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Firearm Violence
January 2017

Firearm Laws and Firearm HomicidesA Systematic Review

Author Affiliations
  • 1Division of Emergency Medicine, Boston Children’s Hospital, Boston, Massachusetts
  • 2Harvard Medical School, Boston, Massachusetts
  • 3Division of Emergency Medicine, Texas Children’s Hospital, Houston
  • 4Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts

Copyright 2016 American Medical Association. All Rights Reserved.

JAMA Intern Med. 2017;177(1):106-119. doi:10.1001/jamainternmed.2016.7051
Key Points

Question  What are the effects of firearm laws on firearm homicides in the United States?

Findings  We found evidence that stronger firearm laws are associated with reductions in firearm homicide rates. The strongest evidence is for laws that strengthen background checks and that require a permit to purchase a firearm. The effect of many of the other specific types of laws is uncertain, specifically laws to curb gun trafficking, improve child safety, ban military-style assault weapons, and restrict firearms in public places.

Meaning  Given the magnitude and gravity of firearm homicides in the United States, effective legal and public health policies and adequate funding to enable high-quality research are essential.


Importance  Firearm homicide is a leading cause of injury death in the United States, and there is considerable debate over the effectiveness of firearm policies. An analysis of the effectiveness of firearm laws on firearm homicide is important to understand optimal policies to decrease firearm homicide in the United States.

Objective  To evaluate the association between firearm laws and preventing firearm homicides in the United States.

Evidence Review  We evaluated peer-reviewed articles from 1970 to 2016 focusing on the association between US firearm laws and firearm homicide. We searched PubMed, CINAHL, Lexis/Nexis, Sociological Abstracts, Academic Search Premier, the Index to Legal Periodicals and Books, and the references from the assembled articles. We divided laws into 5 categories: those that (1) curb gun trafficking, (2) strengthen background checks, (3) improve child safety, (4) ban military-style assault weapons, and (5) restrict firearms in public places and leniency in firearm carrying. The articles were assessed using the standardized Guide to Community Preventive Services data collection instrument and 5 additional quality metrics: (1) appropriate data source(s) and outcome measure(s) were used for the study, (2) the time frame studied was adequate, (3) appropriate statistical tests were used, (4) the analytic results were robust, and (5) the disaggregated results of control variables were consistent with the literature.

Findings  In the aggregate, stronger gun policies were associated with decreased rates of firearm homicide, even after adjusting for demographic and sociologic factors. Laws that strengthen background checks and permit-to-purchase seemed to decrease firearm homicide rates. Specific laws directed at firearm trafficking, improving child safety, or the banning of military-style assault weapons were not associated with changes in firearm homicide rates. The evidence for laws restricting guns in public places and leniency in gun carrying was mixed.

Conclusions and Relevance  The strength of firearm legislation in general, and laws related to strengthening background checks and permit-to-purchase in particular, is associated with decreased firearm homicide rates. High-quality research is important to further evaluate the effectiveness of these laws. Legislation is just 1 part of a multipronged approach that will be necessary to decrease firearm homicides in the United States.