Reconsidering the relationship between veteran status and firearm use among suicide decedents

Background/Purpose: Access to and use of lethal means such as firearms has been suggested to contribute to an elevated risk of suicide among Veterans. Although previous studies have indicated that Veterans are more likely to own guns and the proportion of firearm suicides is higher in this population, demographic and social correlates related to firearm use such as age and location of residence are also related to Veteran status and need to be appropriately controlled for. Clarifying the relationship between firearm use and Veteran status is an important step towards developing effective Veteran suicide prevention strategies, especially given the heterogeneity of and current political turmoil surrounding legislative gun control aimed at reducing gun-related violence in the United States. Methods: We present findings from a cross-sectional study (N=83,543) investigating the differential prevalence of firearm use among suicide decedents for Veterans and non-Veterans utilizing state death certificates supplemented with validated Veteran status information (1999-2009) available for 11 states from the Department of Veteran Affairs. Prevalence ratios controlling for pertinent demographic factors were computed using Robust Poisson Regression. Results/Outcomes: Firearms accounted for 59% of male and 32% of female suicides in our sample. Controlling for age, marital status, race, and place of residence, firearm use was 6% and 20% higher among male and female Veterans, respectively, compared to non-Veterans. Conclusions: We observed a small, yet significantly increased prevalence of firearm use among Veteran suicide decedents. Living in rural locations, however, was associated with a greater increased prevalence of firearm use across genders.