Universal firearm background checks

Evidence Rating  
Some Evidence
Evidence rating: Some Evidence

Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.

Health Factors  
Decision Makers

Federal law requires licensed firearm dealers to conduct background checks of potential firearm purchasers’ criminal histories via the National Instant Criminal Background Check System (NICS), which includes fugitive status and court restraining orders, along with some information about severe mental illness. States can expand background checks to private sales and transfers (e.g., sales at gun shows, online sales, and transfers between acquaintances), and require unlicensed dealers (i.e., private sellers) to perform background checks and keep records of firearm sales1. Such universal background checks (also known as comprehensive background checks) are often adopted with other efforts to strengthen background checks such as expanded qualification criteria, extending policies to include to other types of firearms, and regulations that require licenses to purchase or own firearms2.

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Reduced gun violence

Potential Benefits

Our evidence rating is not based on these outcomes, but these benefits may also be possible:

  • Reduced homicide
  • Reduced suicide
  • Reduced mass shootings
What does the research say about effectiveness? This strategy is rated some evidence.

There is some evidence that universal firearm background check laws reduce gun violence, including firearm homicides3, 4, 5, 6 and workplace homicides7. However, additional evidence is needed to confirm effects and characteristics of successful efforts8.

Firearm homicide rates are lower in states with universal background check laws than states without such laws4, 5. Universal background checks may reduce firearm homicides in medium and large cities, but not in suburban and rural areas3. The effects of universal background check laws on firearm violence can vary depending upon enforcement and sellers’ compliance with the laws, along with the completeness of background check data systems9, 10. Some research, including studies from California, Indiana, and Tennessee, had unclear findings regarding universal background check laws’ impact on firearm homicides11, 12, 13, 14; other studies of large urban counties and Pennsylvania suggest that universal background check laws may actually increase the rates of firearm homicides1, 9.

The effect of universal background check laws on firearm suicides and mass shootings is unclear. While some studies find no impact1, 4, 9, 11, 12, 15, 16, 17, 18, others suggest that such laws are associated with decreases in firearm suicides, especially when combined with other restrictions on firearm purchases, such as laws for mandatory waiting periods before purchases19, 20 or firearm possession restrictions for those under age 2121. States with universal background check laws are associated with lower firearm-related child mortality rates than states without such laws22; however, there is no clear connection to hospitalization rates for firearm-related injuries23. A study of a national youth survey suggests that students in grades 9 to 12 living in states with universal background check laws are less likely to carry firearms than peers in states without these laws24.

Universal background check laws appear to be associated with increases in background check rates10. A 2019 national survey of firearm owners indicates that in states with universal background check laws, firearm owners were more likely to have undergone a background check as part of their most recent firearm purchase, compared to those in states without such laws25. However, seller compliance with the laws is low and many undocumented firearm transfers occur26, 27. Other implementation challenges include police departments’ difficulties conducting frequent compliance audits due to limited time, staffing, and resources; incomplete background data systems; lack of a comprehensive firearm registry; and private sellers’ failure to verify purchasers’ identification with valid documents10, 27. Public education programs for firearm owners, robust enforcement, accurate records of transfers, and additional time to complete background checks may increase compliance with the laws and enhance the laws’ capacity to prevent gun violence9, 26, 27.

In general, states with the lowest firearm death rates are more likely to have stronger gun violence prevention policies28. Experts recommend more restrictive firearm policies to reduce firearm homicides and suicides, mass shootings, and accidental deaths by firearms29.

How could this strategy advance health equity? This strategy is rated inconclusive impact on disparities.

It is unclear what impact universal background check laws may have on disparities in firearm homicides and suicides. Available evidence shows universal background checks for handguns may decrease firearm homicides for Black populations more than white populations6; however, another study suggests firearm homicide rates are reduced for both Black and white populations5. Effects appear to vary by state or level of urbanization, with some studies indicating that universal background check laws may be effective at reducing firearm homicides in urban areas3, 9.

