Suicide Deaths among Women in California Living with Handgun Owners vs Those Living with Other Adults in Handgun-Free Homes, 2004-2016

Matthew Miller*, Yifan Zhang, Lea Prince, Sonja A. Swanson, Garen J. Wintemute, Erin E. Holsinger, David M. Studdert

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)


Importance: Little is known about the extent to which secondhand exposure to household firearms is associated with risk of suicide in adults who do not own guns, most of whom are women. Objective: To evaluate changes in risk of suicide among women living in gun-free households after one of their cohabitants became a handgun owner. Design, Setting, and Participants: This cohort study observed participants for up to 12 years and 2 months from October 18, 2004, to December 31, 2016. Data were analyzed from April to November 2021. The study population included 9.5 million adult women in California who did not own guns and who entered the study while living with 1 or more adults in a handgun-free home. Exposures: Secondhand exposure to household handguns. Main Outcomes and Measures: Suicide, firearm suicide, nonfirearm suicide. Results: Of 9.5 million women living in handgun-free homes, 331968 women (3.5% of the study population; mean [SD] age, 41.6 [18.0] years) became exposed to household handguns during the study period. In the entire study population, 294959 women died: 2197 (1%) of these were by suicide, 337 (15%) of which were suicides by firearm. Rates of suicide by any method during follow-up were higher among cohort members residing with handgun owners compared with those residing in handgun-free homes (hazard ratio, 1.43; 95% CI, 1.11-1.84). The excess suicide rate was accounted for by higher rates of suicide by firearm (hazard ratio, 4.32; 95% CI, 2.89-6.46). Women in households with and without handguns had similar rates of suicide by nonfirearm methods (hazard ratio, 0.90; 95% CI, 0.63-1.27). Conclusions and Relevance: In this study, the rate of suicide among women was significantly higher after a cohabitant of theirs became a handgun owner compared with the rate observed while they lived in handgun-free homes..

Original languageEnglish
Pages (from-to)582-588
Number of pages7
JournalJAMA Psychiatry
Issue number6
Early online date27 Apr 2022
Publication statusPublished - 1 Jun 2022

Bibliographical note

Funding Information:
supported by grants from the National Collaborative on Gun Violence Research, the Fund for a Safer Future, and the Joyce Foundation.

Funding Information:
funds from the Joyce Foundation. Drs Prince, Swanson, and Studdert reported grants from National Collaborative on Gun Violence Research and Joyce Foundation, and internal institutional funds from Stanford University during the conduct of the study. Dr Wintemute reported serving as a consultant for Stanford University during the conduct of the study. No other disclosures were reported.

Publisher Copyright:
© 2022 American Medical Association. All rights reserved.


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