Ninety-three percent of parents interviewed were women. Overall, 19.6% of families reported keeping a firearm in the home. After adjustment for confounders, history of depression (aOR 1.36, 95% CI 1.04–1.77), binge drinking (aOR 1.75, 95% CI 1.14–2.68), and illicit drug use (aOR 1.75, 95% CI 1.12–2.76) were associated with a higher likelihood of keeping a firearm in the home. After a mean of 3.1 years, 6.1% of parents who did not keep a firearm in the home at baseline acquired one by follow-up and kept it in the home (average annual likelihood=2.1%). No risk factors for self-harm or other violence were associated with newly acquiring a gun in the home.