Childhood firearm injuries remain a public problem

Almost 1300 US children die and 5790 are treated for gunshot wounds each year, according to an analysis of information in several national databases. Although child firearm homicide rates in the United States decreased significantly (36%) from 2007 to 2014, child firearm suicide rates showed a significant upward trend (an increase of 60%) during this period.

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The analysis also revealed:

• Boys are at highest risk for nonfatal and fatal firearm injury, particularly those aged 13 to 17 years. African American children have the highest rates of firearm mortality, whereas white and American Indian children are at highest risk for firearm suicide.

• Firearm homicides of children occur more often in the South and Midwest.

• Firearm suicides often are precipitated by situational factors, such as relationship problems, and by mental health factors. In about one-quarter of suicides, the child disclosed his/her intent before the incident.

• Firearm homicides of younger children are likely to be related to conflict between parents or to situations where the child is a bystander, whereas those of older children tend to be precipitated by a crime or be related to a gang, drugs, or gun use.

• Most unintentional firearm deaths of children involve playing with a gun.

(Fowler KA, et al. Pediatrics. 2017;140[1]:e20163486)

Thoughts from Dr Burke

This is a helpful report on the magnitude of firearm injury in the United States. The authors state that firearm-related deaths are the third leading cause of death in children aged 1 to 17 years, and that 4.2% of US children have witnessed a shooting in the past year. Pediatricians have a role in asking about firearms in the home, educating about firearm safety, screening for mental health problems that could lead to firearm injury, and advocating for a rational public health approach to this problem.