Stricter state gun laws associated with lower pediatric firearm injury

1. Stricter state gun laws, as measured by a scorecard, were associated with decreased firearm-related mortality rate in children, after adjusting for sociodemographic factors and gun ownership.

2. States with laws requiring universal background checks for firearm purchases that had been in effect for ≥5 years had significantly lower rates of firearm-related mortality in children compared with states without those laws.

Evidence Rating Level: 3 (Average)

Study Rundown: Firearm injury is the third leading cause of death among children in the United States. Firearm legislation varies widely at the state level, and little is known about the relationship between the stringency of firearm laws and pediatric firearm-related mortality rates. In this cross-sectional study, researchers used data from the Web-based Injury Statistics Query and Reporting System to examine the association between state gun law stringency — scored on the Brady Campaign to Prevent Gun Violence scorecards — and state firearm-related mortality rate in children. Stricter state gun laws were associated with lower firearm-related mortality rate in children, after adjusting for sociodemographic factors and gun ownership. The study also examined 3 specific laws previously associated with lower mortality rates in adults and children: universal background checks for firearm purchase, universal background checks for ammunition purchase, and identification requirements for firearms. Of these, universal background checks for firearm purchase was associated with decreased firearm deaths in children; the other 2 laws were present in only 1-2 states and were not significantly associated with difference in firearm deaths in children.

These findings are limited by the cross-sectional design of the study, which limits inferences of causality. Furthermore, researchers did not assess the effectiveness of enforcement of firearm laws. Nonetheless, the study is strengthened by its comprehensive national data source. For physicians, these findings highlight the importance of further research into the efficacy of firearm legislation and advocacy for implementation of evidence-based policies to reduce firearm injury in children.

Click to read the study, published today in Pediatrics

Click to read an accompanying editorial in Pediatrics

Relevant reading: Firearm-Related Laws in All 50 US States, 1991–2016

In-Depth [cross-sectional study]: Researchers used data from the 2011-2015 Web-based Injury Statistics Query and Reporting System to identify 21 241 firearm-related deaths among U.S. children aged ≤21 years. Using negative binomial multiple regression models, the study examined the association between firearm-related mortality rate in children and state gun law score (based on the 2011-2015 Gun Law Scorecards from the Brady Campaign to Prevent Gun Violence, as well as presence of 3 specific laws previously associated with lower mortality rates in adults and children: universal background checks for firearm purchase, universal background checks for ammunition purchase, and identification requirements for firearms.

State gun law scores ranged from -39 to +81, with higher scores indicating stricter gun laws. Every 10-point increase in gun law score was associated with a 4% decrease (adjusted incident rate ratio [aIRR] = 0.96; 95% confidence interval [CI] 0.93-0.99) in firearm-related mortality rate in children, after adjusting for sociodemographic factors and gun ownership. In the 7 states that had laws requiring universal background checks for firearm purchases that had been in effect for ≥5 years, the predicted mortality rate was 3.80 per 100 000 children compared with 5.88 per 100 000 children in states without those laws (aIRR = 0.65; 95%CI 0.46-0.90). Fewer states had laws requiring universal background checks for ammunition purchase and/or identification requirements for firearms, and there was no statistically significant difference in mortality rates between these states versus states without those laws.

Image: PD

©2019 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.