Household firearm ownership, firearm storage, and healthcare engagement

To assess whether (1) household firearm ownership and, among firearm-owning households, (2) household firearm storage are associated with healthcare engagement.

Data were from the 2024 Behavioral Risk Factor Surveillance System from 19 US states (N = 145,720), including a subsample of respondents living in firearm-owning households (n = 54,125). Four indicators of healthcare engagement were assessed: health insurance status, having a personal healthcare provider, cost as a barrier to care, and time since last routine checkup. Multiply imputed, weighted multivariable logistic regression models were used to estimate associations between (1) household firearm ownership and (2) household firearm storage (unloaded, loaded and locked, and loaded and unlocked) and healthcare engagement, adjusting for age, sex, race/ethnicity, marital status, educational attainment, income, presence of a child in the home, military veteran, bad physical health days, urban-rural classification, and state of residence.

In covariate-adjusted models, household firearm ownership was associated with a higher odds of having a personal health care provider (adjusted odds ratio [aOR] = 1.12, 95% Confidence Interval [CI] = 1.03-1.21) compared with non-firearm-owning households. Household firearm ownership was not associated with any other healthcare engagement measure. Among firearm-owning households, storing firearms loaded and unlocked was associated with a lower odds lower odds of having health insurance (aOR = 0.65, 95% CI = 0.51-0.83), have a personal health care provider (aOR = 0.64, 95% CI = 0.54-0.76), and time since last routine checkup (aOR = 0.80, 95% CI = 0.69-0.92), compared to storing a firearm unloaded.

These findings highlight the potential value of integrating firearm safety discussions into clinical visits and the need to develop strategies for reaching patients who store firearms unsecured and who engage less consistently with the healthcare system.