Personal Circumstances Preceding Firearm Suicide Death Among Black Adults in the United States.

Despite an alarming rise in firearm suicide rates within Black communities, there has been little research on the contributors that precede firearm suicide deaths among Black adults. To fill this knowledge gap, this study was guided by an overarching research question: What are the recurring and salient personal circumstances experienced by Black adults prior to dying by firearm suicide in the US? This basic, interpretive qualitative study analyzed narrative text data for 843 Black adult firearm suicide decedents from the National Violent Death Reporting System. The analysis began with an initial cycle of open coding, followed by a second coding cycle, organizing the circumstances into major categories using a focused coding process. The analysis then moved back and forth between description and interpretation, and major themes were developed. Five themes emerged from this analysis: (1) Decedents often experienced poor health prior to death - but not always poor mental health. (2) Romantic relationships were often deteriorating, leading to frequent interpersonal arguments. (3) Alcohol and substance use were common before a suicide attempt. (4) Decedents frequently experienced financial and legal difficulties prior to death. (5) Decedents had many pathways to accessing firearms, and limiting firearm availability before death was challenging. Additional research on potential intervention pathways will be critical, given recent evidence indicating dramatic increases in firearm ownership among Black adults over the past 5 years.