Reviewed by Zalman S. Agus, MD; Emeritus Professor, Perelman School of Medicine at the University of Pennsylvania
ORLANDO -- The combination of children and guns in the same household contributed to a steady rise in gunshot wounds and deaths in children, according to a review of national data over a 12-year period.
The number of children hospitalized for gunshot wounds increased from 4,270 in 1997 to 7,730 in 2009. In-hospital deaths among pediatric gunshot patients increased from 317 to 503 over the same period.
Alan: The number of kids hospitalized due to gunshot wounds has increased 81% since 1997. There are now 2.5 hospitalized children per U.S. county (per year), one of whom is a "new" casualty since The National Lunacy began on 9/11. Do we believe that two and half citizens in every county use their guns to prevent a crime? Each and every year? The statistics above do not include juvenile or adult suicide nor crimes of domestic passion.
Among gunshot wounds with known incident locations, 40% of the wounds occurred in the child's home. The data showed a significant association between gunshot wounds to children and the presence of one or more guns in the household. The association grew stronger when unsafe gun storage was included in the analysis (P=0.02 to P<0.01), although some of the numbers were small.
"Handguns are responsible for most of the childhood gunshot wounds," Arin L. Madenci, MD, of the University of Michigan in Ann Arbor, said here at the American Academy of Pediatricsmeeting. "Increasing household gun ownership correlated with increasing childhood gunshot wounds. There was a stronger likelihood of home gunshot wounds with unsafe storage practices."
Approximately 2,700 children die of gunshot wounds each year. Precise data on the epidemiology of childhood gunshot wounds are difficult to find, in part, because of limitations in the CDC budget, which includes about $100,000 (of a $6 billion total) for the study of gun-related issues, he said.
According to the Children's Defense Fund, the rate of gun-related deaths among children and teenagers in the United States is 3.24 per 100,000. That rate is 17 times greater than the rates of 25 other developed nations combined, said Madenci.
The U.S. has the highest gun ownership per capita in the world (nine guns for every 10 people). Gun-related homicides involving children more than tripled from 1960 to 2010, he continued.
Given the trends in gun ownership and childhood deaths attributable to gunshot wounds, Madenci and Christopher B. Weldon, MD, PhD, of Boston Children's Hospital and Harvard, hypothesized that household gun ownership would correlate with childhood gunshot wounds.
Over the course of the study period, 31,156 children were hospitalized for gunshot wounds and 2,159 children died in hospital of gunshot wounds.
For the proportion of hospitalizations with a known type of gun, handguns accounted for 77%, shotguns for 19%, and hunting or military rifles for 4%.
Focusing on the 40% of gunshot wounds that occurred in homes, Madenci and Weldon examined the relationship between the presence of a gun in the home and at-home gunshot wounds involving children. They also identified the proportion of households with loaded guns and the proportion with loaded guns in unlocked storage.
The investigators performed regression analysis to determine the relationship between the percentage of households with guns and the percentage of childhood gunshot wounds. Specifically, they calculated the percent change (up or down) in childhood gunshot wounds that would be expected with a 1% change in households with guns. The resulting beta regression coefficient reflected the change.
Across the 50 states, the proportion of households with children and at least one gun ranged from 10% to 62%. The proportion with loaded guns ranged from 1% to 14%, and the proportion with loaded guns in unlocked storage from <1% to 7%. Comparing the household gun-related data and childhood gunshot wounds showed significant associations for all comparisons:
Any gun - beta=0.7, 95% CI 0.3-1.1, P<0.01
Loaded gun - beta=1.7, 95% CI 0.3-3.2, P=0.02
Loaded gun in unlocked storage - beta=2.9, 95% CI 0.6-5.2, P=0.02
An analysis of the relationship between the percentage of gunshot wounds occurring in the home and the proportion of households with a gun and children produced beta values of 0.7 for any gun (P<0.01), 2.1 for loaded firearms (P=0.04), and 4.8 for loaded firearms in unlocked storage (P=0.01).
The study provided more detailed information about trends in firearm injuries involving children than has been available in the past, said David Hemenway, PhD, of the Harvard School of Public Health.
"The results are consistent with a number of other studies which have found that where there are more guns, particularly guns in the home, it's more likely that there will be danger for children," Hemenway told MedPage Today.
"Also, how you store the gun makes a difference. Storing the gun unsafely increases the danger for both accidents and suicide to children 1 to 17 years of age."
The data suggest actions that healthcare providers can take to help reduce the number of children injured and killed by guns each year.
"The study suggests, consistent with other studies, that physicians should talk to patients, particularly parents, about guns in the home, so they can weigh the risks and benefits of having a gun in the home and also talk to patients about how to store a gun," said Hemenway.
Madenci and Weldon reported no relevant disclosures.
Suicide in the Home in Relation to Gun Ownership, Arthur L. Kellermann, MD, MPH; Frederick P. Rivara, MD, MPH; et al, The New England Journal of Medicine, Vol. 327, No. 7, August 13, 1992, pp. 467-472.Key Statistic: The presence of one or more guns in the home increases the risk of suicide in the home nearly five times. http://www.vpc.org/studies/whersuic.htm
Guns in homes increase risk of death and firearm-related violence