CONCEALED CARRY OF FIREARMS IN THE UNITED STATES: A PUBLIC HEALTH LAW ANALYSIS OF STATE POLICY AND STATE SUICIDE MORTALITY

Although research has shown that some laws governing the concealed carry of firearms are associated increased violent crime, the relationship between these laws and suicide mortality has not been rigorously evaluated. This dissertation’s three studies sought to examine this relationship. The first study gathered and analyzed concealed carry laws for all 50 states from 1980–2017, revealing trends toward deregulation of concealed carry. The results describe state concealed carry policy, concluding that while broader access to firearms facilitated by concealed carry laws may increase suicide risk, specific permitting requirements may provide opportunities for preventive interventions. The second study sought to determine whether shall issue and permitless laws—the laws that make it easiest to carry a concealed firearm—affect suicide mortality. Suicide mortality data from 1980–2015 were collected from the National Center for Health Statistics. The primary independent variables were shall issue laws and permitless laws. The statistical analysis consisted of negative binomial models with state fixed effects and synthetic control methods. The analysis found no relationship between shall issue laws and suicide. Laws allowing permitless carry had a harmful effect on suicide, but this result it limited by the small number of states with permitless laws before 2015. The third study sought to determine whether specific elements of concealed carry permitting laws are associated with suicide mortality. The data were identical to the second study, but the independent variables were laws requiring training, a good cause for a permit, and applicant suitability. The statistical analysis consisted of negative binomial models with state fixed effects and synthetic control methods. States requiring training saw decreased suicide. This effect may, however, be limited to states with the most restrictive concealed carry laws. Good cause and suitability requirements had no consistent relationship with suicide. Overall, this dissertation research found that concealed carry is being increasingly deregulated in the United States. Though the loosest permitting laws are not broadly associated with suicide mortality, states allowing permitless carry may see increased suicide. Training may help prevent deaths by suicide in certain contexts. These courses represent a promising point of intervention for suicide prevention efforts