Citation

Grimsley EA, Torikashvili JV, Janjua HM, Read MD, Kuo PC, Diaz JJ. J. Am. Coll. Surg. 2024; ePub(ePub): ePub.

Copyright

(Copyright © 2024, American College of Surgeons, Publisher Elsevier Publishing)

DOI

10.1097/XCS.0000000000000959

PMID

38465793

Abstract

BACKGROUND: Firearm-related death rates continue to rise in the United States. As some states enact more permissive firearm laws, we sought to assess the relationship between a change to permitless open carry and subsequent firearm-related death rates, a currently understudied topic. STUDY DESIGN: Using state-level data from 2013-2021, we performed a linear panel analysis using state fixed-effects. We examined total firearm-related death, suicide, and homicide rates separately. If a significant association between open carry law and death rate was found, we then performed a difference-in-difference analysis to assess for a causal relationship between changing to permitless open carry and increased death rate. For significant difference-in-difference results, we performed confirmatory difference-in-difference separating firearm and non-firearm death rates.

RESULTS: Nineteen states maintained a no open carry or permit-required law, while five changed to permitless, and 26 had a permitless open carry prior to 2013. Fixed-effects model indicated more permissive open carry law was associated with increased total firearm-related deaths and suicides. In difference-in-difference, changing law to permitless open carry had a significant average treatment effect on the treated of 1.57 (95% CI 1.05-2.09) for total suicide rate, but no significant for total firearm-related death rate. Confirmatory difference-in-difference found a significant average treatment effect on the treated of 1.18 (95% CI 0.90-1.46) for firearm suicide rate.

CONCLUSION: Open carry law is associated with total firearm-related death and suicide rates. Based on our difference-in-difference results, changing to permitless open carry is indeed strongly associated with increased suicides by firearm.

Language: en