Homicide and suicide rates associated with implementation of the Brady Handgun Violence Prevention Act

Context In February 1994, the Brady Handgun Violence Prevention Act establi shed a nationwide requirement that licensed firearms dealers observe a wait ing period and initiate a background check for handgun sales. The effects o f this act have not been analyzed. Objective To determine whether implementation of the Brady Act was associat ed with reductions in homicide and suicide rates. Design and Setting Analysis of vital statistics data in the United States f or 1985 through 1997 from the National Center for Health Statistics. Main Outcome Measures Total and firearm homicide and suicide rates per 1000 00 adults (greater than or equal to 21 years and greater than or equal to 5 5 years) and proportion of homicides and suicides resulting from firearms w ere calculated by state and year. Controlling for population age, race, pov erty and income levels, urban residence, and alcohol consumption, the 32 "t reatment" states directly affected by the Brady Act requirements were compa red with the 18 "control" states and the District of Columbia, which had eq uivalent legislation already in place. Results Changes in rates of homicide and suicide for treatment and control states were not significantly different, except for firearm suicides among persons aged 55 years or older (-0.92 per 100000; 95% confidence interval [ CI], -1.43 to -0.42). This reduction in suicides for persons aged 55 years or older was much stronger in states that had instituted both waiting perio ds and background checks (-1.03 per 100000; 95% CI, -1.58 to -0.47) than in states that only changed background check requirements (-0.17 per 100000; 95% CI, -1.09 to 0.75), Conclusions Based on the assumption that the greatest reductions in fatal v iolence would be within states that were required to institute waiting peri ods and background checks, implementation of the Brady Act appears to have been associated with reductions in the firearm suicide rate for persons age d 55 years or older but not with reductions in homicide rates or overall su icide rates. However, the pattern of implementation of the Brady Act does n ot permit a reliable analysis of a potential effect of reductions in the fl ow of guns from treatment-state gun dealers into secondary markets.