Firearm deaths disproportionally affect populations by race and ethnicity, age, gender, poverty level, and urbanization level. In 2020, the firearm homicide rate was highest among Black people (27 per 100,000 individuals), about 13 times higher than white people. Both American Indian and Alaska Native people and white people had higher suicide rates, more than twice that of Black and Hispanic people. Individuals ages 25-44 and males had the highest firearm homicide rates compared to other age groups and females. Counties with higher poverty rates had higher firearm homicide and suicide rates than counties with lower poverty rates31. In 2020, firearm suicide rates for rural counties were 2.1 times higher than large metropolitan counties28. Regarding firearm ownership, males, white people, and residents of rural areas are more likely to own firearms than females, other racial and ethnic groups, and residents of urban or suburban areas32.

What is the relevant historical background?

The first gun control policy was passed by a European colony in 1619, which banned the sale or gift of firearms to Native Americans. This was a controversial policy because firearm trading was profitable and Native Americans were sometimes allies against colonial adversaries33. The addition of the Bill of Rights to the U.S. Constitution in 1791 included the Second Amendment, which states that, “A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed”34. The varied interpretations of the Second Amendment have shaped firearm regulations ever since it was ratified.

Through the early 1930s, there was wide variation in state gun laws: major forms of state gun policies addressed hunting, militia, and gun carrying restrictions, with less attention given to firearm sale bans33. The National Firearms Act was passed in 1934 to control firearm transactions and possession of unregistered firearms, in recognition of increased crime rates and public safety concerns35. Since then, federal firearm legislation has moved forward in regulating firearm owners and dealers, but there have still been gaps in gun laws. For example, the Gun Control Act of 1968 (GCA) created a federal firearm licensing system for dealers and prohibited firearm sales and possession for felons and other unlawful individuals; yet some restrictions were removed by the Firearm Owners’ Protection Act of 198635, 36. The Brady Bill in 1993 established a background check system for gun purchases37; however, loopholes remained that allowed prohibited purchasers to access firearms, such as through private sales without background checks38, 39. Gun rights advocacy groups, such as the National Rifle Association (NRA) and the National Shooting Sports Foundation (NSSF), have been successful at lobbying against firearm regulations and encouraging states to pass preemption laws that prevent local governments from implementing local gun control policies37, 40.

Although the health impacts of firearms are well documented, Congress prohibited federal research dollars from being used for gun violence and injury prevention research from 1996-202041. In 2021, approximately 48,900 people died from firearm-related injuries in the U.S., including firearm homicides (43%) and suicides (54%). Firearm homicide and suicide rates have increased over time; 80% of total homicides and 55% of total suicides in 2021 involved a firearm42.

Equity Considerations
  • Who is at a greater risk of death by firearms in your community? How can universal background check laws help increase their safety?
  • What are objective, nondiscriminatory ways to enforce universal background check laws? What resources and trainings are needed? Which organizations may serve as local partners?
  • How do preemption laws impact your ability to implement universal background check laws?
Implementation Examples

As of January 2022, 14 states and Washington, D.C. require universal background checks at the point of sale or transfer for all sales of all types of firearms; Pennsylvania requires universal background checks for handguns only. Fifteen states and Washington, D.C. require background checks through a firearm permitting or licensing system for private firearm sales of some or all types of firearms; this includes Minnesota and Michigan, where universal background checks via required permits will be effective in August 2023 and early 2024, respectively2.

Most states prevent local governments from enacting gun laws via state preemption legislation; as of October 2022, five states (Connecticut, Hawaii, Massachusetts, New Jersey, and New York) allow local governments to enact gun laws30.

Implementation Resources

Resources with a focus on equity.

Everytown-State gun law strength - Everytown for Gun Safety Support Fund (Everytown). 2022 Everytown gun law rankings.

RAND-Firearm law database - Cherney S, Morral AR, Schell TL, Smucker S, Hoch E. RAND state firearm law database. Santa Monica: RAND Corporation; 2022.

GLC-UBC - Giffords Law Center (GLC). Universal background checks (UBC).

EFSGV-REIA - The Educational Fund to Stop Gun Violence (EFSGV). Racial equity impact assessment tool for gun violence prevention (REIA).

