Incidence of Firearm Suicide in US Congressional Districts Estimated from County-Level Underlying Cause of Death Reports

Abstract

Background: Suicide is the most common form of violent death in the US and firearms are the most common means of suicide, contributing to half of all suicide deaths. The focus of this research is calculating suicide and firearm suicide counts and rates for each congressional district in order to highlight the types of legislation and local programs that can address this public health crisis in each district.Methods: Counts of suicides and firearm suicides for the congressional districts were calculated by weighting county counts as reported by the Centers for Disease Control and Prevention for the five-year period 2014 to 2018 by the proportion of the county population allocated to the congressional district for that population group as available from the Census Bureau’s Summary File for the 116th Congress. The weighted counts were then summed over the counties in the congressional district. Results: There are 52 firearm suicides on average per congressional district each year, yet there is tremendous district-level variation across the country and even within states. Seventeen districts—in Massachusetts, New Jersey, New York and Washington, DC—have 10 or fewer firearm suicides each year. On the other hand, 11 districts—in Alaska, Arizona, Colorado, Idaho, Montana, Oklahoma, Oregon, and Tennessee—have over 100 gun suicides each year. 88 percent of the difference in congressional district-level suicide rates is explained by differences in firearm suicide. The proportion of suicides by firearm out of all suicides ranges from 6% to 73% across districts. Rates of suicide by other means were similar across rural and urban districts, while rates of firearm suicide were on average 5 times higher in rural districts (1.77 in urban compared to 10.60 per 100,000 population in rural). Conclusions: Understanding the incidence of firearm suicide in US congressional districts can provide tools for holding elected officials accountable for taking steps-- including research funding, key policies, storage practices, public education initiatives -- to protect the lives of their constituents by preventing firearm suicide.