Pediatric Firearm-Related Injuries in the United States

Abstract

Pediatric firearm-related deaths and injuries are a national public health crisis. In this Special Review Article, we characterize the epidemiology of firearm-related injuries in the United States and discuss public health programs, the role of pediatricians, and legislative efforts to address this health crisis. Firearm-related injuries are leading causes of unintentional injury deaths in children and adolescents. Children are more likely to be victims of unintentional injuries, the majority of which occur in the home, and adolescents are more likely to suffer from intentional injuries due to either assault or suicide attempts. Guns are present in 18% to 64% of US households, with significant variability by geographic region. Almost 40% of parents erroneously believe their children are unaware of the storage location of household guns, and 22% of parents wrongly believe that their children have never handled household guns. Public health interventions to increase firearm safety have demonstrated varying results, but the most effective programs have provided free gun safety devices to families. Pediatricians should continue working to reduce gun violence by asking patients and their families about firearm access, encouraging safe storage, and supporting firearm-related injury prevention research. Pediatricians should also play a role in educating trainees about gun violence. From a legislative perspective, universal background checks have been shown to decrease firearm homicides across all ages, and child safety laws have been shown to decrease unintentional firearm deaths and suicide deaths in youth. A collective, data-driven public health approach is crucial to halt the epidemic of pediatric firearm-related injury.

Evaluation of Injury Severity and Resource Utilization in Pediatric Firearm and Sharp Force Injuries

“…Conversely, the burden of self-inflicted firearm suicide is higher among white children. 1,5,11,12,13,14,15,16,17,18,19,20,21,22…”

The Centrality of Law for Prevention

“…Graduated driver licensing laws have been found to reduce crash rates and injuries among teen drivers, with stronger laws associated with greater fatality reductions (Russell et al 2011 ). There is inconsistent evidence of whether firearm access prevention laws (i.e., safe storage) and juvenile age restrictions prevent firearm injuries, with some evidence that the strength of the law is related to the size of beneficial effects (Gius 2015 ; Hamilton et al 2018 ; Parikh et al 2017 ).…”

Never Just a Shot in the Dark: Pediatric Firearm Advocacy

“…Examples of the high-impact work that has arisen from SAFER include a comprehensive review of pediatric firearm injuries that was published in Hospital Pediatrics in 2017 and a cross-sectional analysis of the association of pediatric firearm-related deaths with strictness of gun laws in Pediatrics in 2019. 27 , 28 Furthermore, SAFER has participated in a 3-year consecutively accepted workshop on pediatric firearm injury prevention at the Pediatric Academic Societies national meetings.…”