent majority: The male sex role (pp. 1–48). Reading, MA: Addison-Wesley.

Brennan, P. A., Hall, J., Bor, W., Najman, J. M., & Williams, G. (2003). Integrating biological and social processes in relation to early-onset persistent aggression in boys and girls. Developmental Psychology, 39, 309–323. doi:10.1037/0012-1649.39.2.309

Bureau of Alcohol, Tobacco and Firearms. (2000). Following the gun: Enforcing federal laws against firearms traffickers . Retrieved from http://www.mayorsagainstillegalguns.org/downloads/pdf/Following_the_Gun

Bureau of Alcohol, Tobacco, Firearms and Explosives. (2013). Report of active firearms licenses – License type by state statistics . Retrieved from https://www.atf.gov/sites/default/files/assets/inside-atf/2013/0413-ffl-type-by-state.pdf

Bureau of Justice Statistics. (2008). National Crime Victimization Survey: Criminal victimization in the United States, 2006 statistical tables (NCJ 223436). Retrieved from http://www.bjs.gov/content/pub/pdf/cvus06.pdf

Butters, J. E., Sheptycki, J., Brochu, S., & Erikson, P. G. (2011). Guns and sublethal violence: A comparative study of at-risk youth in two Canadian cities. International Criminal Justice Review, 4, 402–426.

Campbell, J. C., Glass, N., Sharps, P. W., Laughon, K., & Bloom, T. (2007). Intimate partner homicide: Review and implications of research and policy. Trauma, Violence & Abuse, 8, 246–260. doi:10.1177/1524838007303505

Campbell, J. C., Webster, D., Koziol-McLain, J., Block, C., Campbell, D., Curry, M. A., . . . Laughon, K. (2003). Risk factors for femicide in abusive relationships: Results from a multisite case control study. American Journal of Public Health , 93 (7), 1089–1097. doi:10.2105/AJPH.93.7.1089

Centers for Disease Control and Prevention. (1999). Motor-vehicle safety: A 20th century public health achievement. MMWR Morbidity and Mortality Weekly Report, 48 (18), 369–374. (Erratum published June 11, 1999, MMWR Morbidity and Mortality Weekly Report, 48 (22), p. 473)

Centers for Disease Control and Prevention. (2003). Source of firearms used by students in school-associated violent deaths — United States, 1992–1999. MMWR Morbidity and Mortality Weekly Report, 52 (9), 169–172.

Centers for Disease Control and Prevention. (2008). School-associated student homicides — United States, 1992–2006. MMWR Morbidity and Mortality Weekly Report, 57 (2), 33–36. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5702a1.htm

Centers for Disease Control and Prevention. (2013a, August 23). Injury prevention & control: Data & statistics (WISQARS™). Retrieved from http://www.cdc.gov/injury/wisqars/index.html

Centers for Disease Control and Prevention. (2013b, February 22). School violence: Data and statistics. Retrieved from http://www.cdc.gov/violenceprevention/youthviolence/schoolviolence/data_stats.html

Chapman, S., & Alpers, P. (2013). Gun-related deaths: How Australia stepped off “The American path.” Annals of Internal Medicine, 158 (10), 770–771. doi:10.7326/0003-4819-158-10-201305210-00624

Cheng, T. L., Brenner, R. A., Wright, J. L., Sachs, H. C., Moyer, P., & Rao, M. (2003). Community norms on toy guns. Pediatrics, 111 (1), 75–79. doi:10.1542/peds.111.1.75

Children’s Defense Fund. (2009, February 19). Cradle to Prison Pipeline Campaign. Retrieved from http://www.childrensdefense.org/child-research-data-publications/data/cradle-prison-pipeline-summary-report.pdf

Children’s Defense Fund. (2012). The state of America’s children handbook . Retrieved from http://www.childrensdefense.org/child-research-data-publications/data/soac-2012-handbook.html

Connell, R. W. (1995). Masculinities. Cambridge, MA: Polity.

Cook, P. J., & Sorenson, S. (2006). The gender gap among teen survey respondents: Why are boys more likely to report a gun in the home than girls? Journal of Quantitative Criminology, 22, 61–76. doi: 10.1007/s10940-005-9002-7

Cooper, A., & Smith, E. L. (2011, November). Homicide trends in the United States, 1980–2008. Retrieved from http://www.bjs.gov/index.cfm?ty=pbse&sid=31

Cornell, D., Allen, K., & Fan, X. (2012). A randomized controlled study of the Virginia Student Threat Assessment Guidelines in kindergarten through grade 12. School Psychology Review, 41, 100–115.

Cornell, D., Gregory, A., & Fan, X. (2011). Reductions in long-term suspensions following adoption of the Virginia Student Threat Assessment Guidelines. Bulletin of the National Association of Secondary School Principals, 95, 175–194. doi:0192636511415255v1

Cornell, D., Sheras, P., Gregory, A., & Fan, X. (2009). A retrospective study of school safety conditions in high schools using the Virginia Threat Assessment Guidelines versus alternative approaches. School Psychology Quarterly, 24, 119–129. doi:10.1037/a0016182

Courtenay, W. H. (2000). Constructions of masculinity and their influence on men’s well-being: A theory of gender and health. Social Science & Medicine, 50 , 1385–1401. doi: 10.1016/S0277-9536(99)00390-1

Dishion, T. J., Véronneau, M-H., & Myers, M. W. (2010). Cascading peer dynamics underlying the progression from problem behavior to violence in early to late adolescence. Development and Psychopathology, 22 (3), 603–619. doi: 10.1017/S0954579410000313

Dodge, K. A., Greenberg, M. T., Malone, P. S., & Conduct Problems Prevention Research Group. (2008). Testing an idealized dynamic cascade model of the development of serious violence in adolescence. Child Development, 79, 1907–1927. doi: 10.1111/j.1467-8624.2008.01233.x

Dodge, K. A., & Pettit, G. S. (2003). A biopsychosocial model of the development of chronic conduct problems in adolescence. Developmental Psychology, 39, 349–371. doi:10.1037/0012-1649.39.2.349

Eaton, D. K., Kann, L., Kinchen, S., Shanklin, S., Flint, K. H., Hawkins, J., . . . Wechsler, H. (2012, June 8). Youth risk behavior surveillance — United States, 2011. MMWR Surveillance Summaries, 61 (4). Retrieved from the CDC website: http://www.cdc.gov/HealthyYouth/yrbs/index.htm

Edelman, M. W. (2007). The cradle to prison pipeline: An American health crisis. Preventing Chronic Disease: Public Health Research, Practice and Policy, 4 (3). Retrieved from http://www.cdc.gov/pcd/issues/2007/jul/07_0038.htm

Evans, A. C., Jr. (2013, January 11). Mental health’s great gray area . Retrieved from http://articles.philly.com/2013-01-11/news/36281940_1_mental-illness-mental-health-health-issues

Fabiano, P. M., Perkins, H. W., Berkowitz, A., Linkenbach, J., & Stark, C (2003). Engaging men as social justice allies in ending violence against women: Evidence for a social norms approach. Journal of American College Health , 52, 105–108. doi: 10.1080/07448480309595732

Farrington, D. P., Jolliffe, D., Loeber, R., Stouthamer-Loeber, M., & Kalb, L. M. (2001). The concentration of offenders in families and family criminality in the prediction of boys’ delinquency. Journal of Adolescence, 24, 579–596. doi:10.1006/jado.2001.0424

Feder, J., Levant, R. F., & Dean, J. (2010). Boys and violence: A gender-informed analysis. Psychology of Violence, 1, 3–12. doi: 10.1037/2152-0828.1.S.3

Federal Bureau of Investigation. (n.d.). Serial murder: Multi-disciplinary perspectives for investigators. Retrieved from http://www.fbi.gov/stats-services/publications/serial-murder

Federal Bureau of Investigation. (2007). Crime in the United States, 2007. Retrieved from http://www2.fbi.gov/ucr/cius2007

Federal Bureau of Investigation. (2012a). Crime in the United States, 2011 . Retrieved from http://www.fbi.gov/about-us/cjis/ucr/crime-in-the-u.s/2011/crime-in-the-u.s.-2011/tables/table-20

Federal Bureau of Investigation. (2012b). National Instant Criminal Background Check System (NICS) operations 2012 . Retrieved from http://www.fbi.gov/about-us/cjis/nics/reports/2012-operations-report

Federal Bureau of Investigation. (2013). NICS firearm background checks: Top 10 highest days/weeks. Retrieved from http://www.fbi.gov/about-us/cjis/nics/reports/nics-firearm-background-checks-top-10-highest-days-and-weeks-033113.pdf

Fein, R. A., & Vossekuil, F. (1998). Protective intelligence and threat assessment investigations: A guide for state and local law enforcement officials. Washington, DC: U.S. Secret Service.

Fein, R., Vossekuil, B., Pollack, W., Borum, R., Modzeleski, W., & Reddy, M. (2002). Threat assessment in schools: A guide to managing threatening situations and to creating safe school climates. Washington, DC: U.S. Department of Education and U.S. Secret Service.

Fessler, D. M. T., Holbrook, C., & Snyder, J. K. (2012). Weapons make the man (larger): Formidability is represented as size and strength in humans. PLOS ONE, 7 (4), e32751. doi:10.1371/journal.pone.0032751

Follman, M., & Aronson, G. (2013, January 30). “A killing machine”: Half of all mass shooters used high-capacity magazines. Mother Jones. Retrieved from http://www.motherjones.com/politics/2013/01/high-capacity-magazines-mass-shootings

Fox, J. A., & Burstein, H. (2010). Violence and security on campus: From preschool through college. Denver, CO: Praeger.

Furlong, M. J., Bates, M. P., & Smith, D. C. (2001). Predicting school weapon possession: A secondary analysis of the Youth Risk Behavior Surveillance Survey. Psychology in the Schools, 38, 127–139. doi:10.1002/pits.1005

Gotsch, K. E., Annest, J. L., Mercy, J. A., & Ryan, G. W. (2001). Surveillance for fatal and nonfatal firearm-related injuries — United States, 1993–1998. MMWR, 50 (SS02), 1–32.

Grossman, D. C., Mueller, B. A., Riedy, C., Dowd, M. D., Villaveces, A., Prodzinski, J., . . . Harruff, R. (2005). Gun storage practices and risk of youth suicide and unintentional firearm injuries. JAMA: Journal of the American Medical Association, 293, 707–714. doi:10.1001/jama.293.6.707

Gruenwald, J. (2012). Are anti-LGBT homicides in the United States unique? Journal of Interpersonal Violence, 27 (18), 3601–3623.

Guerra, N. G., & Bradshaw, C. P. (2008). Linking the prevention of problem behaviors and positive youth development: Core competencies for positive youth development. New Directions for Child and Adolescent Development, 122, 1–17.

Gun Control Act of 1968, 18 U.S.C., § 44-101 et seq. (1968).

Gun-Free Schools Act of 1994, 20 U.S.C. § 8921-23 (1994).

Hardy, M. S. (2002). Teaching firearm safety to children: Failure of a program. Journal of  Developmental and Behavioral Pediatrics, 23 (2), 71–76.

