Child Firearm-Related Homicide and Suicide by State Legislation in the US (2009 to 2020)

BACKGROUND: Firearms are the leading cause of death among US children and adolescents. This study evaluates whether state gun laws are associated with firearm suicides and homicides in children. STUDY DESIGN: This is a cross-sectional database study comparing childhood firearm mortality with 36 state firearm laws using data from CDC WONDER and the RAND State Firearm Law Database. Primary outcomes were firearm-related suicide and homicide mortalities per 100,000 persons. We examined suicide deaths by all firearms, including intentional self-harm by handguns only, intentional self-harm by rifles, shotguns, or large firearms only, and intentional self-harm by other or unspecified firearms, as well as homicide deaths for the same firearm types in each state. Welch's t -tests compared mean rates of suicide and homicide mortality between states with and without these laws. States that either enacted or rescinded firearm legislation during this period were excluded. RESULTS: From 2009 to 2020, there were 6,735 suicides and 10,278 homicides by firearm totaling 17,013 child deaths (younger than 18 years of age) by firearm. States with "child access prevention-negligent storage" laws demonstrated lower suicide mortality rates across all firearm types (handguns: N 13, M [mean per 100,000] 0.68, SD 0.27, p < 0.001; long guns: N 12, M 0.65, SD 0.25, p < 0.001). There were no significant differences in mean suicide death rates across all firearm types when comparing states with or without firearm laws related to "minimum age youth possession," "minimum age youth purchase and sale," or "child access prevention intentional." Comparing homicide mortality rates for all firearm types revealed no notable distinctions between states with and without the identified laws. CONCLUSIONS: Firearm legislation is associated with decreased suicide rates for individuals younger than 18 years of age, but its influence on homicides is less certain. Comprehensive research and thoughtful policy formulation are essential for addressing this pressing public health concern.