尽管美国枪支暴力的社会和公共卫生成本很高,许多旨在降低枪支死亡率的政策的效果仍然不确定。
■评估州枪支政策对枪支相关死亡率的个人和联合影响大小。
■在这项有效性比较研究中,采用贝叶斯方法对年度面板数据进行建模,所有美国枪支死者的州一级死亡率(1979-2019年),2023年10月进行的分析。
■六类枪支政策:背景调查,最低年龄,等待期,子访问,隐蔽携带,和站稳脚跟的法律。
■主要结果(枪支死亡总数,枪支凶杀案死亡,和枪支自杀死亡)使用国家生命统计系统进行评估。贝叶斯估计用于估计枪支政策变化与枪支死亡率随后变化的部分关联。
■单个政策在实施5年或更长时间后的估计效果大小通常很小,并且具有相当大的不确定性。减少枪支死亡概率最高的政策类别是防止儿童接触的法律,估计可将总体枪支死亡率降低6%(80%可信间隔[CrI],-2%至-9%)。枪支死亡人数增加的可能性最高的政策阶层是站稳脚跟的法律,据估计,枪支凶杀案增加6%(80%CrI,0%到13%增加)。实施多个枪支限制与随后的枪支死亡率变化之间的关联估计产生了更大的效果。从最宽松到最严格的枪支政策与估计减少20%的枪支死亡相关(80%CrI,减少10%到28%),枪支死亡率降低的可能性为0.99。
■在这项州枪支政策的比较有效性研究中,计算了枪支法律组合的联合效应估计,这表明限制性枪支政策与枪支死亡率的大幅降低有关。尽管政策制定者将从了解个别政策的影响中受益,个别政策实施后,枪支死亡率的估计变化通常很小且不确定.
UNASSIGNED: Despite high social and public health costs of firearm violence in the United States, the effects of many policies designed to reduce firearm mortality remain uncertain.
UNASSIGNED: To estimate the individual and joint effect sizes of state firearm policies on firearm-related mortality.
UNASSIGNED: In this comparative effectiveness study, bayesian methods were used to model panel data of annual, state-level mortality rates (1979-2019) for all US firearm decedents, with analyses conducted in October 2023.
UNASSIGNED: Six classes of firearms policies: background checks, minimum age, waiting periods, child access, concealed carry, and stand-your-ground laws.
UNASSIGNED: Primary outcomes (total firearm deaths, firearm homicide deaths, and firearm suicide deaths) were assessed using the National Vital Statistics System. Bayesian estimation was used to estimate the partial association of changes in firearms policies with subsequent changes in firearm mortality.
UNASSIGNED: The estimated effect sizes of individual policies 5 or more years after implementation were generally small in magnitude and had considerable uncertainty. The policy class with the highest probability of reducing firearm deaths was child-access prevention laws, estimated to reduce overall firearm mortality by 6% (80% credible interval [CrI], -2% to -9%). The policy class with the highest probability of increasing firearm deaths was stand-your-ground laws, estimated to increase firearm homicides by 6% (80% CrI, 0% to 13% increase). Estimates of association of implementing multiple firearm restrictions with subsequent changes in firearm mortality yielded larger effect sizes. Moving from the most permissive to most restrictive set of firearm policies was associated with an estimated 20% reduction in firearm deaths (80% CrI, 10% to 28% reduction), with a 0.99 probability of any reductions in firearm death rates.
UNASSIGNED: In this comparative effectiveness study of state firearm policies, the joint effect estimates of combinations of firearm laws were calculated, showing that restrictive firearm policies were associated with substantial reductions in firearm mortality. Although policymakers would benefit from knowing the effects of individual policies, the estimated changes in firearm mortality following implementation of individual policies were often small and uncertain.