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 handgun purchasers’ criminal histories via the National Instant Criminal Background Check System (NICS) which includes fugitive status, court restraining orders, and some information regarding severe mental illness. States can also require unlicensed dealers (i.e., private sellers) to perform background checks and keep records of firearm sales via universal background checks. Universal checks are often adopted with other efforts to strengthen background checks such as expansions to other types of firearms, additional qualification criteria, and regulations that require licenses to purchase or own firearms1.

What could this strategy improve?

Expected Benefits

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

  • Reduced homicide

  • Reduced suicide

What does the research say about effectiveness? This strategy is rated some evidence.

There is some evidence that universal firearm background check laws reduce firearm homicide and suicide2. On average, states with universal background check laws have lower firearm homicide3 and suicide rates than states without such laws3, 4. Additional evidence is needed to confirm effects.

How could this strategy impact health disparities? This strategy is rated no impact on disparities likely.
Implementation Examples

As of October 2015, thirteen states require universal background checks for all types of firearm sales and six states (Iowa, Michigan, Maryland, North Carolina, Nebraska, and Pennsylvania) require universal checks for handguns only5.

Most states prevent local governments from enacting gun laws via state preemption legislation6; as of 2015, only seven states (California, Connecticut, Hawaii, Illinois, Massachusetts, New Jersey, and New York) allow local governments to enact gun laws.

Implementation Resources

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 - Giffords Law Center to Prevent Gun Violence (GLC). Save lives from gun violence.

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

Firearms research - Firearms Research. Prevalence, patterns, and prevention of firearm violence.

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


* Journal subscription may be required for access.

1 GLC - Giffords Law Center to Prevent Gun Violence (GLC). Save lives from gun violence.

2 Santaella-Tenorio 2016 - Santaella-Tenorio J, Cerda M, Villaveces A, Galea S. What do we know about the association between firearm legislation and firearm-related injuries? Epidemiologic Reviews. 2016;38(1):140-157.

3 Fleegler 2013 - Fleegler EW, Lee LK, Monuteaux MC, Hemenway D, Mannix R. Firearm legislation and firearm-related fatalities in the United States. JAMA Internal Medicine. 2013;173(9):732-740.

4 Anestis 2015b - Anestis MD, Anestic JC. Suicide rates and state laws regulating access and exposure to handguns. American Journal of Public Health. 2015;105(10):2049-2058.

5 USA Firearm Training - USA Firearm Training. Everything you need to know about universal background checks.

6 Grassroots Change - Grassroots Change: Connecting for better health. Preemption Watch.

Date Last Updated