• Matthew Miller, Deborah Azrael, and David Hemenway.
• Department of Health Policy and Management, Boston, MA 02115, USA. mmiller@hsph.harvard.edu
• J Urban Health. 2002 Mar 1;79(1):26-38.

ContextIn the United States, more than 45,000 women died from gun violence over the last decade.ObjectiveTo determine whether measures of firearm availability are related to rates of suicide, homicide, and unintentional firearm deaths among women in the United States.DesignPooled cross-sectional time series data on suicide, homicide, and unintentional firearm deaths (1988-1997) were used to estimate the association between the rate of violent death among women and four proxies of firearm availability. Two proxies came from survey reports of household firearm ownership rates; two were derived from mortality statistics.SettingUnited States, 1988-1997.ResultsThe increased rate of suicide and homicide in states with high gun levels was accounted for primarily by significantly elevated firearm suicide and firearm homicide rates. Unintentional firearm death rates were also increased in states with more guns. At the regional level, qualitatively similar results were obtained.ConclusionBetween 1988 and 1997, the suicide, homicide, and unintentional firearm death rates among women were disproportionately higher in states where guns were more prevalent. The elevated rates of violent death in states with more guns was not entirely explained by a state's poverty or urbanization and was driven primarily by lethal firearm violence, not by lethal nonfirearm violence.

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