Sadly, over the past decade firearm-related mortality rates involving young children have been going up. The first step in trying to stop this disturbing trend is to better understand what might be contributing to these deaths occurring. That was the goal of Prickett et al. (10.1542/peds.2018-1171) who looked at changes in firearm ownership in families with young children from 1976 to 2016 using linked national data. This data used vital statistics to provide household level information on firearm ownership and what types of firearms are owned in these households. The results, from a good news standpoint, show a decrease in overall ownership of firearms. especially in non-Hispanic white families with young children (50 to 45% ownership) and most notably in non-Hispanic black families (38 to 6%). Unfortunately, however, during this same period of time, the proportion of white families owning handguns increased from 25 to 32%. Moreover 72% of firearm-owning families of young children in this study also owned a handgun. Even when one controls for other socioeconomic confounders, the increase in handgun ownership over the forty years studied is playing a substantive role in the rising rate of firearm-related mortality, especially in non-Hispanic white young children.
What does this suggest in terms of next steps for those of us who see these families bringing their children to us on an ongoing basis? We asked firearm injury prevention specialists Drs. Shilpa Patel, Monika Goyal, Kavita Parikh, all from Children’s National Medical Center, to share with us their thoughts in an accompanying commentary (10.1542/peds.2018-3611). They note a study by Azrael et al. (REF #3 in the commentary) that almost 5 million children live in a home with at least one firearm stored loaded and unlocked, despite the fact that we strive to tell families to do just the opposite—i.e. store the firearm unloaded and locked with ammunition stored separately. But if home-owners have handguns they plan to use for intruders, this is probably why we have so many still loaded and unlocked. This is a setup for an accidental injury in a small child when they encounter a firearm left out for discovery. The authors of this commentary call for all of us to do more—e.g. to not just ask if firearms are in the home, but to inquire about type of firearm and even use this study to show mortality rates that are attributable to handguns being unsafely stored in many homes. They also call on companies that make firearms, especially handguns, to continue to do more to make them inoperable by children. Finally, the commentary authors implore all of us to do what we can to advocate for more legislation that will help protect our children and teens from unnecessary access to a firearm that is loaded and not stored properly. Both the study and commentary are bound to get media attention, so target both on your reading list and then think what else can be done to foster ideally removal of firearms from the homes of children and if that is not possible, then to foster appropriate gun storage—especially if the gun that is owned is an easily accessible loaded handgun.