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Rakshe S, Valek R, Teichman R, Freeman K, DeFrancesco S, Carlson KF. Five Years of Extreme Risk Protection Orders in Oregon: A Descriptive Analysis. Psychol Rep 2024:332941241248599. [PMID: 38676327 DOI: 10.1177/00332941241248599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Extreme Risk Protection Order (ERPO) laws have received increasing attention as a tool to prevent firearm suicide and homicide, including mass shootings. However, important gaps remain in our understanding of ERPO usage and implementation. Using the Oregon Judicial Case Information Network database, we abstracted data from all ERPO petitions filed in Oregon from 2018 to 2022, the first five years after the law took effect (N = 649). ERPO petitions were filed in 29 of 36 counties (81%, range 0-105 per county, median 11), against respondents 17-96 years of age (median: 42). Of ERPOs filed, 78% were initially granted. While only 22% of respondents in initially-granted ERPOs requested a hearing, when a hearing was held, nearly half (44%) of ERPOs were dismissed. The majority of ERPO petitions were motivated by threats of harm to respondents and others (n = 327, 50%), followed by threats of harm to others-only (n = 220, 34%) or respondents-only (n = 81, 12%). During the 5-year period, 72 (11%) ERPO petitions cited threats of mass violence as a motivating factor, including 24 (4%) petitions citing threats to schools or college campuses. The majority of ERPOs were filed by law enforcement officers (60%), and these petitions were significantly more often granted than those filed by family/household members (96% vs. 67%, p < .0001). We also found evidence of important gaps in documentation, including of respondent race (unavailable for 191 respondents, 29%) and of weapon removal or disposition after the ERPO was granted (unavailable in 350 cases, 69%). This study of long-term patterns of ERPO petitions highlights trends in usage and suggests areas where improvement may be possible, with implications for other states that have adopted or are considering similar ERPO laws.
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Affiliation(s)
- Shauna Rakshe
- Oregon Health & Science University Knight Cancer Institute, Portland, OR, USA
| | - Rebecca Valek
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA
| | - Rebecca Teichman
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA
| | - Kathryn Freeman
- University of New Mexico Department of Emergency Medicine, Albuquerque, NM, USA
| | - Susan DeFrancesco
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA
| | - Kathleen F Carlson
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA
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Pear VA, De Biasi A, Charbonneau A. Law Enforcement Officer Knowledge of, Attitudes Toward, and Willingness to Use Extreme Risk Protection Orders. JAMA Netw Open 2023; 6:e2338455. [PMID: 37856122 PMCID: PMC10587793 DOI: 10.1001/jamanetworkopen.2023.38455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/03/2023] [Indexed: 10/20/2023] Open
Abstract
Importance Understanding knowledge of, attitudes toward, and willingness to use extreme risk protection order (ERPO) laws among law enforcement officers (LEOs) can inform efforts to improve implementation of this underused firearm violence prevention strategy. Objective To characterize LEOs' knowledge of, attitudes toward, and willingness to use ERPOs across a range of scenarios. Design, Setting, and Participants A cross-sectional online survey, fielded from April 5 to August 30, 2021, was conducted in all 19 states and the District of Columbia with an ERPO law in 2021. A nonprobability sample of active-duty LEOs was used. Exposure Being a LEO in a state with an ERPO law. Main Outcomes and Measures Survey participants answered questions about their familiarity with and opinions on ERPO laws, as well as whether they would agree with using an ERPO in a variety of specific case scenarios. The analysis included an exploration of whether within-scenario differences, such as ERPO respondent race or gender, affected agreement by randomly assigning survey participants to 1 of 2 versions of each scenario. Results A total of 600 eligible individuals started the survey, and 283 survey participants were included in the analysis. The analytic sample consisted mostly of cisgender men (85.2%) and non-Hispanic White (71.4%) LEOs. Participants represented 14 states and the District of Columbia, with 53.7% living in California. Most participants (81.3%) were very or somewhat familiar with ERPO laws and 56.2% had received ERPO training. Opinions about ERPO laws were generally favorable but varied by self-identified political ideology. Across all scenarios, most participants supported using an ERPO; however, support was highest in cases involving intimate partner violence (71.4%-78.6%) and lowest in cases involving suicidality (54.2%-73.3%). Across all scenarios, LEOs with ERPO training or experience were substantially more likely to agree with using ERPOs than those without. None of the randomly assigned within-scenario differences were associated with differences in ERPO support. Conclusions and Relevance In this survey study of LEOs in states with ERPO laws, many officers had not received training on their use. Additionally, while conservative political ideology was associated with less favorable views of ERPOs, training and experience with ERPOs was associated with greater support for their use across a range of scenarios. These findings suggest that LEO training on ERPOs may promote their uptake and improve implementation.
