Newswise – Key insights

  • Gun suicide rates rose in nine years in states that began allowing gun owners to openly carry a firearm without a permit, according to a new study.
  • Gun-related suicides rose in the U.S. from 21,175 in 2013 to 26,328 in 2021, an increase that may be linked to more permissive open carry gun laws.

CHICAGO: Significantly more people died from firearms and suicide in states that relaxed gun laws to allow the open carry of a loaded firearm in public without a permit than in states without open carry laws, study findspublishedin theJournal of the American College of Surgeons(JACS).

In this study using death data from all 50 states Researcher found that there was a change in permit-free open carry laws within the nine-year study period was too There is a strong association with increases in both firearm-related suicide rates and overall suicide rates. Most suicides each year are due to firearms, investigators reported.

“Our analysis suggests that we have seen an increased firearm suicide rate and an increased overall suicide rate due to the law change allowing easier access to firearms.” said the study’s lead author, Jose J. Diaz, MD, FACS, medical director of trauma at Tampa General Hospital. Dr. Diaz is also a professor of surgery at the University of South Florida in Tampa, where the study was conducted.

Several studies have shown connections between specific firearms laws and their impact on firearm-related deaths. For example, requiring a permit to purchase a firearm reduces firearm-related homicides, and universal background checks and ammunition checks are associated with a decrease in overall firearm deaths.1 Dr. Diaz said he and his research team focused their study on permit-free carry laws because these laws have become more common in the U.S. but remain under-researched.

For this study, researchers assessed states’ annual rates of total firearm deaths, total suicides, and total homicides from 2013 to 2021. Death statistics came from the Centers for Disease Web-based Injury Statistics Query and Reporting System Control and prevention.

Investigators also conducted a causal analysis to estimate the impact of a state’s policy change to open-carry laws that do not require approval. The researchers excluded states that adopted permitted open carry before 2013. So they compared data from states that switched to permitted open carry during the study with states that had laws banning permitted or outright open carry.

Key findings

  • During the study period, five states transitioned to permit-free open carry laws, 19 states banned open carry or required a permit, and the other 26 states already permitted permit-free carry prior to 2013.
  • Total gun deaths increased in all 50 states from 33,636 in 2013 to 48,830 in 2021, a 45% increase.
  • Analyzes showed significant associations between a change in open carry gun laws and overall firearm fatality and suicide rates.
  • In states that transitioned to open carry laws, the root cause analysis found an overall increase in suicide rates of about 57% and an 18% increase in firearm suicides during the study period.

Causal analysis found no association between open carry laws and firearm-related homicides.

Be careful when interpreting the results

“Because the study was retrospective, i.e. used previous data, we cannot say that the shift to more permissive open carry laws was a definitive cause of the increased firearm suicide rate,” said Dr. Diaz.

In addition, Dr. Diaz noted that the COVID-19 pandemic may have affected their results. He pointed to the widely reported social isolation and poorer mental health observed during and after the pandemic.2

However, previous studies support their findings by showing a link between easy access to firearms and an increased risk of firearm-related suicide.3 According to the article.

The bottom line, said Dr. Diaz, is that “changes in firearms laws have potential impacts that we do not foresee.”

The American College of Surgeons (ACS) Trauma Committee supports initiatives to prevent firearm injuries, including legislation that would strengthen mandatory background checks for firearm ownership and increase federal funding for research to prevent firearm injuries. The ACS has too Information on the safe use and storage of firearms.

Study co-authors include Emily A. Grimsley, MD; Johnathan V. Torikashvili, MD; Haroon M. Janjua, MS; Meagan D. Read, MD; and Paul C. Kuo, MD, MS, MBA, FACS. Mr. Janjua is now at Brown University.

The authors of the study do not provide any information.

This study is published asArticle in the presson theJACSWebsite.

Quote: Grimsley EA, Torikashvili JV, Janjua HM. Transition to Allowed Open Carry and Link to Firearm-Related Suicide. Journal of the American College of Surgeons2024. DOI: 10.1097/XCS.0000000000000959

Presented at the 135th Annual Meeting of the Southern Surgical Association, Hot Springs, Virginia, March 3-6. December 2023.


  1. References 7 and 11 cited in the study.
  2. Xiong J, Lipsitz O, Nasri F, et al. Impact of the COVID-19 pandemic on the mental health of the general population: a systematic review. J affective disorder. 2020 Dec 1;277:55-64. DOI:10.1016/j.jad.2020.08.001
  3. References 36 and 37 cited in the study.

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About the American College of Surgeons

TheAmerican College of Surgeonsis a scientific and educational organization of surgeons founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The college is dedicated to the ethical and competent practice of surgery. Its achievements significantly influenced the course of scientific surgery in America and made it a major advocate for all surgical patients. The college has more than 90,000 members and is the largest organization of surgeons in the world. “FACS” means that a surgeon is a Fellow of the American College of Surgeons.

The Journal of the American College of Surgeons (JACS) is the official scientific journal of ACS. Each month, JACS publishes original, peer-reviewed articles on all aspects of surgery with the goal of providing its readership with the highest quality and rapid access to information relevant to surgeons.

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