Engagement with Preventive Health Behaviors and Safe Firearm Storage Practices Using the 2017 Behavioral Risk Factor Surveillance System

Purpose: "Behavioral bundling" is a theory that explains how some health behaviors reinforce one another. This study aims to investigate the relationship between preventive health behaviors (PHBs) and safe firearm storage. Design: This study used a cross-sectional design using 2017 Behavioral Risk Factor Surveillance Survey data. Setting: Survey participants resided in California, Idaho, Kansas, Oregon, Texas, and Utah. Subjects: There were 12,817 people living in households with a firearm included in this study. Measures: We classified individuals' engagement in 5 PHBs: cholesterol screening, influenza immunization, physical activity, primary care, and seatbelt use. We defined safe firearm storage as storing a firearm unloaded, or loaded but locked. Analysis: Using Poisson regression models, we calculated adjusted prevalence ratios (aPRs) to estimate the association between engagement in the five PHBs with safe firearm storage. Results: Most firearm owners reported safe firearm storage (80.3%). The prevalence of safe firearm storage was 3% higher for each additional PHB engaged in (aPR = 1.03 [1.01, 1.05]). There was a higher prevalence of safe firearm storage among those who always wore a seatbelt while driving or riding in a car compared to those who did not (aPR = 1.12 [1.05, 1.18]). Conclusion: This study found preliminary evidence to suggest that engagement in seatbelt usage may be bundled with safe firearm storage, though we are not able to determine causality.