Original Investigation

State Point-of-Sale Comprehensive Background Check Policies and County Firearm Homicide Rates

JAMA Network Open 10.1001/jamanetworkopen.2026.18188

June 12, 2026 at 11:00 AM EDT

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What is the association between state-level point-of-sale comprehensive background check (CBC) policies and county-level firearm homicide rates?In this cross-sectional study of 750 counties across 14 states, using difference-in-differences analysis with synthetic controls, state-level CBC policy implementation was not associated with county-level firearm homicide rates across counties (0.13 deaths per 100 000) or for individual counties (county-specific estimates ranged from −13.2 to 20.5 deaths per 100 000).Results align with prior state-level studies and suggest opportunities for further research on the design, implementation, and enforcement of CBC policies.

Corresponding Author: Julia P. Schleimer, PhD, MPH, Hans Rosling Center for Population, Department of Epidemiology, School of Public Health, University of Washington, 3980 15th Ave NE, Seattle, WA 98195 (jps36@uw.edu).

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