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Affiliation(s)
- Veronica A. Pear
- Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis, Davis
| | - Alaina De Biasi
- Department of Criminology & Criminal Justice, Wayne State University, Detroit, Michigan
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Betz ME, Frattaroli S, Knoepke CE, Johnson R, Christy A, Schleimer JP, Pear VA, McCarthy M, Kapoor R, Norko MA, Rowhani-Rahbar A, Ma W, Wintemute GJ, Swanson JW, Zeoli AM. Extreme Risk Protection Orders in Older Adults in Six U.S. States: A Descriptive Study. Clin Gerontol 2023:1-8. [PMID: 37688772 DOI: 10.1080/07317115.2023.2254279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/11/2023]
Abstract
OBJECTIVES Extreme Risk Protection Orders (ERPOs) allow a court to restrict firearm access for individuals ("respondents") at imminent risk of harm to self/others. Little is known about ERPOs use for older adults, a population with higher rates of suicide and dementia. METHODS We abstracted ERPO cases through June 30, 2020, from California, Colorado, Connecticut, Florida, Maryland, and Washington. We restricted our analysis to petitions for older (≥65 years) respondents, stratified by documented cognitive impairment. RESULTS Among 6,699 ERPO petitions, 672 (10.0%) were for older adults; 13.7% (n = 92) of these noted cognitive impairment. Most were white (75.7%) men (90.2%). Cognitively impaired (vs. non-impaired) respondents were older (mean age 78.2 vs 72.7 years) and more likely to have documented irrational/erratic behavior (30.4% vs 15.7%), but less likely to have documented suicidality (33.7% vs 55.0%). At the time of the petition, 56.2% of older adult respondents had documented firearm access (median accessible firearms = 3, range 1-160). CONCLUSIONS Approximately 14% of ERPO petitions for older adults involved cognitive impairment; one-third of these noted suicide risk. Studies examining ERPO implementation across states may inform usage and awareness. CLINICAL IMPLICATIONS ERPOs may reduce firearm access among older adults with cognitive impairment, suicidality, or risk of violence.
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Affiliation(s)
- Marian E Betz
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
- Firearm Injury Prevention Initiative, University of Colorado School of Medicine, Aurora, Colorado, USA
- VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, Colorado, USA
| | - Shannon Frattaroli
- Center for Gun Violence Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Christopher E Knoepke
- Firearm Injury Prevention Initiative, University of Colorado School of Medicine, Aurora, Colorado, USA
- Adult & Child Consortium for Outcomes Research & Delivery Science, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Division of Cardiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Rachel Johnson
- Center for Innovative Design & Analysis, Department of Biostatistics & Informatics, Colorado School of Public health, Aurora, Colorado, USA
| | - Annette Christy
- Department of Mental Health Law and Policy at the de la Parte Florida Mental Health Institute, College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida, USA
| | - Julia P Schleimer
- Violence Prevention Research Program, University of California Davis School of Medicine, Sacramento, California, USA
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Veronica A Pear
- Violence Prevention Research Program, University of California Davis School of Medicine, Sacramento, California, USA
| | - Megan McCarthy
- Firearm Injury Prevention Initiative, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Reena Kapoor
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Michael A Norko
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Ali Rowhani-Rahbar
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Wenjuan Ma
- Center for Statistical Training and Consulting, Michigan State University, Lansing, Michigan, USA
| | - Garen J Wintemute
- Violence Prevention Research Program, University of California Davis School of Medicine, Sacramento, California, USA
| | - Jeffrey W Swanson
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - April M Zeoli
- Department of Health Management and Policy, University of Michigan, School of Public Health, Ann Arbor, Michigan, USA
- Institute for Firearm Injury Prevention, University of Michigan, Ann Arbor, Michigan, USA
