Pediatric Gun Deaths Are A Massive Problem in the U.S.

Pediatric Gun Deaths Are A Massive Problem in the U.S. thumbnail
School shootings seem random in their locations but predictable in their occurrence. Elementary, high school, and college students are targeted by killers in urban, suburban, and rural communities. Hispanic, black, Asian, Native American, gay and straight children were among those killed.

This year school shootings have occurred more than weekly on average, with 27 in 2022 (so far). Many go virtually unmentioned on the national stage, however, until the “unthinkable” happens, and 19 nine- to 11-year-old children and two teachers die unspeakable deaths at Robb Elementary School in Uvalde, Tex. These killings are not unthinkable. We’ve been there before – at Sandy Hook, Columbine, Marjory Stoneman Douglas High school in Parkland, Fla. and many other schools.

We are both researchers and pediatric emergency physicians who study firearm injuries. After many years of hard work and political turmoil, we believe it is our collective responsibility address the interconnected issues of gun safety, gun safety regulations, gun violence prevention research, and gun availability. We also believe that the politicization or use of guns should not be taken as a priority over public health. We must as a nation confront the fundamental question of what is more important: The narrow focus on individual rights or the wider vision of societal responsibility. Every year, thousands of children are killed in the United States by guns.

Are pediatric gun deaths a real problem in the U.S. Our research and that of others proves it. Guns kill more U.S. children and adolescents between one and 19 years old than any other means. Guns kill more children than motor car collisions , infections or any other diseases. This is a uniquely American problem. Although shocking and sensational, school shootings account for only a small percentage of firearm deaths. Most firearm deaths and injuries occur in homes and neighborhoods. In 2020 10,197 children and young adults age zero to 24 year old died by guns, a 55 percent increase over the decade prior.

Gun deaths are another health disparity. Black teenage boys have been killed by guns at a rate that is five times higher than white teenage boys in the past decade, but their names are rarely mentioned in the national consciousness.

There are at least 400 million guns in the U.S. We don’t really know how many because most states don’t track gun sales or require gun registration, thanks to successful lobbying by the gun industry and progun politicians. Last year 18.9 million guns were sold in the U.S. And between the beginning of 2019 and middle of 2021, an estimated 7.5 million people became first-time gun owners. This includes 5.4 millions people who lived in homes that did not have guns. Twenty years ago, the majority of gun owners owned guns for hunting and other sports. Today 88 percent of them state they own their guns for self-protection. Most of those owners say having a gun at home makes them feel safer, and about 40 percent keep one loaded and “easily accessible” at all times. In 2021 four in 10 children, representing approximately 30 million kids, had at least one gun in the home. Even in homes with children, 73 percent of these guns were stored unlocked and/or loaded, putting those children at risk of injury and death. If you keep a gun in your home, storing it unloaded and keeping the gun and ammunition locked away separately can decrease the risk.

Gun safety regulations are not required unlike cars and almost all other products sold in the United States. That bears repeating: guns are exempt from safety standards set by the federal Consumer Product Safety Act. Between 2015 and 2021, there were 2,446 unintentional child shootings, resulting in 923 deaths and 1,603 injuries. Thus, while pill bottle makers, hair dryer producers and motor vehicle companies constantly work to improve their products’ safety, the U.S. government has decreed gun manufactures do not need to consider whether a two-year-old should be able to pull the trigger on a gun or whether a teenager should be able to fire a gun they don’t own.

Beyond these lack of safety requirements, in 2006 Congress passed the “Protection of Lawful Commerce in Arms Act,” which shields firearm manufactures against liability for any injuries or deaths from guns. Thus, gunmakers have minimal incentive to improve gun safety technology, despite the development of safer gun technology over the last decade in the form of personalized “smart” guns, which use fingerprint technology (like your cell phone, radio-frequency identification (RFID) or other methods to allow only the authorized user to fire the gun. This simple solution would prevent curious children, suicide-minded individuals, and unauthorized persons from finding a gun to fire it. It would save many lives every year.

