Handguns and other firearms cause the deaths of more children in the United States each year than the flu or asthma, according to a comprehensive new report on gun violence and kids.
Each day in the United States, an average of 3.5 people under the age of 18 are shot to death and another 15.5 are treated in a hospital emergency department for a gunshot wound. Between 2012 and 2014, an average of 1,287 children and adolescents died each year as a result of gun violence, making firearms second only to motor vehicle crashes as a cause of injury-related deaths. Another 5,790 were treated for gunshot injuries in U.S. hospitals.
Here's another way to look at it: In the United States, a gun is the cause of death in more than 1 in 10 deaths of people under the age of 18.
The number of child fatalities related to guns is far higher in the U.S. than in any other high-income country. Another study has reckoned that the U.S. accounts for 91% of all the firearms-related deaths of children under 14 in the world's 23 richest countries.
The new analysis, published Monday in the journal Pediatrics, represents an unusually comprehensive look at the toll that guns take on children. It draws from federal databases of injuries and deaths, hospital records, and an effort launched in 2003 to track violent deaths and the circumstances surrounding them in at least 17 states so far.
The majority of the nearly 1,300 children killed in gun-related incidents each year are boys between the ages of 13 and 17. In homicides, which represent an average of 53% of annual gun-related deaths among children, African American youths are the most likely victims.
Indeed, African American children were found to have the highest rates of death-by-firearm — 4.1 per 100,000 between 2012 and 2014 — of any ethnic group counted. That's a major reason why the annual rate of homicide fatalities for African American children (3.5 per 100,000) was nearly twice as high as the rate for Native American children (2.2 per 100,000). Black children's rate of firearm-related fatalities was four times higher than the rate for Latino children (0.8 per 100,000), and roughly 10 times higher than the rate for white children and Asian American children (each 0.4 per 100,000).
Between 2010 and 2014, the states with the highest rates of firearm-related homicide among children were largely concentrated across the South (Alabama, Florida, Georgia, Louisiana. Mississippi, South Carolina and Tennessee). Other states near the top of the list included four in the Midwest (Illinois, Missouri, Michigan and Ohio), two in the West (California and Nevada), and three in the Northeast (Connecticut, Maryland and Pennsylvania).
The new analysis also discerned an alarming rise in gun-related child suicides, which from 2012 to 2014 accounted for 38% of firearms deaths of children each year. Victims were most likely to be white or Native American.
Between 2010 and 2014, Montana, Idaho and Alaska had starkly higher rates of such suicides than the other 47 states and the District of Columbia.
Dr. Garen Wintemute, a gun violence researcher and emergency physician at UC Davis, noted that the hike in gun suicides by children "mirrors a steady increase in suicide among adults." He called the trend particularly concerning.
On average, 6% of yearly firearms deaths involving children were unintentional, the report found. These accidents occurred most often at home, at the hands of another child.
Among children under 12, 150 are killed with guns each year and another 279 are treated in hospital emergency rooms for non-fatal injuries. Most of these younger children appear to be "caught in the crossfire," either as innocent bystanders to community violence or during incidents of intimate-partner violence and family conflict, according to the report.
"These are preventable injuries," said Katherine A. Fowler, an analyst in the Centers for Disease Control and Prevention's Division of Violence Prevention and senior author of the new study. She cited many strategies that could lessen the toll of firearms on children, including street outreach initiatives, school-based efforts to teach deescalation and emotion management, safe gun storage practices, and suicide-prevention programs.
"Ensuring that all children have safe, stable, nurturing environments remains one of our most important priorities," Fowler added.
The findings prompted Vermont pediatrician Dr. Eliot W. Nelson to write an editorial reminding colleagues that despite legal controversies and push-back from parents, it is "both reasonable and wise to ask and talk about firearms as part of our injury prevention guidance" to parents.
In 2012, the American Academy of Pediatrics declared that "the safest home is one without firearms" — a position that may put pediatricians at odds with parents "who are part of a widespread and deeply rooted social gun culture in our country, especially in rural states," Nelson acknowledged.
Pediatricians would do well to point out to gun-owning parents that even kids who have been taught otherwise sometimes mishandle guns, he wrote. Physicians should discuss adolescents' impulsiveness, risk-taking and unpredictability, and explain how those factors make it important to lock up guns and store them safely all the time, not just when a child is distraught.
"We cannot ignore the magnitude of this ongoing public health crisis," Nelson wrote. "We do need to try to engage those gun owners."
Wintemute, who was not involved in the latest research, praised the study for synthesizing data from a variety of programs that track rates and circumstances of injuries and violence in the United States.
"It would be extremely unwise to prevent such data from being collected or used for their intended purpose," Wintemute said. "They provide significant public health benefits."
Advocates for gun violence research worry that gains made during the Obama administration might be reversed under President Trump, who received strong backing from gun rights groups. However, Trump's 2018 budget proposal includes unabated support for the Centers for Disease Control and Prevention's National Violent Death Reporting System, one of the databases used in the new study.
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