Patterns of household gun ownership and firearm suicide among black men compared to white men

Much is known about all-race gun ownership patterns in the United States. For example, it is known that guns are primarily owned by men, and that ownership is lowest among young adults and highest in rural areas (Smith and Son, 2015; Parker et al., 2017; Azrael et al., 2017).

However, surprisingly little is known about gun ownership by race, except, primarily, that levels of gun ownership are substantially lower among Black households than among White households. For example, in 2001 the National Gun Policy Survey of the National Opinion Research Center reported that 39% of White adults lived in homes with guns, compared to 22% of Black adults; in 2010–2014 the respective results were 39% and 18% (Smith, 2001; Smith and Son, 2015). Since Black adults are less likely to own guns than White adults and represent only a relatively small percentage of the total US population, it is unclear how well the all-race patterns of gun ownership apply to Black adults. By contrast, since White Americans are the majority race and own most of the guns, we suspect that what is currently known about all-race gun ownership largely describes gun ownership in White households.

This article examines the race-specific patterns of household gun ownership in terms of geographic (region, urbanicity), demographic (age, education, married, children at home), and health-related characteristics (binge drinking, smoking). Meta-analyses have concluded that both alcohol use issues (Darvishi et al., 2015) and cigarette smoking (Li et al., 2012; Poorolajal and Darvishi, 2016) are substantial risk factors for completed suicide. We then use these results to examine the relationship between race-specific household gun ownership patterns and the patterns of both race-specific firearm suicide rates and the race-specific proportion of suicide deaths that are by firearms.

Many studies have examined all-race firearm suicide patterns in the United States. For example, rates of firearm suicide are much higher for men than for women, increase with age, and are higher in rural than in urban areas (Hemenway, 2017).

There is also a sizeable literature describing the relationship between all-race levels of gun ownership and all-race rates of firearm suicide. For example, among Americans overall, for men and for women, for children and for adults, it is well established that where gun ownership is higher, firearm suicide rates are also higher (Lester, 2019). Studies also commonly find a strong relationship between household gun ownership and suicide by all methods combined, driven by higher rates of firearm suicide (Stroebe, 2013; Anglemyer et al., 2014).

However, little is known about the relationship between levels of Black gun ownership and (a) rates of Black firearm suicide, or (b) the proportion of Black suicides that are firearm suicides. That is because of the lack of data on Black gun ownership.

This article examines the relationship between the patterns of Black household gun ownership and the patterns of Black firearm suicide across age groups, regions, and between metropolitan and non-metropolitan areas and compares that to the similar relationships of White Americans.

The key questions this paper examines are whether Black and White household gun ownership patterns are similar to each other, and whether they are similar to their own race-specific patterns of firearm suicide, and the proportion of suicides that are firearm suicides.

Because men are far more likely than women to own guns (Azrael et al., 2017) and because the vast majority of firearm suicides are adult male firearm suicides, a priori, we decided to focus on adult males aged 18+ (i.e., men). Prior studies of African American suicide have often focused on men (Joe and Kaplan, 2002; Joe et al., 2007; Crosby and Jack, 2018).

a) Gun Ownership Patterns: The only US survey asking questions about gun ownership that is a large enough to give stable estimates of many characteristics of Black men living in gun owning households is the Behavioral Risk Factor Surveillance System (BRFSS) of the Centers for Disease Control and Prevention (CDC). The BRFSS is the nation's premier system of health-related surveys that collects state data about U.S. adult residents regarding their health-related risk behaviors, chronic health conditions, and use of preventive services. BRFSS is the largest continuously conducted health survey system in the world, completing more than 350,000 interviews each year.

The BRFSS has been conducted annually since 1984. The design for the period of interest used a state-level, random digit-dialed probability sample of the adult population (aged 18+), with interviews conducted using computer-assisted telephone interviewing (CATI) systems. The BRFSS uses a disproportionate stratified sample design, with data weighted for noncoverage and nonresponse. The BRFSS methodology is well described elsewhere (Centers for Disease Control and Prevention, 2013).

Unfortunately, the BRFSS asked core questions about household gun ownership in only three years—2001, 2002, and 2004. Since guns are highly durable, and the particular households with guns and the overall levels of gun ownership typically change only very slowly over time, we combined responses from those three surveys. Over 68,000 Black adults responded to the surveys; more than 23,000 were male. Over 250,000 White males responded to the three surveys.

In these years, the BRFSS asked questions about respondents age (a priori we divided age into three categories: 18–29, 30–50, 51+), region, and county urbanization level. Since these were 3 variables for which we also could obtain data on suicide, we put these variables in one table.

The BRFSS also included data on education, married, children in the home, smoking status, and binge drinking. We compare four groups on these measures: Black men living in homes with guns, Black men living in homes without guns; White men living in homes with guns, and White men living in homes without guns. We then use logistic regression to show the individual effect of each of the eight variables on household gun ownership, controlling for the other seven variables.

