About 19 U.S. children per day are killed by or receive emergency treatment for gunshot wounds, according to a new study from federal researchers.
Among injury-related deaths, firearms are the second leading cause behind car accidents for children ages 1-17.
“These are preventable injuries that have a major public health impact on early death and disability among children,” lead author Katherine A. Fowler, Ph.D., said in an email interview.
Dr. Fowler and her colleagues at the Centers for Disease Control and Prevention (CDC) analyzed data from national databases and published the findings in a new study, “Childhood Firearm Injuries in the United States,” (Fowler KA, et al. Pediatrics. June 19, 2017. https://doi.org/10.1542/peds.2016-3486).
Dr. Fowler called the work “the most comprehensive examination of current firearm-related deaths and injuries among children in the U.S. to date.”
Among the 1,300 children who die each year from firearm-related injuries, 53% are homicides, 38% are suicides and 6% are unintentional. Children who are in their teens, male or black are most likely to be victims.
Firearm homicides
From 2007 to 2014, rates of firearm homicides declined after having been on the rise for several years, according to the study. They are most common in southern states and some Midwestern states and for black children more than any other race.
For older children, these homicides often involve other crimes and gang activity while younger victims often are bystanders in a conflict.
“This highlights how children can be caught in the crossfire in cases of domestic violence and points to the importance of addressing the intersection of these forms of violence,” Dr. Fowler said.
Firearm suicides
Child suicides involving firearms rose 60% from 2007 to 2014 after having been on the decline and are 11 times higher among teens than 10- to 12-year-olds, researchers found.
White and American Indian/Alaska native children have highest rates of firearm suicide. When an adolescent commits suicide with a firearm he or she typically does so impulsively while dealing with life stresses or mental health issues, according to the study.
“The high case fatality rate associated with firearm suicide attempts makes availability of highly lethal means in a time of crisis a crucial factor in determining whether a suicide attempt will be fatal,” authors wrote.
Unintentional firearm deaths
Unintentional firearm deaths typically involve one child shooting another while playing with a gun and are 12 times higher for teens than younger children. These deaths declined from 2002 to 2014.
Firearm injuries
Roughly 5,790 children each year are treated in an emergency department for a firearm-related injury. Of these, roughly 84% are male and 88% are teens. The study did not include injured children treated in another setting.
Prevention
CDC researchers say there are a variety of ways to prevent firearm injuries and deaths through programs that help children manage their emotions and develop coping and problem-solving skills. These may take the form of street outreach, school-based programs and therapeutic approaches. Related issues like poverty also need to be addressed, according to the study.
In addition, properly storing guns can prevent access by a child who is playing or one considering suicide at a time of crisis, researchers said.
Dr. Fowler also suggests that pediatricians talk to children about life stressors and watch for signs of depression or anxiety as well as signs of violence in the home.
AAP policy calls for pediatricians to counsel families on gun safety during well-child visits and encourage parents to ask about guns in other homes where their children spend time. The Asking Saves Kids campaign on June 21 will remind families to ask this question.
Commentary
In a related commentary, Eliot W. Nelson, M.D., FAAP, a member of the AAP Council on Injury, Violence, and Poison Prevention, praised the depth of the study, expressed support for the proposed prevention methods and pushed for pediatricians to advocate for new legislation.
“However difficult it may be to confront the problem of firearm injuries in our children, youth, and families, we cannot ignore the magnitude of this ongoing public health crisis,” Dr. Nelson wrote.
