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Study: Gun-related injuries kill nearly 1,300 U.S. children each year

WASHINGTON — 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 U.S., 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 might be most at risk for a gun-related injury.

“When you start putting numbers like that to real lives, real people every day who are injured by firearms … it confirms a statistic we already know a lot about,” said said Dr. Thomas Weiser, a trauma surgeon at Stanford University Medical Center who was not involved in the study.

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.

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 U.S. 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 might 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.

As for unintentional firearm injuries, Weiser said, a third-grade girl he treated in 2011 was not the only accidental gunshot wound he saw in a child.

Another such injury involved a boy around 9 who was given a handgun for his birthday.

“He shot his 6-year-old brother, playing in the backyard,” Weiser said, adding the study findings show that boys are much more likely to be injured by firearms than girls.

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.

Those patterns of gun-related deaths appeared to fluctuate by state.

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.

For suicides, which were calculated only for children 10 and older in the study, the researchers found 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 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 under-reported, 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.

Based on the findings, the data suggest 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 study.

He added 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. 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.