Association of Increased Safe Household Firearm Storage With Firearm Suicide and Unintentional Death Among US Youths
Association of Increased Safe Household Firearm Storage With Firearm Suicide and Unintentional Death Among US Youths
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DOI：
10.1001/jamapediatrics.2019.1078
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发表时间：
2019-07-01
期刊：
影响因子：
26.1
通讯作者：
Miller, Matthew
中科院分区：
文献类型：
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作者：
Monuteaux, Michael C.;Azrael, Deborah;Miller, Matthew
在美国，枪伤是导致儿童和年轻人死亡的第二大原因。当所有家用枪支都被锁起来时，意外和自己造成的枪支伤害的风险较低。目的估计如果有更多的成年人在有青少年的家庭中储存家用枪支，那么青少年枪支自杀和意外枪支死亡率将会减少。设计、背景和参与者2015年使用蒙特卡罗模拟青少年枪支自杀和意外枪支死亡率的建模研究。使用具有全国代表性的枪支拥有率和储备率以及来自美国人口普查的人口数据，对青少年居住的枪支拥有家庭进行模拟抽样，以测试假设干预、在家中安全储存枪支、青少年意外死亡和自杀。从2017年8月3日到2018年1月9日进行了数据分析。EXPOSURES观察到和反事实的家庭级安全枪支储存(即，储存所有锁定的枪支)，后者通过改变假设干预增加安全枪支储存的概率来估计。在0至19岁青年中观察到的枪支自杀和意外枪支死亡的结果和措施以及反事实计数，后者通过结合对增加安全存储预期的死亡率收益的经验估计进行估计(超过2015年观察到的)。结果在与儿童一起居住的枪支拥有者中进行假设干预，有20%的可能性激励这些持有者锁定所有家用枪支，与预期的青少年枪支死亡率下降显著相关(中位数发生率比=0.90；四分位数范围，0.87-0.93)。在整个模型中，根据激发更安全存储的可能性，估计6%到32%的死亡是可预防的。结论和这项模拟研究的相关性结果表明，相对适度地采用简单的安全存储建议-锁定所有家用枪支-可以显著减少年轻人的枪支自杀和意外枪支死亡。需要采取一些方法来激励更多的父母安全储存枪支。
IMPORTANCE Firearm injury is the second leading cause of death in the United States for children and young adults. The risk of unintentional and self-inflicted firearm injury is lower when all household firearms are stored locked.OBJECTIVE To estimate the reduction in youth firearm suicide and unintentional firearm mortality that would result if more adults in households with youth stored household guns locked.DESIGN, SETTING, AND PARTICIPANTS A modeling study using Monte Carlo simulation of youth firearm suicide and unintentional firearm mortality in 2015. A simulated US national sample of firearm-owning households where youth reside was derived using nationally representative rates of firearm ownership and storage and population data from the US Census to test a hypothetical intervention, safe storage of firearms in the home, on youth accidental death and suicide. Data analyses were performed from August 3, 2017, to January 9, 2018.EXPOSURES Observed and counterfactual household-level safe firearm storage (ie, storing all firearms locked), the latter estimated by varying the probability that a hypothetical intervention increased safe firearm storage beyond that observed in 2015.MAIN OUTCOMES AND MEASURES Observed and counterfactual counts of firearm suicide and unintentional firearm mortality among youth aged 0 to 19 years, the latter estimated by incorporating an empirically based estimate of the mortality benefit expected from additional safe storage (beyond that observed in 2015).RESULTS A hypothetical intervention among firearm owners residing with children with a 20% probability of motivating these owners to lock all household firearms was significantly associated with a projected reduction in youth firearm mortality (median incidence rate ratio = 0.90; interquartile range, 0.87-0.93). In the overall model, 6% to 32% of deaths were estimated to be preventable depending on the probability of motivating safer storage.CONCLUSIONS AND RELEVANCE Results of this modeling study suggest that a relatively modest uptake of a straightforward safe storage recommendation-lock all household firearms-could result in meaningful reductions in firearm suicide and unintentional firearm fatalities among youth. Approaches that will motivate additional parents to store firearms safely are needed.