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2023 HSR&D/QUERI National Conference Abstract

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1043 — Rural Women Veterans’ Experiences with Firearms and Perceptions of VA Firearm Injury Prevention Strategies

Lead/Presenter: Megan Lafferty,  COIN - Portland
All Authors: Lafferty MJ (Center to Improve Veteran Involvement in Care, VA Portland Healthcare System), Wyse J. (Center to Improve Veteran Involvement in Care at VA Portland Healthcare System, Oregon Health and Science University, Portland State University School of Public Health) Maxim L. (Center to Improve Veteran Involvement in Care at VA Portland Healthcare System) Mulcahy AC.(Center to Improve Veteran Involvement in Care at VA Portland Healthcare System, Oregon Health and Science University, Portland State University School of Public Health) Carlson K. (Center to Improve Veteran Involvement in Care at VA Portland Healthcare System, Oregon Health and Science University, Portland State University School of Public Health)

Objectives:
The Veterans Health Administration (VA) serves more than 9 million Veterans each year, many of whom reside in rural areas and own firearms. Women Veterans – particularly rural-residing women Veterans – are a rapidly growing demographic of US Veterans and VA healthcare users. Women Veterans are also a growing demographic of those injured, both fatally and nonfatally, by firearms. The VA promotes firearm risk reduction, particularly in relation to suicide prevention, but may need a nuanced approach for women Veterans who own firearms. This study examines rural women Veterans’ experiences with firearms throughout their lives and their perceptions of potential VA firearm injury prevention strategies .

Methods:
We conducted semi-structured interviews with 40 Veterans from four VA facilities that treat a relatively high rate of rural patients with firearm-related injuries. Interviews were audio-recorded and transcribed. We used an integrated approach of content analysis and inductive thematic analysis to interpret interview data to understand gender differences. The results presented here are based on interviews with 8 women Veterans and highlight findings specific to women’s experiences and preferences.

Results:
While most participants grew up with firearms in their households and communities, not all gained experience with firearms until their military service or after, reflecting gendered societal norms of the times. Interviews revealed how women’s experiences of trauma shaped their current motivations for firearm ownership and the storage practices they utilized. Stemming from a desire to protect themselves and their families, most participants owned firearms that they kept loaded and readily accessible for defense. In addition, firearm ownership was influenced by a survivalist mentality informed by traditions of rural life. Several participants discussed owning firearms in relation to protecting freedoms they saw as potentially under threat from future political conflict. Participants were receptive to VA discussions of firearm safety, however they voiced preferences for women messengers and sensitivity to their reasons for firearm ownership. Veterans were receptive to safety strategies, such as VA providing reduced-cost, quick-access firearm safes and home-security systems, as well as classes on firearm safety led by, and for, women Veterans.

Implications:
These preliminary findings suggest women’s experiences with firearms are varied, yet events in their lives influenced their reasons for owning firearms, primarily to ensure a sense of protection. Strategies aimed toward reducing firearm injuries and death among rural women Veterans could include women messengers, classes for women Veterans on firearm safety, and providing quick-access safes and home-security systems.

Impacts:
VA interventions to reduce firearm injury among rural women Veterans must consider their gendered experiences and the context of firearms in their daily lives, particularly around the desire for protection.