March 8, 2012

Study shows benefit of gun cabinets in homes in Alaskan villages

UW Health Sciences/UW Medicine

Alaska Native people have a suicide rate more than three times greater than white Americans.

Installing a gun cabinet dramatically reduces unlocked guns and ammunition in the home, according to a study in rural Alaska villages where the residents are primarily Alaska Native people. Dr. David Grossman, Group Health Research Institute senior investigator and UW professor of health services, led the research published in the American Journal of Public Health March 8. Grossman is also a pediatrician and medical director for preventive care at Group Health.

Grossmans research team included representatives from the Alaska Native Tribal Health Consortium, two Native health organizations (Yukon Kuskokwim Health Corporation and Bristol Bay Area Health Corporation), village tribal governments and faculty from UW Medicines Harborview Injury Prevention and Research Center. They identified households in six Alaska Native villages in the Bristol Bay and Yukon Kuskokwin Delta area of western Alaska.

The study was a randomized trial with 255 gun-owning households. An $80 locking metal gun cabinet was installed free of charge in the homes, with participants given a brief safety message and instructions on how to use the gun cabinet, including keeping the key in a secure place. The households were divided into two groups, with cabinet installation in the “early” group happening 12 months before installation in the “late” group.

To measure the effect of the gun cabinets, the household member most knowledgeable about the guns in the home took a 13-question survey about how the guns and ammunition were stored. The questions were asked by a researcher visiting the home before, and 12 and 18 months after installation of the gun cabinet.

When the study began,

•   93 percent of participating households reported at least one unlocked gun in the home;

  • 89 percent reported unlocked ammunition.

One year after the study began, when early group homes had gun cabinets for 12 months but cabinets were not yet installed in late-group homes,

•     35 percent of households in the early group reported unlocked guns in the home;

•     89 percent of households in the late group, without gun cabinets, reported unlocked guns (declining to 35 percent, six months after receiving a cabinet);

•    35 percent of homes in the early group reported unlocked ammunition;

•     84 percent in the late group reported unlocked ammunition.

Grossman showed in a 2005 JAMA study on U.S. youth that safe firearm storage reduced the risk of unintentional injury and suicide. He conducted this work at UW Medicines Harborview Injury Prevention and Research Center, with which he is still affiliated. Alaska Native people have a suicide rate more than three times greater than white Americans. Among Alaska Native men aged 15 to 19, firearm-related suicides were more than 10 times higher than for U.S. white male teenagers in 2000–2006.

“We learned from a small, successful, community-based pilot project that installing gun cabinets in homes in an Alaskan Native village increased safe household firearm storage,”  Grossman said. “This current study showed conclusively that it can work in other rural Native villages, and the effects are quite durable over time.”

Further discussing the current study,  Grossman added: “This community-supported program to install gun cabinets in homes in rural Alaskan Native villages is feasible and acceptable and clearly reduces exposure of children and teens to unlocked guns and ammunition. If these results are maintained over time, gun-related injuries and deaths could be reduced in this population.”

The Alaska Native Tribal Health Consortium Injury Prevention Program estimates that over 300 gun safes have been placed in rural homes in the past four years. The Alaska Native Tribal Health Consortium provided initial support for the gun safe project in 2008, inviting tribal injury prevention and housing authority staff from regions with an established injury prevention program. From there, regions identified funding and determined how to implement the project locally.

In collaboration with multiple partners, healthy choices are promoted as a means to prevent injury and support community wellness. In addition to suicide prevention and gun safety, the Alaska Native Tribal Health Consortium Injury Prevention Program focuses on water safety, traumatic brain injury prevention and fall prevention. Education, advocacy and coalition-building are ways in which this is achieved.

Grossman is affiliated with UW Medicines Harborview Injury Prevention and Research Center and the UW School of Public Health. His co-authors were Helen Andon Stafford and Ryan Hill, who were at the Alaska Native Tribal Health Consortium at the time of this study; Thomas D. Koepsell, professor emeritus of epidemiology and health services at the UW School of Public Health; Kyla D. Retzer, formerly of the Yukon Kuskokwim Health Corporation and the Alaska Native Tribal Health Consortium and now at the National Institute for Occupational Safety and Health;  and Ward Jones of the Bristol Bay Area Health Corporation.

The Centers for Disease Control and Prevention and the Indian Health Service each provided funding for the study.

Rebecca Hughes is  senior media consultant for the Group Health Research Institute.