key: cord-0837697-0sldm0li
authors: Khubchandani, Jagdish; Price, James H.
title: Public perspectives on firearm sales in the United States during the COVID‐19 pandemic
date: 2020-10-21
journal: J Am Coll Emerg Physicians Open
DOI: 10.1002/emp2.12293
sha: dbba6c3afe1d31f3638638994be4ee13c457e18e
doc_id: 837697
cord_uid: 0sldm0li

OBJECTIVE: Amidst the COVID‐19 pandemic crisis, firearm sales surged to record‐breaking levels in the United States. The purpose of this study was to conduct a national assessment of the views of Americans on the change in firearm sales, the perceived impact of the changes in sales, and how these perceptions differ by a recent purchase of a firearm. METHODS: A multi‐item valid and reliable questionnaire was deployed online via mTurk and social media sites in the last week of May 2020 to recruit adult Americans in the general population across the United States. RESULTS: Among the total sample of study participants (n = 1432), almost a fifth (18%, n = 263) reported buying a firearm during the pandemic. Firearm buyers differed statistically significantly (P < 0.01) from non‐buyers based on sex, age, ethnicity, marital status, education, having children at home, employment status, income, political orientation, location, and region of residence in the United States. Those who did not buy firearms during the pandemic were significantly (P < 0.01) more likely to believe that firearm sales and first‐time ownership/buying of firearms had increased during the pandemic. Similarly, those who did not buy a firearm during the pandemic were significantly more likely to believe that the surge in firearm sales would result in increased firearm access for children, mentally ill, drug users, criminals, and older adults. In relation to perceived changes in selected public health outcomes attributed to the surge in firearm sales, firearm buyers were significantly less likely (P < 0.01) to believe that an increase in sales could result in adverse public health outcomes such as a higher number of suicides, homicides, mass shootings, and crimes in society. In multiple regression analyses, significant predictors of pandemic purchase of firearms were: having children at home, owning firearms before the pandemic, planning to buy firearms in the next year, knowing someone who was shot or killed with a firearm, and personally experiencing firearm violence in the past (ie, threatened or shot with a firearm). CONCLUSIONS: This study delineated the characteristics of those who purchased a firearm during the pandemic and the reasons for such purchases during the COVID‐19 pandemic. Additional research is needed to understand the long‐term impact of firearm sales during the pandemic on public health.

Amidst this national crisis, firearm sales witnessed a major surge and received widespread media attention. 7 Similarly, Small Arms Analytics and Forecasting, a research consulting firm, and others estimated that these background checks would extrapolate to >2 million firearms being purchased in March 2020, significantly higher than in March 2019. 8, 9 This was followed by many expert views and media reports on the increase in firearm sales across the nation and the implications of rising firearm sales on public health. 9-12

Although there were speculations on the reasons for the increase of firearm sales during the pandemic, no systematic study has examined the publics' perceptions of the changes in firearm sales and the impact that the change in firearm sales may have on various public health outcomes. Thus, the purpose of this study was to conduct a comprehensive national assessment of the views of the general public in the United States on change in firearm sales, the perceived potential impact of the changes, and how these perceptions differ by a recent purchase of a firearm.

A web-based cross-sectional study was conducted in the United States using Amazon mTurk in the last week of May 2020. Given the lockdowns and the proven ability of mTurk to recruit nationwide random samples of adults who receive incentives to participate in studies, the survey was deployed online in the last week of May. 13 An a priori power analysis was conducted to estimate the required sample size for the study. 14 Based on the total population of adults in the United States (n = ≈200 million), a conservative 3% margin of error, and 99% confidence levels, we found that a total of 1383 individuals would be needed for the study to make adequate inferences to the beliefs and behaviors of the total US population and for reasonable external validity and generalizability of study results. 13, 14 The Bottom Line

It is no surprise that firearm sales in the United States have   increased during the COVID-19 pandemic, but like any good   study, it brings up other questions, such as why the young,   single, urban dwellers, healthcare professionals, and Hispan- ics were more likely to have purchased a firearm during these difficult times.

There were 36 items on the questionnaire. Participants were requested to provide their sociodemographic information (eg, race, age, sex, education, employment status, geographic region, income, marital status, and political orientation). Each participant was also asked whether he or she purchased a firearm during the pandemic 

Descriptive statistics (frequencies, percentages, and means) were computed to describe the study population, participants' exposure to firearm violence, and firearm ownership and purchases before and during the pandemic. Inferential statistics (eg, χ 2 tests) were computed to assess group differences based on whether an individual bought a firearm during the COVID-19 pandemic. Multiple regression analyses were conducted to compute adjusted odds ratios with 95% confidence intervals for assessing the relationship between the predictor variables and outcome (purchase of firearms during the COVID-19 pandemic).

Nagelkerke R 2 was computed to explore the variability in firearm purchases during the pandemic, and Hosmer-Lemeshow goodness-of-fit tests were used to ensure that models adequately fit the data. Statistical significance for all tests and analyses was assumed a priori at P < 0.01.

A total of 1432 adults with a median age of 33 years responded to the questionnaire (range, 18-85 years). As a first step to delineate our sample, we computed the extent of firearm purchases during the pandemic.

Almost a fifth of all respondents (18%; N = 263) purchased a firearm during the pandemic. Those who purchased a firearm during the pandemic were statistically significantly younger (mean age = 34.7 years) than those who did not (mean age = 37.8 years; t = −3.39; P < 0.001).

Among those who purchased the firearms, the major reasons for pur- (Table 1 ).

