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Background: After a 1996 firearm massacre in Tasmania in which 35 people died, Australian governments united to remove semi-automatic and pump-action shotguns and rifles from civilian possession, as a key component of gun law reforms. Objective: To determine whether Australia’s 1996 major gun law reforms were associated with changes in rates of mass firearm homicides, total firearm deaths, firearm homicides and firearm suicides, and whether there were any apparent method substitution effects for total homicides and suicides. Design: Observational study using official statistics. Negative binomial regression analysis of changes in firearm death rates and comparison of trends in pre–post gun law reform firearm-related mass killings. Setting: Australia, 1979–2003. Main outcome measures: Changes in trends of total firearm death rates, mass fatal shooting incidents, rates of firearm homicide, suicide and unintentional firearm deaths, and of total homicides and suicides per 100 000 population. Results: In the 18 years before the gun law reforms, there were 13 mass shootings in Australia, and none in the 10.5 years afterwards. Declines in firearm-related deaths before the law reforms accelerated after the reforms for total firearm deaths (p = 0.04), firearm suicides (p = 0.007) and firearm homicides (p = 0.15), but not for the smallest category of unintentional firearm deaths, which increased. No evidence of substitution effect for suicides or homicides was observed. The rates per 100 000 of total firearm deaths, firearm homicides and firearm suicides all at least doubled their existing rates of decline after the revised gun laws. Conclusions: Australia’s 1996 gun law reforms were followed by more than a decade free of fatal mass shootings, and accelerated declines in firearm deaths, particularly suicides. Total homicide rates followed the same pattern. Removing large numbers of rapid-firing firearms from civilians may be an effective way of reducing mass shootings, firearm homicides and firearm suicides.

Over the last few decades, the occupation of the Amazon and the expansion of large-scale economic activities have exerted a significant negative impact on the Amazonian environment and on the health of the Amazon’s inhabitants. These processes have altered the context of the manifestation of health problems in time and space and changed the characteristics of the spatial diffusion of health problems in the region. This study analyzed the relationships between the various economic processes of territorial occupation in the Amazon and the spatial diffusion of homicidal violence through the configuration of networks of production, as well as the movements of population and merchandise. Statistical data on violence, deforestation, the production of agricultural items, and socio-economic variables, georeferenced and available for the 771 municipalities of the Legal Amazon were used in this study. The results suggest that the diffusion of violence closely follows the economic expansion front, which is related to deforestation and livestock production but has little relation to grain production, demonstrating steps and typologies of recent occupation in the Amazon that promote violence. These spatial patterns reveal environmental and socio-economic macro-determinants that materialize in geographic space through the construction of highways and the formation of city networks.

The burden of fatal police violence is an urgent public health crisis in the USA. Mounting evidence shows that deaths at the hands of the police disproportionately impact people of certain races and ethnicities, pointing to systemic racism in policing. Recent high-profile killings by police in the USA have prompted calls for more extensive and public data reporting on police violence. This study examines the presence and extent of under-reporting of police violence in US Government-run vital registration data, offers a method for correcting under-reporting in these datasets, and presents revised estimates of deaths due to police violence in the USA. We compared data from the USA National Vital Statistics System (NVSS) to three non-governmental, open-source databases on police violence: Fatal Encounters, Mapping Police Violence, and The Counted. We extracted and standardised the age, sex, US state of death registration, year of death, and race and ethnicity (non-Hispanic White, non-Hispanic Black, non-Hispanic of other races, and Hispanic of any race) of each decedent for all data sources and used a network meta-regression to quantify the rate of under-reporting within the NVSS. Using these rates to inform correction factors, we provide adjusted estimates of deaths due to police violence for all states, ages, sexes, and racial and ethnic groups from 1980 to 2019 across the USA. Across all races and states in the USA, we estimate 30 800 deaths (95% uncertainty interval [UI] 30 300–31 300) from police violence between 1980 and 2018; this represents 17 100 more deaths (16 600–17 600) than reported by the NVSS. Over this time period, the age-standardised mortality rate due to police violence was highest in non-Hispanic Black people (0·69 [95% UI 0·67–0·71] per 100 000), followed by Hispanic people of any race (0·35 [0·34–0·36]), non-Hispanic White people (0·20 [0·19–0·20]), and non-Hispanic people of other races (0·15 [0·14– 0·16]). This variation is further affected by the decedent's sex and shows large discrepancies between states. Between 1980 and 2018, the NVSS did not report 55·5% (54·8–56·2) of all deaths attributable to police violence. When aggregating all races, the age-standardised mortality rate due to police violence was 0·25 (0·24–0·26) per 100 000 in the 1980s and 0·34 (0·34–0·35) per 100 000 in the 2010s, an increase of 38·4% (32·4–45·1) over the period of study. We found that more than half of all deaths due to police violence that we estimated in the USA from 1980 to 2018 were unreported in the NVSS. Compounding this, we found substantial differences in the age-standardised mortality rate due to police violence over time and by racial and ethnic groups within the USA. Proven public health intervention strategies are needed to address these systematic biases. State-level estimates allow for appropriate targeting of these strategies to address police violence and improve its reporting. Bill & Melinda Gates Foundation, National Institute on Minority Health and Health Disparities, and National Heart, Lung, and Blood Institute.