Hemenway, D., Vriniotis, M., Johnson, R. M., Miller, M., & Azrael, D. (2011). Gun carrying by high school students in Boston, MA: Does overestimation of peer gun carrying matter? Journal of Adolescence, 34, 997–1003. doi:10.1016/j.adolescence.2010.11.008

Henggeler, S. W. (2011). Efficacy studies to large-scale transport: The development and validation of multisystemic therapy programs. Annual Review of Clinical Psychology, 7,  351–381. doi:10.1146/annurev-clinpsy-032210-104615

Hepburn, L., Miller, M., Azrael, D., & Hemenway, D. (2007). The U.S. gun stock: Results from the 2004 National Firearms Survey. Injury Prevention, 13 (1), 15–19. doi:10.1136/ip.2006.013607

Hill, K. G., Howell, J. C., Hawkins, J. D., & Battin-Pearson, S. R. (1999). Childhood risk factors for adolescent gang membership: Results from the Seattle Social Development Project. Journal of Research in Crime and Delinquency, 36 (3), 300–322. doi:10.1177/0022427899036003003

Hong, L. (2000). Toward a transformed approach to prevention: Breaking the link between masculinity and violence. Journal of American College Health, 48 (6), 269–279. doi: 10.1080/07448480009596268

Horwitz, S. (2012, December 17). ATF, charged with regulating guns, lacks resources and leadership. The Washington Post. Retrieved from http://www.washingtonpost.com

Hoyert, D. L., & Xu, J. (2012). Deaths: Preliminary data for 2011. National Vital Statistics Reports, 61 (6). Retrieved from http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_06.pdf

Huesmann, L. R. (2010). Nailing the coffin shut on doubts that violent video games stimulate aggression: Comment on Anderson et al. (2010). Psychological Bulletin, 2, 179–181. doi:10.1037/a0018567

Huesmann, L. R., & Guerra, N. G. (1997). Children’s normative beliefs about aggression and aggressive behavior. Journal of Personality and Social Psychology, 72, 408–419. doi:10.1037/0022-3514.72.2.408

Huesmann, L. R., Moise-Titus, J., Podolski, C-L., & Eron, L. D. (2003). Longitudinal relations between children’s exposure to TV violence and their aggressive and violent behavior in young adulthood: 1977–1992. Developmental Psychology, 39, 201–221. doi:10.1037/0012-1649.39.2.201

Hunt, K., Sweeting, H., Keoghan, M., & Platt, S. (2006). Sex, gender role orientation, gender role attitudes and suicidal thoughts in three generations: A general population study. Social Psychiatry and Psychiatric Epidemiology, 41 (8), 641–647. doi: 10.1007/s00127-006-0074-y

Institute of Medicine and National Research Council. (2013). Priorities for research to reduce the threat of firearm-related violence. Washington, DC: National Academies Press. Retrieved from http://www.nap.edu/catalog.php?record_id=18319

International Association of Chiefs of Police. (2012). Building safer communities: Improving police response to persons with mental illness: Recommendations from the IACP National Policy Summit. Retrieved from http://www.theiacp.org/LinkClick.aspx?fileticket=JyoR%2fQBPIxA%3d&tabid=87

Johnson, R. M., Barber, C., Azrael, D., Clark, D. E., & Hemenway, D. (2010). Who are the owners of firearms used in adolescent suicides? Suicide and Life Threatening Behavior, 40 (6), 609–611. doi:10.1521/suli.2010.40.6.609

Johnson, R. M., Miller, M., Vriniotis, M., Azrael, D., & Hemenway, D. (2006). Are household firearms stored less safely in homes with adolescents? Analysis of a national random sample of parents. Archives of Pediatric and Adolescent Medicine, 160, 788–792. doi:10.1001/archpedi.160.8.788

Kairys, D. (2008). Philadelphia freedom: Memoir of a civil rights lawyer . Ann Arbor, MI: University of Michigan Press.

Kalish, R., & Kimmel, M. (2010). Suicide by mass murder: Masculinity, aggrieved entitlement, and rampage school shootings. Health Sociology Review, 19 (4), 451–464.

Kaplan, M. S., & Geling, O. (1998). Firearm suicides and homicides in the United States: Regional variations and patterns of gun ownership. Social Science & Medicine, 46,  1227–1233. doi: 10.1016/S0277-9536(97)10051-X

Kellermann, A. L., & Rivara, R. (2013). Silencing the science on gun research. JAMA: Journal of the American Medical Association, 309 (6), 549–550. doi:10.1001/jama.2012.208207

Kennedy, D. M., Braga, A. A., & Piehl, A. M. (2001). Reducing gun violence: The Boston Gun Project’s Operation Ceasefire (NIJ 188741). Washington, DC: U.S. Department of Justice, National Institute of Justice. Retrieved from https://www.ncjrs.gov/pdffiles1/nij/188741.pdf

Kessler, J., & Trumble, S. (2013, August). The virtual loophole: A survey of online gun sales. Retrieved from http://content.thirdway.org/publications/719/Third_Way_Report_-_The_Virtual_Loophole-_A_Survey_of_Online_Gun_Sales.pdf

Kimmel, M. S. (1994). Masculinity as homophobia: Fear, shame, and silence in the construction of gender identity. In H. Brod & M. Kaufman (Eds.), Theorizing masculinities (pp. 119–141). Thousand Oaks, CA: Sage.

Kimmel, M. S, & Mahler, M. (2003). Adolescent masculinity, homophobia, and violence: Random school shootings, 1982–2001. American Behavioral Scientist, 46, 1439–1458. doi: 10.1177/0002764203046010010

Kivel, P. (1998). Men’s work: How to stop the violence that tears our lives apart (2nd ed.). City Center, MN: Hazelden.

Koper, C. S. (2005). Purchase of multiple firearms as a risk factor for criminal gun use: Implications for gun policy and enforcement. Criminology and Public Policy, 4 (4), 749–778. doi:10.1111/j.1745-9133.2005.00354.x

Koper, C. S. (2007). Crime gun risk factors: Buyer, seller, firearm, and transaction characteristics associated with criminal gun use and trafficking (Report to the National Institute of Justice). Retrieved from www.ncjrs.gov/pdffiles1/nij/grants/221074.pdf

Koper, C. S. (2013). America’s experience with the federal assault weapons ban, 1994–2004: Key findings and implications. In D. Webster & J. Vernick (Eds.), Reducing gun violence in America: Informing policy with evidence and analysis (pp. 157–171). Baltimore, MD: Johns Hopkins University Press.

Koper, C. S., & Roth, J. A. (2001). The impact of the 1994 federal assault weapons ban on gun violence outcomes: An assessment of multiple outcome measures and some lessons for policy evaluation. Journal of Quantitative Criminology, 17 (1), 33–74. doi:10.1023/A:1007522431219

Law Center to Prevent Gun Violence. (2012, May 21). Waiting periods policy summary. Retrieved from http://smartgunlaws.org/waiting-periods-policy-summary

Lizotte, A. J., Krohn, M. D., Howell, J. C., Tobin, K., & Howard, G. J. (2000). Factors influencing gun carrying among young urban males over the adolescent-young adult life course. Criminology, 38, 811–834.

Loeber, R. (1982). The stability of antisocial and delinquent child behavior: A review. Child Development, 53, 1431–1446.

Ludwig, G., Cook, P. J., & Smith, T. W. (1998). The gender gap in reporting household gun ownership. American Journal of Public Health, 88 (11), 1715–1718.

Lytton, T. D. (2004, Winter). Using litigation to make public health policy: Theoretical and empirical challenges in assessing product liability, tobacco, and gun litigation. Journal of Law, Medicine and Ethics, 556–564.

Makarios, M. D., & Pratt, T. C. (2012). The effectiveness of policies and programs that attempt to reduce firearm violence: A meta-analysis. Crime & Delinquency, 58 (2), 222–244.

Mayors Against Illegal Guns. (n.d.). Responsible firearms retail partnership . Retrieved from http://www.mayorsagainstillegalguns.org/html/partnership/partnership.shtml

Mayors Against Illegal Guns. (2013, September). Felon seeks firearm: No strings attached. Retrieved from https://s3.amazonaws.com/s3.mayorsagainstillegalguns.org/images/FINAL_NO_STRINGS_REPORT.pdf

McGarrell, E. F., Hipple, N. K., Corsoro, N., Bynum, T. S., Perez, H., Zimmermann, C. A., & Garmo, M. (2009). Project Safe Neighborhoods: A national program to reduce gun violence (Final rep.). East Lansing, MI: Michigan State University. Retrieved from https://www.ncjrs.gov/pdffiles1/nij/grants/226686.pdf

McIntire, M. (2013, January 26). Selling a new generation on guns. The New York Times. Retrieved from http://www.nytimes.com/2013/01/27/us/selling-a-new-generation-on-guns.html?pagewanted=all&_r=2&

Miller, M., Azrael, D., & Hemenway, D. (2002). Firearm availability and unintentional firearm death, suicide, and homicide among 5–14 year olds. Journal of Trauma, 52, 267–275.

Miller, M., Azrael, D., Hepburn, L., Hemenway D., & Lippmann, S. J. (2006). The association between changes in household firearm ownership and rates of suicide in the United States, 1981–2002 . Injury Prevention, 12, 178–182. doi:10.1136/ip.2005.010850

Miller, M., Barber, C., Azrael, D., Hemenway, D., & Molnar, B. E. (2009). Recent psychopathology, suicidal thoughts and suicide attempts in households with and without firearms: Findings from the National Comorbidity Study Replication. Injury Prevention, 15 (3), 183–187. doi:10.1136/ip.2008.021352.

Miniño, A. M. (2010). Mortality among teenagers aged 12–19 years: United States, 1999–2006 (NCHS Data Brief No. 37). Retrieved from http://www.cdc.gov/nchs/data/databriefs/db37.pdf

Moffitt, T. E. (1993). Adolescent-limited and life-course-persistent antisocial behavior: A developmental taxonomy. Psychological Review, 100, 674–701. doi:10.1037/0033-295X.100.4.674

Moffitt, T. E. (2005). The new look of behavioral genetics in developmental psychopathology: Gene-environment interplay in antisocial behaviors. Psychological Bulletin, 131 , 533-554. doi:10.1037/0033-2909.131.4.533

Molnar, B. E., Miller, M. J., Azrael, D., & Buka, S. L. (2004). Neighborhood predictors of concealed firearm carrying among children and adolescents: Results from the project on human development in Chicago neighborhoods. Archives of Pediatric & Adolescent Medicine, 158, 657–664.

Monahan, J., Steadman, H., Silver, E., Appelbaum, P. S., Robbins, P. C., Mulvey, E. P., … Banks, S. (2001) . Rethinking risk assessment: The MacArthur Study of Mental Disorder and Violence. New York, NY: Oxford University Press.

Moore, T. M., Elkins, S. R., McNulty, J. K., Kivisto, A. J., & Handsel, V. A. (2011). Alcohol use and intimate partner violence perpetration among college students: Assessing the temporal association using electronic diary technology. Psychology of Violence, 1 (4), 315–328. doi: 10.1037/a0025077

Moore, T. M., & Stuart, G. L. (2005). A review of the literature on masculinity and partner violence. Psychology of Men & Masculinity, 6 (1), 46–61. doi: 10.1037/1524-9220.6.1.46

Moscicki, E. K. (2001). Epidemiology of completed and attempted suicide: Toward a framework for prevention. Clinical Neuroscience Research, 1, 310–323. doi://dx.doi.org/10.1016/S1566-2772(01)00032-9

Mozaffarian, D., Hemenway, D., & Ludwig, D. S. (2013). Curbing gun violence: Lessons from public health successes. JAMA: Journal of the American Medical Association, 309,  551–552. doi:10.1001/jama.2013.38.

Murphy, S. L., Xu, J., & Kochanek, D. (2013). Deaths: Final data for 2010. National Vital Statistics Reports, 61 (4). Retrieved from http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04.pdf

National Institute of Justice. (2011). Firearms and Violence Research Working Group meeting summary 2011 . Retrieved from http://www.nij.gov/topics/crime/gun-violence/working-group/2011-summary.htm

Neighbors, C., Walker, D., Mbilinyi, L., O’Rourke, A., Edleson, J. L., Zegree, J., & Roffman, R. A. (2010). Normative misperceptions of abuse among perpetrators of intimate partner violence. Violence Against Women, 16, 370–386. doi: 10.1177/1077801210363608

New York State Office of Mental Health. (2005, March). Kendra’s Law: Final report on the status of assisted outpatient treatment. Retrieved from http://www.omh.ny.gov/omhweb/Kendra_web/KHome.htm

N.Y. Mental Hygiene Law (Kendra’s Law), § 9.60 (McKinney 1999).

O’Keefe, C., Potenza, D. P., & Mueser, K. T. (1997). Treatment outcomes for severely mentally ill patients on conditional discharge to community-based treatment. Journal of Nervous and Mental Disease, 185, 409–411. 

