Gun Shows Across a Multistate American Gun Market: Observational Evidence of the Effects of Regulatory Policies

Objective: To describe gun shows and assess the impact of increased regulation on characteristics linked to their importance as sources of guns used in crime.Design: Cross-sectional, observational.Subjects: Data were collected at a structured sample of 28 gun shows in California, which regulates these events and prohibits undocumented private party gun sales; and in Arizona, Nevada, Texas and Florida -- all leading sources of California's crime guns -- where these restrictions do not exist.Main outcome measures: Size of shows, measured by numbers of gun vendors and people in attendance; number and nature of guns for sale by gun vendors; measures of private party gun sales and illegal surrogate ("straw") gun purchases.Results: Shows in comparison states were larger, but the number of attendees per gun vendor was higher in California. None of these differences was statistically significant. Armed attendees were more common in other states (median 5.7%, interquartile range (IQR) 3.9 - 10.0%) than in California (median 1.1%, IQR 0.5 - 2.2%), p = 0.0007. Thirty percent of gun vendors both in California and elsewhere were identifiable as licensed firearm retailers. There were few differences in the types or numbers of guns offered for sale; vendors elsewhere were more likely to sell assault weapons (34.9% and 13.3%, respectively; p = 0.001). Straw purchases were more common in the comparison states (rate ratio 6.6 (95% CI 0.9 to 49.1), p = 0.06).Conclusions: California's regulatory policies were associated with a decreased incidence of anonymous, undocumented gun sales and illegal straw purchases at gun shows. No significant adverse effects of these policies were observed

The Epidemiology of Firearm Violence in the Twenty-First Century United States

This brief review summarizes the basic epidemiology of firearm violence, a large and costly public health problem in the United States for which the mortality rate has remained unchanged for more than a decade. It presents findings for the present in light of recent trends. Risk for firearm violence varies substantially across demographic subsets of the population and between states in patterns that are quite different for suicide and homicide. Suicide is far more common than homicide and its rate is increasing; the homicide rate is decreasing. As with other important health problems, most cases of fatal firearm violence arise from large but low-risk subsets of the population; risk and burden of illness are not distributed symmetrically. Compared with other industrialized nations, the United States has uniquely high mortality rates from firearm violence

Where the guns come from: The gun industry and gun commerce.

Under federal law, it is illegal for youth under age 18 to purchase rifles or shotguns, and for those under age 21 to purchase handguns. However, fatality and injury statistics clearly show that guns are finding their way into young people's hands. Many of these youth obtain guns through illegal gun markets.This article focuses on how guns in the United States are manufactured, marketed, and sold. The article shows how the legal and illegal gun markets are intimately connected and make guns easily accessible to youth."Although the domestic gun manufacturing industry is relatively small and has experienced declining sales in recent years, it has significant political clout and a large market for its products, and has engaged in aggressive marketing to youth."Lax oversight of licensed firearms dealers, combined with little or no regulation of private sales between gun owners, mean that guns can quickly move from the legal gun market into the illegal market, where they can be acquired by young people.Certain guns, especially inexpensive, poorly made small handguns, are particularly attractive to criminals and youth. The author observes that several policy innovations -- including increased regulation of licensed firearms dealers, intensified screening of prospective buyers, regulation of private sales, gun licensing and registration, and bans on some types of weapons -- hold promise for decreasing the flow of guns into the hands of youth.[Note: The photo on page 68 is not longer available and deleted from the online publication.

Characteristics of Federally Licensed Firearms Retailers and Retail Establishments in the United States: Initial Findings from the Firearms Licensee Survey

