Most older adults support steps to reduce firearm injury risk, U-M study shows

A majority of American adults over 50 -- including the 37% of older adults who own guns or live with someone who does -- supports specific steps that could reduce the risk of firearm injury and death, a new national study shows. 

The University of Michigan study shows support among older adults for everything from firearm safety counseling by health care providers, and background checks for firearm purchasers, to “red flag” policies that allow for temporary firearm removal from people at high risk of harming themselves or others.

The study also highlights opportunities to help older adults recognize and address the risks in their own homes, especially for those who live with children, have heightened suicide risk, or are beginning to experience cognitive decline and/or dementia. 

For instance, the study shows 24% of firearm owners over age 50 regularly store at least one of their firearms loaded and unlocked, which past research has shown increases the potential risk of accidental or intentional injury. Gun locks and locked storage containers such as gun safes can reduce that risk, as can ‘smart guns’ that can only be fired by a specific individual.

Published this week in the journal Preventive Medicine, the study is based on a national survey of more than 2,000 adults aged 50 to 80 carried out by members of the U-M Institute for Firearm Injury Prevention, Injury Prevention Center and the  Institute for Healthcare Policy and Innovation, along with a colleague from Michigan State University. 

The researchers conducted the study because one-third of all firearm-related deaths in the United States occur among people in their 50s, 60s and 70s, with 84% of those deaths resulting from suicide. 

Preventing injury and death among older adults, and the children and teens who live with them, has taken on new urgency because of the rise in such incidents in the past decade, the researchers say. 

“Just as health care providers and health policymakers have worked to address other preventable causes of injury and death, we hope these findings will inform the effort to reduce the toll of firearm injuries among older adults, while respecting firearm ownership rights,” said study leader Patrick Carter, M.D., a U-M emergency physician who co-directs the U-M Institute for Firearm Injury Prevention and directs the Injury Prevention Center. “This is especially true for older adults experiencing depression, cognitive decline, and other conditions that may increase their risk for firearm injury, as well as those with children and teens living with or visiting them.”

Rebecca Cunningham, M.D., the study’s senior author and U-M vice president for research, added, “Firearm safety is about identifying and reducing risk, and creating policies, programs and education that can help achieve this. Every suicide, every accidental shooting, every homicide is a tragedy that affects far more people than just the person pulling the trigger or getting shot. These new data can help us move forward at the societal and personal level.”

The survey covered a wide range of topics, from firearm ownership and storage practices to attitudes toward specific policies and programs. Respondents were also asked about their own health and the presence of children in the home. 

Ownership and storage

• 27% of older adults own at least one firearm, and most of these individuals own more than one. Another 10% say they live with someone who owns a firearm. 
• 40% of firearm owners say they regularly store their firearms locked and unloaded, 35% say they store their firearms unlocked and unloaded, and 24% store their firearms loaded and unlocked. 
• Storage practices differed by firearm type, with a larger proportion of handgun owners reporting they stored at least one firearm loaded and unlocked, while only 3% of long-gun owners reported keeping their long guns stored loaded and unlocked. 
• 69% of those who own firearms cited protection as a reason, while 55% cited target shooting or hunting and 30% cited a constitutional right. (Respondents could choose more than one option.)
• Among those who cited protection as a reason for ownership, only 5% said it was to protect themselves against someone they specifically knew, while most endorsed a general sense they needed the weapon to protect themselves.
• 20% of firearm owners who have children living with them or visiting regularly said they store at least one firearm unlocked and loaded, compared with 35% of firearm owners who do not have children living with them or visiting. Other research has shown that 75% of adolescent suicides involve a gun from the teen’s own home or a relative.

Attitudes toward preventive programs and policies

• Most older adults, both firearm owners and non-firearm owners, said they would be comfortable being asked or counseled about firearm safety by a doctor or other clinician. 69% of firearm owners would be comfortable with healthcare-based screening for firearm ownership, and 63% would be comfortable with receiving counseling about safe firearm storage from a health care provider. The percentages were higher among non-firearm owners, including those who live with a firearm owner.
• “Red flag” laws and programs that allow family members or police to petition courts to restrict firearm access by people they believe to be a danger to themselves or others met with approval from 79% of firearm owners and 89% of non-firearm owners.
• 81% of firearm owners and 92% of non-firearm owners support efforts to remove firearms from the homes of older adults with dementia or confusion.
• 88% of firearm owners and 93% of non-firearm owners support restricting those who are under domestic violence restraining orders from owning or having access to firearms.
• Background checks for all firearm sales, including private ones between individuals, met with support from 85% of firearm owners and 93% of non-firearm owners.

Individual and family characteristics and risk factors

• Firearm owners were more likely to be white, male and veterans than non-firearm owners, and more likely to be in higher income brackets and to live in rural areas outside the Northeast. 
• 77% of firearm owners had children living with them, or regularly visiting them, compared with 70% of non-firearm owners. 
• 40% of non-firearm owners said that the presence of children in their home influenced their decisions about owning firearms, compared with 20% of those who owned firearms.
• 40% of firearm owners said they had experienced social isolation or lack of companionship in the last year; the survey was taken just before the start of the COVID-19 pandemic. This percentage was much higher (89%) among older firearm owners who rated their physical or mental health as fair or poor.
• 9% of the older firearm owners in the survey met criteria for having depression, which is a risk factor for suicide, compared with 8% of non-firearm owners.

The study was funded by the National Institutes of Health (DA039341, CE003085). 

In addition to Carter and Cunningham, the study’s authors are Eve Losman, M.D., Jessica Roche, M.P.H., Preeti Malani, M.D., Jeffrey Kullgren, M.D., M.S., M.P.H., M.S., Erica Solway, Ph.D., M.P.H., Matthias Kirch, M.S., Dianne Singer, M.P.H,, Maureen Walton, Ph.D., of U-M and April Zeoli, Ph.D., of MSU. 

Citation: Firearm ownership, attitudes, and safe storage practices among a nationally representative sample of older U.S. adults age 50 to 80, Preventive Medicine, Vol. 156, March 2022, DOI:10.1016/j.ypmed.2022.106955, https://authors.elsevier.com/c/1eTqWKt2q2WoW