Federal Firearm Licensee Rates and Suicide in Maryland, 2014 to 2019

• Published in: American journal of preventive medicine 2024-12, Vol.67 (6), p.867-877
• Main Authors: Kafka, Julie M., Nestadt, Paul S., Rosen, Erika M., Karon, Samantha, Rush, Macie J., Trangenstein, Pamela J.
• Format: Article
• Language: English
• Subjects: Adult; Female; Firearms - legislation & jurisprudence; Firearms - statistics & numerical data; Humans; Licensure - legislation & jurisprudence; Licensure - statistics & numerical data; Male; Maryland - epidemiology; Middle Aged; Suicide - statistics & numerical data; Suicide - trends
• ISSN: 0749-3797; 1873-2607; 1873-2607
• DOI: 10.1016/j.amepre.2024.07.024

Federal firearm licensee density is associated with interpersonal firearm violence. Yet the role of Federal firearm licensees in firearm suicide remains understudied, even though firearms are the method used in more than half of suicides. This study tested associations between the spatial distribution of federal firearm licensees and firearm suicides in Maryland. Kernel density estimation measured federal firearm licensee and suicide rates at the census tract level (n=1,397), and SaTScan detected clusters of licensees and suicides. Choropleth maps compared visual associations between federal firearm licensee, firearm, and non-firearm suicide rates and clusters. Generalized estimating equations tested associations between Federal firearm licensee rates and clusters and the odds of using a firearm as the lethal means overall and after stratifying by biological sex. Data were obtained in 2020 and analyzed in 2020–2024. The federal firearm licensee rate was associated with greater odds of firearm suicide overall (aOR=1.29, 95% CI=1.21, 1.38, p