Firearm-related behaviors and beliefs varied significantly (P < 0.001) based on whether the respondents did not or did purchase a firearm during the pandemic ( Table 2) . Those who purchased a firearm during the pandemic were significantly more likely to have personally experienced firearm violence (ie, threatened or shot), know someone who was shot or killed with a firearm, have plans to buy a firearm in the next year or owned a firearm before the pandemic, believe that businesses that sell/buy/trade firearms should be considered an essential service, and felt that wearing a face mask in public places increases the risk of being shot. In contrast, those who did not buy a firearm during the pandemic were significantly more likely to believe that firearm laws in the United States should be stricter (Table 2) .

Respondents were asked what they thought had happened to firearm sales from March to May 2020 compared with the same time (22) 48 (18) Other 92 (8) 9 (4) N (%) indicates frequency and percentages. P value indicates significance levels for group differences.

last year (March to May 2019). There was a significant difference between those who did not buy a firearm and those who purchased a firearm during the COVID-19 pandemic (Table 3) . Individuals who did not purchase a firearm during the pandemic were significantly more likely to believe that firearm sales increased a lot (legal, illegal, and online), first-time firearm buyers increased, and private trading of firearms had increased.

Those who did not buy firearms when compared with those who purchased a firearm during the pandemic differed significantly (P < 0.001) on all 20 items about selected public health outcomes (Table 4 ). Those who did not purchase firearms during the pandemic perceived all 7 groups of individuals would have greater access to firearms compared with those who purchased firearms during the pandemic. They also perceived that all 11 potentially negative outcomes of purchasing a firearm during the pandemic would increase more than did those who purchased firearms (Table 4 ).

Although key differences were found between those who did and did not buy firearms during the pandemic, we conducted a multiple Table 2 ). The Nagelkerke R 2 value for this model was 0.58 (indicating 58% variability in firearm purchase explained by the predictors in this final model). In this final multivariate model (Table 5) 

Individuals who have access to firearms are at increased risk for unintentional firearm mortality, firearm homicides, and firearm suicides. 10 COVID-19-induced firearm buying has resulted in almost a fifth (18%) of our sample buying a firearm during the pandemic, and the leading reason was for the protection of self and family. This is not surprising because this was the leading reason reported for buying a firearm before the pandemic. 9 More so, the buying of firearms has been pronounced in times of mass shootings, terrorist attacks, and major economic and political events in the United States. 17, 18 However, it is disconcerting that firearms bought for protection may contribute to a potential increase in firearm suicides. Firearms are the most common method used in adult American completed suicides. 10, 18, 19 The risk factors for suicide include feelings of being alone, feelings of being depressed, substance use disorders, relationship difficulties, death of a partner or someone close, diagnosis of a potentially fatal disease, financial problems, natural disasters, and unemployment, just to name a few especially related to COVID-19. 11, 12, 19, population spread mitigation warranted the use of public health measures of mask wearing, social distancing, avoidance of group encounters, physical distance from others, and quarantine if exposed to a person with the potential infection. Such methods to minimize the spread of COVID-19 may have increased loneliness, feelings of depression, and higher rates of suicidal ideation in many groups. 10 State governments in collaboration with law enforcement officials have a key role to play in ensuring that laws and standards for sales are applied to reduce morbidity and mortality from firearms. 9, 10 Also, state and federal policymakers should consider more legislative Table 4 ]), additional research is needed to assess the long-term effects of the recent surge in firearm sales. Also, evidence-based policymaking would be required to deal with newer challenges such as ghost or build-it-yourself guns (in the current study, almost a fifth of the respondents believed sales of such items had increased). 32 Given the special challenges posed by the pandemic, greater impetus on firearm-related research is recommended with prospective studies to assess the social and economic impacts on public health in relation to firearm violence and crime.

The results of this study should be considered in light of the potential limitations. The study results are restricted by all limitations of a cross-sectional survey study design (eg, self-reported behaviors, recall bias in participants, socially desirable responses, and the inability to establish cause and effect relationships among study variables).

A major threat to external validity is that the sample is limited in nature with selection bias as it relates to the total US population (eg, younger, those with a bachelor's degree or higher, and being selfselected). Similarly, the participants were limited to those who used AOR indicates adjusted odds ratio for the likelihood of the outcome (ie, pandemic purchase of firearms = yes or no). 95% CI indicates 95% confidence intervals for adjusted odds ratios. P value indicates significance levels. Bold indicates significantly higher odds for the outcome. Predictor variables include variables from Tables 1 and 2 that had group differences depending on whether an individual did or did not purchase firearms during the pandemic.

the internet or understood the online survey environment. Despite these limitations, our study is one of the first of its kind in the United States, our final sample exceeds the required sample size and resembles the total US population in several ways (eg, almost a quarter of participants lived in rural areas, the majority were women or White, and there was an equal split of our sample by US median household income = $60,000). 13, 33 In conclusion, this study delineated the characteristics of those who purchased a firearm during the pandemic and the reasons for such purchases during the COVID-19 pandemic. Those who purchased a firearm during the pandemic differed from those who did not on sociodemographic characteristics. Also, those who purchased firearms during the pandemic were significantly more likely to have children at home, personally experienced firearm violence in the past, knew someone who was a victim of firearm violence, owned firearms in the past, or planned to buy additional firearms in the near future.

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Jagdish Khubchandani is the recipient of 2020 Benjamin V. Cohen Peace Fellowship from Ball State University Center for Peace and Conflict Studies.

The authors declare no conflicts of interest.

Jagdish Khubchandani and James Price designed the study. Jagdish