Jason Dickens

Project title: Investigating occupation and environmental factors influencing the practice of safe firearm storage

Degree: MPH | Program: Occupational and Environmental Medicine (OEM) | Project type: Thesis/Dissertation
Completed in: 2020 | Faculty advisor: Debra Cherry


Objectives: Suicide and unintentional deaths related to firearms are a problem in the United States. Findings cited by the National Center for Health Statistics show a 33% increase in the U.S. suicide rate over the past two decades. According to the National Centers for Injury Prevention and Control’s Web-based Injury Statistics Query and Reporting System (WISQARS), two-thirds of gun deaths are suicides and half of all suicides involve guns. Suicide death risk is three times higher if there is access to a firearm. Multiple studies have shown a significant reduction in firearm-related suicide if firearms are stored safely. The Tacoma-Pierce County Health Department (TPCHD) conducted three education and distribution events where locking firearm storage devices were given out after participants received instruction on proper device usage. The purpose of this study was to provide a better understanding of how occupation and perception of neighborhood safety are associated with safe firearm storage practices in order to guide the focus of future community-based programs, efforts, and policies, which would then ultimately decrease gun related suicide and unintentional injury and death. Methods: In this study, we performed cross-sectional analysis of the data of TPCHD’s safe firearm storage event survey. We studied data from 496 respondents who participated in three safe firearm storage events in Pierce County, WA. We used logistic regression to evaluate the associations between: 1) safe firearm storage practices and low skill vs high skill occupations; 2) safe firearm storage practices and working as a first responder; and 3) safe firearm storage practices and perception of neighborhood safety, adjusted for relevant confounders. To determine low vs high skill occupations, the responses were manually coded into categories based on the sectors from the 2017 North American Industry Classification System. These sectors were then divided into low vs high skill occupations based on research presented by the Lincoln Institute of Land Management. Participants were asked directly on the survey of their first responder status. Perception of neighborhood safety was measured by dichotomizing participant responses to a ten-point scale asking how safe they perceive their neighborhoods to be with numbers one to five equating to “not safe” and numbers six to ten equating to “safe”. In all three analyses, effect modification by sex, children living in or visiting the home, and military service was assessed. Results: Low-skill occupations were associated with a higher level of safe firearm storage. Low-skill occupations had 1.74 (95% CI 1.02, 2.99) times the odds of safe firearm storage, after adjusting for sex. There was attenuation noted after further adjusting this model for children living in or visiting the home and military status. No significant associations were noted between first responder status nor perception of neighborhood safety and safe firearm storage practices. Conclusion: This study demonstrated an association between occupational skill level and safe firearm storage practices. To our knowledge, it is the first study to look at how environmental factors such as perception of neighborhood safety might influence safe firearm storage practices. Future research looking at the association between specific occupations and how environmental factors might influence safe firearm storage practices is needed. URI http://hdl.handle.net/1773/45990