Armed and Dangerous? The Effect of Concealed Carry Permitting on Gun-Related Injuries

We explore the effect of changes in the number of concealed pistol permits issued on the number of gun-related hospitalizations in Pennsylvania. With hospital admissions data and license-to-carry permit data, we use a control function approach and several different instruments to analyze this effect. Our results suggest that an increase of roughly 200 permits increases gun-related hospital visits by about 4%. This effect is driven by gun accidents. Changes in the number of permits issued has no effect on the number of gun-assault hospital visits. Results are similar across all three instrument approaches. Additionally, when we exclude counties with a high number of homicides, the effect size decreases but remains statistically significant. We interpret these results as the control function approach accounting for an important omitted variable - the propensity to safely interact with a firearm - which could be influenced by factors such as training and experience, as well as the likelihood of carrying a firearm after obtaining a permit. Overall, our findings suggest that increases in the number of concealed carry permits issued increased gun injuries, particularly accidents, in Pennsylvania