Pediatric firearm injuries substantial cause of premature death, disability

1. Pediatric suicide rates decreased significantly from 2002-2007 but increased significantly from 2008-2014; pediatric homicide rates exhibited the opposite trend.

2. Males had significantly higher rates of fatal and nonfatal firearm-related injuries, regardless of intent or age group, from 2012-2014.

Study Rundown: Deaths resulting from firearms are the 3rd leading cause of death among children aged 1 to 17 in the United States, according to the Centers for Disease Control and Prevention (CDC). In this study, researchers conducted a review of data related to pediatric firearm fatalities and nonfatal injuries from the CDC and National Electronic Injury Surveillance System, respectively. The data included demographic information, incident characteristics (intent, location demographics, number of victims, etc.), circumstance characteristics (related to an argument, intimate-partner violence, recent crisis, playing with gun, etc), and gun type. Results show more than 7000 children are afflicted by gunshot wounds each year, resulting in nearly 1300 pediatric fatalities. This study does not account for nonfatal firearm injuries that are not treated in hospital emergency departments, so these incidents may actually be underreported. Furthermore, data on the context of each firearm related death comes from a surveillance system that is only active in 17 states, and is therefore not nationally representative. Nonetheless, these findings provide a more comprehensive understanding of the nature of firearm injuries and can inform strategies to prevent firearm-related death and disability in children.

Click to read the study, published today in Pediatrics

Relevant reading: Violent Death Rates: The US Compared with Other High-income OECD Countries, 2010

In-depth [retrospective data review]: Researchers analyzed national data on firearm-related fatalities and nonfatal firearm injuries in patients aged 0 to 17 years between 2002 and 2014. Data on incident circumstances were obtained from the National Violent Death Reporting System (NVDRS), a state based surveillance system active in 17 states. Results showed that males accounted for 82% of firearm deaths and 84% of nonfatal injuries regardless of intent, with death rates among males aged 13 to 17 being 6 times higher than those among females. During this time period, 53% of deaths were homicides while 38% were suicides and 6% were unintentional deaths. From 2002 to 2007, homicide rates increased significantly (1.2 to 1.4 per 100,000, P<.05) while rates declined significantly from 2007 to 2014 (1.4 to 0.9, P<.05). Conversely, suicide rates from 2002-2007 decreased significantly (1.3 to 1.0, P<.05) and increased significantly from 2007-2014 (1.0 to 1.6, P<.05). White children had the highest overall risk of fatal firearm injuries, followed by African American and Hispanic children (46%, 35% and 16% respectively). Firearm homicides among children age 0 to 12 were most likely related to intimate partner violence, whereas homicides among children aged 13 to 17 were more likely to be precipitated by another crime, to be gang-related or to involve drugs. 71% of all pediatric suicides were precipitated by relationship problems, and 26% of victims shared their suicidal intentions with someone prior to the incident.

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