A Growing Crisis: Child Deaths Due To Firearms

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All across America, tragically and far too often, children are the victims of deadly gun violence. To understand the cause and scope of the problem and to identify possible solutions, Martin S. Keller, MD, led a study by researchers at Washington University School of Medicine in St. Louis.

The data, gathered from 2008 to 2013, mirror trends in other urban cities, according to the article detailing the study. During a five-year period ending in 2013, nearly 400 children ages 16 or under were taken to one of two hospital emergency rooms in St. Louis, MO for gun-related injuries. Of those children, 20 later died. However, the fatalities cited in the study do not include children who died at the scene, on the way to the two emergency rooms, or at other nearby medical centers.

The study offers a picture not only of the frequency of such incidents but of the circumstances that contributed to the injuries and deaths. Such knowledge, the researchers believe, can help identify risk factors and stem gun-related injuries.

A disproportionate number of the children injured or killed were poor, male and African-American

“Children getting injured by firearms is a major health crisis in this city,” stated Martin S. Keller, MD, the study’s senior author and an associate professor of surgery at the School of Medicine. “St. Louis is the focus of this study; however, it’s representative of many other regions in the U.S.”

Among the study’s findings:

  • Of the 398 children treated, almost 78 percent were African-American.
  • About 82 percent of all firearm injuries, including deaths, occurred among boys. The majority were African-American, with a median age of 15.
  • Fifteen also was the median age of victims injured in shootings designated as assaults. Most victims of accidental shootings, on the other hand, were younger, with a median age of 12.5 years.
  • Thirty-five percent of the injuries resulted from accidental shootings, with the remaining injuries caused by assaults.
  • Nearly 75 percent of accidental shootings occurred in the home. Of those, almost 38 percent were self-inflicted, and about 40 percent were caused by people the victims knew.
  • The majority of firearms used were handguns. 

An urgent need for preventive education: “safe” hiding places not so safe

According to the U.S. Centers for Disease Control and Prevention, more than 35,000 children ages 19 and under have died since 1999 due to firearm injuries, and about 10,000 each year are treated for such injuries.

“If we take a public-health approach to the problem and treat gun violence like we would any other danger facing children, we could decrease gun injuries and deaths,” said Keller in the article.

“I’ve talked to family members of victims who had hidden loaded guns in so-called safe places, and they were shocked when the children found their guns,” Keller stated. “But kids are curious; they snoop. Education emphasizing the importance of gunlocks might have helped some children.”

High-risk communities could greatly benefit from intervention programs

In communities experiencing 20 or more shooting injuries during the five-year time period, the study found the average household income was $24,861. “People in these high-risk areas need more resources” such as violence-prevention programs, overall educational and job opportunities and activities for children, particularly after school, Keller said. “Without outside help, their risk for firearm injury increases.”

More than half of the shootings occurred between 6 p.m. and midnight, researchers found, reflecting similar findings in a recent study by the U.S. Department of Justice. “Instituting a mandatory juvenile curfew doesn’t hurt as an intervention,” Keller said, “but it should not be the main intervention.”

As firearms have become easier to obtain, firearm-related deaths have increased

The study also noted that overall firearm deaths increased after Missouri repealed a permit-to-purchase law in 2007. That law required anyone purchasing a handgun to get a license confirming he or she had passed a background check. After its repeal, an additional 55 to 63 firearm-related homicides occurred annually in Missouri from 2008 to 2012, according to a study by researchers at Johns Hopkins University and published in the Journal of Urban Health.

Gun violence prevention may very well start with pediatricians

Childhood injuries and death caused by firearms stubbornly remains a multi-layered problem—a national calamity that is extremely difficult to solve. However, an article in the February, 2015 edition of Pediatrics in Review, entitled “Preventing Gun Injuries in Children,” suggests that pediatricians can actually play a large role in helping children avoid gun-related violence:

Gun ownership in homes with children is common, and pediatricians should incorporate evidence-based means to discuss firearms and protect children from gun-related injuries and violence. Safe storage of guns, including unloaded guns locked and stored separately from ammunition, can decrease risks to children. Furthermore, several community-based interventions led by pediatricians have effectively reduced firearm-related injury risks to children.

For all of our sakes, let’s hope this is indeed the case.

By Nancy R. Beran, MD, Chief Medical Officer, Westchester Health

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About the Author: ML Ball