O’Neil, J. M. (1981). Male sex-role conflicts, sexism, and masculinity: Implications for men, women, and the counseling psychologist. The Counseling Psychologist, 9, 61–80. doi: 10.1177/001100008100900213

O’Neil, J. M. (2008). Summarizing 25 years of research on men’s gender role conflict using the Gender Role Conflict Scale: New research paradigms and clinical implications. The Counseling Psychologist, 36, 358-445. doi: 10.1177/0011000008317057

O’Toole, M. E. (2000). The school shooter: A threat assessment perspective. Quantico, VA: FBI Academy, National Center for Analysis of Violent Crime. Retrieved from http://www.fbi.gov/stats-services/publications/school-shooter

Patterson, G. R., Forgatch, M. S., & DeGarmo, D. S. (2010). Cascading effects following intervention. Development and Psychopathology, 22, 949–970. doi:10.1017/S0954579410000568

Payne, S., Swami, V., & Stanistreet, D. L. (2008). The social construction of gender and its influence on suicide: A review of the literature . Journal of Men's Health, 5 (1), 23–35.

Peak, K. (Ed.). (2013). Encyclopedia of community policing and problem solving. Thousand Oaks, CA: Sage.

Phillips, S., Matusko, J., & Tomasovic, E. (2007). Reconsidering the relationship between alcohol and lethal violence. Journal of Interpersonal Violence, 22 (1), 66–84. doi: 10.1177/0886260506294997

Plant, E. A., Goplen, J., & Kunstman, J. W. (2011). Selective responses to threat: The roles of race and gender in decisions to shoot. Personality and Social Psychology Bulletin, 37 (9), 1274–1281. doi: 10.1177/0146167211408617

Police Executive Research Forum. (2012). Critical issues in policing: Vol. 6. An integrated approach to de-escalation and minimizing use of force. Retrieved from http://policeforum.org/library/critical-issues-in-policing-series/De-Escalation_v6.pdf

Police Foundation. (2013). After Newtown: Policing and mental health experts meet to develop prevention model for mental health-related gun violence. Retrieved from http://www.policefoundation.org/content/after-newtown-policing-and-mental-health-experts-meet-develop-prevention-model-mental-health

Protection of Lawful Commerce in Arms Act, 15 U.S.C. §§ 7901-7903 (2005). Retrieved from http://www.govtrack.us/congress/bills/109/s397

Roberts, S., Zhang, J., & Truman, J. (2012). Indicators of school crime and safety: 2011 (NCES 2012-002/NCJ 236021). Washington, DC: National Center for Educational Statistics. Retrieved from http://www.bjs.gov/content/pub/pdf/iscs11.pdf

Roth, J. A., & Koper, C. S. (1997). Impact evaluation of the Public Safety and Recreational Firearm Use Protection Act of 1994 (Appendix A). Washington, DC: Urban Institute. Retrieved from http://www.urban.org/UploadedPDF/aw_final.pdf

Saylor, E. A., Vittes, K. A., & Sorenson, S. B. (2004). Firearm advertising: Product depiction in consumer gun magazines. Evaluation Review , 28 (5), 420–433. doi:10.1177/0193841X04267389

Sickmund, M., Sladky, T. J., Kang, W., & Puzzanchera, C. (2011). Easy access to the census of juveniles in residential placement. Washington, DC: U.S. Department of Justice, Office of Justice Programs. Retrieved from http://www.ojjdp.gov/ojstatbb/ezacjrp/

Simon, T. R., Swann, A. C., Powell, K. E., Potter, L. B., Kresnow, M., & O’Carroll, P. W. (2001). Characteristics of impulsive suicide attempts and attempters. Suicide and Life-Threatening Behavior, 32 (Suppl. 1), 49–59.

Sirotich, F. (2008). Correlates of crime and violence among persons with mental disorder: An evidence-based review. Brief Treatment and Crisis Intervention, 8 (2), 171–194. doi: 10.1093/brief-treatment/mhn006

Snyder, H., & Sickmund, M. (2006). Juvenile offenders and victims: 2006 National Report. Washington, DC: U.S. Department of Justice, Office of Justice Programs. Retrieved from https://ojjdp.ncjrs.gov/ojstatbb/nr2006/downloads/NR2006.pdf

Sorenson, S. B. (2006). Firearm use in intimate partner violence: A brief overview. Evaluation Review, 30 (3), 229–236. doi: 10.1177/0193841X06287220

Sorenson, S. B., & Cook, P. J. (2008). “We’ve got a gun?”: Comparing reports of adolescents and their parents about household firearms. Journal of Community Psychology, 36 (1), 1–19. doi: 10.1002/jcop.20213

Sorenson, S. B., & Vittes, K. A. (2003). Buying a handgun for someone else: Firearm dealer willingness to sell. Injury Prevention, 9 (2), 147–150. doi:10.1136/ip.9.2.147

Sorenson, S. B, & Vittes, K. A. (2008). Mental health and firearms in community-based surveys: Implications for suicide prevention. Evaluation Review, 32 (3), 239–256. doi:10.1177/0193841X08315871

Sorenson, S. B., & Wiebe, D. J. (2004). Weapons in the lives of battered women. American Journal of Public Health, 94 (8), 1412–1417. doi: 10.2105/AJPH.94.8.1412

Spano, R., Pridemore, W. A., & Bolland, J. (2012). Specifying the role of exposure to violence and violent behavior on initiation of gun carrying: A longitudinal test of three models of youth gun carrying. Journal of Interpersonal Violence, 27, 158–176. doi:10.1177/088620511416471

Steadman, H. J., Deane, M. W., Borum, R., & Morrissey, J. P. (2000). Comparing outcomes of major models of police responses to mental health emergencies. Psychiatric Services, 51 , 645–649. doi:10.1176/appi.ps.51.5.645

Stroud, A. (2012). Good guys with guns: Hegemonic masculinity and concealed handguns. Gender & Society, 26 (2), 216–238. doi: 10.1177/0891243211434612

Substance Abuse and Mental Health Services Administration. (2012). Mental health, United States, 2010 (HHS Publication No. SMA 12-4681). Retrieved from http://www.samhsa.gov/data/2k12/MHUS2010/index.aspx

Swahn, M. H., Hamming, B. J., & Ikeda, R. M. (2002). Prevalence of youth access to alcohol or a gun in the home. Injury Prevention, 8, 227–230. doi:10.1136/ip.8.3.227

Swanson, J., Robertson, A., Frisman, L., Norko, M., Lin, H., Swartz, M., & Cook, P. (2013). Preventing gun violence involving people with serious mental illness. In D. Webster & J. Vernick (Eds.), Reducing gun violence in America: Informing policy with evidence and analysis (pp. 33–52). Baltimore, MD: Johns Hopkins University Press.

Swanson, J. W., Swartz, M. S., Wagner, H. R., Burns, B. J., Borum, R., & Hiday, VA. (2000). Involuntary out-patient commitment and reduction of violent behavior in persons with severe mental illness. British Journal of Psychiatry, 176, 324–331. doi: 10.1192/bjp.176.4.324

Teller, J. L. S., Munetz, M. R., Gil, K. M., & Ritter, C. (2006). Crisis intervention team training for police officers responding to mental disturbance calls. Psychiatric Services, 57 , 232–237.

Teret, S. P., & Merritt, A. D. (2013). Personalized guns: Using technology to save lives. In D. W. Webster & J. S. Vernick (Eds.), Reducing gun violence in America: Informing policy with evidence and analysis (pp. 172-182). Baltimore, MD: Johns Hopkins Press.

Teret, S. P., & Wintemute, G. J. (1993). Policies to prevent firearm injuries. Health Affairs , 12 (4), 96–108. doi:10.1377/hlthaff.12.4.96

Truman, J. L. (2011). National Crime Victimization Survey: Criminal victimization, 2010 . Retrieved from http://bjs.gov/content/pub/pdf/cv10.pdf

U.S. Department of Defense. (2010). Protecting the force: Lessons from Fort Hood. Retrieved from http://www.defense.gov/pubs/pdfs/dod-protectingtheforce-web_security_hr_13jan10.pdf

U.S. Department of Education. (2013). Guide for developing high-quality emergency operations plans for institutions of higher education. Retrieved from http://www2.ed.gov/about/offices/list/oese/oshs/rems-k-12-guide.pdf

Van Dorn, R., Volavka, J., & Johnson, N. (2012). Mental disorder and violence: Is there a relationship beyond substance abuse? Social Psychiatry and Psychiatric Epidemiology, 47, 487–503. doi:10.1007/s00127-011-0356-x

Vaughn, M. G., Perron, B. E., Abdon, A., Olate, R., Groom, R., & Wu, L. T. (2012). Correlates of handgun carrying among adolescents in the United States. Journal of Interpersonal Violence , 27 , 2003-2021. doi: 10.1177/0886260511432150

Verlinden, S., Hersen, M., & Thomas, J. (2000). Risk factors in school shootings. Clinical Psychology Review, 20 (1), 3–56.

Vernick, J. S., Teret, S. P., & Webster, D. W. (1997). Regulating firearm advertisements that promise home protection: A public health intervention. JAMA: Journal of the American Medical Association, 277 (17), 1391–1397. doi:10.1001/jama.1997.03540410069033

Vernick, J. S., Webster, D. W., & Bulzacchelli, M. T. (2006). Regulating firearm dealers in the United States: An analysis of state law and opportunities for improvement. Journal of Law, Medicine & Ethics, 34 (4), 765–775. doi:10.1111/j.1748-720X.2006.00097.x

Vigdor, E. R., & Mercy, J. A. (2006). Do laws restricting access to firearms by domestic violence offenders prevent intimate partner homicide? Evaluation Review, 30 (3), 313–346. doi:10.1177/0193841X06287307

Violence Policy Center. (2011). The militarization of the U.S. civilian firearms market. Retrieved from http://www.vpc.org/studies/militarization.pdf

Violent Crime Control and Law Enforcement Act of 1994, 18 U.S.C. § 1033 et seq. (1994).

Vittes, K. A., & Sorenson, S. B. (2006). Risk-taking among adolescents who say they can get a handgun. Journal of Adolescent Health, 39, 929–932. doi: 10.1016/j.jadohealth.2006.05.012

Vittes, K. A., Sorenson, S. B., & Gilbert, D. (2003). High school students’ attitudes about firearms policies. Journal of Adolescent Health, 33, 471–478. doi: 10.1016/S1054-139X(03)00142-3

Vittes, K. A., Vernick, J. S., & Webster, D. W. (2013). Legal status and source of offenders’ firearms in states with the least stringent criteria for gun ownership. Injury Prevention, 19 (1), 26–31. doi:10.1136/injuryprev-2011-040290

Vossekuil, B., Fein, R., Reddy, M., Borum, R., & Modzelski, W. (2002). The final report and findings of the Safe School Initiative: Implications for the prevention of school attacks in the United States. Washington, DC: U.S. Secret Service and U.S. Department of Education. Retrieved from http://www.secretservice.gov/ntac/ssi_final_report.pdf

Wachs, T. D. (2006). The nature, etiology, and consequences of individual differences in temperament. In L. Balter & C. S. Tamis-LeMonda (Eds.), Child psychology (2nd ed., pp. 27–52). New York, NY: Psychology Press.

Webster, D. W., Bulzacchelli, M. T., Zeoli, A. M., & Vernick, J. S. (2006). Effects of undercover police stings of gun dealers on the supply of new guns to criminals. Injury Prevention, 12, 225–230.

Webster, D. W., & Starnes, M. (2000). Reexamining the association between child access prevention gun laws and unintentional shooting deaths of children. Pediatrics, 106 (6), 1466–1469. doi:10.1542/peds.106.6.1466

Webster, D. W., & Vernick, J. S. (Eds.). (2013a). Reducing gun violence in America: Informing policy with evidence and analysis. Baltimore, MD: Johns Hopkins University Press. Retrieved from http://jhupress.files.wordpress.com/2013/01/1421411113_updf.pdf

Webster, D. W., & Vernick, J. S. (2013b). Spurring responsible firearms sales practices through litigation: The impact of New York City’s lawsuits against gun dealers on interstate gun trafficking. In D. W. Webster & J. S. Vernick (Eds.), Reducing gun violence in America: Informing policy with evidence and analysis (pp. 123–132) . Baltimore, MD: Johns Hopkins University Press.

