A study based on data from 2012 to 2014 suggests that, on average, 5,790 children in the United States receive medical treatment in an emergency room each year for a gun-related injury. About 21 percent of those injuries are unintentional.
From 2012 to 2014, on average, 1,297 children died annually from a gun-related injury in the US, according to the study, published in the journal Pediatrics on Monday.
The study also revealed which states in the U.S. saw most of those deaths among children and which children may be most at risk for a gun-related injury.
Doctors also emphasize that there are methods available to safely secure and store firearms, away from children, and they recommend that parents employ those methods when keeping guns in the home.
Boys and guns
The researchers examined national data on fatal firearm injuries from death certificates in the Centers for Disease Control and Prevention’s National Vital Statistics System database.
For nonfatal firearm injuries, the researchers examined data from the US Consumer Product Safety Commission’s National Electronic Injury Surveillance System database.
Specifically looking at deaths and injuries among children up to age 17, the researchers analyzed the data for trends that may have occurred from 2002 to 2014.
They found that, among the deaths, 53 percent were homicides, 38 percent were suicides, 6 percent were unintentional, and 3 percent were related to law enforcement or undetermined. Among the injuries, 71 percent were assault, 21 percent were unintentional, 5 percent were related to law enforcement or undetermined, and about 3 percent were from self-harm.
Boys accounted for 82 percent of all child firearm deaths and about 84 percent of all nonfatal firearm injuries that were medically treated in the study. African-American children had the highest rates of firearm homicide, and white and Native American children had the highest rates of firearm suicide.
With boys being responsible for more than 80 percent of gun-related deaths, News4Jax crime and safety analyst Gil Smith said it’s important for boys to safely get accustomed to how a gun works once their parent feels they’ve reached the appropriate age.
“Let them shoot the gun a few times because, once a child fires a gun a few times, then the curiosity is gone,” Smith said. “They’re not curious about the gun anymore. They know what it can do and they tend to not play with firearms if they have an understanding of how they work.”
Parent John Roberts told News4Jax that he’s taken that step, as well as other safety precautions.
“All four of them have shotguns. They’ve been to the shooting range. They’ve all done a little bit of hunting. So training, as well as just obedience in general, is very helpful,” Roberts said.
Those patterns of gun-related deaths appeared to fluctuate by state.
Where children die by firearms
While the District of Columbia and Louisiana had the highest rates of child firearm deaths, several states — including Delaware, Hawaii, Maine and New Hampshire — had 20 or fewer deaths, the researchers found.
The highest rates for homicides were concentrated in the South; across the Midwestern states of Illinois, Missouri, Michigan and Ohio; and in California, Nevada, Connecticut, Maryland and Pennsylvania.
In Jacksonville, there has been seven shootings this year involving children — two of them were deadly.
Serenity Allen, 5, was killed and another child was hurt in February when police said a gun being handled by an 8-year-old boy was discharged at a Northside apartment complex.
In May, Ramya Eunice, 12, was accidentally shot in the head by an 11-year-old boy, who said he found the gun at an unlocked, unoccupied neighboring home, according to police. Eunice died a few weeks later.
For suicides, which were calculated only for children 10 and older in the study, the researchers found that incidents were widely dispersed across the country. However, separate research has found rates of suicide by firearm to be disproportionately higher in rural compared with urban areas.
For Dr. David Wesson, a pediatric surgeon at Texas Children’s Hospital who was not involved in the new study, the rates of suicide that emerged in the data were among the most disturbing trends.
“It’s important for parents to be aware of their children’s state of mind and if they’re depressed,” he said. “Just having access to a gun in a situation where you’re upset with what’s going on at school or with your friends, or your own internal emotional state, it unfortunately can lead to suicide. It’s very important for parents to be aware of that, particularly if they have guns in the home.”
Overall, the researchers found that older children, those 13 to 17, had a rate of fatal firearm injury that was more than 12 times higher than the rate for children 12 and younger.
“These are preventable injuries that have a major public health impact on early death and disability among children,” said Katherine Fowler, a behavioral scientist for the CDC and lead author of the study.
Yet she added that some promising trends also appeared in the data.
