Miller Matthew, Warren Molly, Hemenway David, Azrael Deborah
Harvard Injury Control Research Center, Harvard School of Public Health, Boston, Massachusetts, USA.
Inj Prev. 2015 Apr;21(e1):e116-9. doi: 10.1136/injuryprev-2013-040969. Epub 2013 Dec 3.
On an average day in the USA more than 100 Americans die by suicide-half use firearms. Suicide rates overall and by firearms are higher, on average, in states where household firearm ownership is more common. In general this means in states where a greater proportion of the population lives in rural areas. The current ecological study focuses on the relation between measures of household firearm prevalence and suicide mortality in urban areas (metropolitan statistical areas and divisions) using survey-based measures of firearm ownership. Suicide rates (1999-2010) for metropolitan statistical areas that are comprised of large US cities come from death certificate records; rates of household firearm ownership come from the 2002 and 2004 Behavioural Risk Factor Surveillance System. Higher rates of firearm ownership are strongly associated with higher rates of overall suicide and firearm suicide, but not with non-firearm suicide. Stratification by gender, age and race did not materially affect the association between firearms and suicide. This study provides evidence consistent with previous case-control work and extends evidence from previous state- and region-level ecological studies that firearms in the home impose suicide risk above and beyond baseline.
在美国,平均每天有超过100名美国人自杀,其中一半使用枪支。总体自杀率以及枪支导致的自杀率,平均而言,在家庭枪支拥有率较高的州更高。一般来说,这意味着在农村人口占比更大的州。当前的生态学研究利用基于调查的枪支拥有情况测量方法,聚焦于城市地区(大都市统计区及分区)家庭枪支流行程度测量与自杀死亡率之间的关系。由美国大城市组成的大都市统计区的自杀率(1999 - 2010年)来自死亡证明记录;家庭枪支拥有率来自2002年和2004年行为危险因素监测系统。较高的枪支拥有率与总体自杀率和枪支自杀率的升高密切相关,但与非枪支自杀率无关。按性别、年龄和种族分层并未实质性影响枪支与自杀之间的关联。这项研究提供的证据与之前的病例对照研究一致,并扩展了之前州级和地区级生态学研究的证据,即家中有枪支会带来超出基线水平的自杀风险。