We use data from CDC WISQARS to examine the patterns of race-specific firearm suicides rates, total suicide rates, and the proportion of suicides that were firearm suicides in 2001–2004, across age groups, regions and between metropolitan and non-metropolitan counties. Fortunately, BRFSS and WISQARS use the same Census regions and Rural-Urban Continuum Codes (RUCC). We then examine whether the patterns of household gun ownership are similar to the patterns of firearm suicide, total firearm suicide, and the proportion of suicides that are firearm suicides for adult Black males and adult White males.

The data presented in this paper by race include all ethnicities. Thus Black men include both Hispanic and non-Hispanic Black men, and White men include both Hispanic and non-Hispanic White men.

The BRFSS uses weights to ensure that the results are representative of the United States population. We present the weighted data.

Missing data for each category reported are usually less than 1%, so we do not report them. The one exception is for metropolitan area, where, because of minimum cell size requirements, when there are few respondents (e.g., for less populous non-metropolitan counties) the BRFSS does not provide the Department of Agriculture Rural-Urban Continuum Code (RUCC) results. We present these non-reports of RUCC information as “missing.”

This project was classified as “not human subjects research” by the Harvard Chan School of Public Health IRB.

Among adults, Black males had much lower rates of living in a home with guns—26%--compared to White males—44% (Table 1). The likelihood of living in a home with a gun increased substantially with age for both Black and White men; for Black men it increased from 19% for those aged 18–29 to 35% for those aged 51+; for White men it increased from 38% to 50%. The regional pattern of living in a home with guns was also similar for both Black men and White men—the region with the highest percentage of households with guns was the South and the lowest region was the Northeast.

Fifty-five percent (55%) of Black men lived in the South (Table 1), and because the South had the highest rate of Black men living in homes with guns, over 2/3 of Black men living in homes with guns lived in the South (not shown). By contrast, since only one third of White men lived in the South (Table 1), under 40% of White men living in homes with guns lived in the South (not shown).

The urban-rural pattern of living in a home with guns was also similar for Black men and White men—lower rates were reported in metropolitan compared to non-metropolitan counties (Table 1). For Black men, in metropolitan areas 22% lived in homes with guns; in non-metropolitan areas 41% did. For White men, in metropolitan areas, 37% lived in homes with guns compared to 63% in non-metropolitan areas.

In stratified analysis, we find that for both Black and White men, household gun ownership levels increased with age in both metropolitan and non-metropolitan areas (Table 1) Other potential correlates of household gun ownership were also largely similar for Black men and White men (Table 2). For example, there was no significant difference for either binge drinkers or current smokers between Black men living in homes with guns vs without guns, or between White men living in homes with guns vs without guns. For both Black men and White men, those living in homes with guns were somewhat more likely than those not living in homes with guns to have at least a high school education, to be married, and to not have children living at home.

The household gun ownership patterns of Black Men and White Men remained quite similar to each other for each factor, holding the other factors constant (Table 3).

Similar to the household gun ownership rates, the firearm suicide rate per 100,000 among Black men was much lower than that of White men (7.5 vs 15.3) (Table 4). But unlike the patterns of gun ownership, patterns of firearm suicide were not always similar, but were sometimes quite different for Black men compared to White men.

The age pattern for adult Black male firearm suicide rate did not follow the age pattern for adult Black male household gun ownership. The firearm suicide rate for young Black men (aged 18–29) was much higher than for older Black men. The firearm suicide rate per 100,000 for the 18–29 age group was 10.9 compared to 6.0 for the 30–50 year olds and 6.6 for the 51+ age group. By contrast, similar to their household gun ownership patterns, the White male firearm suicide rate increased with age. Those differing racial firearm suicide patterns meant that the Black male firearm suicide rate in the 18–29 age group was almost as high as the 18–29 year old White male firearm suicide rate (10.9 vs 11.5 per 100,000).

The total suicide rate for White men also increased with age; the total suicide rate for Black men decreased with age (Table 4). The percentage of suicides that were firearm suicides in relation to age was also somewhat anomalous for young Black men. Both Black and White older age men had the highest percentage of suicides that were firearm suicides (67.4% for Black men aged 50+ and 72.6% for White men aged 50+). But for young Black men aged 18–29, 64.5% of their suicides were gun suicides, far higher than for both similar aged White men (53.9%) and middle-aged Black men (48.8%), both of whom had higher rates of household gun ownership (Table 4).

Although the adult Black male household gun ownership rate in the South was substantially higher than in the next highest region, the firearm suicide rate for Black men was not highest in the South—but the total suicide rate was highest in the South, as was the percentage of suicides using guns. While the adult Black male firearm suicide rate in metropolitan areas was almost as high as in non-metropolitan areas, and the total suicide rate was actually higher in metropolitan areas, the percentage of suicides that were gun suicides was higher in non-metropolitan areas. By contrast, firearm suicides for adult White males were more likely to follow their regional and metropolitan/non-metropolitan household gun ownership patterns—the firearm suicide rate was higher in non-metropolitan areas, the overall suicide rate was higher, and the percentage of suicides that were gun suicides was also higher.

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