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Gun violence kills equivalent of bus full of children each week

June 1, 2024

A standard school bus in the U.S. holds about 50-60 kids. Imagine if one school bus full of children crashed each week, killing every child on board.

How outraged would communities be and how quick and aggressive would the response to this public health crisis be?

Tragically, an average of 68 youth ages 1-19 years were killed by a gun each week between 2011 and 2021, according to the Centers for Disease Control and Prevention. Who among us could ever have imagined that firearms would be the single leading cause of death for kids in the U.S.?

Our Academy has led the charge to address the morbidity and mortality from firearms — from science-based policy statements to legislative advocacy at the local, state and federal levels to guidance, education and resources for our members and the families and communities for whom we care. While we have seen significant successes, we must redouble our efforts to protect our kids.

About 40% of homes with kids have at least one firearm, according to a Gallup poll, and almost 5 million children and adolescents live in homes where a firearm is stored loaded and unlocked. In some states, household gun ownership exceeds 60%, researchers from RAND Corp. found.

How many of you routinely ask your patients and families about guns? A survey from KFF last year suggests only about a quarter of us do. We can — and must — do better. We ask about sex and drugs all the time. We are experts in hard conversations.

Kids are killed by guns in three ways: unintentional shooting, suicide and homicide.

Of the 68 gun deaths each week, four are due to unintentional shooting. Most often, young children or adolescents find a loaded gun and shoot themselves or others while exploring or playing with it. Around 23 deaths are among youths who intentionally shoot themselves in a moment of crisis.

In both of these scenarios, the issue is access. If kids can’t get to the gun, they cannot injure themselves or others. The “vaccine” for this part of the epidemic is secure storage using a gun lock, vault or safe. Secure firearm storage has been shown to decrease risk of death by suicide or unintentional shooting by around 80%.

I dream of the day when we have a stack of gun lockboxes, next to our vaccine freezers, to provide to families at the point of care, paid for by insurance.

It also is important to understand the reasons for firearm ownership. In our experience, most families who identify self-protection as a primary reason for having guns in the home want secure storage options that allow rapid access to the gun, like biometric or four-key button locks. While these products are bigger, bulkier and more expensive ($80-$95) than cable locks, many families tell us they would not use less costly products that take longer to open. Working with parents, caregivers and kids themselves to identify risks and concerns can help us collaboratively develop strategies and solutions that meet their unique needs.

Another 48 kids are shot intentionally each week by someone else. These deaths often are related to social drivers of health, especially issues of marginalization and structural oppression, including racism. Gun violence and homicide are big, hairy problems that require significant changes in social and political policy. Our advocacy is needed at the individual level to identify risks and protective factors, at the community level to develop and nurture authentic partnerships, and at the policy level with local, state and federal governments.

This is a heavy lift, but it will become lighter as we exercise our advocacy muscles. My charge to you is to change one thing in your practice, whether it is having simple conversations about firearms, reaching out to a community organization engaged in gun injury prevention or meeting with your state or federal legislators to make sure they know we are here to help address this public health emergency.

The AAP has fantastic resources to help you help protect your patients, families and communities from gun injury, including online training courses on secure storage and the Firearm Injury Prevention Special Interest Group (

We are pediatricians, and we do not shrink from the fight to protect those for whom we care, rising to meet the challenges with grit and determination.

We all agree that no child should ever be hurt by a gun. Let’s get to work. 

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