Abstract
BACKGROUND: Safe firearm storage may reduce suicide and unintentional firearm injuries. However, little is known about safe storage practices in rural US populations. We aimed to examine the association between living in a rural US area and firearm storage practices. METHODS: We used data from the Behavioral Risk Factor Surveillance System (BRFSS), 2021-2023 to compare firearm storage practices between rural and urban populations. The primary outcomes were whether firearms were stored loaded, and among loaded firearms, whether they were stored unlocked. Those living in a rural residence were compared to those living in an urban residence. Descriptive statistics for firearm storage practices were compared between living in rural or urban areas. Unadjusted and adjusted relative risks (with 95% confidence intervals) were calculated using Poisson regression models with robust standard errors. RESULTS: One third of rural (34.71%) and urban (34.33%) firearm-owning households stored at least one firearm loaded. Of these households with loaded firearm(s), 58.55% of rural respondents stored their firearms unlocked compared to 50.66% of urban respondents. Compared to the urban sample, rural respondents were older adults (51.41% vs. 43.91% ≥ the age of 55), non-Hispanic White (83.12% vs. 72.45%), and were high school graduates or less (48.33% vs. 34.77%). While rural respondents were equally likely as urban respondents to store firearms loaded (ARR = 1.00, CI = [0.93-1.06]), they were more likely to store loaded firearms unlocked (ARR = 1.11, CI = [1.03-1.19]). CONCLUSIONS: Additional support for providing firearm storage options, such as firearm safety locks, may promote safer firearm storage practices in rural populations. Future research should explore culturally appropriate interventions tailored to the specific needs of individuals living in the rural US.