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Studies look at youth firearm injury demographics, access to guns

March 29, 2021

About 20% of Colorado teens say they have easy access to handguns, a figure that is even higher among those with mental health concerns.

The study is one of two released today about youths and guns and comes on the heels of mass shootings in Colorado and Georgia.

The second study looks at differences between those injured by firearms in three scenarios — unintentional, self-harm and assault.

Access to handguns

Researchers analyzed data from the 2019 Healthy Kids Colorado Survey that included responses from 46,537 high school students who were asked about perceived gun access and their mental health.

About 11% said they had “sort of easy” access to a handgun, and nearly 9% said they had “very easy” access,” according to “Perceived Access to Handguns among Colorado High School Students,” Brooke-Russell A, et al. Pediatrics. March 29, 2021,

Those reporting easy access were more likely to be male and older. Transgender youths were more likely to report easy access than cisgender youths.

Perception of access was greater in rural areas than urban areas. About 24% of Native Hawaiian/Other Pacific Islander, 23% of multiracial students, 21% of White students, 18% of Hispanic/Latino students, 17% of Black/African-American students and 12% of Asian students reported easy access.

About 32% of students who had been in a physical fight, 30% of students who had attempted suicide and 24% of those with prolonged feelings of depression reported having easy access to a handgun, all higher than their peers who had not had these experiences in the past year.

Intent of firearm injuries

A second team of researchers analyzed national data on emergency department (ED) visits for firearm injuries among youths and young adults ages 21 and younger. They looked at differences between injuries that were intentional, self-harm and assault.

There were an estimated 178,299 such visits for firearm injuries from 2009-’16. The mean age was 17.9 years and 89% were male. Just over half were in the lowest income quartile, according to “Sociodemographic Factors and Outcomes by Intent of Firearm Injury,” (Patel SJ, et al. Pediatrics. March 29, 2021,

About 49% of the visits were for injuries to extremities, 29% of patients were admitted and 6% died, authors found.

Roughly 39% of the injuries were unintentional. They were more likely to be seen in younger patients and in rural areas.

Assaults made up about 38% of the injuries and were more common among adolescents and young adults than younger children. Youths with these injuries tended to come from low-income households and urban areas.

The 2% of firearm injuries caused by self-harm were seen more commonly in older ages, among those from higher income families and in rural areas. Youths with self-harm firearm injuries had 11 times higher odds of dying than being discharged from the ED, according to the study.

AAP guidance and advocacy

The AAP recommends families do not keep guns in their home. Those who do have a gun should keep it locked and unloaded with ammunition locked separately. Clinicians should counsel families that these safety measures are especially critical in homes where youths are at risk of suicide. All parents also should ask if there are guns in other homes where their children spend time.

The AAP recently released Transition Plan: Advancing Child Health in the Biden-Harris Administration, which calls for more investment in gun violence prevention research, stronger background checks, education on safe firearm storage and expanded support of extreme risk protection orders. The AAP also joined more than 200 groups in letters to the House of Representatives and Senate last week asking for $50 million for public health research on prevention of firearm-related injuries and deaths.

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