Adverse childhood experience domains and unsafe firearm storage: The moderating role of social support

Background Firearm storage practices are a critical public health issue, as unsafe storage increases risks for unintentional injuries and suicides. Numerous factors have been linked to unsafe storage, including adverse childhood experiences (ACEs). While ACEs are associated with a range of negative health behaviors, their role in shaping firearm storage practices remains understudied. Social support may serve as a protective factor, but little is known about how it influences the relationship between ACEs and firearm storage. Objective To assess the association between ACE domains and firearm storage and the moderating role of social support. Participants and Setting Data were from the 2023 Behavioral Risk Factor Surveillance System. Methods Structural equation modeling (SEM) was used to identify latent domains of adverse childhood experiences (ACEs) and generate an overall ACE score. Multinomial logistic regression models were then used to examine the association between ACE domains and firearm storage behaviors, with interaction terms included to assess the moderating role of social support. Findings People with more ACEs were more likely to store firearms in unsafe ways – either loaded and locked, or loaded and unlocked. This pattern was especially strong among those who grew up with household dysfunction. For individuals who had experienced sexual abuse in childhood, having strong social support was linked to a significantly lower likelihood of unsafe firearm storage. Conclusion ACEs, especially household dysfunction, are associated with unsafe firearm storage. Social support reduces the likelihood of unsafe storage, particularly among individuals who have experienced sexual abuse. Firearm safety interventions may prioritize social support, particularly for individuals with sexual abuse, while addressing childhood adversity.