State Background Check Requirements and Suicide

January 15, 2015

Loopholes in federal and state law make it easy for people who are a danger to themselves to get guns. But Everytown’s research shows that common-sense public safety laws can help reduce gun suicides and save lives. Simply put, background check laws make people safer: controlling for population, there are 48 percent fewer gun suicides in states that require background checks for private handgun sales than in states that do not.

Methodology

Everytown compared the number of people who committed suicide with guns and without guns over a five-year period (2008-12) in states that did or did not require background checks for unlicensed, “private” handgun sales. Data were obtained from the Centers for Disease Control and Prevention’s Fatal Injury Reports on December 2, 2014.“Fatal Injury Reports,” Injury Prevention & Control: Data & Statistics (WISQARS), last accessed January 7, 2015, available at http://1.usa.gov/1plXBux.

Results

Throughout the study period, 14 states and the District of Columbia required all gun buyers to undergo a background check before buying a handgun in an unlicensed sale, and 36 states did not.We analyzed data for states that required background checks for all handgun sales during the period 2008-12. Since then, Colorado, Delaware, and Washington adopted these laws as well.  During that period, the CDC recorded 27,749 gun suicides in the former group of states, and 69,257 in the latter. Adjusting for population, there were 48 percent fewer gun suicides in states that require background checks for all handgun sales than in states that do not. There was no similar difference in non-firearm suicide rates.

Discussion

These results are consistent with research that employed other methods. An early evaluation of the Brady Handgun Violence Prevention Act found that the implementation of the background check system was associated with a six percent reduction in suicide rates among people ages 55 and older, though the authors speculated this might also be related to changes in both waiting period and background check requirements.Ludwig J and P Cook. “Homicide and suicide rates associated with implementation of the Brady Handgun Violence Prevention Act.” JAMA, 2000 Aug 2;284 (5):585-91. Another study found that state-level firearm purchase permit requirements and bans on firearm sales to minors were associated with lower rates of male suicide.Katherine Hempstead and Antonio Rodriguez, “Gun Control and Suicide: The Impact of State Firearm Regulations, 1995-2004,” Health Policy 101, no. 1 (June 2011): last accessed January 6, 2015, available at http://bit.ly/1AARcUg.

Still, while over 18,000 Americans commit suicide with guns every year, little is understood about the characteristics of the firearms they use or the methods by which they acquire them. Limited data gathered by the Centers for Disease Control and the State of California suggest that young people who commit suicide with guns typically do so inside their homes with guns that belong to their friends, parents, or relatives.Renee M. Johnson et al., “Who are the Owners of Firearms Used in Adolescent Suicides?” Suicide and Life-Threatening Behavior 40, no. 6 (December 2010); and Mona A. Wright et al., “Gun Suicide by Young People in California: Descriptive Epidemiology and Gun Ownership,” Journal of Adolescent Health 43 (2008). But the mechanism by which background checks affect overall suicide rates is not entirely clear. It is plausible that background checks stop dangerously mentally ill people from obtaining firearms and committing acts of self-harm. People with severe mental illness are at a substantially increased risk of suicide, J. T. Cavanagh et al., “Psychological Autopsy Studies of Suicide: A Systematic Review,” Psychological Medicine 33, no. 5 (July 2003): 947. and partially as a result, they are federally prohibited from buying guns.18 U.S.C. § 922(g)(4). According to the ATF, “any person who has been ‘adjudicated as a mental defective’ or ‘committed to a mental institution’ is prohibited under Federal law from shipping, transporting, receiving, or possessing any firearm or ammunition,” under federal law. See http://1.usa.gov/1Bv86DR.  The National Instant Criminal Background Check System (NICS) has proven effective at stopping such gun sales. Since its inception, more than 50,000 gun sales to dangerously mentally ill people have been denied,As of November 30, 2014, the FBI had denied 16,261 background checks due to mental illness (http://1.usa.gov/1HpenTi), and of the 1,131,466 denials by state and local agencies between 2009-12, between 3.4 and 5.4 percent of were for mental health criteria (http://1.usa.gov/179yzf3). In total, over 50,000 gun sales to severely mentally ill people have been blocked by the background check system. particularly as states shore up their databases identifying prohibited, dangerously mentally ill people. Everytown for Gun Safety, Closing the Gaps: Strengthening the Background Check System to Keep Guns Away from the Dangerously Mentally Ill (May 2014) available at http://bit.ly/1pFahAj.  It is also possible that background check requirements are associated with lower suicide rates due to an unobserved variable, such as the availability of firearms. A study of handgun purchasers in California found that merely acquiring a firearm was associated with a substantially elevated risk of suicide in the weeks following, lasting up to six years.Wintemute GJ, Parham CA, Beaumont JJ, Wright MA, Drake C. “Mortality among Recent Purchasers of Handguns.” The New England Journal of Medicine 1999 341(21):1583-1589.  And although estimates of household firearm prevalence are out-of-date and subject to reporting biases, there is evidence that Americans are more likely to commit suicide if they live in an area with a higher prevalence of household gun ownership.Miller M, Lippman SJ, Azrael D, and D Hemenway. “Household Firearm Ownership and Rates of Suicide Across the 50 United States.” The Journal of Trauma Injury, Infection, and Critical Care 62(4). April 2007: 1029-35; and Miller M, Azrael D, Hepburn L, Hemenway D, and SJ Lippman. “The association between changes in household firearm ownership and rates of suicides in the United States 1981-2002.” Injury Prevention (12). 2006: 178-82.