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Tomsich EA, Pear VA, Schleimer JP, Wintemute GJ. The origins of California's gun violence restraining order law: a case study using Kingdon's multiple streams framework. BMC Public Health 2023; 23:1275. [PMID: 37391789 PMCID: PMC10314549 DOI: 10.1186/s12889-023-16043-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/02/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Firearm violence is a major public health problem in the United States, yet most states lack a mechanism to temporarily remove firearms from individuals who are at high and imminent risk of harming themselves or others and are not otherwise prohibited. Extreme risk protection order (ERPO) laws are intended to close this gap. The current study examines the passage of California's gun violence restraining order (GVRO) bill using Kingdon's multiple streams framework. METHODS This study was based on an analysis of interview data from six key informants involved in the passage of the GVRO legislation. RESULTS Findings indicate policy entrepreneurs framed the problem and designed the policy to target individuals at behavioral risk of imminent firearm violence. Policy entrepreneurs comprised an integrated policy network that engaged in a lengthy period of collaboration and bargained with interest groups to yield a bill that satisfied diverse concerns. CONCLUSIONS This case study may inform efforts in other states to pass ERPO policies and other firearm safety laws.
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Affiliation(s)
- Elizabeth A Tomsich
- Violence Prevention Research Program, Department of Emergency Medicine, University of California Davis, 4301 X St., Sacramento, CA, 95817, USA.
- California Firearm Violence Research Center, University of California Davis, 4301 X St., Sacramento, CA, 95817, USA.
| | - Veronica A Pear
- Violence Prevention Research Program, Department of Emergency Medicine, University of California Davis, 4301 X St., Sacramento, CA, 95817, USA
- California Firearm Violence Research Center, University of California Davis, 4301 X St., Sacramento, CA, 95817, USA
| | - Julia P Schleimer
- Violence Prevention Research Program, Department of Emergency Medicine, University of California Davis, 4301 X St., Sacramento, CA, 95817, USA
- California Firearm Violence Research Center, University of California Davis, 4301 X St., Sacramento, CA, 95817, USA
| | - Garen J Wintemute
- Violence Prevention Research Program, Department of Emergency Medicine, University of California Davis, 4301 X St., Sacramento, CA, 95817, USA
- California Firearm Violence Research Center, University of California Davis, 4301 X St., Sacramento, CA, 95817, USA
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Extreme risk protection orders, race/ethnicity, and equity: Evidence from California. Prev Med 2022; 165:107181. [PMID: 35940474 DOI: 10.1016/j.ypmed.2022.107181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/14/2022] [Accepted: 07/30/2022] [Indexed: 11/21/2022]
Abstract
Extreme risk protection orders (ERPOs) provide a civil mechanism to temporarily remove firearm access from individuals at high risk of harming themselves or others. Evidence and theory suggest that ERPOs can prevent firearm-related harm, but the policy's impact on racial/ethnic equity is largely unknown. To examine potential inequities by race/ethnicity in public perceptions and use of California's ERPO law, we drew on two complementary data sources: 1) a 2020 state-representative survey of California adults, and 2) ERPO court documents for the first 3 years of policy implementation (2016-2018). Majorities (54-89%) of all racial/ethnic groups reported that ERPOs are at least sometimes appropriate, and 64-94% were willing to ask a judge for an ERPO for a family member. However, Black and Hispanic/Latinx survey participants less often perceived ERPOs as appropriate and were less willing to serve as petitioners, with Black participants citing lack of knowledge about ERPOs and not trusting the system to be fair as their top reasons for unwillingness. Similarly, review of ERPO court documents revealed that no family or household members served as petitioners for Black and Hispanic/Latinx ERPO respondents. Additionally, Black respondents were the least likely to have documented access to a firearm and legal representation in court. Racial/ethnic equity in ERPO use may be improved by reducing barriers to petitioning, incorporating non-law enforcement intervention professionals like behavioral health specialists into the ERPO process, providing legal assistance to respondents and petitioners, and investing in the social safety net.
