Impact of licensed federal firearm suppliers on firearm-related mortality

Abstract

BACKGROUND Legal firearm sales occur largely through suppliers that have Federal Firearm Licensees (FFLs). Since FFL density might reflect ease-of-access to firearm purchases, we hypothesized that the number of FFL dealers would be associated with firearm-related deaths. We further hypothesized that licensee-type subsets would be associated with differential risks for gun-related deaths. METHODS We used data from the National Center for Health Statistics National Vital Statistics System (2008–2014) and national data on Federal Firearms Licensees for 2014. Correlation analysis and linear regression analysis were performed to determine the relationship between different licensee types and firearm-related deaths. We controlled for population, number of statewide registered firearms, and the density of other types of FFLs. RESULTS We identified a total of 65,297 FFLs. There was a moderate correlation (R = 0.53, ρ = 0.48) between total FFL density and firearm-related death rates. Further analysis by type of firearm-related death showed a strong correlation (R = 0.81, ρ = 0.76) between total FFL density and firearm-related suicide rates. No correlation was found between total FFL density and firearm-related homicide rate. Among individual FFL types, FFL02 (firearm dealing pawnshop) density was the only FFL-type found to be correlated with firearm-related death rates. We found a strong correlation between FFL02 density and overall firearm-related death rate (R = 0.69, ρ = 0.78) and firearm-related suicide rate (R = 0.72, ρ = 0.78). Linear regression analysis showed that even while controlling for number of registered firearms and population, the number of firearm-dealing pawnshops remained significantly associated with overall firearm-related deaths and firearm-related suicides. CONCLUSION Access to legally distributed firearms is associated with firearm-related death rates, particularly firearm-related suicides. Specifically, firearm-dealing pawnshops were associated with suicide-related deaths. These findings suggest that deeper exploration of legal firearm access and firearm-related injuries would benefit discussion of preventative measures. LEVEL OF EVIDENCE Therapeutic, Level V.

Neighbors Do Matter: Between-State Firearm Laws and State Firearm-Related Deaths in the U.S., 2000–2017

“…The per capita number of licensed gun dealers, obtained from U.S. Bureau of Alcohol, Tobacco, Firearms and Explosives, 25 and the percentage of the hunting license holder of the state's population, obtained from the National Survey of Fishing, Hunting, and Wildlife-Associated Recreation, 26 were included as proxy controls for household gun ownership. 3,27,28 As a further proxy measure for state sentiment toward firearm control, the vote share differences between the Republican and Democratic presidential candidates in each presidential election year within the study period 29 were included and extrapolated for years between presidential elections.…”

Associations of firearm dealer openings with firearm self-harm deaths and injuries: A differences-in-differences analysis

“…Our hypothesis that FFL openings would lead to increases in firearm self-harm was based on prior studies that identified positive associations of firearm dealer density with firearm suicide, homicides, robberies, gun-related crimes, and firearm ownership [17][18][19][20][21][22][23]. However, there are several important differences between these studies and our approach.…”

“…To our knowledge, only one previous study has examined firearm dealers and self-harm. Chao and colleagues found a positive association of state-level firearm dealer density with firearm suicides [17], while Price et al found no association [18]. Local-level firearm dealer proximity or density, which are more likely to shape behavior, and nonfatal firearm self-harm injuries remain unexamined.…”

“…Local-level firearm dealer proximity or density, which are more likely to shape behavior, and nonfatal firearm self-harm injuries remain unexamined. Existing evidence on firearm homicides, robberies, gun-related crimes, or the proportion of suicides completed with firearms (a proxy for firearm ownership) suggests these outcomes are higher in areas with greater densities of firearm dealers [17,[19][20][21][22][23]. One concern with these cross-community comparisons is that confounding factors such as gun culture or business opportunity may determine both where firearm dealers are located and where firearm ownership or use may be higher.…”

“…No studies have examined acute changes in firearm dealer density, which can be operationalized as dealer openings. Given that overall firearm dealer density has remained unchanged over time in many places [17][18][19][20][21][22][23], leveraging such changes over time may strengthen causal inference. We exploit variation in the timing and location of firearm dealer openings with a quasiexperimental, differences-in-differences design to investigate whether acute increases in firearm dealer density are associated with short-term increases in firearm suicides and self-harm injuries.…”