Webster, D. W., Vernick, J. S., & Bulzacchelli, M. T. (2009). Effects of state-level firearm seller accountability policies on firearm trafficking. Journal of Urban Health, 86 (4), 525–537. doi:10.1007/s11524-009-9351-x

Webster, D. W., Vernick, J. S., McGinty, E. E., & Alcorn, T. (2013). Preventing the diversion of guns to criminals through effective firearm sales laws. In D. W. Webster & J. S. Vernick (Eds.), Reducing gun violence in America: Informing policy with evidence and analysis (pp. 109–122) . Baltimore, MD: Johns Hopkins University Press.

Webster, D. W., Vernick, J. S., Zeoli, A. M., & Manganello, J. A. (2004). Association between youth-focused firearm laws and youth suicides. JAMA: Journal of the American Medical Association, 292 (5), 594–601. doi:10.1001/jama.292.5.594

Webster, D. W., Whitehill, J. M., Vernick, J. S., & Curriero, F. C. (2012). Effects of Baltimore’s Safe Streets Program on gun violence: A replication of Chicago’s CeaseFire Program. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 90 (1), 27–40. doi:10.1007/s11524-012-9731-5

Weil, D. S., & Knox, R. C. (1996). Effects of limiting handgun purchases on interstate transfer of firearms. JAMA: Journal of the American Medical Association, 275 (22), 1759–1761.

Wellford, C. F., Pepper, J. V., & Petrie, C. V. (Eds.). (2004). Firearms and violence: A critical review. Washington, DC: National Academies Press.

White House. (2013). Now is the time. Retrieved from http://www.whitehouse.gov/issues/preventing-gun-violence

Wiebe, D. J. (2003). Sex differences in the perpetrator-victim relationship among emergency department patients presenting with nonfatal firearm-related injuries. Annals of Emergency Medicine, 42 (3), 405–412. doi:10.1016/S0196-0644(03)00509-2

Williams, K. R., Tuthill, L., & Lio, S. (2008). A portrait of juvenile offending in the United States. In R. D. Hoge, N. G. Guerra, & P. Boxer (Eds.), Treating the juvenile offender  (pp. 15–32). New York, NY: Guilford Press.

Wintemute, G. J. (1996). The relationship between firearm design and firearm violence: Handguns in the 1990s. JAMA: Journal of the American Medical Association, 275 (22), 1749-1753. doi:10.1001/jama.1996.03530460053031

Wintemute, G. J. (2010). Firearm retailers’ willingness to participate in an illegal gun purchase. Journal of Urban Health, 87, 865–878.

Wintemute, G. J. (2011). Association between firearm ownership, firearm-related risk and risk-reduction behaviors, and alcohol-related risk behaviours. Injury Prevention, 17,  422–427. doi: 10.1136/ip.2010.031443

Wintemute, G. J. (2013a, January 14–15). Broadening denial criteria for the purchase and possession of firearms: Need, feasibility, and effectiveness. Paper presented at the Gun Violence Policy Summit, Johns Hopkins University, Baltimore, MD.

Wintemute, G. J. (2013b). Frequency of and response to illegal activity related to commerce in firearms: Findings from the Firearms Licensee Survey . Injury Prevention. Advance online publication. doi:10.1136/injuryprev-2012-040715

Wintemute, G. J., Drake, C. M., Beaumont, J. J., & Wright, M. A. (1998). Prior misdemeanor convictions as a risk factor for later violent and firearm-related criminal activity among authorized purchasers of handguns. JAMA: Journal of the American Medical Association, 280, 2083–2087.

Wintemute, G. J., Parham, C. A., Beaumont, J. J., Wright, M., & Drake, C. (1999). Mortality among recent purchasers of handguns. New England Journal of Medicine, 341 (21), 1583–1589. doi:10.1056/NEJM199911183412106

Wintemute, G. J., Wright, M. A., Drake, C. M., & Beaumont, J. J. (2001). Subsequent criminal activity among violent misdemeanants who seek to purchase handguns: Risk factors and effectiveness of denying handgun purchase . JAMA: Journal of the American Medical Association, 285, 1019–1026.

Wright, M. A., Wintemute, G. J., & Claire, B. E. (2008). Gun suicide by young people in California: Descriptive epidemiology and gun ownership. Journal of Adolescent Health, 43 (6), 619–622. doi:10.1016/j.jadohealth.2008.04.009

Wright, M. A., Wintemute, G. J., & Webster, D. W. (2010). Factors affecting a recently purchased handgun’s risk for use in crime under circumstances that suggest gun trafficking. Journal of Urban Health, 87 (3), 352–364. doi:10.1007/s11524-010-9437-5

Yan, F. A., Howard, D. E., Beck, K. H., Shattuck, T., & Hallmark-Kerr, M. (2010). Psychosocial correlates of physical dating violence victimization among Latino early adolescents. Journal of Interpersonal Violence, 25 (5), 808–831. doi: 10.1177/0886260509336958

Zeoli, A. M., & Webster, D. W. (2010). Effects of domestic violence policies, alcohol taxes and police staffing levels on intimate partner homicide in large U.S. cities. Injury Prevention, 16, 90–95.

APA Panel of Experts

Dewey Cornell, PhD Clinical Psychologist and Professor of Education Curry School of Education University of Virginia

Arthur C. Evans Jr., PhD Commissioner Department of Behavioral Health and Intellectual disAbility Services Philadelphia, Pa.   Nancy G. Guerra, EdD (Coordinating Editor) Professor of Psychology Associate Provost for International Programs Director, Institute for Global Studies University of Delaware   Robert Kinscherff, PhD, JD Associate Vice President for Community Engagement Massachusetts School of Professional Psychology Senior Associate National Center for Mental Health and Juvenile Justice   Eric Mankowski, PhD Professor of Psychology Department of Psychology Portland State University

Marisa R. Randazzo, PhD Managing Partner SIGMA Threat Management Associates Alexandria, Va.   Ellen Scrivner, PhD, ABPP Executive Fellow Police Foundation Washington, D.C.   Susan B. Sorenson, PhD Professor of Social Policy / Health & Societies Senior Fellow in Public Health University of Pennsylvania

W. Douglas Tynan, PhD, ABPP Professor of Pediatrics Jefferson Medical College Thomas Jefferson University   Daniel W. Webster, ScD, MPH Professor and Director Center for Gun Policy and Research Johns Hopkins Bloomberg School of Public Health

We are grateful to the following individuals for their thoughtful reviews and comments on drafts of this report:   Louise A. Douce, PhD Special Assistant, Office of Student Life Adjunct Faculty, Department of Psychology The Ohio State University   Joel A. Dvoskin, PhD, ABPP Department of Psychiatry University of Arizona   Ellen G. Garrison, PhD Senior Policy Advisor American Psychological Association   Melissa Strompolis, MA Doctoral Candidate University of North Carolina at Charlotte   Mathilde Pelaprat, PsyD , provided writing and research assistance on Chapter 2.

Rhea Farberman, APR Executive Director Public and Member Communications American Psychological Association

Editorial and Design Services Deborah C. Farrell, Editor │ Elizabeth F. Woodcock, Designer

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Gun Control

Gun control is one of the most divisive issues in the United States and the disparities across the legal and illegal uses of firearms add complexity to this topic. Read the overview below to gain a balanced understanding of the issue and explore the previews of opinion articles that highlight many perspectives on gun regulation.

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Gun control topic overview.

"Gun Control." Opposing Viewpoints Online Collection , Gale, 2024.

Gun control  refers to legislation and regulations that limit the ownership of firearms, restrict certain types of firearms, or determine where they may be carried. In the United States, gun control is a highly controversial topic that engenders debate surrounding public safety, state and federal government oversight, and individual rights. Supporters of gun control seek tighter restrictions on the sale and circulation of firearms to decrease the high incidence of gun-related violence and deaths in the United States. Opponents argue Americans have a constitutional right to own and bear firearms.

According to the Gun Violence Archive, an independent research group providing near-real-time data on gun violence, there were more than thirty-nine thousand firearm-related deaths in the United States from January to November 2023. Among these, 56 percent were suicides, and 44 percent were homicides. More firearm-related violence incidents in 2023 were unintentional (1,388) and defensive (1,045) than aggressive (583).

Many Americans support the right to bear arms but also believe the government has the right to regulate firearms in the interest of public safety. Though there are differences along party lines, a 2023 Gallup poll found that 56 percent of Americans believe gun control laws should be stricter, and 12 percent believe they should be less strict. Gun rights groups, such as the National Rifle Association (NRA), aim to prevent new gun control legislation and, if possible, roll back existing regulations. Since the late twentieth century, the NRA has wielded significant political influence at the national and state levels, especially among conservative politicians. In response, gun control organizations such as Brady, Giffords, and Everytown for Gun Safety have lobbied for legislation that better regulates gun ownership, such as requiring waiting periods, background checks, gun permits, gun safety training, and restrictions on the possession of assault weapons.

PROS AND CONS OF BANNING ASSAULT WEAPONS

• Self-defense and hunting needs do not require the efficiency and firepower of automatic weapons and high-capacity ammunition magazines. Assault weapons are known to be capable of injuring and killing large groups of people in mass shootings.
• Most Americans support a federal ban on military-style assault weapons. For politicians in many jurisdictions, supporting such legislation would reflect the will of the people.
• While the accidental discharge of a firearm always carries the risk of injury, the accidental discharge of an automatic weapon can result in much greater damage.
• Banning any type of firearm can be interpreted as a violation of the Second Amendment of the US Constitution.
• All assault weapons sold legally in the United States are manufactured domestically, helping local economies and encouraging innovation.
• A federal assault weapons ban would have minimal impact on gun deaths, as the majority of gun deaths are self-inflicted and do not involve automatic weapons.

THE SECOND AMENDMENT

The right to keep and bear arms is included as the Second Amendment to the US Constitution as part of the Bill of Rights ratified on December 15, 1791. It states: "A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed." The precise meaning and purpose of the Second Amendment have been subjects of frequent debate in the early twenty-first century. At the time it was enacted, each state maintained a militia composed of ordinary citizens who served as part-time soldiers to protect settlers on land contested by Native Americans and defend against any attacks by foreign entities, some of which still held territories later claimed by the United States. In addition, some of the authors of the Second Amendment feared the federal government would use its standing army to force its will on the states and intended to protect the state militias' right to take up arms against the federal government.

Opponents of gun control interpret the Second Amendment as guaranteeing individual citizens a right to keep and bear arms, often with little or no limitations. They assert the amendment protects the rights of the general population because colonial law required every household to possess arms and every white male of military age to be ready for self-defense and military emergencies. Therefore, by guaranteeing arms for the militia, the amendment simultaneously guaranteed arms for every citizen. Opponents of gun control further maintain the term "right of the people" in the Second Amendment holds the same meaning as it does in the First Amendment, which guarantees such individual liberties as the freedom of religion and freedom of assembly.

Proponents of gun control debate some of these interpretations and argue that much has changed since the amendment was written. Some gun control supporters argue the amendment was meant to protect only a state's right to arm citizens for the common defense, not private citizens' rights to possess and carry any firearm in any space. They also argue that, according to the amendment, such militias were "well regulated," meaning they were subject to state requirements concerning training, firearms, and periodic military exercises.

MAJOR LEGISLATION AND COURT CASES IN THE TWENTIETH CENTURY

The US Congress has created laws regarding gun regulations and the Supreme Court has ruled on several cases. The National Firearms Act (NFA) of 1934 was the country's first major federal gun control legislation. The law required the registration of certain firearms, imposed taxes on the sale and manufacture of firearms, and restricted the sale and ownership of high-risk weapons such as machine guns. The Federal Firearms Act (FFA) of 1938 provided additional regulations, requiring federal licenses for firearm manufacturers and dealers, and prohibiting certain people from buying firearms. The Supreme Court's ruling in  United States v. Miller  (1939) upheld the NFA and set a precedent that the right to bear arms applied to citizens in active, controlled state guard or militia units.