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Betz ME, Brandspigel S, Barnard LM, Johnson RL, Knoepke CE, Peterson RA, Rivara FP, Rowhani-Rahbar A. Voluntary, temporary out-of-home firearm storage: a survey of law enforcement agencies in two states. Inj Epidemiol 2022; 9:24. [PMID: 35864502 PMCID: PMC9302866 DOI: 10.1186/s40621-022-00389-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/15/2022] [Indexed: 11/23/2022] Open
Abstract
Background Temporary, voluntary storage of firearms away from the home during times of risk is a recommended strategy for suicide prevention. Law enforcement agencies (LEAs) are often suggested as storage sites, and online maps in Colorado and Washington display LEAs willing to consider storage. Questions remain about the experiences and views of LEAs, including barriers to providing storage. Methods LEAs in Colorado and Washington were invited to complete a survey via mail or online from June to July 2021; invitations were sent by email and mail, with telephone calls to non-responders. Survey data were analyzed using descriptive statistics, with testing between states and other subgroups using Fisher’s exact tests. Results Overall, 168 LEAs in Colorado (n = 91) or Washington (n = 77) participated (40% participation rate). Of those, 53% provided temporary, voluntary storage upon request by community members at the time of the survey. More LEAs said they had ever provided storage when the requester was under a court order (74% overall). Over half (60%) of responding LEAs had received at least one storage request in the prior 12 months. Many (41%) said they had declined to return a firearm after temporary storage due to safety concerns. Most LEAs supported engagement in suicide prevention (89%) and provision of community services (77%), but they simultaneously preferred being a storage option of last resort (73%). Factors negatively influencing storage provision included liability and funding concerns. Conclusions In Colorado and Washington, half of LEAs currently offer temporary, voluntary firearm storage upon request. While LEAs support suicide prevention and community engagement, broader provision of storage and participation in online maps may be limited by logistic, liability, and financial concerns. Addressing these barriers may facilitate broader suicide prevention efforts. Supplementary Information The online version contains supplementary material available at 10.1186/s40621-022-00389-3.
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Affiliation(s)
- Marian E Betz
- Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. .,Injury and Violence Prevention Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. .,VA Eastern Colorado Geriatric Research Education and Clinical Center, Denver, CO, USA.
| | - Sara Brandspigel
- Injury and Violence Prevention Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Leslie M Barnard
- Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
| | - Rachel L Johnson
- Department of Biostatistics & Informatics, Colorado School of Public Health, Aurora, CO, USA
| | - Christopher E Knoepke
- Division of Cardiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Adult & Child Consortium for Outcomes Research & Delivery Science, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Ryan A Peterson
- Department of Biostatistics & Informatics, Colorado School of Public Health, Aurora, CO, USA
| | - Frederick P Rivara
- Firearm Injury Policy and Research Program, Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, USA
| | - Ali Rowhani-Rahbar
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
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Pear VA, Pallin R, Schleimer JP, Tomsich E, Kravitz-Wirtz N, Shev AB, Knoepke CE, Wintemute GJ. Gun violence restraining orders in California, 2016-2018: case details and respondent mortality. Inj Prev 2022; 28:465-471. [PMID: 35654574 PMCID: PMC9510437 DOI: 10.1136/injuryprev-2022-044544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/01/2022] [Indexed: 11/22/2022]
Abstract
Background Gun violence restraining orders (GVROs), implemented in California in 2016, temporarily prohibit individuals at high risk of violence from purchasing or possessing firearms and ammunition. We sought to describe the circumstances giving rise to GVROs issued 2016–2018, provide details about the GVRO process and quantify mortality outcomes for individuals subject to these orders (‘respondents’). Methods For this cross-sectional description of GVRO respondents, 2016–2018, we abstracted case details from court files and used LexisNexis to link respondents to mortality data through August 2020. Results We abstracted information for 201 respondents with accessible court records. Respondents were mostly white (61.2%) and men (93.5%). Fifty-four per cent of cases involved potential harm to others alone, 15.3% involved potential harm to self alone and 25.2% involved both. Mass shooting threats occurred in 28.7% of cases. Ninety-six and one half per cent of petitioners were law enforcement officers and one-in-three cases resulted in arrest on order service. One-year orders after a hearing (following 21-day emergency/temporary orders) were issued in 53.5% of cases. Most (84.2%) respondents owned at least one firearm, and firearms were removed in 55.9% of cases. Of the 379 respondents matched by LexisNexis, 7 (1.8%) died after the GVRO was issued: one from a self-inflicted firearm injury that was itself the reason for the GVRO and the others from causes unrelated to violence. Conclusions GVROs were used most often by law enforcement officers to prevent firearm assault/homicide and post-GVRO firearm fatalities among respondents were rare. Future studies should investigate additional respondent outcomes and potential sources of heterogeneity.
