Importance of categories of crime for predicting future violent crime among handgun purchasers in California

BackgroundProhibiting the purchase and possession of firearms by those at risk of violence is an established approach to preventing firearm violence. Prior studies of legal purchasers have focused on convictions for specific crimes, such as violent misdemeanors and driving under the influence (DUI). We broaden that line of inquiry by investigating and comparing the associations between prior arrests for most categories of crime and subsequent arrest for violent offenses among legal handgun purchasers in California.MethodsIn this longitudinal cohort study of 79,678 legal handgun purchasers in California in 2001, we group arrest charges prior to their first purchases in 2001 according to categories defined by the Uniform Crime Report (UCR) Handbook. We use a gradient boosting machine to identify categories of offenses that are most important for predicting arrest for violent crime following firearm purchase. For each category identified, we then estimate the difference in risk of subsequent arrest for a violent offense using survival regression models.ResultsWe identified eight crime categories with high predictive importance: simple assaults, aggravated assaults, vehicle violations, weapon, other crimes, theft, drug abuse, and DUI. Compared to purchasers with no prior arrests, those with a prior arrest for any one of the eight important categories and no other categories were found to be at increased risk of arrest for a Crime Index-listed violent crime (murder, rape, robbery, aggravated assault), with the greatest estimated risk corresponding to the simple assault UCR category (adjusted hazard ratio 4.0; 95% CI 2.8-5.9). Simple assault was also associated with the greatest risk for subsequent arrest for firearm violence (adjusted hazard ratio 4.6; 95% CI 2.4-9.0) and any violent offense (adjusted hazard ratio 3.7; 95% CI 2.7-5.0).ConclusionThe findings of this study suggest that prior arrests for a broad array of crimes, both violent and non-violent, are associated with risk of subsequent violent crimes, including Crime Index-listed violent crimes and firearm violence, among legal purchasers of firearms. Current policies aimed at restricting access to firearms for individuals at increased risk of violence should be re-examined considering these findings

Criminal charge history, handgun purchasing, and demographic characteristics of legal handgun purchasers in California.

BackgroundThe prevalence and characteristics of handgun purchasers' criminal charge histories have never been described for a large population of firearm owners, but such information is critical to understanding risk factors for subsequent violence in this population. We sought to characterize legal handgun purchasers in California and compare this group to the state population, to quantify the proportion with a criminal charge history at purchase, and to identify modifiable factors associated with of having such a history.MethodsThis cross-sectional study of all 79,927 legal handgun purchasers aged 21-49 years in California in 2001 used log-linear generalized additive models to identify factors associated with having a criminal charge history at purchase. Subjects are from a longitudinal study of incident criminal activity among handgun purchasers.ResultsThe majority (91.03%) of purchasers were male; whites were overrepresented and Hispanics were underrepresented relative to their population size. At the time of purchase, 16.68%  had a criminal charge history and 10.71% had a criminal conviction. Among men with such a history, 31.28% had been charged with a violent crime and 16.54% had been charged with a firearm-related crime. The strongest factor associated with having a criminal charge history was redeeming a pawned handgun (prevalence ratio: 1.82; 95% confidence interval: 1.71, 1.93).ConclusionsDespite California's stringent firearm purchase laws, more than 1-in-6 handgun purchasers had a criminal charge history at purchase. This proportion may be higher in states with less restrictive firearm purchasing eligibility criteria

Prescription Drug Monitoring Program: Registration and Use by Prescribers and Pharmacists Before and After Legal Mandatory Registration, California, 2010-2017.

ObjectivesTo estimate the effect of California's prescription drug monitoring program's (PDMP) registration mandate on use of the PDMP.MethodsWe evaluated the effect of California's mandatory PDMP registration law by fitting time series models on the percentage of clinicians registered for California's PDMP and the percentage of clinicians who were active PDMP users (users who created ≥ 1 patient prescription reports in a given month) from 2010 through 2017. We also compared PDMP use among early PDMP adopters (clinicians who registered > 8 months before the mandatory registration deadline) versus late adopters (clinicians who registered ≤ 8 months before the deadline).ResultsMandatory registration was associated with increases in active PDMP users: 53.5% increase for prescribers and 17.9% for pharmacists. Early adopters were 4 times more likely to be active PDMP users than were late adopters.ConclusionsMandatory registration was associated with increases in PDMP registration and use, but most new registrants did not become active users. Public Health Implications. Mandatory PDMP registration increases PDMP use but does not result in widespread PDMP usage by all clinicians prescribing controlled substances

Criminal charge history, handgun purchasing, and demographic characteristics of legal handgun purchasers in California.

