Community Level Safe Storage of Firearms Assessment- Behavioral Risk Factor Surveillance Survey and Child Fatality Review Informs Child Firearm Suicide Risk and Safe Storage of Firearms Information

BACKGROUND:    Unsafely stored firearms, which include unlocked, loaded or unlocked and loaded firearms, pose a public health and public safety threat to communities at a population level. The risks include unintentional shootings, assaults and homicides, suicide, firearm theft, lockdowns and threats of shootings in schools and other community settings. This presentation will highlight a nationally unique Washington State effort to organize at the local and state levels to gather Behavioral Risk Factor Surveillance Survey (BRFSS) information on firearm storage practices and use of combined local data from Child Death Reviews to generate local estimates of youth suicide risk due to unsecured firearms.

METHODS:    The BRFSS module on firearm ownership and storage (last asked nationally and in Washington State in 2009) was added to both the 2013 and 2015 Washington State BRFSS based on stakeholder input and local and statewide injury and violence prevention programmatic need for information about the presence of firearms in homes and related storage practices. Local data from the King County Child Death Review process and BRFSS were used to estimate risk of King County youth suicide related to unsecured firearms.

RESULTS:    From the 2013 Washington State BRFSS, an estimated 1.8 million adult residents reported firearm(s) in or around their homes.  Over 950,000 Washington State residents reported at least one firearm in or around their home that was unlocked.  Additionally, almost 200,000 children under 18 years of age statewide were estimated to reside in homes with unsafely stored (unlocked) firearms.   From child death reviews, twenty-five children under 18 years were found to have died by firearm suicide between 1999 and 2012 in King County, WA.  Combining local data from these two systems, the estimated risk of youth firearm suicide was at least nine times higher in a household with unsecured firearms than in households with safely stored firearms (Risk Ratio =9.2; 95% Confidence Interval: 4.2-20.1).

CONCLUSIONS:    Unsafely stored firearms pose a risk to our communities.  Using public health assessment data in conjunction with information from Child Death Review can help to identify risks, areas for improvement and collaboration with all sides of the firearm issue, and inform strategies to reduce the burden of gun violence on communities as well as the public health and public safety systems.  If additional states were to add this BRFSS module back into their assessment it would be beneficial to population level health.