Objectives. To describe associations between neighborhood racial and economic segregation and violence during the COVID-19 pandemic. Methods. For 13 US cities, we obtained zip code–level data on 5 violence outcomes from March through July 2018 through 2020. Using negative binomial regressions and marginal contrasts, we estimated differences between quintiles of racial, economic, and racialized economic segregation using the Index of Concentration at the Extremes as a measure of neighborhood privilege (1) in 2020 and (2) relative to 2018 through 2019 (difference-in-differences). Results. In 2020, violence was higher in less-privileged neighborhoods than in the most privileged. For example, if all zip codes were in the least privileged versus most privileged quintile of racialized economic segregation, we estimated 146.2 additional aggravated assaults (95% confidence interval = 112.4, 205.8) per zip code on average across cities. Differences over time in less-privileged zip codes were greater than differences over time in the most privileged for firearm violence, aggravated assault, and homicide. Conclusions. Marginalized communities endure endemically high levels of violence. The events of 2020 exacerbated disparities in several forms of violence. Public Health Implications. To reduce violence and related disparities, immediate and long-term investments in low-income neighborhoods of color are warranted. (Am J Public Health. 2022;112(1):144–153. https://doi.org/10.2105/AJPH.2021.306540 )

Some interventions could help to reduce racism and rein in the use of unnecessary force in police work, but the evidence base is still evolving. Some interventions could help to reduce racism and rein in the use of unnecessary force in police work, but the evidence base is still evolving.

Several past studies have found that media reports of suicides and homicides appear to subsequently increase the incidence of similar events in the community, apparently due to the coverage planting the seeds of ideation in at-risk individuals to commit similar acts. Here we explore whether or not contagion is evident in more high-profile incidents, such as school shootings and mass killings (incidents with four or more people killed). We fit a contagion model to recent data sets related to such incidents in the US, with terms that take into account the fact that a school shooting or mass murder may temporarily increase the probability of a similar event in the immediate future, by assuming an exponential decay in contagiousness after an event. We find significant evidence that mass killings involving firearms are incented by similar events in the immediate past. On average, this temporary increase in probability lasts 13 days, and each incident incites at least 0.30 new incidents (p = 0.0015). We also find significant evidence of contagion in school shootings, for which an incident is contagious for an average of 13 days, and incites an average of at least 0.22 new incidents (p = 0.0001). All p-values are assessed based on a likelihood ratio test comparing the likelihood of a contagion model to that of a null model with no contagion. On average, mass killings involving firearms occur approximately every two weeks in the US, while school shootings occur on average monthly. We find that state prevalence of firearm ownership is significantly associated with the state incidence of mass killings with firearms, school shootings, and mass shootings.

Income inequality has been rising in the US and thought to be associated with violence especially homicide. About 75% of homicides involve firearms. We quantified the association between county-level income inequality and all-race/ethnicity and race/ethnicity-specific firearm homicide rates among individuals aged 14-39 years. We conducted a cohort study of US counties to examine the association of Gini Index (ranging from 0 [perfect income equality] to 1.0 [perfect income inequality]) separately measured in 1990 and 2000 with all-race/ethnicity and race/ethnicity-specific firearm homicide rates in 2005-2015. Generalised linear mixed models with Poisson distribution including a random intercept for state provided IRRs and 95% CIs. Bayesian Poisson-lognormal hierarchical modelling with integrated nested Laplace approximations was used in exploratory spatial analyses. Models accounted for county-level age, sex and race/ethnicity composition, crime rate, deprivation, social capital, urbanicity, and firearm ownership. The Gini Index was associated with firearm homicide rates among all races/ethnicities. After accounting for contextual determinants of firearm homicide, the association persisted among African-Americans. In this group, a 1 SD greater Gini Index in 1990 (IRR=1.09; 95% CI 1.02 to 1.16) and 2000 (IRR=1.09; 95% CI 1.01 to 1.17) was associated with greater firearm homicide rates in 2005-2015. Exploratory spatial analyses did not materially change the results. Policies addressing the gap between the rich and the poor deserve further considerations for reducing firearm homicide rates. Incorporating income inequality to refine measures of socioeconomic position may advance public health and clinical research and practice for firearm violence prevention.