Click to enlarge

Loopholes in federal and state law make it easy for people who are a danger to themselves to get guns. But Everytown’s research
shows that common-sense public safety laws can help reduce gun suicides and save lives. Simply put, background check laws
make people safer: controlling for population, there are 48 percent fewer gun suicides in states that require background checks
for private handgun sales than in states that do not.
METHODOLOGY
Everytown compared the number of people who committed suicide with guns and without guns over a five-year period (2008-12)
in states that did or did not require background checks for unlicensed, “private” handgun sales.
Data were obtained from the Centers for Disease Control and Prevention’s Fatal Injury Reports on December 2, 2014.1

RESULTS
Throughout the study period, 14 states and the District of Columbia required all gun buyers to undergo a background check
before buying a handgun in an unlicensed sale, and 36 states did not.2
During that period, the CDC recorded 27,749 gun suicides
in the former group of states, and 69,257 in the latter. Adjusting for population, there were 48 percent fewer gun suicides in
states that require background checks for all handgun sales than in states that do not. There was no similar difference in
non-firearm suicide rates.
STATE BACKGROUND CHECK REQUIREMENTS
AND SUICIDE
Population
(2008-2012 average)
Firearm suicides
(2008-2012 total)
Firearm suicide rate per
million residents
(2008-2012 total)
Non-firearm suicides
(2008-2012 total)
Non-firearm suicide
rate petr million
residents
(2008-2012 total)
Total 309,013,456 97,006 62.8 94,420 61.1
States that require a
background check for
private handgun sales (15)
134,244,366 27,749 41.3 40,749 60.7
States that do not require a
background check for
private handgun sales (36)
174,769,090 69,257 79.3 53,671 61.4
Difference – 48% -1.2%
DISCUSSION
These results are consistent with research that employed other methods. An early evaluation of the Brady Handgun Violence
Prevention Act found that the implementation of the background check system was associated with a six percent reduction in
suicide rates among people ages 55 and older, though the authors speculated this might also be related to changes in both
waiting period and background check requirements.3
Another study found that state-level firearm purchase permit requirements
and bans on firearm sales to minors were associated with lower rates of male suicide.4

Still, while over 18,000 Americans commit suicide with guns every year, little is understood about the characteristics of the
firearms they use or the methods by which they acquire them. Limited data gathered by the Centers for Disease Control and the
State of California suggest that young people who commit suicide with guns typically do so inside their homes with guns that
belong to their friends, parents, or relatives.5
But the mechanism by which background checks affect overall suicide rates is not
entirely clear.

