Modification of Firearm Law-Firearm Injury Association by Economic Disadvantage

To assess whether the association between firearm law restrictiveness and firearm-related events in the US is modified by community distress and economic connectedness (EC).Methods: National cross-sectional study of firearm incidents (interpersonal and unintentional firearm events) occurring between 1/2015-12/2021 using the Gun Violence Archive (GVA). Exposures were community distress (Distressed Communities Index, DCI), EC, and year-state-level firearm restrictiveness. Primary outcome was mean annual urban firearm incidence rate per ZIP Code Tabulation Area. Data analyses took place in 2022. Results: 266,020 firearm incidents were included. The mean rate was higher with each DCI tertile, with a RR of 3.18 (95% CI: 3.06, 3.30) in high versus low distress communities. Low EC was associated with over 1.8 times greater rate of firearm-related injury. The association between restrictive laws and lower incidence rates was strongest in low and medium distress and high EC communities. Conclusions: Stricter firearm laws are associated with lower rate of firearm incidents. The magnitude of this association is smallest for communities experiencing the greatest economic disadvantage.