Firearm Death Rates and Association with Level of Firearm Purchase Background Check Original Research Article

Background Past ecologic analyses of firearm deaths have studied the effects of various gun-control laws; however, no study has analyzed the effects of the differences among states in the background checks required for firearm purchase. Some states utilize a federal agency to conduct the background checks; others use a state agency; still others use a local agency. The information potentially available to checking agencies at different levels of government varies; the consequence of this variation is not known. Methods In 2007, negative binomial regression models were used to assess the association between the Department of Justice classification of agencies conducting firearm background checks for each state in 2002–2004 and firearm suicide and homicide rates for the same years from the National Center for Injury Prevention and Control while controlling for age, race, unemployment, crime, income inequality, poverty, alcohol consumption, urbanization, and divorce rate. Results Performing local-level background checks was associated with a 27%-lower firearm suicide rate (incidence rate ratio [IRR]=0.73, 95% CI=0.60, 0.89) and a 22%-lower homicide rate (IRR=0.78, 95% CI=0.61, 1.01) in adults ≥21 years. Conclusions Using local-level agencies to perform firearm background checks is associated with reduced rates of firearm suicide and homicide. Methods to increase local-level agency background checks, such as authorizing local police or sheriffʹs departments to conduct them, or developing the capability to share local-level records with federal databases, should be evaluated as a means of reducing firearm deaths.