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Youth suicide rates are higher in states where household gun ownership is more common, according to a new study published in the American Journal of Preventive Medicine.

In the 10 states with the highest youth suicide rates, the average household gun ownership rate was more than 50 percent, according to the study. In the 10 states with the lowest suicide rates, it was 20 percent. That includes New Jersey, which had the lowest youth suicide rate in the nation.

“The availability of firearms is contributing to an increase in the actual number of suicides,” said predoctoral fellow Anita Knopov, the study’s lead author, “not just leading youth to substitute other means of suicide for guns.”

Suicides have been rising across all age groups, but notably among young people, for whom suicide is the second-leading cause of death, behind unintentional injury. Every day, an average of three people between ages 10 and 19 die by firearm-related suicide, the Centers for Disease Control and Prevention says. The year 2016 saw 1,102 youth suicides by guns across the United States.

The study, reported in Preventive Medicine, said New Jersey had the second-lowest rate of household gun ownership of any state and a youth suicide rate of 2.6 per 100,000 people. By contrast, in the states with the four highest suicide rates — between 11 and 15 per 100,000 in Alaska, South Dakota, Wyoming, and Montana — 60 percent to 65 percent of households own guns, researchers from the Boston University School of Public Health found.

Pennsylvania rate: Pennsylvania was tied with New Hampshire for the 10th-lowest suicide rate, 4.2 per 100,000, and has a middling proportion of gun ownership at 35 percent. Wyoming had the highest household gun ownership at 65.5 percent; Hawaii the lowest at 10.2 percent.

“This study demonstrates that the strongest single predictor of a state’s youth suicide rate is the prevalence of household gun ownership in that state,” said coauthor Michael Siegel, Boston University professor of community health sciences.

The study is the first to examine youth suicide state by state as it relates to household gun-ownership rates. It adds to a body of findings that owning a gun increases the risk that someone in the household may die by committing suicide.

For youth, every 10 percentage-point increase in household gun ownership was associated with a 26.9 percent increase in the suicide rate, the study found. The study used household gun ownership data collected in 2004 and examined suicide rates in people age 10 to 19 between 2005 and 2015.

“Given that we know that youth suicide rates have been increasing in our country over the past decade, which is a certainly troublesome trend, being able to identify factors that put youth suicide at risk is critical — in particular with regard to firearms, which tend to be the most common method for males and also the most lethal,” said Rinad Beidas, an associate professor of psychiatry and medical ethics and health policy at the University of Pennsylvania’s Perelman School of Medicine.

In 2008, Harvard researchers looking at the whole population, not just youth, also found that states with higher gun ownership had higher suicide rates. A 2016 Boston University study reviewing three decades’ worth of data found the same, and specifically that firearm ownership was a strong predictor of male suicide rates.

Recommendations: Doctors and researchers have recommended safe firearm storage practices for gun-owning parents, such as using gun locks and storing firearms and ammunition separately. The Philadelphia Sheriff’s Office distributes free gun locks; a similar program in Bucks County was so popular it distributed thousands of locks in less than two years.

“Any time you have the means for suicide readily accessible to a person at risk, that increases the risk,” said Doreen Marshall, vice president of programs for the American Foundation for Suicide Prevention. “If we can just put some time and distance between the person and their chosen method, they may not end up trying to take their lives.”

The Boston University researchers found that while high household gun ownership strongly corresponded to youth suicide involving firearms, it did not correspond to the rate of non-firearm-related suicide — suggesting that removing guns could reduce the likelihood of suicides.

“It’s important that we understand not only what may contribute to (the youth suicide rate) but also what we can do to take steps to prevent it,” Marshall said. “Understanding that … (makes it) a higher priority for us to make sure we’re asking our teens about mental health as well as making sure we’re storing firearms safely.”

The suicide impulse comes and goes for most people, Marshall said, making firearms of particular concern because they are more lethal than other methods.

Marshall, who worked with the National Shooting Sports Foundation to develop and distribute guides for firearm owners discussing suicide risk, recommended storing firearms unloaded and locked, keeping the keys to locks out of the reach of children or at-risk family members, or temporarily removing weapons from a house when someone is at risk. Beidas cited the “20-2” rule: Store firearms so that a 20-year-old with two hours of free time couldn’t get them.

“If you reduce access to the most lethal means,” Beidas said, “you’re likely to result in saved lives.”

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