The Supreme Court's landmark ruling on gun ownership last week focused on citizens' ability to defend themselves from intruders in their homes. But research shows that surprisingly often, gun owners use the weapons on themselves.
Suicides accounted for 55 percent of the nation's nearly 31,000 firearm deaths in 2005, the most recent year for which statistics are available from the Centers for Disease Control and Prevention.
There was nothing unique about that year — gun-related suicides have outnumbered firearm homicides and accidents for 20 of the last 25 years. In 2005, homicides accounted for 40 percent of gun deaths. Accidents accounted for 3 percent. The remaining 2 percent included legal killings, such as when police do the shooting, and cases that involve undetermined intent.
Public-health researchers have concluded that in homes where guns are present, the likelihood that someone in the home will die from suicide or homicide is much greater.
Studies have also shown that homes in which a suicide occurred were three to five times more likely to have a gun present than households that did not experience a suicide, even after accounting for other risk factors.
In a 5-4 decision, the high court on Thursday struck down a handgun ban enacted in the District of Columbia in 1976 and rejected requirements that firearms have trigger locks or be kept disassembled. The ruling left intact the district's licensing restrictions for gun owners.
One public-health study found that suicide and homicide rates in the district dropped after the ban was adopted. The district has allowed shotguns and rifles to be kept in homes if they are registered, kept unloaded and taken apart or equipped with trigger locks.
The American Public Health Association, the American Association of Suicidology and two other groups filed a legal brief supporting the district's ban. The brief challenged arguments that if a gun is not available, suicidal people will just kill themselves using other means.
More than 90 percent of suicide attempts using guns are successful, while the success rate for jumping from high places was 34 percent. The success rate for drug overdose was 2 percent, the brief said, citing studies.
"Other methods are not as lethal," said Jon Vernick, co-director of the Johns Hopkins Center for Gun Policy and Research in Baltimore.
The high court's majority opinion made no mention of suicide. But in a dissenting opinion, Justice Stephen Breyer used the word 14 times in voicing concern about the impact of striking down the handgun ban.
"If a resident has a handgun in the home that he can use for self-defense, then he has a handgun in the home that he can use to commit suicide or engage in acts of domestic violence," Breyer wrote.
Researchers in other fields have raised questions about the public-health findings on guns.
Gary Kleck, a researcher at Florida State University's College of Criminology and Criminal Justice, estimates there are more than 1 million incidents each year in which firearms are used to prevent an actual or threatened criminal attack.
Public-health experts have said the telephone survey methodology Kleck used likely resulted in an overestimate.
Both sides agree there has been a significant decline in the last decade in public-health research into gun violence.
The CDC traditionally was a primary funder of research on guns and gun-related injuries, allocating more than $2.1 million a year to such projects in the mid-1990s.
But the agency cut back research on the subject after Congress in 1996 ordered that none of the CDC's appropriations be used to promote gun control.
Vernick said the Supreme Court decision underscores the need for further study into what will happen to suicide and homicide rates in the district when the handgun ban is lifted.
Today, the CDC budgets less than $900,000 for firearm-related projects, and most of it is spent to track statistics. The agency no longer funds gun-related policy analysis.