Firearms and Suicide Prevalence Ecologic Studies Bibliography

Birckmayer J, and Hemenway D. Suicide and gun prevalence: Are youth disproportionately affected? Suicide and Life Threatening Behavior. 2001; 31:303-310.

Hemenway D, and Miller M. The association of rates of household handgun ownership, lifetime major depression and serious suicidal thoughts with rates of suicide across US census regions. Injury Prevention. 2002; 8:313-16.

Miller M, Azrael D, and Hemenway D. Household frearm ownership levels and suicide across U.S. regions and states, 1988-1997. Epidemiology. 2002; 13:517-524.

Miller M, Hemenway D, and Azrael D. Firearms and suicide in the Northeast. Journal of Trauma. 2004; 57:626-632.

Miller M, Lippmann S, Azrael D, Hemenway D. Household firearm ownership and rates of suicide across the 50 US States. J Trauma. 2007; 62:1029-1034.

Shrira I and Christenfeld N. “Disentangling the Person and the Place as Explanations for Regional Differences in Suicide” Suicide and Life-Threatening Behavior. 2010: 40(3).

To determine whether suicide rates vary in different parts of the US because of characteristics of the local environment or differences in the traits of the people who live there, or both, the researchers compared the suicides of a region’s residents with people who were temporarily visiting the region. They created tworegions – states with the highest suicide rates in recent decades (AZ, CO, MT, NM, NV, OR) and states with the lowest rates (CT, IL, MA, NJ, NY), then compared three groups of people: residents of the two regions who died inside the region, residents who died while visiting outside the region, and visitors to the region. Proportionate mortality ratios (PMR) were calculated for all suicides and for firearm suicides. (PMR indicates the proportion of all deaths that suicide represents.) In the high suicide regions, PMRs for suicide were high in all three groups (that is residents dying in the region, residents dying while visiting outside the region, and visitors who die in the region) all had elevated PMRs. In the low suicide region, residents had low suicide levels at home but elevated suicide levels when they traveled outside the region, while visitors to the region did not have a reduced PMR for suicide. Results suggested that both the traits of the context and of the individual likely contributed to extreme high or low suicide rates. Being a resident or visitor to a high suicide region predicted suicide.  The level of firearm use predicted suicide levels in both regions.