Suicide by Firearm Among Women: An Analysis of Ecological and Individual Correlates
Although firearm suicide is consistently higher among men than among women, the growing number of firearm suicides in women is a cause for concern. The purpose of this study is to understand the distal and proximal risk factors associated with firearm suicides rates and the choice of methods using ecological and individual-level data. First, the ecological study obtained state-level data from the U.S. American Community Survey (2017), Social Capital Project (2018), YouGov (2015), Behavioral Risk Factor Surveillance System (2017), and the Centers for Disease Control and Prevention’s Web-based Injury Statics Query and Reporting System (2017). A model using multivariate and stepwise regression analyses was developed to examine the complex relationship between firearm suicide rates and state-level characteristics among women. Second, the individual study obtained data from 32 states from the National Violent Death Reporting System Restricted Access Database, 2012–2016. A multivariate logistic regression model was used to differentiate women who used firearms to complete suicide from those who used other methods. The results of the ecological study showed that states with higher rates of divorce, veterans, gun ownership, depression, and lower rates of accessing health care had significantly higher rates of firearm suicide among women. From the individual-level data, the presence of intimate partner problems, acute alcohol use, and loss of a family member by suicide prior to the time of death were significant predictors of an increased likelihood of firearm use among women. Suicides occurring in a rural area and the South were significantly more likely to involve firearms. Future research, clinical practice, and policy changes are discussed to address suicide prevention strategies. From a micro perspective, these discussions will center on improving social work services to identify risks among those who are suicidal for further assessment in health care and gender-specific mental health interventions. From a macro perspective, research using both population-level and individual-level data would help policymakers identify updated policies to prevent gun suicide.