What is gun culture? Cultural variations and trends across the United States

Abstract We developed empirical methods to identify variations in elements of gun culture across states. Using these methods, we then analyzed the prominence of these subcultures between states and over time from 1998 through 2016. Using state-level data, we conducted a principal component analysis of 11 variables associated with gun-related behaviors and retained only the significant components. We then analyzed the presence of these components over time and across states. Based on the principal component analysis, we identified three cultural variations. Component 1 reflected recreational elements of gun culture. Component 2 represented a self-defense element of gun culture. Component 3 was indicative of a symbolic cultural element centered around the protection of the Second Amendment and insurrectionism. Over time, the recreational cultural element declined in prominence while the self-defense one rose and the Second Amendment advocacy one remained stable. This paper advances the literature on gun culture by demonstrating that: (1) gun culture is not monolithic; (2) there are multiple elements of gun culture that vary substantially between states; (3) over time, the recreational gun subculture has been falling in prominence whereas the self-defense subculture has been rising; and (4) there is another subculture, distinct from the self-defense one, which consists in mobilization around the Second Amendment and was strongest in places where state firearm laws are most extensive

Relative Risk of Mortality from Unintentional Injury: United States 1999–2012.

<p>Relative Risk of Mortality from Unintentional Injury: United States 1999–2012.</p

Injury Fatalities, Population Attributable Fraction, and Attributable Deaths for County Poverty, 1999–2010.

<p>Injury Fatalities, Population Attributable Fraction, and Attributable Deaths for County Poverty, 1999–2010.</p

Trends in Mortality for All Unintential Injuries and Specific Causes by County Poverty Rates, US 1999–2012.

<p>Trends in Mortality for All Unintential Injuries and Specific Causes by County Poverty Rates, US 1999–2012.</p

Mortality Rates (per 100,000)^a for All Unintentional Injuries and Specific Causes, US 1999–2012.

<p>Mortality Rates (per 100,000)^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0153516#t001fn002" target="_blank">a</a>} for All Unintentional Injuries and Specific Causes, US 1999–2012.</p

Two-Year Utilization and Expenditures for Children After a Firearm Injury

INTRODUCTION: Firearm injuries are a leading cause of morbidity among children, but data on healthcare utilization and expenditures after injury are limited. This study sought to analyze healthcare encounters and expenditures for 2 years after a nonfatal firearm injury. METHODS: A retrospective cohort study was conducted between 2020 and 2022 of children aged 0-18 years with International Classification of Diseases, Ninth Revision/ICD-10 diagnosis codes for firearm injury from 2010 to 2016 in the Medicaid MarketScan claims database. Outcomes included the difference in healthcare encounters and expenditures, including mental health. Descriptive statistics characterized patient demographics and healthcare utilization. Changes in health expenditures were evaluated with Wilcoxon sign rank tests. RESULTS: Among 911 children, there were 12,757 total healthcare encounters in the year before the index firearm injury, 15,548 1 encounters in the year after (p\u3c0.001), and 10,228 total encounters in the second year (p\u3c0.001). Concomitantly, there was an overall increase of $14.4 million in health expenditures ($11,415 per patient) 1 year after (p\u3c0.001) and a $0.8 million decrease 2 years after the firearm injury (p=0.001). The children with low previous expenditures (majority of sample) had sustained increases throughout the second year after injury. There was a 31% and 37% absolute decrease in mental health utilization and expenditures, respectively, among children 2 years after the firearm injury. CONCLUSIONS: Children who experience nonfatal firearm injury have an increased number of healthcare encounters and healthcare expenditures in the year after firearm injury, which is not sustained for a second year. Mental health utilization and expenditures remain decreased up to 2 years after a firearm injury. More longitudinal research on the morbidity associated with nonfatal firearm injuries is needed