It is plausible that background checks stop dangerously mentally ill people from obtaining firearms and committing acts of self-harm.
People with severe mental illness are at a substantially increased risk of suicide,6
and partially as a result, they are federally
prohibited from buying guns.7
The National Instant Criminal Background Check System (NICS) has proven effective at stopping
such gun sales. Since its inception, more than 50,000 gun sales to dangerously mentally ill people have been denied,8
particularly as
states shore up their databases identifying prohibited, dangerously mentally ill people.9
It is also possible that background check requirements are associated with lower suicide rates due to an unobserved variable,
such as the availability of firearms. A study of handgun purchasers in California found that merely acquiring a firearm was
associated with a substantially elevated risk of suicide in the weeks following, lasting up to six years.10 And although estimates of
household firearm prevalence are out-of-date and subject to reporting biases, there is evidence that Americans are more likely to
commit suicide if they live in an area with a higher prevalence of household gun ownership.11
1. “Fatal Injury Reports,” Injury Prevention & Control: Data & Statistics (WISQARS), last accessed January 7, 2015, available at http://1.usa.gov/1plXBux.
2. We analyzed data for states that required background checks for all handgun sales during the period 2008-12. Since then, Colorado, Delaware, and Washington adopted these
laws as well.
3. Ludwig J and P Cook. “Homicide and suicide rates associated with implementation of the Brady Handgun Violence Prevention Act.” JAMA, 2000 Aug 2;284 (5):585-91.
4. Katherine Hempstead and Antonio Rodriguez, “Gun Control and Suicide: The Impact of State Firearm Regulations, 1995-2004,” Health Policy 101, no. 1 (June 2011): last accessed
January 6, 2015, available at http://bit.ly/1AARcUg.
5. Renee M. Johnson et al., “Who are the Owners of Firearms Used in Adolescent Suicides?” Suicide and Life-Threatening Behavior 40, no. 6 (December 2010); and Mona A. Wright et
al., “Gun Suicide by Young People in California: Descriptive Epidemiology and Gun Ownership,” Journal of Adolescent Health 43 (2008).
6. J. T. Cavanagh et al., “Psychological Autopsy Studies of Suicide: A Systematic Review,” Psychological Medicine 33, no. 5 (July 2003): 947.
7. 18 U.S.C. § 922(g)(4). According to the ATF, “any person who has been ‘adjudicated as a mental defective’ or ‘committed to a mental institution’ is prohibited under Federal law
from shipping, transporting, receiving, or possessing any firearm or ammunition,” under federal law. See http://1.usa.gov/1Bv86DR.
8. As of November 30, 2014, the FBI had denied 16,261 background checks due to mental illness (http://1.usa.gov/1HpenTi), and of the 1,131,466 denials by state and local agencies
between 2009-12, between 3.4 and 5.4 percent of were for mental health criteria (http://1.usa.gov/179yzf3). In total, over 50,000 gun sales to dangerously mentally ill
people have been blocked by the background check system.
9. Everytown for Gun Safety, Closing the Gaps: Strengthening the Background Check System to Keep Guns Away from the Dangerously Mentally Ill (May 2014) available at
http://bit.ly/1pFahAj.
10. Wintemute GJ, Parham CA, Beaumont JJ, Wright MA, Drake C. “Mortality among Recent Purchasers of Handguns.” The New England Journal of Medicine 1999 341(21):1583-1589.
11. Miller M, Lippman SJ, Azrael D, and D Hemenway. “Household Firearm Ownership and Rates of Suicide Across the 50 United States.” The Journal of Trauma Injury, Infection, and
Critical Care 62(4). April 2007: 1029-35; and Miller M, Azrael D, Hepburn L, Hemenway D, and SJ Lippman. “The association between changes in household firearm
ownership and rates of suicides in the United States 1981-2002.” Injury Prevention (12). 2006: 178-82.
FIREARM AND NON-FIREARM SUICIDES, 2008-2012
2008 2009 2010 2011 2012 2008-2012
BACKGROUND
CHECK REQUIRED
FOR ALL HANDGUN
SALES?
FIREARM
SUICIDES
NONFIREARM