The next major piece of federal firearms legislation was the Gun Control Act (GCA) of 1968, passed in the wake of the assassinations of Dr. Martin Luther King Jr. and Senator Robert F. Kennedy. The GCA expanded both the NFA and the FFA. The law ended mail-order sales of all firearms and ammunition and banned the sale of guns to minors, felons, fugitives from justice, people who use illegal drugs, persons with mental illness, and those dishonorably discharged from the armed forces. The Supreme Court bolstered controls when it upheld New Jersey's strict gun control law in  Burton v. Sills  (1969) and the federal ban on possession of firearms by felons in  Lewis v. United States  (1980).

The Firearms Owners' Protection Act of 1986 (FOPA), however, eased many GCA restrictions. Opponents of gun control lauded FOPA for expanding where firearms could be sold and who could sell them but continued to object to prohibitions on the manufacture and possession of machine guns for civilian use. In 1989 the administration of President George H. W. Bush announced a permanent ban on importing assault rifles. With passage of the Public Safety and Recreational Firearms Use Protection Act of 1994 (also called the Federal Assault Weapons Ban), Congress banned the manufacture and sale of specific assault weapons. The ban expired in 2004.

The Brady Handgun Violence Prevention Act of 1993 passed as an amendment to the GCA. The Brady Act addressed several key concerns of gun control proponents by requiring a five-day waiting period for all handgun sales, during which a background check would be run on all prospective purchasers. This provision expired in 1998 and was replaced by the National Instant Criminal Background Check System (NICS), a database used to verify the eligibility of a buyer to possess a firearm.

LEGISLATION AND COURT CASES IN THE EARLY TWENTY-FIRST CENTURY

After several victims and families of victims of gun violence and others sued gun manufacturers and dealers whose weapons were used to commit a crime, Congress passed the Protection of Lawful Commerce in Arms Act (PLCAA) and the Child Safety Lock Act of 2005. The first act limited the liability of gun manufacturers and dealers when their firearms were used in crimes. The second act required anyone licensed to transfer or sell firearms to provide gun storage or safety devices. During his 2020 presidential campaign, Democratic candidate Joe Biden supported repeal of the PLCAA. Congress enacted the NICS Improvement Amendments Act in 2007. It was meant to improve failures in the NICS system which had allowed a shooter to acquire a gun despite a disqualifying mental health status that had not been submitted to NICS by the state of Virginia. The shooter killed thirty-two people and himself on a Virginia college campus.

Gun rights proponents have used legislation and the federal courts to challenge gun restrictions. The US Supreme Court ruled in  District of Columbia v. Heller  (2008) that the Second Amendment prohibits the federal government from making it illegal for private individuals to keep loaded handguns in their homes. It was the first Supreme Court decision to explicitly rule that the right to keep and bear arms is an individual right. The decision in  McDonald v. Chicago  (2009) clarified that state and local authorities cannot prohibit private individuals from keeping loaded handguns in their homes. However, both decisions affirmed that the Second Amendment allows for limits on the types of arms that can be kept and how they are used. Together, the  Heller  and  McDonald  decisions have been used as the basis for several city, county, and state bans on assault weapons and specific arms such as the AR-15 rifle.

Following a 2022 mass shooting during a Fourth of July parade in Chicago that killed six and injured dozens of people, Illinois governor J. B. Pritzker signed into law the Protect Illinois Communities Act in January 2023. The law prohibits anyone from selling or distributing assault weapons throughout the state. The law immediately faced legal challenges from gun advocates, but it was upheld twice by the Illinois Supreme Court in August 2023 and by a federal appeals court in November 2023. Ten other states, including California, New Jersey, New York, and Washington have a similar active ban as of late 2023.

State and local laws regarding licensing, registration, and possession of firearms vary widely. For instance, in some states, a permit to carry a concealed weapon in public is only issued if the applicant demonstrates a need or meets safety and training requirements. In other states, a concealed carry permit is guaranteed to any citizen legally allowed to own a weapon. Several courts have used the  Heller  and  McDonald  decisions as a basis to allow concealed carry of firearms. As of September 2023, twenty-eight states allowed concealed carry without a permit.

The Supreme Court's rulings in  Heller  and  McDonald  also provided precedents for its ruling in  New York State Rifle & Pistol Association, Inc. (NYSRPA) v. Bruen  (2022). In its decision, the court deemed a 1911 New York state law that required applicants for concealed handgun permits to show "proper cause," or a special need for self-defense rather than a general desire to protect oneself, unconstitutional. The ruling was handed down in June 2022, less than two months after ten people were killed in a mass shooting in Buffalo, New York, drawing harsh criticism from the state's governor and Immediate action by its legislature. In July 2022 Governor Kathy Hochul signed the Concealed Carry Improvement Act into law. Drafted in response to the court's decision, the new law retained certain requirements for concealed carry permit holders, strengthened background checks, and increased safety and training requirements. The law also identified several "sensitive locations" as gun-free zones, including schools, polling places, theaters, places of worship, government buildings, and medical and health care facilities.

LOOPHOLES IN LEGISLATION

Gaps in legislation can enable people to obtain guns who may not otherwise meet the legal requirements for purchase. The background check requirement, for example, can be avoided by purchasing firearms from an unlicensed seller who does not perform these checks. While referred to as the "gun show loophole," such sales can take place elsewhere, including online. Temporary loans of firearms are typically allowed, as are transfers of weapons that are inherited or given as gifts. While unlicensed gun transfers are acceptable within one's own state, interstate sales are prohibited.

Federal law and some states allow juveniles to purchase long guns, such as rifles and shotguns, from an unlicensed firearms dealer. Child safety advocates have long campaigned for federal legislation that would raise the minimum age to own any type of firearm and have also called for regulations aimed at preventing children from accessing guns in the home. In October 2023, a study published in the journal  Pediatrics  named firearm-related injuries as the leading cause of death among US children.

An amendment passed in 1996 known as the Lautenberg Amendment prevents people who have been convicted of domestic abuse or are the subject of a protective order prohibiting contact from owning guns. However, abusers who are not a parent, guardian, or legal spouse to their victims face no such restrictions. A provision intended to narrow this gap, known as the "boyfriend loophole," was included in the Bipartisan Safer Communities Act, signed into law by President Biden in June 2022.

Underreporting and underfunding of NICS have contributed to lapses in data that resulted in multiple instances of weapons sales to unauthorized persons who then used the weapons to commit crimes. For example, following an incident in which a former member of the US Air Force killed twenty-six people at a church in Sutherland Springs, Texas, the Air Force acknowledged they had failed to report the shooter's military court-martial conviction for domestic violence to civilian authorities. In response, Congress passed the Fix NICS Act of 2017 to penalize federal agencies that do not meet NICS reporting requirements.

In 2015, a gunman shot and killed nine Black worshippers at a Charleston, South Carolina, church. Authorities later discovered the perpetrator had purchased the murder weapon while his background check was still pending because firearms sales are allowed to proceed by default if the check takes more than three days. The House of Representatives passed a bill in 2021 to extend background checks from three days to ten days, allowing more time for a full check to be completed. Known as the "Charleston loophole" bill, as of November 2023, the Senate had not voted on the legislation.

CRITICAL THINKING QUESTIONS

• Do you interpret the Second Amendment as recognizing an individual or a collective right to own weapons? Explain your reasoning.
• Under what circumstances, if any, do you think gun control measures could be implemented without violating the Second Amendment? Why or why not?
• In your opinion, are existing gun control regulations sufficient to ensure public safety? What other types of measures, if any, do you think are needed? Explain your answer.

TWENTY-FIRST-CENTURY APPROACHES TO GUN CONTROL

Several mass shootings occurred during the presidency of Barack Obama, including the murders of twenty-seven children and teachers at Sandy Hook Elementary in 2012 and forty-nine people at a Florida nightclub in 2016. Congressional inaction led Obama to issue executive orders that expanded background checks to cover firearms sold at gun shows and online, sought more federal agents to process background checks, advocated greater use of smart-gun technology, and required states to provide more information on people disqualified from purchasing guns. The subsequent Donald Trump administration rescinded the last order.

The largest mass shooting in US history, in which sixty people were killed in Las Vegas in 2017, and the February 2018 shooting of fourteen students and three staff members at Marjory Stoneman Douglas High School in Parkland, Florida, renewed debate over access to assault weapons. Student survivors of the massacre joined other gun control advocates in calling for reform. In March 2018 the Marjory Stoneman Douglas High School Public Safety Act was signed into law in Florida. The law placed some limits on gun sales while expanding resources for law enforcement and safety personnel. Later the same month, a group of survivors and student activists organized a nationwide school walkout alongside the March for Our Lives to voice their demands for gun control legislative reform. An estimated one to two million people participated.

Leading up to the 2020 elections, lobbying organizations and political groups again invested substantial amounts of money in political campaigns to elect candidates favorable to their stance on gun control. For example, the NRA gun rights lobbying group alone spent approximately $28.5 million to back the political campaigns of Republican candidates during the 2020 election cycle. Gun control groups such as Everytown for Gun Safety and Giffords collectively spent about $21.6 million in support of Democratic candidates in 2020.

In 2021 and 2022, with congressional action on gun control unlikely, President Joe Biden also issued a series of executive orders. Biden's orders focused on regulating specific types of firearms and gun modifications, funding research on firearms trafficking in the United States, and encouraging states to pass "red flag" laws. Red flag laws allow for the temporary removal of firearms from a person identified as a potential danger by law enforcement or family members, who can petition for a court order. Biden's executive orders also affirmed the federal government's jurisdiction in regulating the sale of firearm-building kits bought through private sellers online and assembled at home. Referred to as "ghost guns," these firearms do not have serial numbers and are untraceable. The US Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF) issued revised rules clarifying that ghost guns must comply with all federal laws related to firearm sales. In October 2023, the Supreme Court blocked a lower court ruling that would have prevented ATF from enforcing the new rules.

Following back-to-back mass shootings in Buffalo, New York, and Uvalde, Texas, in May 2022 that killed a total of thirty-one people, citizens' criticism of federal inaction on gun control once again intensified, leading to the passage of the Bipartisan Safer Communities Act of 2022. President Biden signed the bill—the first major gun control legislation in nearly thirty years—into law two days after the Supreme Court's decision in  NYSRPA v. Bruen  was released.

The Bipartisan Safer Communities Act does not go as far as instituting universal background checks or banning assault weapons, but it contains multiple provisions intended to strengthen the background check system. For instance, the law takes steps to close the boyfriend loophole and institutes a more thorough background check process for buyers under age twenty-one. In addition, the new law requires all people who earn a profit from selling guns to register as licensed dealers, while previous regulations required licensing only for people who sold guns as their principal means of income. Bringing internet and gun show sellers under federal licensure will require they run background checks through NICS and may be a significant step toward closing the gun show loophole.

In September 2023, President Biden announced the creation of the White House Office of Gun Violence Prevention, which aims to execute and build upon important legislation and government initiatives aimed at reducing gun violence in the United States. In October, however, the United States experienced the thirty-sixth and worst mass shooting of the year, when a gunman killed at least eighteen people and injured at least thirteen in two towns in Maine.

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In the following viewpoint, Brown argues that lawmakers should avoid being swayed by victims of gun violence and resist passing gun legislation in the immediate wake of a national tragedy, such as the 2018 mass shooting at Marjory Stoneman Douglas High School in Parkland, Florida. The author contends that gun control advocates frequently use mass shootings as opportunities to push their political agenda. Further, he asserts, gun control groups exploit the victims of gun violence and use them to evoke an emotional response from the public. Dismissing the calls for gun control raised by the student survivors of the 2018 shooting, Brown argues that the students’ personal experiences with gun violence do not qualify them to make decisions regarding gun rights.

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• Introduction
• Conclusions
• Article Information

There were 854 counties included in the analytical sample. Eligibility criteria included states with complete data on deer hunting season start dates and counties not in or adjacent to a metropolitan area. To convert miles to kilometers, multiply by 1.6.

