2. Guns and Suicide 2000-2002 15 States 116 million people 47% Gun Ownership Firearm Suicides 9749 Non Firearm suicides 5060 Total suicides 14,809 Firearm suicides per 100,000 8.4 6 States 119 million people 15% gun ownership Firearm Suicides 2606 Non-firearm Suicides 5446 Total Suicides 8052 Firearm suicides per 100,000 2.2 High Gun OwnershipLow Gun Ownership

3. Male Suicide Rates Age 10-14 Age 15-19 Age 20-24 YearFire- arm OtherAllFire- arm OtherAllFire- arm OtherAll 19941.430.932.3613.114.8417.9518.809.1627.96 19990.770.781.858.404.6513.0512.818.0420.85 20040.461.251.716.476.1812.6511.129.7220.84 1994- 2004 -.97+.32-0.65-6.64+1.34-5.3-7.68+.56-7.12

4. Risk of Suicide in a Home Case Control studies are often used to determine whether a gun in the home increases the risk of suicide These studies find a risk of 2.1 to 4.8 times greater for suicide when a gun is present Shah and colleagues looked at adolescent suicides in Colorado from 1991 to 1993

5. Adolescent Suicide in Colorado 1991-1993 36 of 54 suicides were committed with a gun 24 used a gun form home, 2 a non resident parent’s gun, 2 a relative’s, 4 a friend, neighbor or acquaintance, 4 unknown 42% used a handgun Only 25% of the guns were stored locked

6. Adolescent Suicide in Colorado 1991-1993 VariableCasesControlsP value A gun in the home 72%50%.05 An unlocked gun 58%35%.05 > 1 gun56%28%.02 Conduct problem 64%25%<.01 Mental Health Rx 47%19%.01 Ever drank alcohol 54%34%<.01

7. Independent Factors predicting the risk of suicide in adolescents VariableAdjusted Odds Ratio Conduct Disorder Related Behaviors 7.45 Past Mental Health Problem4.84 Household access to a gun3.91 Ever drank Alcohol1.86

8. Does Storage Matter? Grossman et al studied 106 suicide and gun injury cases from Washington, Oregon and Missouri in individuals less than 20 years old 82 Suicide attempts, 95% fatal 24 unintentional injuries, 50% fatal Control gun owning households were found by random telephone dialing and matched by age group of a household member and county

9. Does Storage Matter? Storage Practice /Safety Device Cases N=106 Controls N=480 Gun loaded34%9% Gun unloaded66%91% Gun and Ammo stored separately 41%65% Both accessible56%28% Gun locked32%58% Ammunition locked24%48% Both locked17%35%

10. Does Storage Matter? Storage PracticeOdds Ratio Gun and Ammunition Accessible 1.0 Gun Accessible, Ammunition Not 0.47 Ammunition Accessible, Gun Not 0.34 Neither Accessible0.22

11. Figure 7: Indiana Suicide Deaths by Gender and Age, 2001-2005 (Source: Indiana State Department of Health, Suicide Report, 2001-2005)

12. Figure 8: Indiana Suicide Rates by Race and Age, 2001-2005 (Source: Indiana State Department of Health, Suicide Report, 2001-2005) *Black Females not included due to all age categories having less than 20 deaths and therefore unstable rates.

13. Table 4: Indiana Suicide Rates by Mechanism, Race and Gender, 2001-2005 Mechanism White Males Black Males White Females All Number Death Rate* Number Death Rate* Number Death Rate* Number (%) Firearms1688 12.71 99 8.14 234 1.66 2021 (60%) Suffocation607 4.49 35 2.70 90 0.65 732 (22%) Poisoning338 2.49 **261 1.87 599 (18%)

14. Indiana Gun Ownership 44.2% of families reported owning a gun* 25.8% reported owning a handgun* 9.6% store guns loaded** 6% store guns loaded and unlocked**

15. Good News in Indiana YearGun in the Household Handgun in the Household 200048.6%29.5% 200444.2%25.8%

16. Guns and Suicide Answered This is a problem usually involving legal guns accessed by people at risk from mental illness, substance abuse, physical illness, old age, etc. Simply removing guns from the community on a large scale is the simplest and probably most effective measure. Regulation of gun storage could limit the risk to the actual owner. Enforced waiting periods under Brady led to a decrease in suicide. Educational campaigns may be helpful.

