© 2018 – 2021 GWEN DEWAR, PH.D., ALL RIGHTS RESERVED
Kids get killed or injured by firearms all over the world, but the
United States has a special problem with gun violence. And the problem hasn’t improved during the COVID-19 pandemic.
On the contrary, in a recent study published in the journal Pediatrics, researchers report that firearm injuries among young children in the United States have actually increased during the pandemic (Cohen et al 2021).
Some politicians have tried to take action, but it’s unclear if “background check” bills passed by the U.S. House of Representatives will pass in the Senate. Is this because there is nothing to agree about?
No. There are plenty of facts to guide us. If adults find this common ground and cooperate, they can start to make the world much safer for children.
Taking measure of the crisis
A snapshot of global gun deaths tells the story.
When Erin Grinshteyn and David
Hemenway analyzed firearm mortality in 23 affluent countries (including Canada,
Germany, Japan, Australia, and the United Kingdom), they found that kids were much more likely to be killed by firearms in the United States (Grinshteyn and
Compared with other wealthy nations, the U.S. gun homicide rate for children under the age of 14 was 19-22 times higher. For youth between 15 and 24 years
of age, the U.S. rate for gun homicide was 49 times higher.
How many kids die? What are the circumstances?
Hospitals and medical examiners keep records, so we know the
answer. Based on national data collected between 2002 and 2014, Katherine Fowler
and her colleagues (2017) found that
- approximately 5790 children
are treated for gunshot wounds each year,
- approximately 1300 kids die
of gunshot wounds each year,
- boys, older kids, and
minority children are disproportionately affected, and
- most child and teen firearm
deaths are homicides.
For young children, the
homicides usually occur in a home, often in the context of intimate partner
violence. For teenagers, homicides happen in a variety settings, and are frequently
accompanied by the commission of other crimes.
of firearm death are suicide and accidents — the result of kids playing with guns, or
handling weapons they didn’t realize were loaded.
Grim as these details are,
they don’t illustrate the total cost of gun violence.
In addition to the children
injured or slain, there are the kids who lose siblings, parents, friends, neighbors, and classmates. There are children whose families have been upended by gunshot injuries,
psychological problems, medical bills, and lost wages. How many kids are affected?
I haven’t been able to find
any hard data addressing this question. But a large, national study conducted
in 2013-2013 offers us a hint of how prevalent gun violence is the lives of U.S
Thirteen percent of teens
aged 14-17 said they had seen or heard a shooting in their lifetimes (Finkelhor
et al 2015).
So it’s clear that the United
States has a problem. What can be done —
in the U.S. and elsewhere — to prevent firearm deaths?
for gun violence research has been greatly reduced since the U.S. Congress passed
the 1996 Dickey Amendment, many researchers have continued to work on the
problem, and their studies offer clear guidance.
So we can’t fail to act on the grounds that there is no basis for agreement, no possibility for consensus.
That’s a phony excuse. There are at least five observations about child gun violence that any reasonable person can accept. These should be the basis for cooperation — a starting point for making changes that everyone can agree on.
- Military-style rifles, often called assault weapons, are especially deadly. But most kids are killed by handguns. So if we want to save lives, we need to take measures that address the threat posed by all firearms.
- Many kids live in households where firearms aren’t stored safely. Surveys consistently reveal that 30-65% of gun-owning parents say they don’t keep their firearms as gun safety experts recommend — unloaded and locked away.
- A substantial number of teens say they have carried a gun, or have ongoing access to a loaded firearm without adult permission. The rate is especially high among kids who have been extensively bullied. This suggests we need to we need to identify and treat kids with aggressive behavior problems, and prevent bullying at school.
- When state governments enforce strong gun regulations, fewer kids die. There is ample evidence showing that firearm deaths are more common in places where regulations are weak.
- We need to reinstate funding for research on gun safety and gun violence. If we’re serious about finding solutions, we need to make an investment, and support rigorous research.
Here are the details.
1. Yes, military-style rifles are especially deadly, but
most kids are killed by handguns. So if we’re serious about protecting youth,
we need to address the threat posed by all firearms.