Incidence rate ratios (IRRs) from Poisson regression. Model 1 is a Poisson regression with year, month of year, and day of week fixed effects, plus indicators for the Wednesday to Sunday before and after Thanksgiving and the period from December 24 to January 2. Models 2 and 3 include county fixed effects. The outcome for models 1 and 2 include all shootings. The outcome for model 3 excludes all hunting accidents. Standard errors are adjusted for heteroskedasticity and clustering at the county level. Error bars indicate 95% CIs.

Incidence rate ratios (IRRs) from Poisson regression. All models are county fixed-effects Poisson regressions with year, month of year, and day of week fixed effects, plus indicators for the Wednesday to Sunday before and after Thanksgiving and the period from December 24 to January 2. The outcome for all models includes all shootings. Standard errors are adjusted for heteroskedasticity and clustering at the county level. Error bars indicate 95% CIs.

eAppendix 1. Analysis

eAppendix 2. Results From Models of Fatal Shootings

eFigure. Association Between Deer Season and Fatal Shootings

Data Sharing Statement

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Sharkey P , Cristancho JC , Semenza D. Deer Hunting Season and Firearm Violence in US Rural Counties. JAMA Netw Open. 2024;7(8):e2427683. doi:10.1001/jamanetworkopen.2024.27683

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Deer Hunting Season and Firearm Violence in US Rural Counties

• 1 Princeton University School of Public and International Affairs, Princeton, New Jersey
• 2 School of Education, University of California, Irvine
• 3 Department of Sociology, Anthropology, and Criminal Justice, Rutgers University, Camden, New Jersey
• 4 Department of Urban-Global Public Health, Rutgers University, Camden, New Jersey
• 5 New Jersey Gun Violence Research Center, Rutgers University, Camden

Question   What is the association between the start of deer hunting season and shootings in rural US counties?

Findings   This cohort study examined variation within 854 rural US counties in the timing of the start of deer hunting season, in which modern firearms are used. The first week of deer hunting season was associated with a significant increase in shootings relative to the week prior.

Meaning   This study suggests that the start of deer hunting season is associated with a substantial increase in shootings, highlighting the role of firearm prevalence in gun violence.

Importance   Firearm violence is a major public health problem in the US. However, relatively little research has focused particular attention on firearm violence in rural areas, and few studies have used research designs that draw on exogenous variation in the prevalence of firearms to estimate the association between firearm presence and shootings.

Objective   To investigate the association between the start of deer hunting season and shootings in rural counties in the US.

Design, Setting, and Participants   In this cohort study, data from all rural US counties in states with available data on the timing of deer hunting season were matched with data on shootings from the Gun Violence Archive from January 1, 2014, to December 31, 2021.

Exposure   Shootings in the first 3 weeks of deer hunting season were compared with the week prior to the start of deer hunting season.

Main Outcomes and Measures   The main outcome was daily total shootings. The association between the start of deer hunting season and shootings was estimated using Poisson regression models to analyze change within counties while controlling for relevant calendar year, month of year, and seasonal effects.

Results   The sample included 854 rural counties with a mean (SD) population of 16 416 (18 329) per county and 5.4 (13.3) annual shootings per 100 000 people. The county fixed-effects specification analyzing the association between deer hunting season and shootings showed that relative to the week prior to deer hunting season, the incidence rate ratio for total shootings was 1.49 (95% CI, 1.13-1.95) for the first week of deer hunting season and 1.41 (95% CI, 1.02-1.94) for the second week of deer hunting season. Estimates remained consistent when excluding hunting accidents and were most pronounced in states with more hunting licenses per capita.

Conclusions and Relevance   In this cohort study of the association between the start of deer hunting season and firearm violence, results showed that the start of deer hunting season was associated with a substantial increase in shootings. The findings highlight the role of firearm prevalence in gun violence and suggest the need for focused policies designed to reduce firearm violence in areas with substantial hunting activity during the first weeks of deer hunting season.

Firearm injuries and deaths are a significant public health problem in the US. 1 , 2 A large body of research suggests that greater availability of firearms is associated with increased risk for firearm injury, accidental shootings, suicide, and homicide in the home, across US states, and among high-income nations throughout the world. 3 - 6 This research has been predicated on the premise that the prevalence of guns in a given home, community, or nation is likely to make violent incidents more injurious and more deadly. 7 - 12 However, to our knowledge, few studies have been designed to exploit plausibly exogenous variation in the prevalence of firearms in public and private settings to generate evidence on the association between firearm prevalence and shootings.

This study adds new evidence to the literature on firearm presence and gun violence by using variation in the timing of deer hunting season across US counties. Throughout much of the rural US, the start of deer hunting season is a major annual event that leads to an abrupt increase in the number of people with firearms in public and private spaces. 13 - 20 The timing of deer hunting season, or the date when residents can begin hunting deer with modern firearms, varies across states and, in some cases, across counties within states. This variation provides a natural experiment for assessing whether the opening of deer hunting season is associated with the number of shootings in rural US counties.

This study integrates several data sources spanning from January 1, 2014, to December 31, 2021, a period for which we collected data on both shootings and deer hunting season start dates. First, we created a county-level dataset using the date that deer hunting season starts and its duration. States typically have distinct seasons for different types of hunting. We focused on the earliest date that hunters can begin using modern firearms to hunt deer, which generally matches with the period with the largest deer harvest. The vast majority of hunters hunt big game, and deer hunting is by far the most common form of big game hunting. 14 , 17 For example, between one-fifth and one-third of the total annual deer harvested in Wisconsin are killed in the opening weekend of deer hunting season, and 70% of annual deer harvested are killed in the first 9 days of the season. 14 One study conducted in rural counties found that the percentage of male arrestees armed with a long gun increased 300% at the start of deer hunting season, providing evidence that the deer hunting season is associated with a sharp increase in the presence of firearms in public and private spaces. 14 The study was determined to be exempt from review by Princeton University’s institutional review board because it is not human participants research. The study adheres to the Strengthening the Reporting of Observational Studies in Epidemiology ( STROBE ) reporting guideline for cohort studies.

Due to the absence of a centralized source for information on deer hunting season and variation within states, we coded the start of deer hunting season using diverse references, including state departments of fish and wildlife reports, hunting magazines, and newspaper notices. Dates were reported at the state level or by state-defined hunting zones, which often align with counties. We excluded all counties in Arizona, Iowa, Louisiana, Nevada, New Mexico, and Wyoming because it was not possible to match counties to specific deer hunting seasons due to within-state variation in deer hunting season start dates and misalignment between counties’ borders and hunting zones. The group of excluded states includes some with relatively high (Iowa and Wyoming), medium (Louisiana, New Mexico, and Utah), and low (Arizona) rates of hunting licenses per capita; thus, there does not seem to be a clear link between the prevalence of hunting in a state and the complexity of the timing and geographic variation in hunting seasons. Nonetheless, it is unlikely that the methods exploiting variation in the timing and location of deer hunting season can be used in these states, and our results pertain only to rural counties outside of these 6 states.

The second source of data is the Gun Violence Archive (GVA), which documents shootings across the US, including information about the incident, location, date, type of gun, and number of victims. 21 Gun Violence Archive data are based on various published sources, including media and government reports and local police department reports. Each recorded shooting is geostamped and includes the date of the incident, allowing us to merge each incident with our county dataset by location and timing. The GVA includes a field indicating if the incident was a hunting accident, based on media or police reports. A growing number of studies draw on data from the GVA because it is the only source that tracks all shootings across the entire country. 22 Research validating data from the GVA has found that total counts of homicides correspond closely with data collected and published by the Centers for Disease Control and Prevention. 22 However, recent work has shown that the GVA may undercount certain types of incidents, with a bias toward shootings with multiple victims and those involving women and children. 23 , 24

To create our sample, we classified all counties according to the National Center for Health Statistics urban-rural classification. 25 Research on the prevalence of hunting with firearms shows that participation is extremely low (and often not legal) in counties that are part of or near metropolitan areas and increases substantially in sparsely populated areas outside of central cities and suburbs. 14 For this reason, we reduced the final sample to include 854 counties not located in metropolitan areas and not adjacent to a metropolitan area. Figure 1 shows the location of counties included in the analysis. In the last step, we merged each state with the number of hunting licenses per capita, collected from the US Fish and Wildlife Service between 1980 and 2016. 10

The statistical analysis exploits variation in the precise timing of the start of deer hunting season across and within US counties to identify the association between deer hunting season and gun violence. Although in some states deer hunting season lasts longer than 3 weeks, data on deer harvests suggest that the number of deer killed typically increases sharply in the first week of the season, subsides by week 2, and decreases quickly in the weeks afterward. All models use a Poisson regression in which the outcome is the count of the number of total shootings on a specific day in the specified county. 26 We ran the same set of models using negative binomial regressions, and the results were extremely similar. All SEs adjust for heteroskedasticity and clustering at the county level. We report 95% CIs for all point estimates. We use 2-sided z score tests to determine statistical significance. Although we report 95% CIs for all estimates, we refer to results as statistically significant if P  < .05. Statistical analysis was performed with Stata/SE, version 2018.0 (StataCorp LLC).

The sequence of models begins with a specification that draws on variation across counties (equation 1 in eAppendix 1 in Supplement 1 ). The model includes indicators for each 7-day period before and after the start of deer hunting season, ranging from 3 weeks prior to the start of the season to the third week of the season. We included fixed effects for the calendar year, the day of the week (dummy indicators for Sunday through Saturday, with Monday as the reference), and 2 indicators for holidays—one for the period including the Wednesday to Sunday before and after Thanksgiving, and another for the period from December 23 through January 2.

We then estimated a second model including county fixed effects (equation 2 in eAppendix 1 in Supplement 1 ). In this second model, we compared the weeks after the start of deer hunting season with the weeks prior to deer hunting season within the same counties. 27 , 28 We used the same controls as in model 1. In a third model, we altered the outcome to exclude shootings labeled in the GVA as hunting accidents. This model allowed us to assess whether the association between deer hunting season and shootings was due simply to accidents occurring while hunting, or whether any association was instead due to shootings other than hunting accidents.

Last, we examined how results vary by the prevalence of hunting across states. Using a measure of the number of hunting licenses per capita, we grouped states into tertiles representing states with relatively low, middle, or high prevalences of hunting. We conducted the main analyses separately for each category of states to assess whether results were stronger in states with more hunting licenses per capita.

Figure 2 displays results from models focusing on total shootings for the 854 rural counties (mean [SD] population, 16 416 [18 329] per county; 5.4 [13.3] annual shootings per 100 000 people) in our analytical sample. Of the 854 counties in the sample, 305 had at least 1 shooting during the study period. The graphs show results from 3 models: the first comparing weeks before and after deer hunting season when pooling all counties together, the second making the same comparisons within counties (county fixed effects), and the third showing the county fixed-effects results after excluding hunting accidents. The similarity of results between the first 2 models suggests that findings are robust to the decision to make comparisons across vs within counties. Focusing on the left side of the graph, incidence rate ratios for weeks prior to the start of deer hunting season were close to zero and were not statistically significant, indicating no clear trend in shootings before the start of deer hunting season. This finding provides evidence that the timing of deer hunting season can be considered exogenous.

The point estimates shown in “Week 1 of deer hunting season” capture the association between the first week of deer hunting season and total shootings, relative to the week before deer hunting season ( Figure 2 ). The county fixed-effects specification shows that the incidence rate ratio was 1.49 (95% CI, 1.13-1.95) for the first week of deer hunting season and 1.41 for the second week of deer hunting season (95% CI, 1.02-1.94). There was no statistically significant association in the third week of deer hunting season.

The third set of models in Figure 2 excludes all shootings labeled as hunting accidents from the outcome measure. Results from this model were close to identical to the results including all shootings, with incidence rate ratios slightly smaller in magnitude. In this model, the incidence rate ratio was 1.38 (95% CI, 1.05-1.82) for the first week of deer hunting season and 1.37 (95% CI, 1.00-1.89) for the second week of deer hunting season.

