Exploring Firearm Safety Barriers among Black American Firearm Owners

Abstract

Introduction

Suicide rates are rising among Black Americans (i.e., increasing 39.9% from 5.01 deaths/100,000 persons in 2009 to 7.51 deaths/100,000 persons in 2020), while firearm-related homicide rates increased by 75.8% among Black Americans over the same period. Complicating suicide prevention efforts, 1 in every 2 suicide deaths among Black adults involve firearms, the most lethal suicide method. Lethal means counseling (LMC) may help physicians prevent firearm-related deaths and injuries. LMC incorporates counseling strategies to help limit access to firearms in times of crisis, including dialogue on safe firearm storage options in the home. However, studies evaluating LMC have not included perspectives from racially/ethnically diverse communities. This gap is problematic because different populations experience different barriers to practicing firearm safety, and LMC depends on understanding patients’ firearm safety barriers. Our objective was to gather feedback from Black adult firearm owners on (1) why they keep firearms in the home and (2) barriers preventing safe firearm storage in their homes.

Methods

Insights were collected through in-depth semi-structured interviews with n=15 Black adults (age 18+) in the U.S. who have access to firearms in their homes. Open-ended questions focused on eliciting information on interviewees’ history with firearms, rationale for keeping firearms in their homes, and perceived barriers to discussing firearm safety with clinicians. Participants were purposively recruited through study advertising and postings, word-of-mouth referrals, and organizations (e.g., gun ranges/National African American Gun Association). Interview data were analyzed at a semantic level using rapid qualitative analysis. We completed an episode profile for each transcribed interview to deductively organize relevant information by topics aligned with our interview guide. We aggregated our findings in matrix format to generate preliminary themes in the responses to each topic.

Results

Participants were 40 years old on average. 67% were male. 10 states and all U.S. Census Regions were represented. Theme 1: Most interviewees were introduced to firearms at an early age, often by their fathers, and learned how to handle firearms safely. Theme 2: Most interviewees kept firearms in their homes to protect themselves, their families, and their property. The perceived need for protection through firearm ownership was repeatedly a response to fear of experiencing racial violence, racism, or prejudice. Theme 3: Interviewees discussed both a lack of firearm safety knowledge and limited access to firearm safety knowledge in Black communities as causing barriers to safe firearm practices in the home. Theme 4: Despite not asking about children during the interviews, when asked about barriers to maintaining firearm safety in their homes, interviewees repeatedly and spontaneously discussed concerns about their children’s curiosity, perceptiveness, and capability of gaining access to their firearms.

Conclusion

New ideas emerged counseling Black patients on firearm safety during healthcare encounters. Familiarity with biometric storage devices may help Black firearm owners secure their firearms from children while maintaining the perception of quick accessibility in the event of danger. Moreover, physicians may have opportunities to share firearm safety training resources with their patients, including lists of local instructors, classes, and ranges, and focus on child safety.