Many mass shootings have been committed with military-style
rifles, like the AR-15. These weapons can wreck far more devastation than
handguns, and not merely because they are designed to minimize recoil, or
because they can be used with high-capacity magazines and bump stocks.
What makes these weapons especially deadly is the speed and
power of their bullets. Compared to a 9mm gun, the AR-15 fires bullets that
travel two to three times faster, and can deliver 7 times as much kinetic
energy on impact. Their bullets twist and deform in ways that magnify the
damage, and as they travel through the body, these high energy bullets push the
surrounding tissues apart in an explosive, destructive wave (Stephanopoulos et
al 2017; Rhee et al 2016).
Thus, there is a huge difference between between a
military-style assault rifle injury and a hand gun wound. As trauma surgeon
Peter Rhee notes in Wired, “One looks like a grenade went off in there.
The other looks like a bad knife cut.” It’s crucial that we find ways to
keep these weapons out of the hands of would-be shooters.
But as deadly as
these military-style rifles are, we must also keep in mind: Most firearm deaths
are caused by handguns.
Between 2002 and 2013, 75% of firearm homicides in children
and 85% of firearm homicides in teens involved handguns. Sixty percent of
juvenile suicides involved handguns, and approximately 58% of deaths classified
as “unintentional” involved handguns (Fowler et al 2017).
So if we are serious
about preventing gun violence, we need to address handguns as well as
military-style rifles and other firearms.
2. Surveys consistently indicate that many kids in the U.S.
live in homes where firearms are kept unlocked. Some parents may believe their
guns are safely hidden. But they’re wrong.
If you have child attending school in the United States,
chances are excellent that one of your child’s classmate’s lives in a home
where guns are not stored as gun
safety experts recommend: unloaded and in a locked cabinet or container.
Across surveys the numbers vary. But the estimates are
For instance, when researchers analyzed data collected by a
nationally representative study of early childhood development, they found that
approximately one fifth of households with children under the age of 5
contained firearms. Within this group, one third of the parents reported that
they kept their guns unlocked (Martin-Storey et al 2015; Morrissey 2017).
In other surveys,
30-65% of parents living in households with firearms say they don’t store
their guns unloaded and locked away (Simonetti et al 2017; Crifasi et al 2018;
Scott et al 2018, Durant et al 2007).
In fact, an alarming
portion of parents have admitted that they don’t take either precaution.
one study, almost one in ten gun-owning parents made this admission (Johnson et al 2006).
In another, more than 25% of gun-owning parents said that there was at least one firearm in the home kept unlocked and loaded (Salhi et al 2021).
What are these parents thinking?
Maybe they believe that locked storage is unnecessary
because they’ve stashed their guns in a safe, secret hiding place. But one
study — that interviewed parents and children separately — suggests how
foolhardy this assumption can be.
Among parents who believed their kids didn’t know where the
family gun was hidden, almost 40% had children who claimed otherwise. And 22% of
parents who said their kids had never handled a household firearm “were
contradicted by their children’s reports” (Baxley and Miller 2006).
Then there are communication problems between parents. If
one parent is in charge of the family firearm, how much does the other parent
In a survey of households with firearms, researchers
distinguished between parents who personally owned a gun, and parents who
weren’t gun owners themselves but who lived with a gun-owning partner. When questioned
about gun storage, only 2% of the non-gun-owning partners said the firearms
were stored unlocked and loaded. But 9% of the gun-owning parents admitted to
this (Asreal et al 2000). So some
It appears that some parents had false confidence
that weapons were safely stored.
3. Self-reported gun access and gun-carrying among U.S.
teenagers is substantial, and alarmingly high among kids who feel threatened,
or believe that other students are bringing guns to school.
In a national survey
of more than 228,000 secondary students (9th-12th grade), 6.7% of teens said
they had carried a gun at least once in the previous 30 days (Xuan and
A similar survey of slightly younger students (aged 12 to
17) found that 3-4 %
had “carried a gun” at some time during the previous year
(Vaughn et al 2016).
And a study of more than 10,000 kids (aged 12 to 18) found
that 4% — 1 in 25 — claimed to have access to a loaded gun
(Simckes et al 2017).
