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Cited by 115Gun Ownership and Violence ResearchSuicide and Self-Harm StudiesHomicide, Infanticide, and Child Abuse

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Association of Firearm Ownership, Use, Accessibility, and Storage Practices With Suicide Risk Among US Army Soldiers

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Dempsey, Catherine L., Benedek, David M., Zuromski, Kelly L., Riggs-Donovan, Charlotte, Ng, Tsz Hin H., Nock, Matthew K., Kessler, Ronald C., Ursano, Robert J.·2019·JAMA Network Open
DOI 10.1001/jamanetworkopen.2019.5383PMC PMC6563574
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Abstract

Importance: Since 2004, the suicide rate among US Army soldiers has exceeded the rate of death from combat injury. It is critical to establish factors that increase the risk of acting on suicidal thoughts to guide early intervention and suicide prevention. Objective: To assess whether firearm ownership, use, storage practices, and accessibility are associated with increased risk of suicide. Design, Setting, and Participants: In this case-control study, suicide cases (n = 135) were defined as US Army soldiers who died by suicide while on active duty between August 1, 2011, and November 1, 2013. Next-of-kin and Army supervisors of soldiers who died by suicide (n = 168) were compared with propensity-matched controls (n = 137); those soldiers with a suicidal ideation in the past year (n = 118) provided structured interview data. Data were analyzed from April 5, 2018, to April 2, 2019. Main Outcomes and Measures: Firearm ownership, storage, and accessibility were assessed by using items from the World Health Organization Composite International Diagnostic Interview screening scales along with items created for the purpose of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) study. Results: Among the 135 suicide decedents, next-of-kin reported that they had greater accessibility to firearms compared with propensity-matched controls. Specifically, suicide decedents were more likely to own 1 or more handguns compared with propensity-matched controls (odds ratio [OR], 1.9; 95% CI, 1.0-3.7; χ21 = 4.2; false discovery rate [FDR] P = .08), store a loaded gun at home (OR, 4.1; 95% CI, 1.9-9.1; χ21 = 12.2; FDR P = .003), and publicly carry a gun when not required for military duty (OR, 3.2; 95% CI, 1.4-7.3; χ21 = 7.4; FDR P = .02). The combination of these 3 items was associated with a 3-fold increase in the odds of suicide death (OR, 3.4; 95% CI, 1.2-9.4; χ21 = 5.4; FDR P = .05). Storing a loaded gun with ammunition at home or publicly carrying a gun when not on duty was associated with a 4-fold increase in the odds of suicide death (OR, 3.9; 95% CI, 1.9-7.9; χ21 = 14.1; FDR P = .002). Conclusions and Relevance: In this study, in addition to gun ownership, ease and immediacy of firearm access were associated with increased suicide risk. Discussion with family members and supervisors about limiting firearm accessibility should be evaluated for potential intervention.

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Metadata

Authors
Dempsey, C. L., Benedek, D. M., Zuromski, K. L., Riggs-Donovan, C., Ng, T. H. H., Nock, M. K., Kessler, R. C., & Ursano, R. J.
Affiliations
  • Uniformed Services University of the Health Sciences (US)
  • Harvard University (US)
Corresponding author
Dempsey, Catherine L.
ORCID
Venue
JAMA Network Open
Publisher
American Medical Association (AMA)
Published
2019-06-07
Volume
2
Issue
6
Pages
e195383
ISSN
2574-3805 (ISSN-L)
DOI
10.1001/jamanetworkopen.2019.5383
PMC
PMC6563574
OpenAlex
W2948729807
Cited by
114
References
39
Citations by year
2026: 10 · 2025: 15 · 2024: 32 · 2023: 11 · 2022: 9 · 2021: 29 · 2020: 7 · 2019: 1
FWCI
11.18
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JAMA Network Open (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • Centers for Disease Control and Prevention (R01CE003270)
  • National Institute of Mental Health (U01MH087981)
Topics
  • Social Sciences › Health › Gun Ownership and Violence Research
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
Keywords
gun ownership, firearm storage, suicide risk, suicide prevention, U.S. Army soldiers, military suicide, handguns, suicidal ideation, suicide decedents, Army STARRS, suicide prevention interventions, military mental health services, suicide prevention messaging
MeSH terms
Suicide Prevention, Autopsy, Depressive Disorder, Firearms, Humans, Military Personnel, Ownership, Risk Factors, Suicide, United States, Prevalence, Case-Control Studies, Propensity Score, Suicidal Ideation

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