COMMENTS AND RESPONSES Guns, Suicide, and Homicide TO THE EDITOR: In Hemenway’s editorial (1), he correctly suggests

that our systematic review and meta-analysis (2) “provides too con-servative an estimate of the relationship among guns and suicide and homicide at a societal level ” (1). Although we agree that our methods have probably underestimated the true relationship between guns and suicide or homicide victimization, our inclusion of only studies that assessed the individual’s personal firearm experience does pro-vide an estimate of the minimum likely risk. The narrative around studies of firearm ownership and harms usually discredits causality assumptions, and causal inference is par-ticularly problematic in ecologic studies. Critics are quick to point out conflicting “evidence ” from various sources of rates and their interpretations. In fact, a commonly cited review of ecologic data by Kates and Mauser (3) only adds fodder to the ongoing debate. We purposefully excluded ecologic data, in part, to obviate this common critique regarding the interpretability of population-level data