BackgroundThe prevalence and characteristics of handgun purchasers' criminal charge histories have never been described for a large population of firearm owners, but such information is critical to understanding risk factors for subsequent violence in this population. We sought to characterize legal handgun purchasers in California and compare this group to the state population, to quantify the proportion with a criminal charge history at purchase, and to identify modifiable factors associated with of having such a history.MethodsThis cross-sectional study of all 79,927 legal handgun purchasers aged 21-49 years in California in 2001 used log-linear generalized additive models to identify factors associated with having a criminal charge history at purchase. Subjects are from a longitudinal study of incident criminal activity among handgun purchasers.ResultsThe majority (91.03%) of purchasers were male; whites were overrepresented and Hispanics were underrepresented relative to their population size. At the time of purchase, 16.68%  had a criminal charge history and 10.71% had a criminal conviction. Among men with such a history, 31.28% had been charged with a violent crime and 16.54% had been charged with a firearm-related crime. The strongest factor associated with having a criminal charge history was redeeming a pawned handgun (prevalence ratio: 1.82; 95% confidence interval: 1.71, 1.93).ConclusionsDespite California's stringent firearm purchase laws, more than 1-in-6 handgun purchasers had a criminal charge history at purchase. This proportion may be higher in states with less restrictive firearm purchasing eligibility criteria

Age- and Sex-Specific Increases in Stimulant Prescribing Rates—California, 2008-2017

Objective: To describe trends in prevalent and incident stimulant prescribing between 2008 and 2017 in California. Method: Statewide trends were estimated by age and sex category for prevalent (any) and incident (no prescriptions in the preceding 2 years) stimulant prescribing while adjusting for area-level covariates. Results: Prevalent prescribing rates increased by 126%, while incident prescribing increased 23%. Patients aged 25 to 44 years experienced over 200% increases in prevalent prescribing and 34% to 55% increases in incident prescribing. Among patients older than 25, women had consistently higher prescribing rates than men. ZIP code tabulation areas with the largest minority populations had the lowest baseline prescribing rates but experienced the greatest annual prescription rate increases. Conclusion: Adult stimulant prescribing increased substantially for early working aged adults. Prescription rates were greater for women than men

Changes in opioid prescribing after implementation of mandatory registration and proactive reports within California’s prescription drug monitoring program

BackgroundIn 2016, California updated its prescription drug monitoring program (PDMP), adding two key features: automated proactive reports to prescribers and mandatory registration for prescribers and pharmacists. The effects of these changes on prescribing patterns have not yet been examined. We aimed to evaluate the joint effect of these two PDMP features on county-level prescribing practices in California.MethodsUsing county-level quarterly data from 2012 to 2017, we estimated the absolute change associated with the implementation of these two PDMP features in seven prescribing indicators in California versus a control group comprising counties in Florida and Washington: opioid prescription rate per 1000 residents; patients' mean daily opioid dosage in milligrams of morphine equivalents[MME]; prescribers' mean daily MME prescribed; prescribers' mean number of opioid prescriptions per day; percentage of patients getting >90 MME/day; percentage of days with overlapping prescriptions for opioids and benzodiazepines; multiple opioid provider episodes per 100,000 residents.ResultsProactive reports and mandatory registration were associated with a 7.7 MME decrease in patients' mean daily opioid dose (95 %CI: -11.4, -2.9); a 1.8 decrease in the percentage of patients prescribed high-dose opioids (95 %CI: -2.3, -0.9); and a 6.3 MME decrease in prescribers' mean daily dose prescribed (95 %CI: -10.0, -1.3).ConclusionsCalifornia's implementation of these two PDMP features was associated with decreases in the total quantity of opioid MMEs prescribed, and indicators of patients prescribed high-dose opioids compared to states that had PDMP's without these features. Rates of opioid prescribing and other high-risk prescribing patterns remained unchanged

Gun violence restraining orders in California, 2016-2018: case details and respondent mortality.

BackgroundGun violence restraining orders (GVROs), implemented in California in 2016, temporarily prohibit individuals at high risk of violence from purchasing or possessing firearms and ammunition. We sought to describe the circumstances giving rise to GVROs issued 2016-2018, provide details about the GVRO process and quantify mortality outcomes for individuals subject to these orders ('respondents').MethodsFor this cross-sectional description of GVRO respondents, 2016-2018, we abstracted case details from court files and used LexisNexis to link respondents to mortality data through August 2020.ResultsWe abstracted information for 201 respondents with accessible court records. Respondents were mostly white (61.2%) and men (93.5%). Fifty-four per cent of cases involved potential harm to others alone, 15.3% involved potential harm to self alone and 25.2% involved both. Mass shooting threats occurred in 28.7% of cases. Ninety-six and one half per cent of petitioners were law enforcement officers and one-in-three cases resulted in arrest on order service. One-year orders after a hearing (following 21-day emergency/temporary orders) were issued in 53.5% of cases. Most (84.2%) respondents owned at least one firearm, and firearms were removed in 55.9% of cases. Of the 379 respondents matched by LexisNexis, 7 (1.8%) died after the GVRO was issued: one from a self-inflicted firearm injury that was itself the reason for the GVRO and the others from causes unrelated to violence.ConclusionsGVROs were used most often by law enforcement officers to prevent firearm assault/homicide and post-GVRO firearm fatalities among respondents were rare. Future studies should investigate additional respondent outcomes and potential sources of heterogeneity