Figure 3 shows results from county fixed-effects specifications estimated among states in the lowest third, middle third, and highest third of hunting licenses per capita. Reducing the sample of states led to less precise estimates, and we did not find a linear association between hunting licenses per capita and shootings. We did find, however, that the strongest association between deer hunting season and total shootings was in states with the highest number of hunters relative to the population. Among states in the top third of licenses per capita, the incident rate ratio for shootings in the first week of deer hunting season was 3.19 (95% CI, 1.86-5.49).

We conducted a set of additional tests of robustness, results of which are available in eAppendix 2 and the eFigure in Supplement 1 . First, we conducted an analysis that included information on the type of gun used in each shooting incident. We found that the increase in shootings after the start of deer hunting season was more pronounced for shootings with a handgun rather than a long gun. However, this finding should be interpreted with caution, as data on the type of gun used are incomplete for a large percentage of incidents in the GVA data. Second, we conducted a supplemental analysis mirroring the main results but focusing only on fatal shootings, rather than total shootings. Full model results are shown in eAppendix 2 and the eFigure in Supplement 1 . Results from our preferred county fixed-effects specification were extremely similar to models of all shootings; the incidence rate ratio for fatal shootings was 1.57 (95% CI, 1.11-2.21) for the first week of deer hunting season and 1.44 (95% CI, 0.98-2.10) for the second week of deer hunting season.

We analyzed the association between the start of deer hunting season and shootings in 44 states between 2014 and 2021. Our analysis produced 3 key findings. First, in our preferred models examining variation within counties, we found significantly higher rates of shootings in the first week after the start of deer hunting season relative to the week prior to deer hunting season. The magnitude of the association was smaller in the second week of deer hunting season and was close to zero by the third week. Second, the results were largely replicated when hunting accidents were removed from the analysis. Third, the association of deer hunting season with shootings was most pronounced in states with the greatest number of hunting licenses per capita. Taken together, these findings offer evidence that the start of deer hunting season has a strong association with gun violence. In the sample of rural US counties, more people were killed by gunfire in the first week of deer hunting season than in any other week of the calendar year.

Although the core finding from the analysis is clear, there are multiple ways to interpret this finding. One plausible interpretation is that the beginning of deer hunting season leads to more people walking through the woods with guns, which is associated with an increase in accidental shootings relative to the weeks before deer hunting season. Although it is true that the start of deer hunting season brings about an increase in hunting-related accidental shootings, these shootings are rare, as most hunting accidents do not involve firearms. 16 , 17 Models excluding hunting accidents produced results that were nearly identical to the main results, suggesting that our estimates were not due to accidental shootings.

A second plausible interpretation is that the association between deer hunting season and gun violence is due to an unrelated change that occurs at the same time as the beginning of deer hunting season. The main analysis shows clearly that the exact timing of deer hunting season, which varies from state to state and in some cases from county to county, is associated with a sharp change in shootings, providing evidence that it is associated with deer hunting season instead of some other change occurring around the same time. To bolster this evidence, we stratified states by the number of hunting licenses per capita and demonstrated that the findings are much stronger in states with a large hunting population.

A third plausible interpretation is that the findings are associated with the start of deer hunting season but due to behavioral shifts unrelated to firearms, such as people being out in public more often, sleeping less, taking time off from work to hunt, or consuming more alcohol. These behavioral changes might increase opportunities for shootings to take place and create conditions for interpersonal conflicts to turn violent. We are not able to fully rule out these mechanisms with our data; however, 1 prior study showed that the start of deer hunting season was associated with null effects on overall crime, as measured with data reported by police departments, as well as a reduction in alcohol-related arrests, suggesting that the start of deer hunting season is not causally related to broader patterns of alcohol-related behavior or more generalized criminal activity. 14 At the same time, the same study found that the number of male arrestees armed with a long gun in rural jurisdictions increased 300% with the opening of deer hunting season, suggesting that the prevalence of firearms around hunting season increases dramatically. 14

This evidence leads us to conclude that the most plausible explanation for the increase in shootings the week after the start of deer hunting season is the heightened presence of firearms in public and private spaces. This conclusion is supported by the supplemental analysis showing that the increase in shootings after the start of deer hunting season was more pronounced for shootings with a handgun rather than a long gun. Although the data on type of gun are incomplete for a large percentage of incidents, this additional evidence suggests the main results may be associated with a broader influx of guns into public and private spaces, rather than simply an increase in long guns used for hunting. 29 - 31 It will be helpful for future research to incorporate different methods and sources of data, including qualitative data on gun prevalence during hunting season and in other parts of the year, to disentangle these explanations.

There are limitations to the present study that provide opportunities for future research. First, we excluded 6 states from our analysis due to incomplete data about hunting season start dates across the years of the analysis; any conclusions should be drawn only about the states in our sample. Second, our study relies on shooting data from a single source, the GVA. Data from GVA have been shown to have a bias toward incidents that receive more media attention and do not include comprehensive counts of firearm suicides. 23 , 24 Considering that much of the literature on the prevalence of guns has focused on suicide, we consider this a natural extension of our research and encourage similar analyses with alternative data sources that provide details on the location and timing of suicides. Third, we analyzed a relatively small analytic sample given our focus on counties not in or adjacent to metropolitan areas. Although this decision is appropriate for studying the association between hunting season and gun violence, future research should seek similar approaches to studying shocks that lead to more guns in public and private spaces in more densely populated areas where most shootings take place.

Our findings align with a body of research showing that firearm prevalence is associated with an increase in the risk of firearm violence. Although our findings do not address state or federal policy, research showing that state-level firearm regulations reduce shootings is relevant to discussions of how states might respond. 7 States with more firearm regulations, especially policies such as waiting periods and background checks, have lower overall firearm death rates, including both homicide and suicide. 7 , 32 Enhanced firearm regulations that govern firearm storage, carrying, and purchasing, particularly in states where deer hunting is popular, may serve to reduce the number of shootings that occur at the onset of the hunting season. 4 , 7 , 12 , 32

Accepted for Publication: June 18, 2024.

Published: August 14, 2024. doi:10.1001/jamanetworkopen.2024.27683

Open Access: This is an open access article distributed under the terms of the CC-BY License . © 2024 Sharkey P et al. JAMA Network Open .

Corresponding Author: Patrick Sharkey, PhD, Princeton University School of Public and International Affairs, Wallace Hall, Princeton University, Princeton, NJ 08540 ( [email protected] ).

Author Contributions: Dr Sharkey had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Sharkey, Semenza.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: All authors.

Critical review of the manuscript for important intellectual content: Sharkey, Semenza.

Statistical analysis: Sharkey, Cristancho.

Administrative, technical, or material support: Sharkey, Semenza.

Supervision: Sharkey, Semenza.

Conflict of Interest Disclosures: None reported.

Data Sharing Statement: See Supplement 2 .

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• v.8(1); 2018 Aug

The Science of Gun Policy

Short abstract.

This study synthesizes the available scientific evidence on the effects of various firearm policies on firearm deaths, violent crime, the gun industry, participation in hunting and sport shooting, and other outcomes.

The RAND Corporation's Gun Policy in America initiative is a unique attempt to systematically and transparently assess available scientific evidence on the real effects of firearm laws and policies. Good gun policies require consideration of many factors, including the law and constitutional rights, the interests of various stakeholder groups, and information about the likely effects of different laws or policies on a range of outcomes. This study seeks to provide the third—objective information about what the scientific literature examining gun policy can tell us about the likely effects of laws. The study synthesizes the available scientific data on the effects of various firearm policies on firearm deaths, violent crime, the gun industry, participation in hunting and sport shooting, and other outcomes.

By highlighting where scientific evidence is accumulating, the authors hope to build consensus around a shared set of facts that have been established through a transparent, nonpartisan, and impartial review process. In so doing, they also illuminate areas where more and better information could make important contributions to establishing fair and effective gun policies.

The RAND Corporation's Gun Policy in America initiative is a unique attempt to systematically and transparently assess available scientific evidence on the real effects of gun laws and policies. Our goal is to create resources where policymakers and the general public can access unbiased information that informs and enables the development of fair and effective policies. Good gun policies in the United States require consideration of many factors, including the law and constitutional rights, the interests of various stakeholder groups, and information about the likely effects of different policies on a range of outcomes. This study seeks to provide the third factor—objective information about what the scientific literature examining gun policies can tell us about the likely effects of those policies.

This study synthesizes the available scientific evidence on the effects of various gun policies on firearm deaths, violent crime, the gun industry, participation in hunting and sport shooting, and other outcomes. 1 It builds and expands on earlier comprehensive reviews of scientific evidence on gun policy conducted more than a decade ago by the National Research Council (see National Research Council, 2004 ) and the Community Preventive Services Task Force (see Hahn et al., 2005 ).

Methodology

We used Royal Society of Medicine guidelines for conducting systematic reviews of a scientific literature ( Khan et al., 2003 ). We focused on the empirical literature assessing the effects of 13 classes of firearm policies or of the prevalence of firearms on any of eight outcomes, which include both public health outcomes and outcomes of concern to many gun owners. We reviewed scientific reports that have been published since 2003, a date chosen to capture studies conducted since the last major systematic reviews of the science of gun policy were published by the National Research Council (2004) and Hahn et al. (2005) .

The 13 classes of gun policies considered in this research are as follows:

• background checks
• bans on the sale of assault weapons and high-capacity magazines
• stand-your-ground laws
• prohibitions associated with mental illness
• lost or stolen firearm reporting requirements
• licensing and permitting requirements
• firearm sales reporting and recording requirements
• child-access prevention laws
• surrender of firearms by prohibited possessors
• minimum age requirements
• concealed-carry laws
• waiting periods
• gun-free zones.

The eight outcomes considered in this research are

• violent crime
• unintentional injuries and deaths
• mass shootings
• officer-involved shootings
• defensive gun use
• hunting and recreation
• gun industry. 2

Policy Analyses, by Outcome

Building on the earlier reviews ( National Research Council, 2004 ; Hahn et al., 2005 ) and using standardized and explicit criteria for determining the strength of evidence that individual studies provide for the effects of gun policies, we produced research syntheses that describe the quality and findings of the best available scientific evidence. Each synthesis defines the class of policies being considered; presents and rates the available evidence; and describes what conclusions, if any, can be drawn about the policy's effects on outcomes.

In many cases, we were unable to identify any research that met our criteria for considering a study as providing minimally persuasive evidence for a policy's effects. Studies were excluded from this review if they offered only correlational evidence for a possible causal effect of the law, such as showing that states with a specific law had lower firearm suicides at a single point in time than states without the law. Correlations like these can occur for many reasons other than the effects of a single law, so this kind of evidence provides little information about the effects attributable to specific laws. We did not exclude studies on the basis of their findings, only on the basis of their methods for isolating causal effects. For studies that met our inclusion criteria, we summarize key findings and methodological weaknesses, when present, and provide our consensus judgment on the overall strength of the available scientific evidence. We did this by establishing the following relativistic scale describing the strength of available evidence:

• No studies. This designation was made when no studies meeting our inclusion criteria evaluated the policy's effect on the outcome.
• Inconclusive evidence. This designation was made when studies with comparable methodological rigor identified inconsistent evidence for the policy's effect on an outcome or when a single study found only uncertain or suggestive effects.
• Limited evidence. This designation was made when at least one study meeting our inclusion criteria and not otherwise compromised by serious methodological problems reported a significant effect of the policy on the outcome, even if other studies meeting our inclusion criteria identified only uncertain or suggestive evidence for the effect of the policy.
• Moderate evidence. This designation was made when two or more studies found significant effects in the same direction and contradictory evidence was not found in other studies with equivalent or strong methods.
• Supportive evidence. This designation was made when (1) at least three studies found suggestive or significant effects in the same direction using at least two independent data sets or (2) the effect was observed in a rigorous experimental study.

These ratings are meant to describe the relative strengths of evidence available across gun policy research domains, not any rating of our absolute confidence in the reported effects. For instance, when we find supportive evidence for the conclusion that child-access prevention laws reduce self-inflicted injuries and deaths, we do not mean to suggest that it is comparable to the evidence available in more-developed fields of social science. That is, in comparison to the evidence that smoking causes cancer, the evidence base in gun policy research is very limited. Nevertheless, we believe that it may be valuable to the public and to policymakers to understand which laws currently have more or less persuasive evidence concerning the effects the laws are likely to produce.

