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iiq130121 732 740.pdf


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A

B
20

80
LA

10

AZ MT
WY
AR WV
KY NM
SC
OK
MO GA
FL
ID

MD

NC

VA
TX CO
KS
PA
OR
IN
UT
OH
WI
DE
VT
ND
ME WA

MI
CA
IL

NE
MN

SD
NH

5

WY

AL

MT GA
AK AR
TN
ID OK
NC
TX SC
ND AZ
VT
VA
MO NV
OR
KS IN
ME
WA
FLNE OH
UT
NM
CO MN PA
SD NH
WI
IA DE

60

TN

Household Firearm Ownership, %

Firearm Deaths/100 000 Individuals/y, Mean No.

KY LA

AL
NV

15

MS

WV

MS
AK

MI

40

MD

CA

IL
NY
CT
RI

MA

NJ

IA

NY

20
CT

RI

NJ

HI

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HI

0

0
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

Legislative Strength Score, Median

Legislative Strength Score, Median

C
20

LA

Firearm Deaths/100 000 Individuals/y, Mean No.

AK

AL

NV
15

10
CA
IL

AZ AR
WY
NM
TN MT
WV
KY
SC
GA
FL MO
OK
MD
NC ID
MI
PA VAKS
TX
CO
OR IN
DE
UT OH VT
ME
WI WA ND

NJ

SD NH

NY

IA

CT

MA

Figure 2. Relationship between legislative strength score,
household firearm ownership, and firearm death rates, 2007
through 2010. A, Legislative strength score vs overall firearm
death rate (P ⬍ .001). B, Legislative strength score vs
percentage household firearm ownership (P ⬍ .001).
C, Percentage household firearm ownership vs overall firearm
death rate (P ⬍ .001). Percentage household firearm ownership
was calculated by mean firearm suicides/total suicides
(2007-2010) by state. Lines represent regression lines with 90%
prediction bands. The US postal abbreviation codes used for all
state names.

NE

MN
5

MS

RI
HI

0
0

10

20

30

40

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60

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80

Household Firearm Ownership, %

outcomes, with stronger background checks associated
with lower overall firearm fatality rates: a 1-point increase in the background check category had an adjusted IRR of 0.84 (95% CI, 0.78-0.92), lower firearm
suicide fatality rates (adjusted IRR, 0.90; 95% CI, 0.870.94), and lower firearm homicide fatality rates (adjusted IRR, 0.91; 95% CI, 0.84-0.99) (Table 4).
Higher legislative strength scores were associated
with lower household firearm ownership (P ⬍ .001)
(Figure 2B). Higher percentage of household firearm ownership was associated with higher rates of overall firearm
fatalities (P ⬍ .001) (Figure 2C). The Sobel-Goodman test
of mediation demonstrated a significant effect of firearm

ownership on the relationship between the legislative
strength score and overall firearm fatalities (P ⬍ .001).
The simple Poisson regression demonstrated no association between firearm-related deaths and nonfirearm violent deaths (P = .50). There was also no association between legislative strength scores and nonfirearm
violence–related deaths (P = .20).
COMMENT

In an analysis of all states using data from 2007 through
2010, we found that a higher number of firearm laws in

JAMA INTERN MED/ VOL 173 (NO. 9), MAY 13, 2013
737

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