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Banning open carry of unloaded handguns decreases firearm-related fatalities and hospital utilization
  1. Rachael A Callcut1,2,
  2. Anamaria Joyce Robles1,2,
  3. Matthew W Mell3
  1. 1 Department of Surgery, University of California, San Francisco, California, USA
  2. 2 Department of Surgery, San Francisco General Hospital, San Francisco, California, USA
  3. 3 Department of Surgery, University of California, Sacramento, California, USA
  1. Correspondence to Dr Rachael A Callcut, Department of Surgery, University of California, San Francisco, CA 94110, USA; rachael.callcut{at}


Background Since 1967, in California it has been illegal to openly carry a loaded firearm in public except when engaged in hunting or law enforcement. However, beginning January 1, 2012, public open carry of unloaded handguns also became illegal. Fatal and non-fatal (NF) firearm injuries were examined before and after adoption of the 2012 ban to quantify the effect of the new law on public health.

Methods State-level data were obtained directly from California and nine other US state inpatient and emergency department (ED) discharge databases, and the Centers for Disease Control Web-Based Injury Statistics Query and Reporting System. Case numbers of firearm fatalities, NF hospitalizations, NF ED visits, and state-level population estimates were extracted. Each incident was classified as unintentional, self-inflicted, or assault. Crude incidence rates were calculated. The strength of gun laws was quantified using the Brady grade. There were no changes to open carry in these nine states during the study. Using a difference-in-difference technique, the rate trends 3 years preban and postban were compared.

Results The 2012 open carry ban resulted in a significantly lower incident rate of both firearm-related fatalities and NF hospitalizations (p<0.001). The effect of the law remained significant when controlling for baseline state gun laws (p<0.001). Firearm incident rate drops in California were significant for male homicide (p=0.023), hospitalization for NF assault (p=0.021 male; p=0.025 female), and ED NF assault visits (p=0.04). No significant decreases were observed by sex for suicides or unintentional injury. Changing the law saved an estimated 337 lives (3.6% fewer deaths) and 1285 NF visits in California during the postban period.

Discussion Open carry ban decreases fatalities and healthcare utilization even in a state with baseline strict gun laws. The most significant impact is from decreasing firearm-related fatal and NF assaults.

Level of evidence III, epidemiology.

  • gunshot
  • health care policy

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  • Presented at 76th Annual Meeting of the American Association for the Surgery of Trauma (AAST), September 14, 2017, Baltimore, Maryland.

  • Contributors RAC: literature search, study design, data collection, analysis, interpretation, writing. AMJR: literature search, study design, interpretation, critical review. MWM: study design, data analysis, interpretation, critical review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement There are no unpublished data. All data are from publicly available data sets.