Views of democracy and society and support for political violence in the USA: findings from a nationally representative survey

Abstract Background Current conditions in the USA suggest an increasing risk for political violence. Little is known about the prevalence of beliefs that might lead to political violence, about support for and personal willingness to engage in political violence, and about how those measures vary with individual characteristics, lethality of violence, political objectives that violence might advance, or specific populations as targets. Methods This cross-sectional US nationally representative survey was conducted on May 13 to June 2, 2022, of adult members of the Ipsos KnowledgePanel. Outcomes are weighted, population-representative proportions of respondents endorsing selected beliefs about American democracy and society and violence to advance political objectives. Results The analytic sample included 8620 respondents; 50.5% (95% confidence interval (CI) 49.3%, 51.7%) were female; and weighted mean (± standard deviation) age was 48.4 (± 18.0) years. Nearly 1 in 5 (18.9%, 95% CI 18.0%, 19.9%) agreed strongly or very strongly that “having a strong leader for America is more important than having a democracy”; 16.2% (95% CI 15.3%, 17.1%) agreed strongly or very strongly that “in America, native-born white people are being replaced by immigrants,” and 13.7% (95% CI 12.9%, 14.6%) agreed strongly or very strongly that “in the next few years, there will be civil war in the United States.” One-third of respondents (32.8%, 95% CI 31.7%, 33.9%) considered violence to be usually or always justified to advance at least 1 of 17 specific political objectives. Among all respondents, 7.7% (95% CI 7.0%, 8.4%) thought it very or extremely likely that within the next few years, in a situation where they believe political violence is justified, “I will be armed with a gun”; 1.1% (95% CI 0.9%, 1.4%) thought it very or extremely likely that “I will shoot someone with a gun.” Support for political violence and for the use of firearms in such violence frequently declined with increasing age, education, and income. Conclusions Small but concerning proportions of the population consider violence, including lethal violence, to be usually or always justified to advance political objectives. Prevention efforts should proceed urgently based on the best evidence available

Firearm purchasing and firearm violence during the coronavirus pandemic in the United States: a cross-sectional study.

BackgroundFirearm violence is a significant public health problem in the United States. A surge in firearm purchasing following the onset of the coronavirus pandemic may have contributed to an increase in firearm violence. We sought to estimate the state-level association between firearm purchasing and interpersonal firearm violence during the pandemic.MethodsCross-sectional study of the 48 contiguous states and the District of Columbia from January 2018 through July 2020. Data were obtained from the National Instant Criminal Background Check System (a proxy for firearm purchasing) and the Gun Violence Archive. Using negative binomial regression models, we estimated the association between cumulative excess firearm purchases in March through July 2020 (measured as the difference between observed rates and those expected from autoregressive integrated moving average models) and injuries (including nonfatal and fatal) from intentional, interpersonal firearm violence (non-domestic and domestic violence).ResultsWe estimated that there were 4.3 million excess firearm purchases nationally from March through July 2020 and a total of 4075 more firearm injuries than expected from April through July. We found no relationship between state-level excess purchasing and non-domestic firearm violence, e.g., each excess purchase per 100 population was associated with a rate ratio (RR) of firearm injury from non-domestic violence of 0.76 (95% CI: 0.50-1.02) in April; 0.99 (95% CI: 0.72-1.25) in May; 1.10 (95% CI: 0.93-1.32) in June; and 0.98 (95% CI: 0.85-1.12) in July. Excess firearm purchasing within states was associated with an increase in firearm injuries from domestic violence in April (RR: 2.60; 95% CI: 1.32-5.93) and May (RR: 1.79; 95% CI: 1.19-2.91), though estimates were sensitive to model specification.ConclusionsNationwide, firearm purchasing and firearm violence increased substantially during the first months of the coronavirus pandemic. At the state level, the magnitude of the increase in purchasing was not associated with the magnitude of the increase in firearm violence. Increases in purchasing may have contributed to additional firearm injuries from domestic violence in April and May. Results suggest much of the rise in firearm violence during our study period was attributable to other factors, indicating a need for additional research