Misleading numbers: Why are suicides and homicides lumped together under the “gun violence” umbrella?

A recent article in TIME Magazine purports that “California’s answer to gun violence could be a model for the entire country.” In sum, the article states that California’s firearm violence has decreased over the last 20 years or so, relative to the rest of the country. They attribute this to the various gun legislation passed in California over the years that disrupted the manufacturing of cheap guns within the state, closed private sales loopholes, and restricted gun ownership for people convicted of a violent misdemeanor. But when looking at the actual data, these claims appear misleading.

According to the article, California’s rate of firearm violence decreased by more than half between 1993 and 2017. They cite this fact sheet ranking California as #1 for gun safety, which shows a gun death rate 37% lower than the national average. They also mention that Californians are 25% less likely to die in a mass shooting compared to other states. But all of these numbers are based on gun-related deaths, which includes suicides. When it comes to the data, public health officials and academics are pretty specific in the way they describe shootings. The CDC defines “firearm violence” as shootings that are self-inflicted, unintentional, the result of interpersonal violence, and officer-involved shootings. The CDC’s fatal injury database allows people to filter cause-of-death data by “firearms,” resulting in a report headlined “Firearm Deaths and Rates.” But it seems misleading to include suicides by guns in the “gun violence” count. Normally when one thinks about gun violence, they think about crimes like homicide, attempted homicide, robbery, or other violent crimes. As a result, laypersons catching headlines relating to “gun violence” could likely misinterpret the findings and inadvertantly spread misinformation. However, learning that approximately 60% of gun-related deaths in the U.S. are suicides adds important context to this conversation.

Gun crimes versus gun-related suicides are certainly both violent, but combining them into one “gun violence” measure is misleading for a few reasons. First, it inflates gun violence numbers. America has the highest gun suicide rate of any country, and including gun-related suicides in the “gun violence” count certainly inflates the numbers in a way that paints the U.S. in a bad light. The gun homicide rate ranks about 30th in comparison to other countries, but this is masked due to the high suicide rates and overall inflated gun violence numbers. Second, people typically think that gun violence correlates with gun crime, when this will not always be the case. Gun crimes versus gun suicides follow different patterns over time — patterns that can’t be captured with a single measure. For example, suicides might increase while homicides decrease (or vice versa), but without looking at the trends separately there is no way to know which one is more responsible for driving the trend in “gun violence” numbers.

From a policy standpoint, the policies needed to address gun suicides versus gun crime are very different; the former would involve suicide prevention and mental health treatment, while the latter would focus on policies designed to deter criminal behavior. Whether or not a policy will be successful in reducing gun violence depends on what the true underlying issue is. Knowing that suicides comprise the majority of gun-related deaths in the U.S., coupled with the fact that the U.S. has a high suicide rate overall, why do we not see more policymakers pushing for suicide prevention? They seem to forget that suicides are ultimately caused by one’s declining mental health and inability to receive proper treatment. Shifting the conversation toward broader “gun violence” seems to get away from the heart of this issue. Importantly, some laws do appear beneficial in terms of reducing suicides, such as child-access prevention laws and waiting periods. When it comes to the impact of gun ownership though, the research is less clear.

I am not the only one who has questioned why suicides and gun crimes are combined into a single measure, and others speculate that this could be a way to inflate the gun violence numbers. Taken together, one has to wonder whether the two numbers are purposefully combined to make gun violence a more pressing topic – leading to fear among the masses, who will then demand change, which policymakers will use to justify drastic policy decisions to please their constituents and increase their likelihood of re-election.

In an article by The Trace, Cathy Barber, a well-reknowned suicide prevention expert and founding director of Means Matter (a gun suicide prevention campaign at Harvard’s School of Public Health) reminds us to “not overlook the suicides.” She argues that the term “gun violence” is misleading, because “most members of the public assume it refers to homicide and assault and not suicide or accidental gun deaths.” While technically suicide is a violent act, it is a solitary act, and not the culmination of a conflict between people. Therefore, there is less danger from another person.

Regardless of how misleading the annual gun death count might be, lawmakers use this statistic to push for more policies that would reduce firearm ownership. The TIME magazine article states, “One of the mechanisms by which California’s laws produce their effect is [that] we have a substantially lower prevalence of firearm ownership in this state than many other states do,” Wintemute says. “There are fewer of those tools in circulation…and no surprise, they get used less.” Many people seem to think that reducing gun ownership will reduce gun deaths, and many of those same people assume that gun-related homicides will also decrease as gun ownership decreases. Unfortunately though, the two do not always correlate.

Going beyond the article, looking at the number of gun-related homicides though, the data tell a different story. In sum, California’s trends in gun homicide rates do not look that different from nationwide trends, nor are they consistently lower than states with less restrictive laws. From 2011 through 2019, California’s gun homicide rates (as well as overall homicide rates) ebbed and flowed with no real discernable downward trend, in contrast to what the TIME Magazine article states. The same is true for overall homicides, which ebbed and flowed many years, amounting to an overall increase of about 15% during this time. This trend almost exactly mirrors larger nationwide trends, which also showed a lot of ebb-and-flow in homicides but ultimately amounted to a 15% increase over the last ten years. Further, in 2019-2020, there was a discernable 30% increase in overall homicides and a 35% increase in gun homicides in both California and the rest of the country, suggesting no discernable difference between California and the nation as a whole. Thus, it is misleading to infer that California’s gun homicide rates are declining as a result of the restrictive legislation.