We know that firearm deaths are lower in states with more firearm laws. We also know that no single law or strategy can address the problem of gun violence in the United States. We need a multipronged strategy that includes all states.

One approach is to treat owning guns as owning cars: there are age limits that can be set for purchase and possession, licensing, registration, and insurance requirements. Some states, such as New York, Connecticut, and California, have meaningful age limits, licensing, and registration requirements. Other states, including Florida, Georgia, Tennessee and Rhode Island, specifically prohibit gun registries. Nearly two thirds of Americans, including 53 percent of Republicans, support moderate or strong regulation of gun ownership. And after every school shooting, federal firearm legislation, such as universal background checks or raising the legal age to buy a long gun from 18 to 21, is proposed once again. This is the most practical way to reduce firearm deaths, but it is also the most quickly dismissed. We are left with “thoughts & prayers .”

We also need laws to minimize access to firearms among individuals at risk of harming themselves or others (such as people who have been charged with domestic violence or who have homicidal ideation). These needed measures include universal background checks (supported by 81 percent of Americans) and extreme risk protection order (“red flag”) laws that allow a judge to prohibit at-risk individuals’ purchase or possession of a firearm for a time limited period. Nineteen states plus Washington, D.C., have red flag laws. These laws are often passed in Republican-led states by bipartisan consensus. People still slip through the cracks. We need to increase awareness and have more states pass these laws.

As pediatric emergency physicians, our concern is with children accessing their parents guns. Strong child access prevention laws, currently in 34 states and Washington, D.C., hold adult gun owners liable if a child can or does access a firearm. We and others are concerned about criminalizing grieving families as well as non-discriminatory application of these laws. Another option would be to encourage gun owners to store their firearms in safer places.

And then there’s funding. There is a lack of federal funding for federal research, which means that there are significant gaps in knowledge and effective interventions as well as information about gun violence victims and perpetrators. There was no Congressional federal funding for firearm research at the Centers for Disease Control and Prevention after Congress passed the Dickey Amendment in 1996–and no such funding for the National Institutes of Health after the amendment was extended to that agency in late 2011–until 2019, when $25 million was appropriated. This is a small amount compared to the number of people who have been affected by gun violence. The National Heart, Lung, and Blood Institute, however, has a budget of $3.8 million to support research on conditions like heart disease and cancer.

But while we are considering these approaches, it is important to remember these names. These are children, sons and daughters whose parents had dreams and hopes for them, youth with aspirations and goals for themselves:

Nevaeh Bravo

Jacklyn “Jackie” Cazares

Makenna Elrod

Jose Flores, Jr.

Eliana “Ellie” Garcia

Irma Garcia

Uziyah Garcia

Amerie Jo Garza

Xavier Lopez

Jayce Luevanos

Tess Marie Mata

Maranda Mathis

Eva Mireles

Alithia Ramirez

Annabell Guiadalupe Rod

Maite Yuleana Rod

Alexandria “Lexi” Aniyah Rubio

Layla Salazar

Jailah Nicole Silguero

Eliahana Cruz Torres

Rojelio Torres

We will never again have to list names of innocent children who were killed at their elementary school. History and a contemptuous inaction from our elected officials predict that we will. We must demand more, even when there are actions that we can take. We must do more for our children, youth, and society. We must.

This is an opinion and analysis article, and the views expressed by the author or authors are not necessarily those of Scientific American.


    Eric W. Fleegler is a pediatric emergency physician and a researcher at Boston Children’s Hospital and Harvard Medical School. With Lois K. Lee, he is editor of the bookPediatric Firearm Injuries and Fatalities: The Clinician’s Guide to Policies and Approaches to Firearm Harm Prevention.

      Lois K. Lee is a pediatric emergency physician and a researcher at Boston Children’s Hospital and Harvard Medical School. With Eric W. Fleegler, she is editor of the bookPedia

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