Risk and Protective Factors Associated with Firearm Access and Suicide Risk in a National Sample of Young Adults

Background: Suicide is a leading cause of death among young adults in the U.S. A growing body of research suggests that firearm access and/or ownership may be linked to increased psychological distress and suicide risk among young adults. Removing access to firearms – a particularly lethal means – can significantly reduce risks for suicide in this population. This study investigates the role of demographic and contextual risk and protective factors in relation to firearm access and suicide-related outcomes among emerging adults ages 18-29.

Method: Data from a nationally representative survey of young adults ages 18-29 (N = 1077) were used to assess the relationship between current firearm access and suicide-related outcomes. Descriptive statistics identified demographic, household, and geographic characteristics associated with firearm access. Hierarchal binary logistic regressions were used to model associations between study variables and the outcomes of suicidal ideation and suicidal behavior across four steps: 1) demographics (e.g., age group, racial/ethnic identity, gender identity, sexual orientation), 2) self-reported current access to a firearm in the home (yes or no), 3) geographic and household characteristics (e.g., urbanicity, geographic region, household size, home ownership), and 4) contextual risk and protective factors (e.g., social support, coping strategies, youth violence victimization, intimate partner violence victimization).

Results: Greater proportions of young adults who were married, living in larger household sizes, living in rural areas, and living in the U.S. Midwest and South regions reported significantly increased access to firearms in their home. Of note, a greater proportion of cisgender men reported current access to firearms compared to cisgender women and transgender/non-binary young adults. A greater proportion of heterosexual adults had access to firearms compared to sexual minority (LGBQIA+) young adults. Young people identifying as multiracial non-Hispanic reported the highest rate of firearm access, followed by white non-Hispanic, Latino/a, Black/African American non-Hispanic, and Asian non-Hispanic. In the multivariate analyses, firearm access was significantly associated with suicidal ideation in Step 2 (OR = .617, p<.05), however, this was no longer significant in step 3 accounting for household and geographic characteristics. There was no significant association between firearm access and suicidal behavior. Notably, higher levels of social support and coping using positive reframing decreased risks for ideation (OR = .665, p<.05; OR = .680, p<.001, respectively); whereas coping using substance use, self-blame and disengagement increased odds for ideation (OR = 1.51, p<.001; OR = .2.03, p<.001; OR = 1.41, p<.05, respectively). In the final model (step 4) for suicidal behavior, significant demographic variables included income, whereas significant risk and protective factors included youth violence exposure, and the coping sub-scales of substance use and religion. Specifically, coping using substance use and religion increased odds for suicidal behavior (OR = 2.7, p<.001; OR = 1.44, p<0.5), respectively).

Conclusions: Understanding the complex interplay of firearm access, social support, youth violence exposure, coping and other risk and protective factors is crucial in addressing suicide risk among young adults aged 18-29. Findings can inform violence prevention and harm-reduction strategies among young adults at increased risk for poor mental health outcomes.