Firearms have widely supported legitimate purposes but are also frequently used in violent crimes. Owners and senior executives of federally licensed firearms dealers and pawnbrokers are a potentially valuable source of information on retail commerce in firearms, links between legal and illegal commerce, and policies designed to prevent the firearms they sell from being used in crimes. To our knowledge, there has been no prior effort to gather such information. In 2011, we conducted the Firearms Licensee Survey on a probability sample of 1,601 licensed dealers and pawnbrokers in the United States believed to sell 50 or more firearms per year. This article presents details of the design and execution of the survey and describes the characteristics of the respondents and their business establishments. The survey was conducted by mail, using methods developed by Dillman and others. Our response rate was 36.9 % (591 respondents), similar to that for other establishment surveys using similar methods. Respondents had a median age of 54; 89% were male, 97.6% were White, and, 98.1% were non-Hispanic. Those who held licenses under their own names had been licensed for a median of 18 years. A large majority of 96.3% agreed that "private ownership of guns is essential for a free society"; just over half (54.9%) believed that "it is too easy for criminals to get guns in this country." A match between the job and a personal interest in the shooting sports was the highest-ranking reason for working as a firearms retailer; the highest-ranking concerns were that "there are too many 'gun control' regulations" and that "the government might confiscate my guns." Most respondents (64.3%) were gun dealers, with significant variation by region. Residential dealers accounted for 25.6% of all dealers in the Midwest. Median annual sales volume was 200 firearms for both dealers and pawnbrokers. Dealers appeared more likely than pawnbrokers to specialize; they were more likely to rank in the highest or lowest quartile on sales of handguns, inexpensive handguns, and tactical rifles. Sales of inexpensive handguns and sales to women were more common among pawnbrokers. Internet sales were reported by 28.3% of respondents and sales at gun shows by 14.3%. A median of 1% of sales were denied after purchasers failed background checks; firearm trace requests equaled G1 % of annual sales. Trace frequency was directly associated with the percentage of firearm sales involving handguns, inexpensive handguns, and sales to women. Frequency of denied sales was strongly and directly associated with frequency of trace requests (pG0.0001). These results are based on selfreport but are consistent with those from studies using objective data

The role of firearm and alcohol availability in firearm suicide: A population-based weighted case-control study

Firearm availability has been linked to firearm self-harm, but the joint relationship with alcohol availability, while supported by theory, has not been examined. This study sought to quantify the separate and joint relations of community firearm and alcohol availability with individual-level risk of (fatal and nonfatal) firearm self-harm. We conducted a case-control study of California residents, 2005-2015, using statewide mortality, hospital, firearm transfer, and alcohol license data. We estimated monthly marginal risk differences per 100,000 in the overall population and in white men aged 50+ under various hypothetical changes to firearm and alcohol availability and assessed additive interactions using case-control-weighted g-computation. In the overall population, non-pawn shop firearm dealer density was associated with firearm self-harm (RD: 0.02, 95% CI: 0.003, 0.04) but pawn shop firearm dealer and alcohol outlet densities were not. Secondary analyses revealed a relationship between firearm sales density and firearm self-harm (RD: 0.07, 95% CI: 0.04, 0.10). There were no additive interactions between measures of firearm and alcohol availability. Among older white men, generally the same exposures were related to self-harm as in the overall population, but point estimates were substantially larger. Findings suggest community-level approaches to reducing firearm sales may help mitigate suicide risk

Firearm Violence Following the Implementation of California's Gun Violence Restraining Order Law.

Importance: California's gun violence restraining order (GVRO) law, implemented beginning in 2016, allows for people at high risk of harming themselves or others with a firearm to be temporarily disarmed and prevented from purchasing firearms for 3 weeks to 1 year; many states have recently enacted similar laws. The research to date is on older and more limited risk-warrant laws. Objective: To determine whether implementation of the California GVRO law was associated with decreased rates of firearm assault or firearm self-harm in a large metropolitan county between 2016 and 2019. Design, Setting, and Participants: This serial cross-sectional study including data from 28 counties used the synthetic control method to evaluate differences in firearm violence between San Diego County and its synthetic control following implementation of the California law from 2016 to 2019. San Diego County was used as the treated unit because it issued substantially more GVROs than any other county in California during the study period. A total of 27 California counties that issued no or very few gun violence restraining orders from 2016 to 2019 and that had stable rates of firearm violence between 2005 and 2015 were included in the control pool. Data were analyzed from February 2021 to July 2021. Exposures: Implementation of the statewide GVRO law in 2016 in San Diego County. Main Outcomes and Measures: Annual rates of fatal and nonfatal firearm assault injuries and firearm self-harm injuries per 100 000 people. Results: In the study period, there were 355 GVROs in San Diego county, and a median (IQR) total of 8 (3-20) GVROs per donor county. The mean difference between the observed rate in San Diego County and the estimated rate in the synthetic San Diego County, 2016-2019, was -0.74 firearm assaults per 100 000 (-13% difference) and 0.13 firearm self-harm injuries per 100 000 (3% difference). Results from in-space placebo tests suggested that these differences cannot be distinguished from variation due to chance (pseudo-P values from a 1-sided test: P for assault = .35, P for self-harm = .67). Conclusions and Relevance: To our knowledge, this study was the first to analyze the association between GVRO implementation and firearm violence in California and the first to evaluate the association between risk-based firearm removal laws and firearm assault in any state. GVROs were not associated with reduced population-level rates of firearm violence in San Diego County, but this may change as the number of orders increases over time; the association between GVROs and firearm violence at the individual level cannot be inferred from our findings and should be the subject of future studies

