ArticleInjury epidemiology2026
Extreme risk protection orders and firearm violence: a synthetic control analysis.
Article in Injury epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundExtreme Risk Protection Orders (ERPOs) are an evidence-based provision to prevent firearm violence present in 21 states, and Washington D.C. as of 2024. Examining the potential of varied ERPO versions to prevent fatal and nonfatal forms of firearm violence is crucial for shaping effective policy creation and enactment.
methodsWe use a synthetic control approach to estimate how varied ERPO versions impact firearm violence incidents resulting in injury and/or death per the Gun Violence Archive between 2014 and 2021. Our 'treated' state cohort (California, Delaware, Florida, Illinois, Massachusetts, Maryland, Oregon, Rhode Island, Vermont, and Washington) had ERPO effective dates after 2015 and before 2019, and experienced a statistically significant increase in petitions relative to the petition volume (zero) before ERPO implementation.
resultsSignificant reductions in state-month firearm violence rates were associated with ERPO policies in Rhode Island and Massachusetts (due largely to reductions in nonfatal firearm assault). Florida's, Oregon's, Vermont's, and Washington's ERPO policies were not associated with changes in firearm violence incidents. Poor pre-period fit made California, Delaware, Illinois, and Maryland results uninterpretable.
conclusionsWe conclude not all ERPO policies are created or implemented equally. Under certain enactment and implementation conditions, ERPO policies may protect against nonfatal firearm assault incidents in particular. Increasing effect sizes over time may suggest state capacity for implementing ERPOs effectively is improving, however, effect size magnitudes also indicate factors other than ERPO policies may be contributing to observed declines.
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