17. Finally If Indiana were to somehow become a low gun ownership state, we might expect little change in non gun suicides but gun suicides to go from 60% to 33% of all suicides For an average year this would decrease the number of suicides from about 700 to about 420. The decrease would come preferentially from suicides in younger males

18. We don’t have more crime in our country, just much more lethal violence. CountryCar Theft BurglaryRobberySexual Incident Assault or Threat 11 Crimes United States 0.51.80.61.53.421.1 Australia1.93.91.24.06.423.8 Canada1.42.30.92.15.330.0 17 Industrial -ized Nations 1.01.80.81.73.521.3 Guns and Crime

19. NationFire Arm Homicide Rate Non- Firearm Homicide Rate Total Homicide Rate Household s with guns United States 4.02.26.141% Canada0.61.21.826% Australia0.41.41.816% New Zealand 0.21.51.720%

20. Gun Ownership and Homicide Homicide Deaths in High Ownership States, 1988-1997 Person Years at Risk 158 million Gun-related15283 Non-gun related 5865 Total21148 Homicide Deaths in Low Ownership States, 1988-1997 Person Years at Risk 160 million Gun –related3668 Non-gun related3598 Total7266

21. Guns and Crime Guns don’t kill people, but they make it so darn easy –The use of a gun in the commission of a crime greatly increases the likelihood of a homicide –Most gun homicides are not premeditated or planned, but occur in the context of another crime or dispute

22. Guns and Crime Homicides in Robberies and Assaults are: –3-5 times more likely with guns than knives –6-10 times more likely with guns than with other weapons (clubs, bats, bottles, etc.) –40 times more likely than with no weapon

23. Circumstances of Gun Assault and Violence in Indianapolis, 2002-2004* Robbery or Burglary153 (14%) Argument146 (14%) Domestic Violence29 (3%) Drive By44 (4%) Other 118 (11%) Unknown547 (54%) When known, a handgun was used in 85% of cases.

27. Gun Violence in Indiana 6-7 homicides per 100,000 from 1999-2001 68% are done with firearms Firearm homicide was the leading cause of injury death for black males from 1999-2001, accounting for 478 or 38% of 1264 deaths

28. Gun Violence Marion Cty. 2004 392 injuries, 83 of which were fatal (21%) Males were 89% of the victims 90% were black (139/100,000) 72% were younger than 35 38% in a home, 35% a road or vehicle, 27% other location

29. Gun Violence, Marion Cty. 2004 For 83 firearm homicides, the shooter was –An acquaintance 24 % –A stranger 11% –A family member or intimate 10% –Other or Unknown 56% Handguns accounted for 89 % of the firearms when the firearm was known

30. Gun violence is costly Medical care costs are increased by about $2 billion per year Increased costs to the criminal justice system of $2.4 billion per year for longer incarcerations, trials, etc. Increased costs of law enforcement, preventive actions by schools, airports, etc. of more than $1 billion dollars. Costs of decreased willingness to work evenings estimated at $3-7 billion per year Costs of depopulation of central cities, decline in property values, problems delivering services, etc. are in the billions but difficult to quantify

31. Gun Violence Costs as Willingness to Pay Would you be willing to pay more taxes to decrease gun violence? Cook and Ludwig review several studies that suggest Americans would be willing to pay $80 billion to eliminate the use of guns in crime

32. Guns and Crime, Answers If locking up criminals is the answer, we should be the safest country in the world: The US has the highest rate of incarceration in the developed world. CountryPrisoners*Prisoners/100,000* Homicide Rate/100,000 ** United States2,053,3317014.28 Canada36,0241161.4 England74,4521411.4 Australia22,4921151.5

33. Guns and Crime, Answers If guns were the answer to crime, we should be remarkably safe. We have 290 million guns in circulation, nine guns for every 10 people. No other country has more than six guns for ten people. Responsible gun ownership does not protect from crime. Guns in home are rarely useful in defense and increase likelihood of suicide or homicide. Gun carry laws have little effect on crime.

34. Guns and Crime, Answers Acknowledge Guns are the problem. –The governor, mayor, and key legislators need to address guns as a threat to the community –Key community leaders to need to denounce guns and gun violence Different Communities need different speakers

35. Guns and Crime, Answers For Crime Guns, the problem is the migration of guns, mainly hand guns, from legal sales to criminal users. This can happen at the point of sale through straw man purchasers. This can happen in secondary markets where no records are kept. This can happen through theft.

36. Guns and Crime, Answers Better regulation of the gun market –One handgun per month requirment –No unscreened sales or transfers –Registration requirement, with required reporting of loss or theft –Storage requirements –Improvements in manufacture that restrict use to the gun’s owner –Increased support for the ATF and better distribution of information to states and localities

37. Guns and Crime, Answers Recognition that gun violence is not the same threat in the city and rural areas. Allow municipalities to set different rules for gun ownership and use. Focused policing aimed at literally getting guns off the street –Stop and frisk laws –Focus on violence associated with drug trafficking, getting sellers off the streets

38. Measures Favored By a Majority of Hoosiers, 2004 Background checks at gun shows 87% Waiting period to buy a handgun 85% Raise age to 21 for purchase of a long gun 63% Storage requirements for guns 73% Child Access Prevention Law 73% Safety Training for New Owners 83% Recognition device for new handguns 75%

39. Reasons For Hope “At one time, the United States had the worst traffic fatality rate in the developed world. The automobile industry wanted to blame the problem on bad driving, no regulation needed. Progress was made when we were convinced that the problem was not only bad driving, but unsafe cars and roads. Despite fierce industry opposition, great progress has been made now that that traffic safety is recognized as a public health issue. Traffic fatalities per mile driven are down 80%.” Hemenway, Private Guns, Public Health, 2004

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