That’s worrying already, but the statistic about gun access
represents the average rate for all kids in the survey. When researchers
drilled down to a subset of kids — those who said they had been bullied in
some way — the rate was twice as high.
Kids who said they were being bullied extensively — both
online and in person — were 6 times as likely to say they could access a
loaded gun without adult permission (Simckes et al 2017).
Other research supports a similar theme. In a national
survey of high school students, researchers found that bullied teens were more
likely to bring a weapon to school if they reported at least one of three
experiences — having been threatened or injured at school; having skipped school
because it felt unsafe; and having been in a physical fight at school (Pham et
Among kids who reported having all three experiences, 46%
said they had carried “a weapon such as a gun, knife, or club” to
school in the previous month (Pham et al 2017).
This survey didn’t ask students to specify whether the
weapon was a firearm or something else, like a knife. But other studies
focusing on firearms have reported the same strong link: Kids are more likely
to carry guns if they’ve been victimized or witnessed violence (Reid et al
And a study of Boston high school students (Hemenway et al
2011) suggests the potential for a literal arms race: Kids were more likely to report
bringing guns to school if they believed that other students were carrying
Moreover, students “substantially overestimated the
percentage of their peers who carried guns” and “believed it was
easier for other youth to obtain guns than it was for them” (Hemenway et
4. When governments enforce stricter gun regulations, fewer kids die.
The previous points suggest we need to do more to keep kids from
getting their hands on guns, and we need to make school and other environments
feel safe. Some of this can be accomplished through gun safety education, and
through comprehensive programs aimed at reducing bullying and aggression.
But it’s also clear that sheer availability matters. For example, in one study, researchers analyzed FBI homicide
reports from all fifty U.S. states.
They compared rates of gun ownership with rates of “non-stranger
homicides” (deaths caused by people known the victims), and found a strong
For every 1%
increase in a state’s gun ownership rate, there was a 1.04% increase in
non-stranger homicides (Seigel et al 2014).
If we enforce stronger
laws to regulate gun ownership, can we save children’s lives? There is ample
reason to think so.
When researchers analyzed 15 years of firearm-related
fatalities in the U.S, they found that fewer children die in states that have
stronger gun regulations (Resknick et al 2017).
In another large study, researchers found that kids in the United States
were less likely to have been injured by firearms if they lived in a state with
strong gun regulations (Safavi et al 2014).
It’s the trend for gun-related homicides in general. When Elinore Kaufman and her colleagues analyzed data
collected by the Center for Disease Control in the 48 contiguous U.S. states,
they found that counties in states with the weakest gun regulations had the highest rates of firearm homicide
(Kaufaman et al 2018).
And internationally, researchers confirm that that regulations are linked with lower mortality. In a review of 130 studies conducted in 10 different countries, Julian Santaella-Tenoria and his colleagues found that “the simultaneous implementation of laws targeting
multiple firearms restrictions is associated with reductions in firearm
deaths” (Santaella-Tenorio et al 2016).
Which regulations are the most helpful? For some regulations, we simply don’t have enough information to judge. We need more research.
But there is a great deal of support for at least one type of law: Mandatory background checks are consistently linked
with lower firearm homicide rates (Sen and Panjampirom 2012; Wright et al 1999; Swanson
et al 2016; Lee et al 2017). If background checks were strictly enforced throughout the U.S., and were required by private sellers as well as federally licensed sellers, it’s likely that many child deaths would be prevented.
There is also evidence in favor of strong laws regulating the storage of guns in and around children. In particular, “child access prevention” (CAP) laws are linked with lower child firearm injuries — but only if these laws impose liabilities on adults who store their guns negligently. Weaker laws (that merely prohibit adults from deliberately or recklessly giving kids weapons) do not appear to be effective (Hamilton et al 2017; Simonetti et al 2015).
In addition, domestic partner deaths are less common in
places where the law prohibits firearm access to people who’ve had a
restraining order issued against them, or who have been convicted of violent
misdemeanors (Diez et al 2017; Zeoli et al 2017; Sen and Panjampirom 2012). Given that young children often die in the context of domestic partner homicide, it’s reasonable to think that such laws would protect kids too.