“Although firearm homicides of children significantly increased between 2002 and 2007, they significantly declined between 2007 and 2014,” Fowler said.
“This is a very encouraging trend. There are many evidence-based programs and policies that have been found to be effective in preventing youth violence, including youth homicide,” she said. “Preventing such injuries and ensuring that all children have safe, stable, nurturing relationships and environments remains one of our most important priorities.”
Fowler pointed to a collection of strategies that the CDC has developed to help states and communities build effective programs, policies and practices around violence prevention.
“Firearm-related injuries contribute substantially each year to premature death, illness and disability of children. These injuries are preventable,” she said.
The researchers noted in the study that their findings are subject to limitations.
For instance, unintentional firearm deaths may be significantly underreported, which skews data, and firearm injuries that were not treated in a hospital or similar health care setting were not included.
All in all, the new findings seem to fall in line with previous research on gun violence among children in America.
‘It really is a complex disease’
Based on the findings, the data suggest that about 19 children a day die from or are medically treated in an emergency room for a gunshot wound.
Previously, it was estimated that on average 16 children a day are hospitalized due to firearm injuries in the U.S., according to research presented at the Pediatric Academic Societies Meeting in San Francisco in May.
Globally, 91 percent of children killed by firearms in 2010 were from the U.S., according to a study published in The American Journal of Medicine last year.
Dr. Stephen Hargarten, professor and chairman of emergency medicine at the Medical College of Wisconsin, likened gun violence in America to a disease.
“The fact that these children are injured, they are cared for by surgeons, within the health care system, they have fractures, they have brain injuries, they have lacerations to their body and so forth, so that’s the biology of this disease,” said Hargarten, who was not involved in the new study.
He added that the agent of the disease would be the kinetic energy from a bullet that is firing out of a gun.
“The psychosocial components are related to the circumstances of these events, of the domestic violence disputes that result in children getting injured or killed, the psychological issues surrounding the transitions of thinking or feeling suicidal and ending their life,” Hargarten said.
“Then the social aspects of this are related to the environmental circumstances,” he said. “And the social constructs of companies that make these products that are available to children, that can be used very easily by children, and so it really is a complex disease.”
There are ways in which guns can be made not so easily accessible to children, Hargarten said.
Safety tips for parents with guns
A lock box or gun safe can be an effective way to keep a gun away from children, Hargarten said. Or stimulating the marketplace for smart guns designed to unlock only for an authorized user could be promising, he said.
“That would have an impact in the home — where, again, properly secure it — but even if the child or young adult does find the gun, they can’t use it because they’re not authorized to access the gun,” Hargarten said.
According to Smith, one of the best things to do is to lock up a gun separately from the ammunition. Smith said the key to the lock box or gun safe should not be placed on a key hook or next to other keys, but instead, the key should be stored somewhere separately, but also a place where it can be found in case of an emergency.
Smith also advised that parents have a serious conversation with children about how dangerous guns are because, while some parents may not have firearms inside the home, friends or relatives may have guns at their homes.
Being mindful of who is nearby when a gun is being handled in the home can also play a role in injury prevention, said Wesson, the pediatric surgeon in Texas.
Dr. Eliot Nelson, a pediatrician at the University of Vermont Medical Center, wrote an editorial that accompanied the new study in the journal Pediatrics.
Recommending to remove guns completely from a home can be off-putting for parents who might keep guns for hunting or protection, he said.
Rather, “We can point out that parents may underestimate kids’ propensity to handle guns unsafely, even when they’ve been taught,” Nelson wrote.
“Excellent information can be shared on safe storage and locking methods that still allow quick access to a handgun if it were ever needed,” he wrote. “And finally, given the impulsivity, risk-taking, and unpredictability of adolescence, we should promote safe storage as a routine measure.”
Dr. Thomas Weiser, a trauma surgeon at Stanford University Medical Center, hopes there will be fewer gun-related injuries and deaths among children in the future. He compared gun violence to an earthquake.
“When you build a city in an earthquake zone, you make the buildings as earthquake-proof as possible. You try to build in as much possible safety as you can,” Weiser said. “And so, why we can’t make safer guns and make safer laws is beyond me.”