1. Guns and homicide (literature review).
We performed a review of the academic literature on the effects of gun availability on homicide rates.
Major findings:  A broad array of evidence indicates that gun availability is a risk factor for homicide, both in the United States and across high-income countries.  Case-control studies, ecological time-series and cross-sectional studies indicate that in homes, cities, states and regions in the US, where there are more guns, both men and women are at higher risk for homicide, particularly firearm homicide.
Publication:  Hepburn, Lisa; Hemenway, David.  "Firearm Availability and Homicide: A Review of the Literature." Aggression and Violent Behavior: A Review Journal.  2004; 9:417-40.

2. Guns availability and homicide rates across nations.
We analyzed the relationship between homicide and gun availability using data from 26 developed countries from the early 1990s.
Major findings: Across developed countries, where guns are more available, there are more homicides. These results often hold even when the United States is excluded.
Publication: Hemenway, David; Miller, Matthew. "Firearm Availability and Homicide Rates across 26 High Income Countries." Journal of Trauma. 2000; 49:985-88.

3. Gun availability and state homicide rates, 1988-1997
Using a validated proxy for firearm ownership, we analyzed the relationship between firearm availability and homicide across 50 states over a ten year period.
Major findings:  After controlling for poverty and urbanization, for every age group, people in states with many guns have elevated rates of homicide, particularly firearm homicide.
Publication:  Miller, Matthew; Azrael, Deborah; Hemenway, David.  "Household Firearm Ownership Levels and Homicide Rates across U.S. Regions and States, 1988-1997." American Journal of Public Health. 2002: 92:1988-1993.

4. Gun availability and state homicide rates, 2001-2003
Using survey data on rates of household gun ownership, we examined the association between gun availability and homicide across states, 2001-2003.
Major findings: States with higher levels of household gun ownership had higher rates of firearm homicide and overall homicide.  This relationship held for both genders and all age groups, after accounting for rates of aggravated assault, robbery, unemployment, urbanization, alcohol consumption, and resource deprivation (e.g., poverty). There was no association between gun prevalence and non-firearm homicide.
Publication:  Miller, Matthew; Azrael, Deborah; Hemenway, David. "State-level Homicide Victimization Rates in the U.S. in Relation to Survey Measures of Household Firearm Ownership, 2001-2003." Social Science and Medicine. 2007; 64:656-64.

5. Homicide followed by suicide in Kentucky.
We analyzed data from the Kentucky Firearm Injury Statistics Program for 1998-2000.
Major findings:  While less than 7% of all firearm homicides were followed by a firearm suicide, in two-thirds of the cases in which a women was shot in an intimate partner-related homicide, the male perpetrator then killed himself with the firearm.  Few of these female victims had contact with the Department of Community-based Services.   Publication: Walsh, Sabrina; Hemenway, David. "Intimate Partner Violence: Homicides followed by Suicides in Kentucky." Journal of Kentucky Medical Association. 2005; 103:667-70.

6. Homicide in Jamaica.
We read the police narratives for every homicide in Jamaica, 1998-2002.
Major findings:  The murder rate has been increasing steadily in Jamaica, and most of the murders are with firearms.  The principal motives are disputes and revenge.  Drugs, gangs, and political killings are no longer the main factors associated with murder.
Publication:  Lemard, Glendene; Hemenway, David.  "Violence in Jamaica: An Analysis of Homicides 1998-2002." Injury Prevention. 2006; 12:15-18.

SUICIDE

7-8. Guns and suicide (literature review).
We performed reviews of the academic literature on the effects of gun availability on suicide rates.
Major findings:  The preponderance of current evidence indicates that gun availability is a risk factor for youth suicide in the United States.  The evidence that gun availability increases the suicide rates of adults is credible, but is currently less compelling.  Most of the disaggregate findings of particular studies (e.g. handguns are more of a risk factor than long guns, guns stored unlocked pose a greater risk than guns stored locked) are suggestive but not yet well established.
Publication: Miller, Matt; Hemenway, David. "The Relationship between Firearms and Suicide: A Review of the Literature." Aggression and Violent Behavior: A Review Journal. 1999; 4:59-75.
Publication:  Miller, Matt; Hemenway, David.  "Gun Prevalence and the Risk of Suicide: A Review." Harvard Health Policy Review. 2001; 2:29-37.

