20,000 U.S. children transported to Emergency Departments each year for firearm–related injuries.
A review led by Children’s National Health System researchers published May 23, 2017 in the journal Hospital Pediatrics indicates that while firearms are present in 18 percent to 64 percent of U.S. homes, almost 40 percent of parents erroneously believe that their children are unaware where weapons are stored, and 22 percent of parents wrongly think that their children have never handled household firearms.

For the many children who do encounter firearms in the home, the results can be devastating, the study authors indicate. Younger children are more likely to be victims of unintentional firearm injuries, the majority of which occur in the home. Older adolescents are more likely to suffer from intentional injuries. Homicide by firearm is the second–leading cause of death for 15– to 19–year–olds, and suicide by firearm ranks as the third–most common cause of death for children aged 10 to 19. The cost of medical treatment for firearm–related injuries suffered by youths younger than 21 exceeds $330 million, the study indicates.

“In the course of providing care, pediatricians can ask patients and their families about children’s access to firearms, can encourage safe storage of firearms in the home and can support research into firearm–related injury prevention,” says Kavita Parikh, MD, MSHS, associate professor of pediatrics in the Division of Hospitalist Medicine at Children’s National and study lead author.

The review includes research by four Children’s National co–authors who comprise the institution’s newly formed firearm–injury prevention research work group. Alyssa Silver, MD, Children’s Hospital at Montefiore, is another co–author.

The study team found that about 20,000 children are transported to Emergency Departments each year for firearm–related injuries. Youths aged 12 to 19 make up 90 percent of this total. On average, 20 U.S. children and youths are hospitalized daily for firearm–related injuries. About 50 percent of the children who are hospitalized for firearm–related injuries are discharged with a disability.

The researchers identified regional variations in the percentage of households with firearms, as well as differences in firearm ownership by race and ethnicity. Across a number of surveys, 6 percent to nearly 50 percent of families reported storing firearms safely by using such methods as trigger locks and locked storage containers. There is a mismatch in what parents report — with many saying their child would never touch a firearm – compared with children who tell researchers they handle “hidden” firearms, including by pulling the trigger. One survey of 5,000 fifth–graders and their caregivers living in three metropolitan areas found 18 percent had household firearms. Of this group, African American and Latino households had lower odds of firearm ownership than families of white, non–Latino children. Among these survey respondents, families of white non–Latino children were less likely than families of African American children to use safer strategies for firearm storage.

Screening for access to firearms within the health care setting where youths receive routine care may represent a beneficial strategy, the authors write. A recent survey conducted among 300 adolescents seen in an Emergency Department found that 16 percent reported having a gun in the home and 28 percent said they could access a loaded gun within three hours. About 50 percent of adolescents screened for firearm access said a friend or relative owned a gun.

The study authors also discuss the benefit of “rigorous, well–conducted” research of firearm–related injuries to guide the work of public health agencies, policymakers and pediatricians.