Date of Award

Fall 1-8-2021

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Dr. Shannon Self-Brown

Second Advisor

Dr. Melissa Osborne

Abstract

Firearm violence in the United States is a substantial health concern and improper storage within the home is a prominent risk factor for suicide, homicide, and unintentional injury. Studies have examined the negative influence of adult alcohol misuse on firearm storage in households with children, but none have included adult mental health problems. The purpose of this study was to describe the prevalence of various forms of firearm storage in households with children in California, Idaho, Kansas, Oregon, Texas, and Utah and analyze how adult alcohol misuse and adult mental health problems relate to how firearms are stored. Data from the 2017 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. Only households with children were included in this study (n=12,489). Predictor variables included adult alcohol misuse and adult mental health. The outcome variables were presence of firearms in the household and subsequent firearm storage method categorized as unloaded, loaded and locked, and loaded and unlocked. Weighted prevalence estimates and 95% confidence intervals of sociodemographic and predictor variables were calculated for all respondents for each firearm storage category. Weighted relative risks and 95% confidence intervals of sociodemographic variables by the predictor variables were calculated for all respondents for each firearm storage category using multivariable logistic regression. Overall, 33.8% of respondents reported owning at least one firearm. Among firearm owners, 27% (n = 1,105) stored their firearms loaded and 11% (n = 463) stored firearms both loaded and unlocked. Firearm owners reported higher alcohol misuse (25.6%) and higher mental health problems (26.5%) than non-firearm owning respondents (16.9% and 20.4%, respectively). Alcohol misuse was associated with greater risk of owning a firearm (aRR = 1.2 [1.02, 1.41]) and greater risk of storing a firearm loaded and unlocked (aRR = 1.67 [1.2, 2.34]). Mental health problems were associated with a greater risk of owning a firearm (aRR = 1.22 [1.04, 1.42]). Firearms are common in households with children and a significant minority are stored improperly. Adult alcohol misuse was associated with the least safe method of firearm storage. Effective prevention approaches addressing firearm storage must be developed and disseminated, especially programs that target adults experiencing alcohol problems and other significant risk factors for firearm violence.

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