JHCGPR - Johns Hopkins Center for Gun Policy and Research (JHCGPR). Reducing gun-related injuries and deaths.

US DOJ-ATF - U.S. Department of Justice (U.S. DOJ). Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF).


* Journal subscription may be required for access.

1 Crifasi 2018 - Crifasi CK, Merrill-Francis M, McCourt A, et al. Association between firearm laws and homicide in urban counties. Journal of Urban Health. 2018;95:383-390.

2 GLC-UBC - Giffords Law Center (GLC). Universal background checks (UBC).

3 Siegel 2020 - Siegel M, Solomon B, Knopov A, et al. The impact of state firearm laws on homicide rates in suburban and rural areas compared to large cities in the United States, 1991‐2016. The Journal of Rural Health. 2020;36(2):255-265.

4 Siegel 2019 - Siegel M, Pahn M, Xuan Z, Fleegler E, Hemenway D. The impact of state firearm laws on homicide and suicide deaths in the USA, 1991–2016: A panel study. Journal of General Internal Medicine. 2019;34:2021-2028.

5 Knopov 2019 - Knopov A, Siegel M, Xuan Z, et al. The impact of state firearm laws on homicide rates among Black and white populations in the United States, 1991-2016. Health and Social Work. 2019;44(4):232-240.

6 Kaufman 2020b - Kaufman EJ, Morrison CN, Olson EJ, et al. Universal background checks for handgun purchases can reduce homicide rates of African Americans. Journal of Trauma and Acute Care Surgery. 2020;88(6):825-831.

7 Sabbath 2020 - Sabbath EL, Hawkins SS, Baum CF. State-level changes in firearm laws and workplace homicide rates: United States, 2011 to 2017. American Journal of Public Health. 2020;110(2):230-236.

8 RAND-Gun policy research - RAND Corporation. Gun policy research review.

9 McCourt 2020 - McCourt AD, Crifasi CK, Stuart EA, et al. Purchaser licensing, point-of-sale background check laws, and firearm homicide and suicide in 4 US states, 1985–2017. American Journal of Public Health. 2020;110(10):1546-1552.

10 Castillo-Carniglia 2019a - Castillo-Carniglia A, Webster DW, Wintemute GJ. Effect on background checks of newly-enacted comprehensive background check policies in Oregon and Washington: A synthetic control approach. Injury Epidemiology. 2019;6(45):1-6.

11 Castillo-Carniglia 2019 - Castillo-Carniglia A, Kagawa RMC, Cerdá M, et al. California’s comprehensive background check and misdemeanor violence prohibition policies and firearm mortality. Annals of Epidemiology. 2019;30:50-56.

12 Kagawa 2018 - Kagawa RMC, Castillo-Carniglia A, Vernick JS, et al. Repeal of comprehensive background check policies and firearm homicide and suicide. Epidemiology. 2018;29(4):494-502.

13 Zeoli 2018 - Zeoli AM, McCourt A, Buggs S, et al. Analysis of the strength of legal firearms restrictions for perpetrators of domestic violence and their associations with intimate partner homicide. American Journal of Epidemiology. 2018;187(11):2365-2371.

14 Gius 2015a - Gius M. The effects of state and federal background checks on state-level gun-related murder rates. Applied Economics. 2015;47(38):4090-4101.

15 Anestis 2017 - Anestis MD, Anestis JC, Butterworth SE. Handgun legislation and changes in statewide overall suicide rates. American Journal of Public Health. 2017;107(4):579-581.

16 Luca 2020 - Luca M, Malhotra D, Poliquin C. The impact of mass shootings on gun policy. Journal of Public Economics. 2020;181:104083.

17 Webster 2020 - Webster DW, McCourt AD, Crifasi CK, Booty MD, Stuart EA. Evidence concerning the regulation of firearms design, sale, and carrying on fatal mass shootings in the United States. Criminology & Public Policy. 2020;19:171-212.

18 Gius 2018 - Gius M. The effects of state and federal gun control laws on school shootings. Applied Economics Letters. 2018;25(5):317-320.