Objective. To evaluate the National Violent Death Reporting System (NVDRS) as a surveillance system for homicides by law enforcement officers. Methods. We assessed sensitivity and positive predictive value of the NVDRS “type of death” variable against our study count of homicides by police, which we derived from NVDRS coded and narrative data for states participating in NVDRS 2005 to 2012. We compared state counts of police homicides from NVDRS, Vital Statistics, and Federal Bureau of Investigation Supplementary Homicide Reports. Results. We identified 1552 police homicides in the 16 states. Positive predictive value and sensitivity of the NVDRS “type of death” variable for police homicides were high (98% and 90%, respectively). Counts from Vital Statistics and Supplementary Homicide Reports were 58% and 48%, respectively, of our study total; gaps varied widely by state. The annual rate of police homicide (0.24/100 000) varied 5-fold by state and 8-fold by race/ethnicity. Conclusions. NVDRS provides more complete data on police homicides than do existing systems. Policy Implications. Expanding NVDRS to all 50 states and making 2 improvements we identify will be an efficient way to provide the nation with more accurate, detailed data on homicides by law enforcement.

Objectives. We examined the relationship between levels of household firearm ownership, as measured directly and by a proxy—the percentage of suicides committed with a firearm—and age-adjusted firearm homicide rates at the state level. Methods. We conducted a negative binomial regression analysis of panel data from the Centers for Disease Control and Prevention’s Web-Based Injury Statistics Query and Reporting Systems database on gun ownership and firearm homicide rates across all 50 states during 1981 to 2010. We determined fixed effects for year, accounted for clustering within states with generalized estimating equations, and controlled for potential state-level confounders. Results. Gun ownership was a significant predictor of firearm homicide rates (incidence rate ratio = 1.009; 95% confidence interval = 1.004, 1.014). This model indicated that for each percentage point increase in gun ownership, the firearm homicide rate increased by 0.9%. Conclusions. We observed a robust correlation between higher levels of gun ownership and higher firearm homicide rates. Although we could not determine causation, we found that states with higher rates of gun ownership had disproportionately large numbers of deaths from firearm-related homicides.

BackgroundWe investigated whether ghost gun recovery rates are significantly associated with firearm mortality rates in the following year across California’s 58 counties from 2014 to 2023.MethodsWe obtained yearly county-level data on ghost guns recovered in California from The Trace’s Gun Violence Data Hub. County-level firearm death counts (total, suicide and homicide) were pulled from the Centers for Disease Control and Prevention’s Restricted-Use Vital Statistics Data. Spatiotemporal models quantified the covariate-adjusted associations between ghost gun recoveries per capita and firearm death rates (total, suicide and homicide) in the following year. Secondary analyses examined suicide and homicide models stratified by sex and race/ethnicity.Results For every 20 ghost guns recovered per 100 000 population, there was an associated 6.4% increase in firearm suicide rate (adjusted incidence rate ratio (aIRR): 1.064, 95% credible interval (CrI) 1.019 to 1.111) in the following year. We found no evidence of a significant ghost gun recovery association with total firearm death rate (aIRR: 1.036, 95% CrI 0.999 to 1.075) and firearm homicide rates (aIRR: 1.002, 95% CrI 0.946 to 1.064). Stratified models for firearm suicide rates suggested variations across sex and racial/ethnic groups, with significant positive associations observed for male (6.5% increase; aIRR: 1.065, 95% CrI 1.017 to 1.115), non-Hispanic white (6.2% increase; aIRR: 1.062, 95% CrI 1.005 to 1.122) and Hispanic (12.6% increase; aIRR: 1.126, 95% CrI 1.031 to 1.230) individuals. A different pattern emerged for firearm homicide death rates, where associations across demographic groups were not statistically significant.ConclusionsPractitioners concentrating on suicide prevention efforts should be advised about the threat that ghost guns may present.