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Affiliation(s)
- Veronica A Pear
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Rocco Pallin
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Julia P Schleimer
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Elizabeth Tomsich
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Nicole Kravitz-Wirtz
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Aaron B Shev
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Christopher E Knoepke
- Adult and Child Consortium for Outcomes Research and Delivery Science, University of Colorado Denver School of Medicine, Aurora, Colorado, USA.,Division of Cardiology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Garen J Wintemute
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
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Pear VA, Wintemute GJ, Jewell NP, Ahern J. Firearm Violence Following the Implementation of California's Gun Violence Restraining Order Law. JAMA Netw Open 2022; 5:e224216. [PMID: 35380646 PMCID: PMC8984773 DOI: 10.1001/jamanetworkopen.2022.4216] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
IMPORTANCE California's gun violence restraining order (GVRO) law, implemented beginning in 2016, allows for people at high risk of harming themselves or others with a firearm to be temporarily disarmed and prevented from purchasing firearms for 3 weeks to 1 year; many states have recently enacted similar laws. The research to date is on older and more limited risk-warrant laws. OBJECTIVE To determine whether implementation of the California GVRO law was associated with decreased rates of firearm assault or firearm self-harm in a large metropolitan county between 2016 and 2019. DESIGN, SETTING, AND PARTICIPANTS This serial cross-sectional study including data from 28 counties used the synthetic control method to evaluate differences in firearm violence between San Diego County and its synthetic control following implementation of the California law from 2016 to 2019. San Diego County was used as the treated unit because it issued substantially more GVROs than any other county in California during the study period. A total of 27 California counties that issued no or very few gun violence restraining orders from 2016 to 2019 and that had stable rates of firearm violence between 2005 and 2015 were included in the control pool. Data were analyzed from February 2021 to July 2021. EXPOSURES Implementation of the statewide GVRO law in 2016 in San Diego County. MAIN OUTCOMES AND MEASURES Annual rates of fatal and nonfatal firearm assault injuries and firearm self-harm injuries per 100 000 people. RESULTS In the study period, there were 355 GVROs in San Diego county, and a median (IQR) total of 8 (3-20) GVROs per donor county. The mean difference between the observed rate in San Diego County and the estimated rate in the synthetic San Diego County, 2016-2019, was -0.74 firearm assaults per 100 000 (-13% difference) and 0.13 firearm self-harm injuries per 100 000 (3% difference). Results from in-space placebo tests suggested that these differences cannot be distinguished from variation due to chance (pseudo-P values from a 1-sided test: P for assault = .35, P for self-harm = .67). CONCLUSIONS AND RELEVANCE To our knowledge, this study was the first to analyze the association between GVRO implementation and firearm violence in California and the first to evaluate the association between risk-based firearm removal laws and firearm assault in any state. GVROs were not associated with reduced population-level rates of firearm violence in San Diego County, but this may change as the number of orders increases over time; the association between GVROs and firearm violence at the individual level cannot be inferred from our findings and should be the subject of future studies.
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Affiliation(s)
- Veronica A. Pear
- Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis School of Medicine
- Division of Epidemiology, University of California, Berkeley School of Public Health
| | - Garen J. Wintemute
- Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis School of Medicine
| | - Nicholas P. Jewell
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jennifer Ahern
- Division of Epidemiology, University of California, Berkeley School of Public Health
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