More than 4.5 million children in the United States live in homes with loaded, unlocked firearms, according to the most recent National Firearms Survey. That’s despite guidance from groups like the American Academy of Pediatrics, which says that guns should be stored unloaded, in a locked box or with a locking device, and away from ammunition.
With children now physically in their houses more than usual due to school closures from COVID-19, exposure to unsafe firearm storage has significantly increased, says Alison Buttenheim, a researcher in Penn’s School of Nursing and associate director of the Center for Health Incentives and Behavioral Economics. “Think about hours of exposure in a home that has an unsafely stored firearm,” she says. “We just quadrupled that for a whole lot of young kids.”
Generally, Buttenheim’s work focuses on how people make decisions that affect their health, which she approaches through the lens of behavioral economics, a field that bridges ideas from psychology and economics to nudge behavior change. In a graduate course Buttenheim teaches on the subject, third-year nursing doctoral candidate Katelin Hoskins, along with Unmesha Roy Paladhi and Caitlin McDonald, then students in the Master of Public Health program, developed several hypotheses about behavioral barriers or roadblocks to safe firearm storage.
With guidance from Buttenheim, the trio sought to understand what factors influence how parents elect to store guns and what strategies might lead to safer storage practices. Reviews of injury prevention and behavioral economics literature along with stakeholder interviews revealed that specific mental shortcuts and cognitive biases—overemphasizing current danger and discounting future risk, for example—shape firearm owner decisions. The team also identified techniques such as leveraging trusted individuals and institutions that can inform interventions to increase safe firearm storage. The researchers published their findings in Pediatrics.
The work started with several hypotheses. “We wondered if the presence of minor inconvenience impedes safe storage or if people might lack motivation if they don’t think their child will handle unsecured firearms,” Hoskins says. “We also thought that some individuals might view present risk as low for their child and potential future benefits as too intangible or improbable.” This last notion, known as present bias, often leads to a misperception of what something costs today versus what advantages it might result in later.
In the case of gun storage, that means that the hassle of separating guns from ammunition and storing each securely may subconsciously outweigh protecting children in the house at some vague future date. That focus on the here and now instead of on long-term consequences makes sense to Buttenheim. She explains it’s a necessary shortcut the human brain takes to allow it to process a barrage of information. “We’re wired to do that,” she says.
Beyond present bias, the researchers also analyzed others from behavioral economics, including in-group/out-group bias and the availability heuristic. In-group/out-group bias is the willingness of people to trust those in their community more than those outside of it, Hoskins says. The availability heuristic is the tendency people have to place greater significance on events that come to mind more easily than those harder to imagine or remember.
“The human brain looks for shortcuts, ways to make information a little simpler to process,” Buttenheim says. Typically, that’s a positive adaptation. It becomes problematic, however, when it means the most readily accessible fact overshadows one that offers a more complete or accurate picture. For instance, the prevalence of mass shootings and gun violence in the media could inadvertently signify to a firearm owner that the world has gotten more dangerous, increasing the perceived need to have a firearm handy rather than locked away.
With an understanding of how these concepts apply to safe firearm storage, the researchers aimed to determine whether behavioral economics strategies might motivate change. Three stood out: signing commitment contracts, leveraging in-group messengers, and shifting how firearm owners think about the negative consequences of not locking up a loaded gun.
A commitment contract asks a firearm owner—at time of purchase, perhaps—to pledge to safely store the weapon and identify a specific date and time to complete this task. It closes the gap between intention and action, Buttenheim says. “Firearm owners know there’s an important safety step they need to take, but it’s never the moment. It’s never top-of-mind. A commitment contract can make it more salient.”
That can be especially true if the message comes from someone within the individual’s social network like a friend, trusted community member, or socially connected retailer. Hoskins and colleagues note that one approach could entail a retailer cross-promoting firearm-safety items with babyproofing items. “It sends the signal that the social norm is to safeguard the home when a baby is born,” Hoskins says. This could happen both physically in the store and online, she says.
Finally, the researchers suggest increasing the vividness of events to promote greater recall. Pediatricians could “prescribe” safe firearm storage, bundling the recommendation with other routine pediatric interventions. So, too, could firefighters or law enforcement personnel, as part of a message provided during a car seat installation or safety check.
Hoskins says that although theory supports these behavioral constructs, they haven’t yet been studied in the context of firearm storage, something she hopes her future work can include. She also says she wants to better understand what biases exist in certain subpopulations and how to frame interventions around them.
It’s all with an eye toward preventing harm to children, she says. “In terms of firearm injury, we know that many happen in the home. These nudges are a soft touch, and they keep the focus on child safety.”
Alison Buttenheim is the Patricia Bleznak Silverstein and Howard A. Silverstein Endowed Term Chair in Global Women’s Health at the School of Nursing at the University of Pennsylvania. She is also an assistant professor of health policy at the Perelman School of Medicine, a senior fellow at the Leonard Davis Institute of Health Economics, associate director of the Center for Health Incentives and Behavioral Economics, and associate director of the National Clinician Scholars Program.
Katelin Hoskins is a third-year doctoral student at the School of Nursing and an associate fellow at the Leonard Davis Institute of Health Economics at the University of Pennsylvania.
Caitlin McDonald, a recent graduate of the Master of Public Health program, is a clinical research coordinator for the Acceleration Lab at the Penn Medicine Center for Health Care Innovation at the University of Pennsylvania.
Unmesha Roy Paladhi, a recent graduate of the Master of Public Health program, is a first-year doctoral student in epidemiology at the University of Washington and a graduate research assistant at Seattle Children’s Hospital.
