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Abstract Mass shootings (incidents with four or more people shot in a single event, not including the shooter) are becoming more frequent in the United States, posing a significant threat to public health and safety in the country. In the current study, we intended to analyze the impact of state-level prevalence of gun ownership on mass shootings—both the frequency and severity of these events. We applied the negative binomial generalized linear mixed model to investigate the association between gun ownership rate, as measured by a proxy (i.e., the proportion of suicides committed with firearms to total suicides), and population-adjusted rates of mass shooting incidents and fatalities at the state level from 2013 to 2022. Gun ownership was found to be significantly associated with the rate of mass shooting fatalities. Specifically, our model indicated that for every 1-SD increase—that is, for every 12.5% increase—in gun ownership, the rate of mass shooting fatalities increased by 34% (pvalue < 0.001). However, no significant association was found between gun ownership and rate of mass shooting incidents. These findings suggest that restricting gun ownership (and therefore reducing availability to guns) may not decrease the number of mass shooting events, but it may save lives when these events occur. 

Objectives: Mass shooting incidents have drastically increased in the United States in the last 10 years, with a disproportionate number of incidents occurring in some states. Gun laws vary greatly by state, but little research has been conducted to examine the association between the strength of state gun laws and mass shootings. This study aims to explore the aggregate effect of state gun laws on the rate of mass shooting incidents and fatalities. Study design: This was a cross-sectional time series. Methods: This study applied the negative binomial generalized linear mixed model to assess the impact of state gun laws restrictivenessdas measured by the total number of active gun lawsdon the rate of mass shooting incidents and fatalities. Results: The restrictiveness of state gun laws was significantly associated with the rate of mass shooting fatalities; specifically, for every 1 standard deviation (SD) increase in the state gun law restrictiveness score (i.e. for every additional 27 gun laws in place), the rate of mass shooting fatalities was decreased by 24% (P-value <0.0001), controlling for other predictor variables in the model. However, no significant association was found between the restrictiveness of state gun laws and rate of mass shooting incidents. Conclusions: State gun laws may not decrease the number of mass shooting events, but they appear to help reduce the number of deaths when these mass shootings occur. Better data collection on mass shootings and further research on the impacts of specific gun laws are needed to help understand the effectiveness of gun laws and inform law-based interventions.