19 Kawano 2023 - Kawano B, Agarwal S, Krishnamoorthy V, et al. Restrictive firearm laws and firearm-related suicide. Journal of the American College of Surgeons. 2023;236(1):37-44.

20 Anestis 2017a - Anestis MD, Selby EA, Butterworth SE. Rising longitudinal trajectories in suicide rates: The role of firearm suicide rates and firearm legislation. Preventive Medicine. 2017;100:159-166.

21 Rich 2022 - Rich JA, Miech EJ, Semenza DC, Corbin TJ. How combinations of state firearm laws link to low firearm suicide and homicide rates: A configurational analysis. Preventive Medicine. 2022;165(A):107262.

22 Goyal 2019 - Goyal MK, Badolato GM, Patel SJ, et al. State gun laws and pediatric firearm-related mortality. Pediatrics. 2019;144(2):e20183283.

23 Neufeld 2022 - Neufeld MY, Poulson M, Sanchez SE, Siegel MB. State firearm laws and nonfatal firearm injury-related inpatient hospitalizations: A nationwide panel study. Journal of Trauma and Acute Care Surgery. 2022;92(3):581-587.

24 Timsina 2020 - Timsina LR, Qiao N, Mongalo AC, et al. National instant criminal background check and youth gun carrying. Pediatrics. 2020;145(1):e20191071.

25 Hepburn 2022 - Hepburn L, Azrael D, Miller M. Firearm background checks in states with and without background check laws. American Journal of Preventive Medicine. 2022;62(2):227-233.

26 Kleck 2021 - Kleck G. Compliance with universal background check gun laws. Journal of Crime and Justice. 2021;44(4):414-418.

27 Jacobs 2017 - Jacobs J, Fuhr Z. The potential and limitations of universal background checking for gun purchasers. New York University of Law. 2017: Working Paper 17-13.

28 JHCGVS 2022 - Johns Hopkins Center for Gun Violence Solutions (JHCGVS). A Year in Review: 2020 Gun Deaths in the U.S. 2022.

29 RAND-Gun policy expert - RAND Corporation. Gun policy expert – opinion tool.

30 LawAtlas-State preemption - LawAtlas. State preemption laws in 12 domains.

31 Kegler 2022 - Kegler SR, Simon TR, Zwald ML, et al. Vital Signs: Changes in firearm homicide and suicide rates - United States, 2019–2020. Morbidity and Mortality Weekly Report (MMWR). 2022;71:656-663.

32 Pew-Schaeffer 2021 - Schaeffer K. Key facts about Americans and guns. Washington, D.C.: Pew Research Center; 2021.

33 Spitzer 2017 - Spitzer R. Gun law history in the United States and Second Amendment rights. Law and Contemporary Problems. 2017;80(2):55-83.

34 CONAN-Second Amendment - The Constitution Annotated (CONAN). Second Amendment: Right to bear arms.

35 ATF-NFA - Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF). National Firearms Act (NFA).

36 US DOJ-Gun violence 2001 - U.S. Department of Justice (U.S. DOJ). Gun violence reduction: National integrated firearms violence reduction strategy. Appendix C. History of federal firearms laws in the United States. 2001.

37 GLC-Gun lobby - Giffords Law Center (GLC). The gun lobby.

38 Everytown-Loopholes - Everytown. Undeniable: How long-standing loopholes in the background check system have been exacerbated by COVID-19. 2021.

39 CAP-Parsons 2020 - Parsons C, Bhatia R. Dangerous gaps in gun laws exposed by the coronavirus gun sale surge. Washington, D.C.: Center for American Progress (CAP); 2020.

40 Montez 2020 - Montez JK. US state polarization, policymaking power, and population health. Milbank Quarterly. 2020;98(4):1033-1052.

41 APA-Weir 2021 - Weir K. A thaw in the freeze on federal funding for gun violence and injury prevention research. American Psychological Association (APA). 2021.

42 Pew-Gramlich 2023 - Gramlich J. What the data says about gun deaths in the U.S. Washington, D.C.: Pew Research Center; 2023.

Date Last Updated