• Evan V Goldstein and Fernando A Wilson.
• Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, The University of Utah, Salt Lake City, Utah. Electronic address: evan.goldstein@hsc.utah.edu.
• Am J Prev Med. 2024 Nov 1; 67 (5): 753758753-758.

IntroductionOver 40,000 people die by suicide annually in the U.S., and firearms are the most lethal suicide method. There is limited evidence on the effectiveness of many state-level policies on reducing firearm suicide. The objective of this study was to identify public policies that best predict state-level firearm suicide rates.MethodsData from the Centers for Disease Control and Prevention's WONDER system and the State Firearm Law Database, a longitudinal catalog of 134 firearm safety laws, were analyzed. The analysis included 1,450 observations from 50 states spanning 1991-2019. An ElasticNet regression technique was used to analyze the relationship between the policy variables and firearm suicide rates. Nested cross-validation was performed to tune the model hyperparameters. The study data were collected and analyzed in 2023 and 2024.ResultsThe optimized ElasticNet approach had a mean squared error of 2.07, which was superior to nonregularized and dummy regressor models. The most influential policies for predicting the firearm suicide rate on average included laws requiring firearm dealers that sell handguns to have a state license and laws requiring individuals to obtain a permit to purchase a firearm through an approval process that includes law enforcement, among others.ConclusionsOn average, firearm suicide rates were lower in state-years that had each influential policy active. Notably, these analyses were ecological and noncausal. However, this study was able to use a supervised machine learning approach with inherent feature selection and many policy types to make predictions using unseen data (i.e., balancing Lasso and Ridge regularization penalties).Copyright © 2024 Elsevier Inc. All rights reserved.

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