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.

Firearm Retailers’ Willingness to Participate in an Illegal Gun Purchase

Firearm-related violence is a significant public health and public safety problem for cities in the USA, and licensed firearm retailers are an important source of the guns used in that violence. Using a scripted telephone interview, we screened a sample of licensed retailers in California to assess their willingness to participate in the surrogate or “straw” purchase of a handgun; such purchases are illegal under federal law. Of 149 retailers who provided a response, 30 (20.1%) agreed to participate. In multivariate analysis, pawnbrokers were more likely to agree than were gun dealers (odds ratio 6.58, 95% confidence interval 1.99–21.71). Sales of handguns that were later subjected to ownership tracing (a proxy measure for a gun’s use in crime) were not more frequent among retailers who agreed to participate than among others, and other findings were unexpected as well

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 impact of spikes in handgun acquisitions on firearm-related harms.

BackgroundResearch has documented sharp and short-lived increases in firearm acquisitions immediately following high-profile mass shootings and specific elections, increasing exposure to firearms at the community level. We exploit cross-city variation in the estimated number of excess handgun acquisitions in California following the 2012 presidential election and the Sandy Hook school shooting 5 weeks later to assess whether the additional handguns were associated with increases in the rate of firearm-related harms at the city level.MethodsWe use a two-stage modeling approach. First, we estimate excess handguns as the difference between actual handgun acquisitions, as recorded in California's Dealer Record of Sales, and expected acquisitions, as predicted by a seasonal autoregressive integrated moving-average (SARIMA) time series model. We use Poisson regression models to estimate the effect of city-level excess handgun purchasing on city-level changes in rates of firearm mortality and injury.ResultsWe estimate there were 36,142 excess handguns acquired in California in the 11 weeks following the election (95% prediction interval: 22,780 to 49,505); the Sandy Hook shooting occurred in week 6. We find city-level purchasing spikes were associated with higher rates of firearm injury in the 52 weeks post-election: a relative rate of 1.044 firearm injuries for each excess handgun per 1,000 people (95% CI: 1.000 to 1.089). This amounts to approximately 290 (95% CI: 0 to 616) additional firearm injuries (roughly a 4% increase) in California over the year. We do not detect statistically significant associations for shorter time windows or for firearm mortality.ConclusionThis study provides evidence for an association between excess handgun acquisitions following high-profile events and firearm injury at the community level. This suggests that even marginal increases in handgun prevalence may be impactful

Replacement thinking, status threat, and the endorsement of political violence among non-Hispanic white individuals in the US: A cross-sectional study.

OBJECTIVE: This study investigates the association between replacement thinking, status threat perceptions, and the endorsement of political violence among non-Hispanic white adults in the United States. It explores how perceived threats to social status can drive support for extreme measures aimed at preserving white hegemony, addressing a gap in research on factors contributing to political violence, a public health concern. METHODS: The 2022 Life in America Survey provided data for this cross-sectional study, focusing on status threat and replacement thinking among non-Hispanic white respondents. Status threat was inferred from relative income, education level, and racial segregation in residential census tracts, while replacement thinking was derived through agreement with the statement in America, native-born white people are being replaced by immigrants. The outcome was the endorsement of political violence. Analysis utilized a survey-weighted robust modified Poisson model. RESULTS: Among 5,976 non-Hispanic white respondents, 18.7 % supported political violence in at least one scenario. A U-shaped relationship was observed between racial segregation and political violence endorsement: respondents from more diverse communities were less likely to support political violence. Those endorsing replacement thinking were 233 %-229 % more likely to endorse political violence than those who did not, dependent on income levels. White respondents without a high school degree were 29 % more likely to endorse political violence. CONCLUSION: The study found a positive association between replacement thinking, markers of status threat, and political violence endorsements among non-Hispanic white Americans. These findings emphasize the need for research and interventions to mitigate these perceptions and prevent political violence

Expectations of and perceived need for civil war in the USA: findings from a 2023 nationally representative survey.

BACKGROUND: Surveys have found concerningly high levels of agreement that the United States will experience civil war soon. This study assesses variation in expectation of and perceived need for civil war with respondent sociopolitical characteristics, beliefs, firearm ownership, and willingness to engage in political violence. METHODS: Findings are from Wave 2 of a nationally representative annual longitudinal survey of members of the Ipsos KnowledgePanel, conducted May 18-June 8, 2023. All respondents to 2022s Wave 1 who remained in KnowledgePanel were invited to participate. Outcomes are expressed as weighted proportions and adjusted prevalence differences, with p-values adjusted for the false discovery rate and reported as q-values. RESULTS: The completion rate was 84.2%; there were 9385 respondents. After weighting, half the sample was female (50.7%, 95% CI 49.4%, 52.1%); the weighted mean (± standard deviation) age was 48.5 (25.9) years. Approximately 1 respondent in 20 (5.7%, 95% CI 5.1%, 6.4%) agreed strongly or very strongly that in the next few years, there will be civil war in the United States. About 1 in 25 (3.8%, 95% CI 3.2%, 4.4%), and nearly 40% (38.4%, 95% CI 32.3%, 44.5%) of those who strongly or very strongly agreed that civil war was coming, also agreed strongly or very strongly that the United States needs a civil war to set things right. Expectation of and perceived need for civil war were higher among subsets of respondents who in Wave 1 were more willing than others to commit political violence, including MAGA Republicans, persons in strong agreement with racist beliefs or statements of the potential need for violence to effect social change, persons who strongly approved of specified extreme right-wing political organizations and movements, firearm owners who purchased firearms in 2020 or later, and firearm owners who carried firearms in public all or nearly all the time. CONCLUSIONS: In 2023, the expectation that civil war was likely and the belief that it was needed were uncommon but were higher among subsets of the population that had previously been associated with greater willingness to commit political violence. These findings can help guide prevention efforts

Talking about firearm injury prevention with patients: a survey of medical residents.

BackgroundFirearm injury and death are significant public health problems in the U.S. and physicians are uniquely situated to help prevent them. However, there is little formal training in medical education on identifying risk for firearm injury and discussing safe firearm practices with patients. This study assesses prior education, barriers to counseling, and needs for improved training on firearm safety counseling in medical education to inform the development of future education on clinical strategies for firearm injury prevention.MethodA 2018 survey administered to 218 residents and fellows at a large, academic medical center asked about medical training on firearm injury prevention, frequency of asking patients about firearm access, and perceived barriers.ResultsThe most common barriers cited were not knowing what to do with patients' answers about access to firearms (72.1%), not having enough time (66.2%), not feeling comfortable identifying patients at-risk for firearm injury (49.2%), and not knowing how to ask patients about firearm access (48.6%). Prior education on firearm injury prevention was more strongly associated with asking than was personal exposure to firearms: 51.5% of respondents who had prior medical education reported asking compared with who had not received such education (31.8%, p=0.004). More than 90% of respondents were interested in further education about interventions, what questions to ask, and legal mechanisms to separate dangerous people from their firearms.ConclusionsEducation on assessing risk for firearm-related harm and, when indicated, counseling on safe firearm practices may increase the likelihood clinicians practice this behavior, though additional barriers exist

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