9.  Gun availability and state suicide rates, 1988-1997 (cross sectional analysis)
Using a validated proxy for firearm ownership rates, we analyzed the relationship between firearm availability and suicide across 50 states over a ten year period.
Major findings:  After controlling for poverty and urbanization, for every age group, across the United States, people in states with many guns have elevated rates of suicide, particularly firearm suicide.
Publication:  Miller, Matthew; Azrael, Deborah; Hemenway, David.  "Household Firearm Ownership Levels and Suicide across U.S. Regions and States, 1988-1997."  Epidemiology. 2002; 13:517-524.

10. Gun availability and state suicide rates, 1999-2001 (cross sectional analysis)Using survey data on rates of household gun ownership, we examined the association between gun availability and suicide across states, 1999-2001.
Major findings: States with higher levels of household gun ownership had higher rates of firearm suicide and overall suicide.  This relationship held for both genders and all age groups.  It remained true after accounting for poverty, urbanization and unemployment.  There was no association between gun prevalence and non-firearm suicide. Publication:  Miller, Matthew; Lippmann, Steven; Azrael, Deborah; Hemenway, David. "Household Firearm Ownership and Rates of Suicide across U.S. States."  Journal of Trauma. 2007; 62:1029-35. 

11. Gun availability and state suicide rates, 1981-2001 (time series analysis)
Using survey data on rates of household gun ownership, we examined the association between gun availability and suicide over time, 1981-2001.
Major findings:  Changes in the levels of household firearm gun ownership was significantly associated with changes in both firearm suicide and overall suicide, for men, women and children, even after controlling for region, unemployment, alcohol consumption and poverty. There was no relationship between changes in gun ownership and changes in non-firearm suicide.
Publication:  Miller, Matthew; Azrael, Deborah; Hepburn, Lisa; Hemenway, David; Lippman, Steven.  "The Association between Changes in Household Firearm Ownership and Rates of Suicide in the United States, 1981-2002." Injury Prevention. 2006; 12:178-82.

12-13.  Gun availability and suicide in the Northeast
We analyzed data on suicide and suicide attempts for states in the Northeast
Major findings:  Even after controlling for rates of attempted suicide, states with more guns had higher rates of suicide. Case fatality rates ranged from over 90% for firearms to under 5% for drug overdoses, cutting and piercing (the most common methods of attempted suicide).  Hospital workers rarely see the type of suicide (firearm suicide) that is most likely to end in death.       
Publication: Miller, Matthew; Hemenway, David; Azrael, Deborah. "Firearms and Suicide in the Northeast" Journal of Trauma. 2004; 57:626-632.
Publication:  Miller, Matthew; Azrael, Deborah; Hemenway, David. "The Epidemiology of Case Fatality Rates for Suicide in the Northeast." Annals of Emergency Medicine. 2004; 723-30.

14-15. Gun availability and regional suicide rates (cross sectional analysis)
We analyzed the relationship of gun availability and suicide among differing age groups across the 9 US regions.
Major findings:  Levels of gun ownership are highly correlated with suicide rates across all age groups, even after controlling for lifetime major depression and serious suicidal thoughts. After controlling for divorce, education, unemployment, poverty and urbanization, the statistically significant relationship holds for 15 to 24 year olds and 45 to 84 year olds, but not for 25 to 44 year olds.
Publication:  Birckmayer, Johanna; Hemenway, David.  "Suicide and Gun Prevalence: Are Youth Disproportionately Affected?"  Suicide and Life Threatening Behavior.  2001; 31:303-310.
Publication:  Hemenway, David; Miller, Matthew. "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.

16. Suicide following homicide
We analyzed characteristics of homicides that were followed by suicide and by suicide attempts using data from multiple sites.
Major finding: Fifty-nine percent of the men who killed a female intimate partner with a firearm also took their own life.
Publication: Barber, Catherine W; Azrael, Deborah; Hemenway, David; Olson, Lenora M.; Nie, C;  Schaechter, Judy; Walsh, Sabrina.  Suicides and suicide attempts following homicide: Victim-suspect relationship, weapon type, and presence of antidepressants. Homicide Studies. 2008; 12:285-97. 

