Anglemyer · Annals of internal medicine 2014 · systematic review and meta-analysis · n=16 studies

The accessibility of firearms and risk for suicide and homicide victimization among household members: a systematic review and meta-analysis.

Cited 623 times in the scientific literature.

Level 3 - non-randomized controlled study

Systematic review and meta-analysis of observational studies

PubMed 24592495 · doi:10.7326/M13-1301 · record verified 2026-08-31

What was done

Authors systematically reviewed and meta-analyzed data from PubMed, EMBASE, Cochrane CENTRAL, Web of Science, and gray literature through August 23, 2013. They included studies comparing suicide and homicide outcomes between individuals with and without household firearm access, with no restrictions on age, sex, or country. Two authors independently extracted data, preferentially using published adjusted estimates, and calculated pooled odds ratios using random- and fixed-effects models.

What was found

Pooling data from 16 observational studies revealed that firearm access was associated with increased odds of suicide (pooled OR 3.24, 95% CI 2.41 to 4.40) and homicide victimization (pooled OR 2.00, 95% CI 1.56 to 3.02). When limited to studies using interviews to assess firearm access, the pooled OR for suicide was 3.14 (95% CI 2.29 to 4.43).

Why it matters

This meta-analysis quantifies the substantial link between firearm accessibility in households and elevated risks of violent death by suicide or homicide across diverse populations.

Limits

All included data derive from observational studies rather than randomized trials. Exposure was determined by survey interviews in most studies, introducing risk of misclassification, and findings synthesize heterogeneous populations with varying baseline risks.

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