Effects of Policies Designed to Keep Firearms from High-Risk Individuals

This article summarizes and critiques available evidence from studies published between 1999 and August 2014 on the effects of policies designed to keep firearms from high-risk individuals in the United States. Some prohibitions for high-risk individuals (e.g., those under domestic violence restraining orders, violent misdemeanants) and procedures for checking for more types of prohibiting conditions are associated with lower rates of violence. Certain laws intended to prevent prohibited persons from accessing firearms -- rigorous permit-to-purchase, comprehensive background checks, strong regulation and oversight of gun dealers, and requiring gun owners to promptly report lost or stolen firearms -- are negatively associated with the diversion of guns to criminals. Future research is needed to examine whether these laws curtail nonlethal gun violence and whether the effects of expanding prohibiting conditions for firearm possession are modified by the presence of policies to prevent diversion

Factors Affecting a Recently Purchased Handgun’s Risk for Use in Crime under Circumstances That Suggest Gun Trafficking

While many handguns are used in crime each year in the USA, most are not. We conducted this study to identify factors present at the time of a handgun’s most recent retail sale that were associated with its subsequent use in crime under circumstances suggesting that the handgun had been trafficked—purchased with the intent of diverting it to criminal use. Handguns acquired in multiple-gun purchases were of particular interest. Using data for 180,321 handguns purchased from federally licensed retailers in California in 1996, we studied attributes of the handguns, the retailers selling them, the purchasers, and the sales transactions. Our outcome measure was a handgun’s recovery by a police agency, followed by a gun ownership trace, conducted by the Bureau of Alcohol, Tobacco, Firearms and Explosives, that determined (a) that the recovery had occurred within 3 years of the handgun’s most recent purchase from a licensed retailer and (b) that the person who possessed the gun when it was recovered by police was not its most recent purchaser. Altogether, 722 handguns were recovered and had trace results that met the additional criteria. Handguns acquired in multiple-gun, same-day transactions were more likely to be traced than were single-purchase handguns (odds ratio [OR] 1.33, 95% confidence intervals [CI] 1.08 to 1.63). This was not the case for multiple-purchase handguns defined more broadly as multiple handguns purchased by one individual over any 30-day period as used in “one-gun-a-month” laws. Bivariate regressions indicated increased risk of a handgun being traced when it sold new for $150 or less (OR 4.28, 95% CI 3.59 to 5.11) or had been purchased by a woman (OR 2.02, 95% CI 1.62 to 2.52). Handguns sold by retailers who also had a relatively high proportion (≥2%) of purchases denied because the prospective purchasers were prohibited from owning firearms were more likely to be traced than were those sold by other retailers (OR 4.09, 95% CI 3.39 to 4.94). These findings persisted in multivariate analyses. Our findings suggest specific strategies for intervention to prevent gun violence

Assembly of the LongSHOT cohort: Public record linkage on a grand scale

Background: Virtually all existing evidence linking access to firearms to elevated risks of mortality and morbidity comes from ecological and case-control studies. To improve understanding of the health risks and benefits of firearm ownership, we launched a cohort study: the Longitudinal Study of Handgun Ownership and Transfer (LongSHOT). Methods: Using probabilistic matching techniques we linked three sources of individual-level, state-wide data in California: official voter registration records, an archive of lawful handgun transactions and all-cause mortality data. There were nearly 28.8 million unique voter registrants, 5.5 million handgun transfers and 3.1 million deaths during the study period (18 October 2004 to 31 December 2016). The linkage relied on several identifying variables (first, middle and last names; date of birth; sex; residential address) that were available in all three data sets, deploying them in a series of bespoke algorithms. Results: Assembly of the LongSHOT cohort commenced in January 2016 and was completed in March 2019. Approximately three-quarters of matches identified were exact matches on all link variables. The cohort consists of 28.8 million adult residents of California followed for up to 12.2 years. A total of 1.2 million cohort members purchased at least one handgun during the study period, and 1.6 million died. Conclusions: Three steps taken early may be particularly useful in enhancing the efficiency of large-scale data linkage: thorough data cleaning; assessment of the suitability of off-the-shelf data linkage packages relative to bespoke coding; and careful consideration of the minimum sample size and matching precision needed to support rigorous investigation of the study questions