• More guns, more suicides

    Post-Aurora debate has sometimes focused on generic gun control issues, and important but familiar questions about why weaponry holds such an iconic place in American culture and law. As I mentioned yesterday, I don’t believe this massacre raises constitutional issues. One can be a strong 2nd Amendment advocate without believing that some modern-day Raskolnikov has the right to buy AR-15 rifles or high-capacity ammunition clips to perpetrate a massacre.

    As Mitt Romney rightly observed in 2004, “people should have the right to bear arms, but I don’t believe that we have to have assault weapons as part of our personal arsenal.” At a bill signing ceremony, Romney commented: “Deadly assault weapons have no place in Massachusetts. These guns are not made for recreation or self-defense. They are instruments of destruction with the sole purpose of hunting down and killing people.” Romney has since executed an unfortunate retreat on this issue. He’s hardly alone in this bipartisan failure of gun policy.

    But I actually want to discuss another gun policy challenge that has received less attention. Yesterday, Ezra Klein listed six facts about gun violence and gun control. He quotes from Kieran Healy’s nice posts with further pertinent statistics on gun violence. I would add a seventh fact to Klein’s list: the strong link between gun possession and suicide….

    Matthew Miller and David Hemenway discuss these issues in a 2008 New England Journal commentary. These authors note some simple realities:

    First, many suicidal acts — one third to four fifths of all suicide attempts, according to studies — are impulsive. Among people who made near-lethal suicide attempts, for example, 24% took less than 5 minutes between the decision to kill themselves and the actual attempt, and 70% took less than 1 hour.

    Second, many suicidal crises are self-limiting. Such crises are often caused by an immediate stressor, such as the breakup of a romantic relationship, the loss of a job, or a run-in with police…. The temporary nature and fleeting sway of many suicidal crises is evident in the fact that more than 90% of people who survive a suicide attempt, including attempts that were expected to be lethal (such as shooting oneself in the head or jumping in front of a train), do not go on to die by suicide….

    A suicide attempt with a firearm rarely affords a second chance. Attempts involving drugs or cutting, which account for more than 90% of all suicidal acts, prove fatal far less often.

    Household gun possession is a powerful predictor of suicide for the actual gun owner, as well as for the owner’s spouse and other family members. Given widespread gun ownership, this is therefore a serious public health problem. Although this is hardly an airtight comparison, the fifteen states with the highest rates of gun ownership have about twice the suicide rates of the fifteen states at the bottom of the gun ownership list.

    Via Twitter, Scott Bolitho alerted me to a nice 2010 study by Andrew Leigh and Christine Neill which gets to the causal connection between gun possession and suicide.

    In 1997, following a Colorado-style massacre, Australia implemented a gun buyback program that reduced the stock of firearms by around one-fifth. Different states experienced vastly different per-capita rates of firearms withdrawn, allowing these authors to test how reductions in firearms availability affected firearm homicide and suicide rates.

    These authors found that the gun buyback led to an almost 80 percent drop in the firearm suicide rate, with little sign of offsetting increases in suicides by other means.

    The authors report many regressions, but Figure 2 below tells the basic story. Although both firearm suicides and homicides both declined in areas that implemented aggressive buyback programs, the impact on suicide was especially stark.

    Policymakers at all levels might ponder these relationships as they balance the constitutional, cultural, and public safety concerns of gun policy.

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    • I looked at suicide a while ago and in doing so I think it was the case that making it harder to kill yourself by one means does have an effect but eventually the rate returns to where it was. This was in the UK though where there are few guns. It is also the case that men tend to chose violent means.

      I know the firearm suicide number in the US is high – but is the overall rate particularly high? According to:

      http://en.wikipedia.org/wiki/List_of_countries_by_suicide_rate

      No.

      Another type of gun violence to add is accidents – I believe a lot of children are killed or injured accidentally in the US.

    • While this gets outside of the health realm, I grew up in Singapore, which has military conscription but forbids any sort of firearm (including air rifles), and which has the death penalty for merely discharging a firearm. In the army, you train months before you’re trusted with live ammunition in a live-fire exercise. Combat is confusing and disorienting, and it’s not just about being able to shoot straight – it’s about knowing when and where to shoot and about being able to identify a target. The problem is compounded for counterterrorism or hostage rescue units – you have civilians in the line of fire. Military folks just shoot anything that’s not clearly the enemy that moves.

      Some folks on the right think that having a easily available firearms means that more people would be available to respond to firearm incidents. That’s true. But I’m not certain it would reduce total deaths from firearms.

      If you think about the Giffords shooting, Loughner opened fire from within a crowd. An armed responder could well have hit a bystander. More than one armed responder would create an instant crossfire, and by then it might not be possible to tell who was the enemy. Very bad.

      The Colorado guy was standing against the theater screen, so no worry about crossfire, but he was wearing armor. An experienced shooter could go for the head, but once people start running and screaming, and the tear gas had gone off, you might not be able to get such a good shot. Human heads are much smaller than human torsos.

      In a world where firearms are easily available, you have more leakages from the supply chain: this means that people who can’t legally get guns are more likely to get them illegally. That means likely more mass shootings.

      In addition, you increase the number of single victim incidents. People will be more likely to succeed at suicide. More disputes, like domestic disputes or bar fights or George Zimmerman/Trayvon Martin cases, will be settled by gun, rather than by hand.

      Bottom line, even if we assume decreased mortality per mass firearm shooting, you have increased number of mass shootings and increased number of single shootings. Total firearm mortality would probably go up, not down. And I’m not convinced that total mortality rates from mass shootings will go down. Having a gun may make you safer, but it will not make you as safe as you’d like in any one incident, and it means that there are a greater number of incidents.

      This is in response to a Slate interview with a gun rights advocate who’s a firearms instructor.

    • Interesting comments. Thanks