17. Summary of the literature on guns and suicide.
This commentary summarized the literature that shows that firearms in the home increase the likelihood of completed suicide, and argued for increased involvement of physicians in recognizing and helping to reduce the problem.
Publication: Miller, Matthew; Hemenway, David.  Guns and suicide in the United States.  The New England Journal of Medicine.  2008; 359:989-991. 

 
ACCIDENTS

18. Gun availability and state unintentional firearm death rates
We analyzed data for 50 states over 19 years to investigate the relationship between gun prevalence and accidental gun deaths across different age groups.
Major findings: For every age group, where there are more guns there are more accidental deaths.  The mortality rate was 7 times higher in the four states with the most guns compared to the four states with the fewest guns.
Publication:  Miller, Matthew; Azrael, Deborah; Hemenway, David.  "Firearm Availability and Unintentional Firearm Deaths." Accident Analysis and Prevention.  2001; 33:477-84.

19. Firearm storage and unintentional firearm death across U.S. states
We analyzed data from the 2002 Behavioral Risk Factor Surveillance System that asked questions about guns and gun storage in the home, combined with information on deaths from the National Center for Health Statistics.
Major findings:  Both firearm prevalence AND questionable storage practices (i.e. storing firearms loaded and unlocked) were associated with higher rates of unintentional firearm deaths.  Publication: Miller, Matthew; Azrael, Deborah; Hemenway, David; Vriniotis, Mary. "Firearm Storage Practices and Rates of Unintentional Firearm Deaths in the United States." Accident Analysis and Prevention.  2005; 37:661-67.

CHILDREN and WOMEN

20. Gun availability and deaths to children.
We analyzed the relationship between firearm availability and unintentional gun death, homicide and suicide for 5-14 year olds across the 50 states over a ten year period.
Major findings:  Children in states with many guns have elevated rates of unintentional gun deaths, suicide and homicide.  The state rates of non-firearm suicide and non-firearm homicide among children are not related to firearm availability.
Publication:  Miller, Matthew; Azrael, Deborah; Hemenway, David.  "Firearm Availability and Unintentional Firearm Deaths, Suicide, and Homicide among 5-14 Year Olds." Journal of Trauma. 2002; 52:267-75.

21. Gun versus non-gun suicide by children
We analyzed data from the Arizona Childhood Fatality Review Team comparing youth gun suicide with suicide by other means.
Major findings:  Children who use a firearm to commit suicide have fewer identifiable risk factors for suicide, such as expressing suicidal thoughts.  Gun suicides appear more impulsive and spontaneous than suicide by other means.
Publication:  Azrael, Deborah; Hemenway, David; Miller, Matthew; Barber, Catherine; Schackner, Robert.  "Youth Suicide: Insights from 5 Years of Arizona Child Review Team Data."  Suicide and Life Threatening Behavior. 2004; 34:36-43.

22. Infant homicides
This article uses data from various locations to describe the circumstances of infant homicides.
Major findings: Guns are almost never used to kill infants.  The perpetrator is virtually always caught, and often is the one calling the police.
Publication: Fujiwara, Takeo; Barber, Catherine; Schaechter, Judy; Hemenway, David. Characteristics of infant homicides in the U.S.: findings from a multi-site reporting system. Pediatrics. in press

23.  Gun availability and deaths to women.
We analyzed the relationship between firearm availability and unintentional gun death, homicide and suicide for women across the 50 states over a ten year period.
Major findings:  Women in states with many guns have elevated rates of unintentional gun deaths, suicides and homicide, particularly firearm suicides and firearm homicides.
Publication:  Miller, Matthew; Azrael, Deborah; Hemenway, David. "Firearm Availability and Unintentional Firearm Deaths, Suicide, and Homicide among Women." Journal of Urban Health. 2002; 79:26-38.

24.  Gun availability and homicides of women across nations.
We analyzed the relationship between gun availability and homicides of women with data from 25 high income countries.
Major findings: Across developed nations, where gun are more available, there are more homicides of women.  The United States has the most firearms and U.S. women have far more likely to be homicide victims than women in other developed countries.
Publication:  Hemenway, David; Shinoda-Tagawa, Tomoko; Miller, Matthew. "Firearm Availability and Female Homicide Victimization Rates Across 25 Populous High-Income Countries." Journal of the American Medical Women's Association. 2002; 57:100-04.