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State handgun purchase age minimums in the US and adolescent suicide rates: regression discontinuity and difference-in-differences analyses

OBJECTIVE: To evaluate the association between US state policies that establish age 18 or 21 years as the minimum purchaser age for the sale of handguns and adolescent suicide rate. DESIGN: Regression discontinuity and difference-in-differences analyses. SETTING: 46 US states without policy changes...

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Autores principales: Raifman, Julia, Larson, Elysia, Barry, Colleen L, Siegel, Michael, Ulrich, Michael, Knopov, Anita, Galea, Sandro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group Ltd. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7374798/
https://www.ncbi.nlm.nih.gov/pubmed/32699008
http://dx.doi.org/10.1136/bmj.m2436
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author Raifman, Julia
Larson, Elysia
Barry, Colleen L
Siegel, Michael
Ulrich, Michael
Knopov, Anita
Galea, Sandro
author_facet Raifman, Julia
Larson, Elysia
Barry, Colleen L
Siegel, Michael
Ulrich, Michael
Knopov, Anita
Galea, Sandro
author_sort Raifman, Julia
collection PubMed
description OBJECTIVE: To evaluate the association between US state policies that establish age 18 or 21 years as the minimum purchaser age for the sale of handguns and adolescent suicide rate. DESIGN: Regression discontinuity and difference-in-differences analyses. SETTING: 46 US states without policy changes between 2001 and 2017; Missouri and South Carolina, which lowered the age for handgun sales in 2007 and 2008, respectively; and West Virginia and Wyoming, which increased the age for handgun sales in 2010. PARTICIPANTS: Adolescents aged 13 to 20 years(554 461 961 from 2001 to 2017) in the regression discontinuity analysis, and adolescents aged 18 to 20 years (168 934 041 from 2002 to 2014) in the main difference-in-differences analysis. MAIN OUTCOME MEASURE: Suicide rate per 100 000 adolescents. RESULTS: In the regression discontinuity analysis, state policies that limited the sale of handguns to those aged 18 or older (relative to 21 or older) were associated with an increase in suicide rate among adolescents aged 18 to 20 years equivalent to 344 additional suicides in each state where they were in place between 2001 and 2017. In the difference-in-differences analysis, state policies that limited the sale of handguns to those aged 21 or older were associated with 1.91 fewer suicides per 100 000 adolescents aged 18 to 20 years (95% confidence interval −3.13 to −0.70, permutation adjusted P=0.025). In the difference-in-differences analysis, there were 1.83 fewer firearm related suicides per 100 000 adolescents (−2.66 to −1.00, permutation adjusted P=0.002), with no association between age 21 handgun sales policies and non-firearm related suicides. Separate event study estimates indicated increases in suicide rates in states that lowered the age of handgun sales, with no association in states that increased the age of handgun sales. CONCLUSIONS: A clear discontinuity was shown in the suicide rate by age at age 18 in states that limited the sale of handguns to individuals aged 18 or older. State policies to limit the sale of handguns to individuals aged 21 or older were associated with a reduction in suicide rates among adolescents. Increases in suicide rates were observed after states lowered the age of handgun sales, but no effect was found in states that increased the age of handgun sales.
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spelling pubmed-73747982020-07-27 State handgun purchase age minimums in the US and adolescent suicide rates: regression discontinuity and difference-in-differences analyses Raifman, Julia Larson, Elysia Barry, Colleen L Siegel, Michael Ulrich, Michael Knopov, Anita Galea, Sandro BMJ Research OBJECTIVE: To evaluate the association between US state policies that establish age 18 or 21 years as the minimum purchaser age for the sale of handguns and adolescent suicide rate. DESIGN: Regression discontinuity and difference-in-differences analyses. SETTING: 46 US states without policy changes between 2001 and 2017; Missouri and South Carolina, which lowered the age for handgun sales in 2007 and 2008, respectively; and West Virginia and Wyoming, which increased the age for handgun sales in 2010. PARTICIPANTS: Adolescents aged 13 to 20 years(554 461 961 from 2001 to 2017) in the regression discontinuity analysis, and adolescents aged 18 to 20 years (168 934 041 from 2002 to 2014) in the main difference-in-differences analysis. MAIN OUTCOME MEASURE: Suicide rate per 100 000 adolescents. RESULTS: In the regression discontinuity analysis, state policies that limited the sale of handguns to those aged 18 or older (relative to 21 or older) were associated with an increase in suicide rate among adolescents aged 18 to 20 years equivalent to 344 additional suicides in each state where they were in place between 2001 and 2017. In the difference-in-differences analysis, state policies that limited the sale of handguns to those aged 21 or older were associated with 1.91 fewer suicides per 100 000 adolescents aged 18 to 20 years (95% confidence interval −3.13 to −0.70, permutation adjusted P=0.025). In the difference-in-differences analysis, there were 1.83 fewer firearm related suicides per 100 000 adolescents (−2.66 to −1.00, permutation adjusted P=0.002), with no association between age 21 handgun sales policies and non-firearm related suicides. Separate event study estimates indicated increases in suicide rates in states that lowered the age of handgun sales, with no association in states that increased the age of handgun sales. CONCLUSIONS: A clear discontinuity was shown in the suicide rate by age at age 18 in states that limited the sale of handguns to individuals aged 18 or older. State policies to limit the sale of handguns to individuals aged 21 or older were associated with a reduction in suicide rates among adolescents. Increases in suicide rates were observed after states lowered the age of handgun sales, but no effect was found in states that increased the age of handgun sales. BMJ Publishing Group Ltd. 2020-07-22 /pmc/articles/PMC7374798/ /pubmed/32699008 http://dx.doi.org/10.1136/bmj.m2436 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Research
Raifman, Julia
Larson, Elysia
Barry, Colleen L
Siegel, Michael
Ulrich, Michael
Knopov, Anita
Galea, Sandro
State handgun purchase age minimums in the US and adolescent suicide rates: regression discontinuity and difference-in-differences analyses
title State handgun purchase age minimums in the US and adolescent suicide rates: regression discontinuity and difference-in-differences analyses
title_full State handgun purchase age minimums in the US and adolescent suicide rates: regression discontinuity and difference-in-differences analyses
title_fullStr State handgun purchase age minimums in the US and adolescent suicide rates: regression discontinuity and difference-in-differences analyses
title_full_unstemmed State handgun purchase age minimums in the US and adolescent suicide rates: regression discontinuity and difference-in-differences analyses
title_short State handgun purchase age minimums in the US and adolescent suicide rates: regression discontinuity and difference-in-differences analyses
title_sort state handgun purchase age minimums in the us and adolescent suicide rates: regression discontinuity and difference-in-differences analyses
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7374798/
https://www.ncbi.nlm.nih.gov/pubmed/32699008
http://dx.doi.org/10.1136/bmj.m2436
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