Risk Factors for Firearm Violence

What You Can Do believes in your ability, as a provider, to prevent firearm injury and death—especially firearm suicide, firearm homicide, and accidental firearm death—among the patients with whom you already are interacting.

Some patients are at higher risk of firearm injury and death either because they are belong to demographic groups with relatively elevated risk, they have individual characteristics or histories associated with violence, or they have violent intent or ideation against self or someone else.1 In some cases, the factors exposing patients to increased risk of firearm violence may be the reasons those patients are coming into contact with a health care provider like you.

Identifying risk factors in your patients is the first step to planning an informed conversation about firearm risk and safety. There are three main categories of risk for firearm injury and death:

  1. Patients with acute risk of violence to self or others. This includes patients with suicidal or homicidal ideation or intent.
  2. Patients with individual-level risk factors for firearm violence or unintentional firearm injury. This includes patients with
    • History of violent behavior
    • History of violent victimization
    • Abusive partners
    • Alcohol and drug abuse
    • Serious and poorly controlled mental illness
    • Impaired cognition or judgement
  3. Patients in a demographic group at increased risk of firearm violence or unintentional injury, including
    • Children and adolescents
    • Middle-aged and older men, for suicide
    • Adolescent and young men, for homicide

Read about and consider making use of the “5 Ls” mnemonic (Locked, Loaded, Little children, feeling Low, Learned owner), published by Pinholt, et al., to remember the risk factors for firearm injury and death.2

Continue to tips on preparing to counsel your at-risk patients on firearm safety.

  1. Wintemute GJ, Betz ME, Ranney ML. Yes, you can: physicians, patients, and firearms. Ann Intern Med 2016;165:205-13.
  2. Pinholt EM, Mitchell JD, Butler JH, Kumar H. "Is there a gun in the home?" Assessing the risks of gun ownership in older adults. J Am Geriatr Soc 2014;62:1142-6.