Family Conflict and Gun Carrying in Adolescence: Multilevel Analysis of Household and Neighborhood Effects in Los Angeles County

Background: Firearm-related injuries are the leading cause of death among children and adolescents (ages 1 to 19 years) in the United States. Access to and carrying firearms are key risk factors for violence and adolescent firearm use. This study examines the association between family conflict and adolescent gun carrying in Los Angeles County, and the extent to which household and neighborhood contexts contribute to adolescent gun carrying. Methods: We use cross-sectional multilevel data from adolescents ages 12–17 years in the Los Angeles Family and Neighborhood Study, conducted in 2002, to fit a series of generalized linear mixed models to examine the association between family conflict (scale range: 0–2) and adolescent gun carrying. Models include random effects to examine the contributions of household and neighborhood contexts on the outcome measure. Results: After controlling for demographic characteristics, gang involvement, substance use, and household and neighborhood contexts, adolescent experiences of family conflict remain positively associated with adolescent gun carrying behavior (OR = 3.45, p = 0.043). Random effects estimates indicate that a relatively large amount of variation in adolescent gun carrying is explained by household and neighborhood contexts: 23% and 24%, respectively. Conclusions: Multilevel family and community-level interventions, with an emphasis on family violence, are necessary components of prevention strategies to reduce high rates of firearm-related mortality among US adolescents.