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

Context In February 1994, the Brady Handgun Violence Prevention Act established a nationwide requirement that licensed firearms dealers observe a waiting period and initiate a background check for handgun sales. The effects of this act have not been analyzed. Objective To determine whether implementation of the Brady Act was associated with reductions in homicide and suicide rates. Design and Setting Analysis of vital statistics data in the United States for 1985 through 1997 from the National Center for Health Statistics. Main Outcome Measures Total and firearm homicide and suicide rates per 100000 adults (greater than or equal to 21 years and greater than or equal to 55 years) and proportion of homicides and suicides resulting from firearms were calculated by state and year. Controlling for population age, race, poverty and income levels, urban residence, and alcohol consumption, the 32 "treatment" states directly affected by the Brady Act requirements were compared with the 18 "control" states and the District of Columbia, which had equivalent 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 periods 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 violence would be within states that were required to institute waiting periods and background checks, implementation of the Brady Act appears to have been associated with reductions in the firearm suicide rate for persons aged 55 years or older but not with reductions in homicide rates or overall suicide rates. However, the pattern of implementation of the Brady Act does not permit a reliable analysis of a potential effect of reductions in the flow of guns from treatment-state gun dealers into secondary markets.