When comparing California’s gun homicide rate to other states, it is not true that rates are lower in California compared to states with less restrictive gun laws. In 2020, the gun-related homicide rate in California was 4.2 per 100,000. While slightly lower than the nationwide rate of 5.9 per 100,000, the rate is still higher than many other states, including those with less restrictive gun laws, such as Oregon (3.8 per 100,000), Idaho (2.5), Iowa (3.6), North Dakota (4.4), and Maine (1.6). Many argue that gun ownership and gun laws are the main factors influencing gun homicide rates, but these studies are often based on the overall gun death rate, and when considering homicides, the arguments are not valid. There are many states with restrictive gun laws that have higher-than-average gun homicide rates, while some states with less restrictive laws have lower-than-average homicide rates.

When looking at the state-level 2020 data for gun-related homicides, gun ownership, and gun laws across all states, the link between gun ownership, gun laws, and gun homicides becomes less clear. In sum, for many of the laws, the effectiveness varies and is not always consistent. In terms of overall gun prevalence, Montana ranked #1 for gun ownership but #32 in gun homicides. Wyoming ranked #2 for gun ownership, but their gun homicide rate was so low that the calculated rate was unreliable and not reported by the CDC.

Relatedly, states with restrictive gun laws do not always see lower gun homicide rates. The District of Columbia had the highest homicide rate in 2020 (22 per 100,000), yet they had both a firearm purchaser law as well as an Extreme Risk Protection Order (ERPO) law. Illinois ranked #9 for gun homicide rates and Maryland ranked #10, despite both of these states having firearm purchaser laws and ERPO laws. Illinois and Maryland also ranked very low (#42 and #40, respectively) in terms of gun ownership. These data contrast with the claim that more gun ownership leads to more murders.

When looking at all of the states with less restrictive policies, such as “Stand your Ground” or permitless carry laws, the link to gun-related homicide is also not strong. For example, Idaho had both laws on the books as of 2020 and ranked #4 in gun ownership, yet they ranked #45 in gun homicide rates. Similarly, South Dakota ranked #34 in gun homicide rates despite having both of these laws on the books and ranking #9 in terms of gun ownership. Alaska, ranking #3 in gun owenership, also showed low gun homicide rates relative to other states (ranking #31 in gun homicide rates), despite having both of these laws on the books.

At a a glance, California’s gun safety laws include the following:

-A strict ban on the possession, distribution, selling, and manufacturing of assault weapons. According to a comprehensive analysis of gun legislation by the RAND Corporation, the research does not indicate that these laws decrease suicide or homicide rates.

-Gun Violence Restraining Order (GVRO) or “red flag” law that prohibits certain people from posessing firearms if they are suspected of being a danger to themselves or others. GVROs can be filed by law enforcement, family members, employers, coworkers and school employees. This was enacted in 2016, and strengthened in 2019 through 2021. According to RAND, there is still limited evidence for the impact of GVROs on violent crime rates.

-Ten day waiting period for all gun purchases. According to Giffords, “Studies suggest that waiting period laws are associated with reduced rates of firearm suicide. Waiting period laws also appear to reduce gun homicide rates.” According to RAND, there is some moderate evidence that these laws can reduce violent crime, and stronger evidence that they can reduce suicides.

-Universal background checks on all gun purchases and transfers, including private transfers and sales at gun shows. According to RAND, there is some evidence that background checks may decrease violent crime, but the research is still limited.

-Laws preventing those with serious mental illness from acquiring firearms. California law requires the immediate reporting of involuntary inpatient and outpatient treatment, as well as those under guardianship. Mental health treatment facilities and psychotherapists are also required to report under certain circumstances.According to RAND, these types of laws are supported by very little evidence.

-Age restrictions that prohibit people under 21 years of age to purchase firearms.  There are narrow exceptions to this restriction (e.g. 18 year old with a valid hunting license is able to purchase certain long guns). According to RAND, age restrictions may decrease suicide rates, but they don’t have an impact on homicide rates.

-Currently, California is taking additional actions to strengthen gun laws, including a new law that would allow people affected by gun crime to sue gun manufacturers. At this time, there is no evidence pointing one way or the other as to whether this would be effective.

While it is possible that some of California’s laws are helpful in reducing suicide rates, my main criticisms of the TIME Magazine article (as well as many other articles on gun violence) are that: 1) gun prevalence does not automatically equate to more gun violence, and 2) it is ingenuous and misleading to lump homicides and suicides together into an overall “gun violence” measure. This is not to say that suicides are unimportant, however. But suicides and homicides are qualitatively different from each other, and to say that any one policy could reduce both homicides and suicides (i.e., overall “gun violence”) is misleading and wrong. For better policy decisions, we should be targeting the issues of gun-related suicide and gun-related homicide separately, not as a “one size fits all” approach.