A National Evaluation of the Impact of Child Access Prevention Laws on Rates of Youth Suicide and Other Youth Firearm Deaths

Abstract

Objective

Rates of youth firearm injury deaths are precipitously increasing, in part because of increases in youth firearm suicides. State policies may reduce youth suicide and other firearm death rates by limiting access to firearms. This study evaluated the impact of child access prevention (CAP) laws on rates of youth firearm suicide mortality. We evaluated whether CAP law–associated changes in youth firearm suicide rates reflected shifts to nonfirearm suicide methods or systematic changes in the classification of suicide deaths.

Method

Nationally representative mortality data from 1990 through 2020 were disaggregated by state and year. CAP laws fall into 2 major categories: negligent storage of firearms policies that regulate how firearms are stored in households with children and reckless provision of a firearm to a minor policies that impose liability on firearm owners who provide youth with firearms that are used to harm others. Firearm suicide, nonfirearm suicide, firearm homicide, and firearm unintentional injury death rates among youth ages 1 to 17 were the main outcomes.

Results

Growth curve models revealed that CAP firearm storage laws were associated with significant reductions in youth firearm suicide mortality, with small-to-medium effects for their overall presence and medium-to-large effects for specific aspects of storage requirements. There was no evidence that these findings were the result of shifts in youth suicide methods or manner of death classifications. CAP firearm storage laws are a promising tool for reducing overall rates of youth suicide and youth firearm injury deaths.

Conclusion

CAP firearm storage policies appear to effectively reduce firearm suicide mortality as well as firearm-related unintentional injuries and homicide in youth.

Plain language summary

This nationally representative study used more than 30 years of mortality data maintained by the Centers for Disease Control and Prevention to evaluate the association between a firearm storage policy and youth suicide mortality. The study showed that child access prevention policies that govern the safe storage of firearms in homes with children were associated with lower rates of youth suicide mortality. Laws that require families to store firearms unloaded and secured in a locking device appear to effectively prevent youth suicide deaths and firearm-related youth deaths by accident and homicide. Results highlight the importance of policy level interventions in improving youth mental health outcomes.