One in five Colorado high school students say they have easy access to a handgun, according to a new study published Monday that draws on more than 46,000 student responses across the state, noting that male and older-aged youths, along with youths in rural areas, are most likely to report ease of access.

The study's release coincides with the fatal mass shooting that occurred at King Soopers grocery store last week in Boulder, Colorado. A gunman entered the grocery store armed with military-style weapons, including a handgun, and opened fire, taking the lives of 10 people, including a police officer. 

"In Colorado, we have a relatively high suicide rate," Ashley Brooks-Russell, the lead author of the paper and assistant professor at the Colorado School of Public Health, told The Academic Times. "And we've had a number of these mass shooting events. The interest in this topic came from the mental health sphere and knowing that when suicide attempts happen with firearms they are very, very lethal."

Suicide is the second leading cause of death for adolescents aged 15 to 19, with firearms being the leading method of those deaths, according to the study. 

"Knowing about firearm access for youth and knowing that suicide is a major fatality for youth, this is just such an important topic," Brooks-Russell said.

The study, published in the Journal of Pediatrics, analyzed data from the Fall 2019 Healthy Kids Colorado Survey, which is a biennial cross-sectional survey of Colorado public high school students. In the survey, 46,537 high school students responded, totaling a 71% student response rate.

The survey is a state effort funded through the Colorado Department of Public Health and Environment, and it is part of a national surveillance effort by the Youth Risk Behavior Survey, which is guided by the Centers for Disease Control and Prevention. 

Colorado's survey is self-administered in schools, and its methods are consistent with those used by the Youth Risk Behavior Survey. Student participation in the survey is voluntary and approved by parents. The survey collects sociodemographic information on students and asks questions about their mental health, but it does not collect identifying information. 

In fall 2019, the Healthy Kids Colorado Survey included a new question for students: "If you wanted to get a handgun, how easy would it be for you to get one?" Student response options ranged from very hard to very easy. 

One in five students said it was "sort of easy" or "very easy" to access a handgun — 11.1% and 8.8% of respondents, respectively — a stark finding considering that 34.7% of overall students reported feeling sad or hopeless almost every day for two weeks over the past 12 months, and 7.6% of overall students reported an attempted suicide in the past 12 months, according to the study.  

The researchers noted that 24.2% of students who said they had felt hopeless almost every day for two weeks reported easy handgun access, as did 30.1% of students who had attempted suicide and 31.8% of students who had been in a physical fight in the past 12 months.

The researchers also uncovered sociodemographic patterns among those who reported perceived easy handgun access. Whereas male students had a prevalence rate of 22%, female students' prevalence rate was 18.1%. Moreover, 25% of 12th-graders said they had easy handgun access, compared to 16.3% of ninth-graders, 18.9% of 10th-graders and 24.1% of 11th-graders. 

The study also uncovered racial and ethnic differences in perceived ease of access. The racial and ethnic groups where the highest percent have perceived easy access are Native Hawaiian or Pacific Islander students at 23.8%; multiracial students at 23.3%; and white students at 21.3%. White youths' prevalence rate is significantly higher than that of Hispanics, at 18.2%; Black or African American students, at 16.9%; and Asian American students, at 12.2%. 

Students in more rural schools were also more likely to report perceived easy access. The prevalence rate for rural students was 26.8%, compared to 17.1% for urban students and 18.7% for suburban students. 

"What we see is significantly more teens in rural areas reporting they have easy access to a handgun than in urban or suburban areas," Brooks-Russell said. "This is consistent with what we think about in terms of rural communities having a hunting culture, though that in and of itself is not necessarily problematic. It's all about how they're [handguns] stored and the kind of culture surrounding firearm safety."

She said, though, that their measure isn't perfect as it relies on self-reported perceptions, "and perceptions aren't always the truth." 

"I suspect there are some youths who have inaccurate perceptions of their ease of access," Brooks-Russell said. "They may know there's guns in their home and assume they could get to them, but in fact their parents are storing them safely and locking the ammo separately."

On the other hand, though, "There are students who haven't gone through a moment of mental health crisis or it has never crossed their mind that they would need a firearm," she said. "They may think there aren't guns available, but the truth is that there are, and that's what I worry about — for teens, mental health concerns or suicidality can come on quickly."

And the concern is not solely about guns in students' own homes, according to Brooks-Russell: "There's also the issue of visiting friends and relatives' homes, and I think we need to be concerned about the overall environment of guns in places that teens may go."

Reflecting on some of the news coverage she's seen, especially comparing firearm death rates in the U.S. to other countries, Brooks-Russell said, "It's really hard not to come to the conclusion that the scale of our access to guns and the sheer number of guns is the cause of our gun fatalities, both homicide, suicide and unintended accidents."

"We need to do what we can to ensure that firearms are stored safely in homes with children," she added.

This study adds to a growing library of research investigating the impact of guns on children and adolescents and Americans' views on how to protect schools from shooters. 

Colorado lawmakers recently advanced the Safe Storage of Firearms bill that would require Colorado gun owners who share their homes with children to securely store their weapons. 

Moreover, several gun shops and law enforcement agencies in Colorado are offering out-of-home gun storage options; and if those are not viable options, the Colorado School of Public Health has an out-of-home gun storage map to help people find a location.

From a policy perspective, the U.S. needs to encourage behaviors that ensure that firearms are stored safely in homes with children, but a cultural shift may also be in order, according to Brooks-Russell.

"It's pretty taboo to talk about guns; people assume, rightly or wrongly, that it's a personal topic, and you can't ask someone about it," she said. "But I think if it's your child, you should feel comfortable saying 'I know that the places my child is spending time are safe and that any firearms in those spaces are stored safely.'"

People should encourage family members and neighbors to change their firearm storage habits "in any way we can," Brooks-Russell said.

"If someone's in crisis, it shouldn't be taboo to ask them whether they are safe and if they have firearms available to them," she said. "It's coming from a place of love and we should feel comfortable approaching these topics."

The study "Perceived Access to Handguns Among Colorado High School Students," published March 29 in the Journal of Pediatrics, was co-authored by Ashley Brooks-Russell and Ming Ma, Colorado School of Public Health; Sarah Brummet, Colorado Department of Public Health and Environment; Erin Kelly, University of Colorado, Boulder; and Marian Betz, University of Colorado Anschutz Medical Campus and Rocky Mountain Regional Veteran Affairs Medical Center.