Table 1 summarizes our judgments for all policy and outcome pairings. Several outcomes show multiple judgments, and these correspond to different characterizations of the specific policy-outcome association. For instance, we identified limited evidence that background checks reduce total suicides and moderate evidence that they reduce firearm suicides .

Strength of Evidence Across Gun Policies and Outcomes

NOTE: I = inconclusive; L = limited; M = moderate; S = supportive. When we identified no studies meeting eligibility criteria, cells are blank. ⊠ = the policy increases the outcome; ⊠ = the policy decreases the outcome.

* We concluded that there is moderate evidence that dealer background checks decrease firearm homicides, and there is inconclusive evidence for the effect of private-seller background checks on firearm homicides.

Rather than concerning how strong a policy's effects are, our findings concern the strength of the available scientific evidence examining those effects. Thus, even when the available evidence is limited, the actual effect of the policy may be strong. Presumably, every policy has some effect on a range of outcomes, however small or unintended. Until researchers design studies that can detect these effects, available evidence is likely to remain inconclusive or limited. But this fact should not be confused with the conclusion that the policies themselves have limited effects. They may or may not have the effects they were designed to produce; available scientific research cannot yet answer that question. Moreover, even a policy with a small effect may nevertheless be beneficial to society or worth its costs. For instance, a policy that reduces firearm deaths by just a few percentage points could save more than 1,000 lives per year. This kind of “small” effect might be very difficult to detect with existing study methods but could represent an important contribution to public health and safety.

Supplementary Essays

The 13 types of policies reviewed in this study and the scope of the systematic review for the research synthesis were selected a priori and represent the central focus of our research synthesis efforts. Nevertheless, in reviewing evidence on these policies, other important themes emerged that the research team believed provided useful context for the policies or that were frequently cited in gun policy debates. Thus, we also researched what rigorous studies reveal about

• the possible mechanisms by which laws may affect outcomes
• how taxes, access to health care, and media campaigns might affect gun violence
• the effectiveness of laws used to target domestic violence
• methodological challenges in defining and estimating the prevalence of mass shootings and defensive gun use
• how suicide, violence, and mass shootings were affected by Australia's implementation of the National Firearms Agreement.

Conclusions and Recommendations

Of more than 100 combinations of policies and outcomes, we found that surprisingly few were the subject of methodologically rigorous investigation. Notably, research into four of our outcomes was essentially unavailable, with three of these four outcomes—defensive gun use, hunting and recreation, and the gun industry—representing issues of particular concern to gun owners or gun industry stakeholders. Here, we summarize the key conclusions and recommendations that can be drawn from the policy-outcome combinations with the strongest available evidence (conclusions 1 through 8). Thereafter, we draw conclusions and recommendations concerning how to improve evidence on the effects of gun policies (conclusions 9 through 13).

Conclusions and Recommendations Based on the Existing Evidence Base

Our first set of conclusions and recommendations describes the policy-outcome combinations with the strongest available evidence as identified through our review of the existing literature, as well as recommendations for policy based on this evidence.

Conclusion 1 . Available evidence supports the conclusion that child-access prevention laws, or safe storage laws, reduce self-inflicted fatal or nonfatal firearm injuries among youth. There is moderate evidence that these laws reduce firearm suicides among youth and limited evidence that the laws reduce total (i.e., firearm and nonfirearm) suicides among youth.

Conclusion 2 . Available evidence supports the conclusion that child-access prevention laws, or safe storage laws, reduce unintentional firearm injuries or unintentional firearm deaths among children. In addition, there is limited evidence that these laws may reduce unintentional firearm injuries among adults.

Recommendation 1 . States without child-access prevention laws should consider adopting them as a strategy to reduce firearm suicides and unintentional firearm injuries and deaths. We note, however, that scientific research cannot, at present, address whether these laws might increase or decrease crime or rates of legal defensive gun use.

Recommendation 2 . When considering adopting or refining child-access prevention laws, states should consider making child access to firearms a felony; there is some evidence that felony laws may have the greatest effects on unintentional firearm deaths.

Conclusion 3 . There is moderate evidence that background checks reduce firearm suicides and firearm homicides, as well as limited evidence that these policies can reduce overall suicide and violent crime rates.

Conclusion 4 . There is moderate evidence that stand-your-ground laws may increase state homicide rates and limited evidence that the laws increase firearm homicides in particular.

Conclusion 5 . There is moderate evidence that laws prohibiting the purchase or possession of guns by individuals with some forms of mental illness reduce violent crime, and there is limited evidence that such laws reduce homicides in particular. There is also limited evidence these laws may reduce total suicides and firearm suicides.

Recommendation 3. States that currently do not require a background check investigating all types of mental health histories that lead to federal prohibitions on firearm purchase or possession should consider implementing robust mental illness checks, which appear to reduce rates of gun violence. The most robust procedures involve sharing data on all prohibited possessors with the National Instant Criminal Background Check System.

Conclusion 6 . There is limited evidence that before implementation of a ban on the sale of assault weapons and high-capacity magazines, there is an increase in the sales and prices of the products that the ban will prohibit.

Conclusion 7 . There is limited evidence that a minimum age of 21 for purchasing firearms may reduce firearm suicides among youth.

Conclusion 8 . No studies meeting our inclusion criteria have examined required reporting of lost or stolen firearms, required reporting and recording of firearm sales, or gun-free zones.

Conclusions and Recommendations for Improving Gun Policy Research

Based on our review of the existing literature on the effects of firearm policy changes, we offer the following conclusions and recommendations for improving the evidence base on the effects of gun laws.

Conclusion 9 . The modest growth in knowledge about the effects of gun policy over the past dozen years reflects, in part, the reluctance of the U.S. government to sponsor work in this area at levels comparable to its investment in other areas of public safety and health, such as transportation safety.

Recommendation 4 . To improve understanding of the real effects of gun policies, Congress should consider whether to lift current restrictions in appropriations legislation, and the administration should invest in firearm research portfolios at the Centers for Disease Control and Prevention, the National Institutes of Health, and the National Institute of Justice at levels comparable to its current investment in other threats to public safety and health.

Recommendation 5 . Given current limitations in the availability of federal support for gun policy research, private foundations should take further steps to help fill this funding gap by supporting efforts to improve and expand data collection and research on gun policies.

Conclusion 10 . Research examining the effects of gun policies on officer-involved shootings, defensive gun use, hunting and recreation, and the gun industry is virtually nonexistent.

Recommendation 6 . To improve understanding of outcomes of critical concern to many in gun policy debates, the U.S. government and private research sponsors should support research examining the effects of gun laws on a wider set of outcomes, including crime, defensive gun use, hunting and sport shooting, officer-involved shootings, and the gun industry.

Conclusion 11 . The lack of data on gun ownership and availability and on guns in legal and illegal markets severely limits the quality of existing research.

Recommendation 7 . To make important advances in understanding the effects of gun laws, the Centers for Disease Control and Prevention or another federal agency should resume collecting voluntarily provided survey data on gun ownership and use.

Recommendation 8 . To foster a more robust research program on gun policy, Congress should consider whether to eliminate the restrictions it has imposed on the use of gun trace data for research purposes.

Conclusion 12 . Crime and victimization monitoring systems are incomplete and not yet fulfilling their promise of supporting high-quality gun policy research in the areas we investigated.

Recommendation 9 . To improve the quality of evidence used to evaluate gun policies, the National Violent Death Reporting System should be expanded to include all states with rigorous quality control standards.

Recommendation 10 . The Bureau of Justice Statistics should examine the cost and feasibility of expanding its existing programs to generate state-level crime data.

Recommendation 11 . The Bureau of Justice Statistics should continue to pursue its efforts to generate state-level victimization estimates. The current goal of generating such estimates for 22 states is a reasonable compromise between cost and the public's need for more-detailed information. However, the bureau should continue to expand its development of model-based victimization rates for all states and for a wider set of victimization experiences (including, for instance, crimes involving firearm use by an assailant or victim).

Conclusion 13 . The methodological quality of research on firearms can be significantly improved.

Recommendation 12 . As part of the Gun Policy in America initiative, we have published a database containing a subset of state gun laws from 1979 to 2016 ( Cherney, Morral, and Schell, 2018 ). We ask that others with expertise on state gun laws help us improve the database by notifying us of its errors, proposing more-useful categorizations of laws, or submitting information on laws not yet incorporated into the database. With such help, we hope to make the database a resource beneficial to all analysts.

Recommendation 13 . Researchers, reviewers, academics, and science reporters should expect new analyses of the effects of gun policies to improve on earlier studies by persuasively addressing the methodological limitations of earlier studies, including problems with statistical power, model overfitting, covariate selection, poorly calibrated standard errors, multiple testing, undisclosed state variation in law implementation, unjustified assumptions about the time course of each policy's effects, the use of spline and hybrid effect codings that do not reveal coherent causal effect estimates, and inadequate attention to threats of reciprocal causation and simultaneity bias.

In conclusion, with a few exceptions, there is a surprisingly limited base of rigorous scientific evidence concerning the effects of many commonly discussed gun policies. This does not mean that these policies are ineffective; they might well be quite effective. Instead, it reflects shortcomings in the contributions that scientific study can currently offer to policy debates in these areas. It also reflects, in part, the policies we chose to investigate, all of which have been implemented in some U.S. states and, therefore, have proven to be politically and legally feasible, at least in some states. This decision meant that none of the policies we examined would dramatically increase or decrease the stock of guns or gun ownership rates in ways that would produce more readily detectable effects on public safety, health, and industry outcomes. The United States has a large stock of privately owned guns in circulation—estimated in 2014 to be somewhere between 200 million and 300 million firearms ( Cook and Goss, 2014 ). Laws designed to change who may buy new weapons, what weapons they may buy, or how gun sales occur will predictably have only a small effect on, for example, homicides or participation in sport shooting, which are affected much more by the existing stock of firearms. Although small effects are especially difficult to identify with the statistical methods common in this field, they may be important. Even a 1-percent reduction in homicides corresponds to more than 1,500 fewer deaths over a decade.

By highlighting where scientific evidence is accumulating, we hope to build consensus around a shared set of facts that have been established through a transparent, nonpartisan, and impartial review process. In so doing, we also mean to highlight areas where more and better information could make important contributions to establishing fair and effective gun policies.

This project is a RAND Venture. Funding was provided by gifts from RAND supporters and income from operations.

1 Although not all guns are firearms, in this study, we follow conventional use in U.S. policy discussions and treat the terms gun and firearm as interchangeable.

2 The terms in these lists describe broad categories of policies and outcomes that are defined and described in detail in the full study, available at www.rand.org/t/RR2088 .

• Cherney Samantha, Morral Andrew R. and Schell Terry L. RAND State Firearm Law Database. Santa Monica, Calif.: RAND Corporation; 2018. https://www.rand.org/pubs/tools/TL283.html TL-283-RC. As of March 2, 2018: [ Google Scholar ]
• Cook Philip J. and Goss Kristin A. The Gun Debate: What Everyone Needs to Know. New York: Oxford University Press; 2014. [ Google Scholar ]
• Hahn Robert A., Bilukha Oleg, Crosby Alex, Fullilove Mindy T., Liberman Akiva, Moscicki Eve, Snyder Susan, Tuma Farris. and Briss Peter A. “Firearms Laws and the Reduction of Violence: A Systematic Review,” American Journal of Preventive Medicine. 2005; Vol. 28 (No. 2):40–71. pp. [ PubMed ] [ Google Scholar ]
• Khan Khalid S., Kunz Regina, Kleijnen Jos. and Antes Gerd. “Five Steps to Conducting a Systematic Review,” Journal of the Royal Society of Medicine. 2003; Vol. 96 (No. 3):118–121. pp. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• National Research Council. Firearms and Violence: A Critical Review. Washington, D.C.: National Academies Press; 2004. [ Google Scholar ]