SUICIDES
FIREARM
SUICIDES
NONFIREARM

SUICIDES
FIREARM
SUICIDES
NONFIREARM

SUICIDES
FIREARM
SUICIDES
NONFIREARM

SUICIDES
FIREARM
SUICIDES
NONFIREARM

SUICIDES
AVERAGE
POPULATION
AVERAGE ANNUAL
FIREARM
SUICIDES
FIREARM SUICIDE
RATE
AVERAGE ANNUAL
NON-FIREARM
SUICIDES
NON-FIREARM
SUICIDE RATE
ALABAMA NO 424 180 479 194 454 225 452 202 500 224 4,775,007 462 96.7 205 42.9
ALASKA NO 116 53 79 64 107 57 99 44 98 70 710,053 100 140.6 58 81.1
ARIZONA NO 540 432 605 455 620 473 674 486 663 493 6,407,096 620 96.8 468 73
ARKANSAS NO 275 172 285 137 266 181 299 163 307 178 2,915,130 286 98.2 166 57
CALIFORNIA YES 1,478 2,297 1,519 2,304 1,492 2,421 1,564 2,432 1,549 2,344 37,297,616 1,520 40.8 2,360 63.3
COLORADO NO 387 416 454 487 427 438 443 470 533 519 5,039,796 449 89.1 466 92.5
CONNECTICUT YES 109 206 93 223 110 243 111 259 111 257 3,572,439 107 29.9 238 66.5
DELAWARE NO 41 68 38 69 43 63 46 59 46 79 899,715 43 47.6 68 75.1
DISTRICT OF COLUMBIA YES 12 31 5 24 13 28 7 30 10 27 605,448 9 15.5 28 46.2
FLORIDA NO 1,397 1,343 1,472 1,386 1,454 1,335 1,490 1,390 1,550 1,452 18,877,098 1,473 78 1,381 73.2
GEORGIA NO 616 365 743 391 718 415 742 415 750 418 9,707,834 714 73.5 401 41.3
HAWAII YES 28 105 36 139 37 170 42 139 43 147 1,361,244 37 27.3 140 102.8
IDAHO NO 149 103 176 128 182 108 167 114 176 121 1,567,172 170 108.5 115 73.3
ILLINOIS YES 438 760 402 775 442 736 461 765 490 802 12,819,722 447 34.8 768 59.9
INDIANA NO 450 359 458 370 455 409 411 470 513 427 6,484,410 457 70.5 407 62.8
IOWA YES 180 200 160 201 177 195 185 237 175 208 3,047,020 175 57.6 208 68.3
KANSAS NO 185 152 200 182 210 191 233 161 297 205 2,849,769 225 79 178 62.5
KENTUCKY NO 394 218 403 189 404 227 453 222 469 255 4,338,584 425 97.9 222 51.2
LOUISIANA NO 351 181 328 162 385 172 377 196 375 192 4,527,587 363 80.2 181 39.9
MAINE NO 103 78 106 91 95 91 113 122 112 97 1,328,961 106 79.6 96 72.1
MARYLAND YES 263 244 252 299 222 280 242 316 272 311 5,782,803 250 43.3 290 50.1
MASSACHUSETTS YES 118 391 89 441 138 460 116 469 151 453 6,557,159 122 18.7 443 67.5
MICHIGAN YES 570 610 575 594 601 662 619 602 623 638 9,897,846 598 60.4 621 62.8
MINNESOTA NO 289 307 281 303 280 326 322 361 310 346 5,311,780 296 55.8 329 61.9
MISSISSIPPI NO 286 123 269 112 256 132 268 121 296 114 2,967,643 275 92.7 120 40.6
MISSOURI NO 421 358 471 389 489 367 513 420 546 368 5,981,704 488 81.6 380 63.6
MONTANA NO 132 71 136 83 141 86 152 80 153 80 990,581 143 144.2 80 80.8
NEBRASKA YES 98 93 93 77 106 87 111 82 115 117 1,826,500 105 57.3 91 49.9
NEVADA NO 291 237 295 210 289 258 272 244 274 250 2,702,230 284 105.2 240 88.7
NEW HAMPSHIRE NO 85 94 82 84 102 94 75 123 98 104 1,317,634 88 67.1 100 75.7
NEW JERSEY YES 175 440 173 384 187 532 181 508 160 523 8,792,595 175 19.9 477 54.3
NEW MEXICO NO 195 224 192 184 204 209 221 199 230 212 2,053,620 208 101.5 206 100.1
NEW YORK YES 429 980 422 995 459 1,088 505 1,153 516 1,192 19,395,291 466 24 1,082 55.8
NORTH CAROLINA YES 669 493 678 496 707 467 728 485 709 577 9,538,848 698 73.2 504 52.8
NORTH DAKOTA NO 55 31 50 40 56 50 51 55 63 42 676,268 55 81.3 44 64.5
OHIO NO 684 728 590 586 724 715 726 739 784 758 11,536,719 702 60.8 705 61.1
OKLAHOMA NO 346 229 363 204 376 242 440 253 411 259 3,747,843 387 103.3 237 63.3
OREGON NO 319 253 345 299 376 309 343 313 367 357 3,835,232 350 91.3 306 79.8
PENNSYLVANIA YES 770 769 825 806 762 814 883 864 819 828 12,697,461 812 63.9 816 64.3
RHODE ISLAND YES 23 87 40 78 30 99 20 81 26 79 1,052,374 28 26.4 85 80.6
SOUTH CAROLINA NO 343 222 377 242 392 245 426 232 433 240 4,628,232 394 85.2 236 51
SOUTH DAKOTA NO 68 56 61 68 65 75 60 68 76 65 815,638 66 80.9 66 81.4
TENNESSEE NO 609 364 574 373 585 358 591 364 626 352 6,350,562 597 94 362 57
TEXAS NO 1,506 1,046 1,583 1,226 1,702 1,189 1,684 1,212 1,744 1,293 25,191,613 1,644 65.3 1,193 47.4
UTAH NO 196 194 217 232 275 198 268 234 283 267 2,763,998 248 89.7 225 81.4
VERMONT NO 44 50 59 28 66 40 70 50 50 37 625,396 58 92.4 41 65.6
VIRGINIA NO 524 424 527 436 576 387 604 450 587 476 8,010,587 564 70.4 435 54.3
WASHINGTON NO 439 450 470 451 464 493 495 526 529 509 6,734,199 479 71.2 486 72.1
WEST VIRGINIA NO 172 89 178 75 210 69 200 106 198 128 1,850,589 192 103.5 93 50.5
WISCONSIN NO 344 399 345 379 378 415 351 394 348 375 5,686,117 353 62.1 392 69
WYOMING NO 87 37 82 29 83 48 84 48 102 69 562,695 88 155.7 46 82.1