Age-21 Handgun Purchase Policies and Adolescent Suicide Fatalities

Julia Raifman
Elysia Larson, Harvard School of Public Health
Michael Siegel, Boston University School of Public Health
Michael Ulrich, Boston University School of Public Health
Anita Knopov, Boston University School of Public Health
Sandro Galea, Boston University School of Public Health

Suicide is the second leading cause of death among U.S. adolescents. We estimated a difference-in-differences model comparing suicide fatality rates among adolescents aged 18-20 before and after policy changes in three states that changed their handgun sales policies to 21, relative to 18, and over the same time period in neighboring comparison states. We controlled for state, year, sex, race, age, proportion of adult suicides due to firearms, and state poverty and unemployment levels. Age 21 handgun sales policies were associated with 2.7 fewer suicide fatalities per 100,000 person-years (95% confidence interval: -4.1 to -1.4) among adolescents aged 18 to 20 years old. The 22% relative reduction in suicide fatalities in the three policy-change states would be equivalent to 249 fewer suicide fatalities among adolescents aged 18-20 years old each year in the 35 US states without age 21 handgun sales policies.

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 Presented in Session 198. Determinants of Adolescent Mortality