# Association of veteran suicide risk with state-level firearm ownership rates and firearm laws in the USA

## TL;DR

Veterans and non-veterans have higher suicide rates in states with higher firearm ownership and fewer firearm laws, especially for firearm-related suicides.

## Contribution

This study links state-level firearm ownership and laws to suicide risk among veterans and non-veterans using a longitudinal analysis.

## Key findings

- Higher household firearm ownership is strongly linked to increased suicide rates for both veterans and non-veterans.
- More restrictive firearm laws are associated with lower suicide rates, primarily due to reduced firearm suicides.
- Veterans and non-veterans show similar associations between firearm policies and suicide risk.

## Abstract

Veterans have higher suicide rates than matched non-veterans, with firearm suicides being especially prevalent among veterans. We examined whether state firearm laws and state firearm ownership rates are important risk factors for suicide among veterans.

US veteran’s and demographically matched non-veteran’s suicide rates, 2002–2019, are modelled at the state level as a function of veteran status, lethal means, state firearm law restrictiveness, household firearm ownership rates and other covariates.

Marginal effects on expected suicide rates per 100 000 population were contrasted by setting household firearm ownership to its 75th versus 25th percentile values of 52.3% and 35.3%. Ownership was positively associated with suicide rates for both veterans (4.35; 95% credible interval (CrI): 1.90, 7.14) and matched non-veterans (3.31; 95% CrI: 1.11, 5.77). This association was due to ownership’s strong positive association with firearms suicide, despite a weak negative association with non-firearm suicide. An IQR difference in firearm laws corresponding to three additional restrictive laws was negatively associated with suicide rates for both veterans (−2.49; 95% CrI: −4.64 to –0.21) and matched non-veterans (−3.19; 95% CrI: −5.22 to –1.16). Again, these differences were primarily due to associations with firearm suicide rates. Few differences between veterans and matched non-veterans were found in the associations of state firearm characteristics with suicide rates.

Veterans’ and matched non-veterans’ suicide risk, and specifically their firearm suicide risk, was strongly associated with state firearm characteristics.

These results suggest that changes to state firearm policies might be an effective primary prevention strategy for reducing suicide rates among veterans and non-veterans.