And studies show that permit to purchase laws and mandatory waiting periods are linked
with fewer firearm deaths (Zeoli et al 2017; Diez et al 2017; Sen and Panjampirom 2012; Santaella-Tenorio
et al 2016; Luca et al 2017).
5. To identify more ways to save lives, we need to support gun violence research
We still have more to learn, which is why it’s important for the U.S. Congress to restore funding for the Center for Disease Control to support gun violence research.
There should be no controversy about it. Even Jay Dickey, the former congressman who introduced the Dickey Amendment in 1996, agrees.
In an interview with Steve Inskeep on NPR radio in 2015, Dickey said he hadn’t anticipated the chilling effect that Congress’ actions would have on research. He regrets he didn’t take steps to prevent this.
“I didn’t follow through and say, we need – still need to do research,” Dickey said.
It’s time for all of us to follow through.
References: Gun violence
Behrman P, Redding CA, Raja S, Newton T, Beharie N, Printz
D. 2018. Society of Behavioral Medicine (SBM) position statement: restore CDC
funding for firearms and gun violence prevention research. Transl Behav Med.
2018 Feb 21. doi: 10.1093/tbm/ibx040. [Epub ahead of print]
Cohen JS, Donnelly K, Patel SJ, Badolato GM, Boyle MD,
McCarter R, Goyal MK. 2021. Firearms Injuries Involving Young Children in the
United States During the COVID-19 Pandemic. Pediatrics. 2021 Apr
Díez C, Kurland RP, Rothman EF, Bair-Merritt M, Fleegler E,
Xuan Z, Galea S, Ross CS, Kalesan B, Goss KA, Siegel M. 2017. State Intimate
Partner Violence-Related Firearm Laws and Intimate Partner Homicide Rates in
the United States, 1991 to 2015. Ann Intern Med. 167(8):536-543.
Dillon KP, Bushman BJ. 2017. Effects of Exposure to Gun
Violence in Movies on Children’s Interest in Real Guns. JAMA Pediatr. 2017 Nov
DuRant RH, Barkin S, Craig JA, Weiley VA, Ip EH, Wasserman
RC. 2007. Firearm ownership and storage patterns among families with children who
receive well-child care in pediatric offices. Pediatrics. 119(6):e1271-9.
Finkelhor D, Turner HA,
Shattuck A, Hamby SL. 2015. Prevalence of Childhood Exposure to Violence,
Crime, and Abuse: Results From the National Survey of Children’s Exposure to
Violence. JAMA Pediatr. 169(8):746-54.
Fowler KA, Dahlberg LL, Haileyesus T, Gutierrez C, Bacon S.
2017. Childhood Firearm Injuries in the United States. Pediatrics. 140(1). pii:
Grinshteyn E, Hemenway D. 2016. Violent Death Rates: The
US Compared with Other High-income OECD Countries, 2010. Am J Med. 129(3):266-73.
Hemenway D1, Vriniotis M, Johnson RM, Miller M, Azrael D.
2011. Gun carrying by high school students in Boston, MA: does overestimation
of peer gun carrying matter? J Adolesc. 34(5):997-1003.
Johnson RM, Miller M, Vriniotis M, Azrael D, Hemenway D. Are
household firearms stored less safely in homes with adolescents?: Analysis of a
national random sample of parents. Arch Pediatr Adolesc Med. 2006
Lee LK, Fleegler EW, Farrell C, Avakame E, Srinivasan
S, Hemenway D, Monuteaux MC. 2017. Firearm Laws and Firearm Homicides: A
Systematic Review. JAMA Intern Med. 177(1):106-119. doi:
Lee J, Moriarty KP, Tashjian DB, Patterson LA. 2013. Guns
and states: pediatric firearm injury. J Trauma Acute Care Surg. 75(1):50-3;
Lankford A1. 2016. Public Mass Shooters and Firearms: A
Cross-National Study of 171 Countries. Violence Vict. 2016;31(2):187-99.
Luca M, Malhotra D, Poliquin C. 2017. Handgun waiting periods
reduce gun deaths. Proc Natl Acad Sci U S A. 114(46):12162-12165.
Monuteaux MC, Lee LK, Hemenway D, Mannix R, Fleegler EW. 2015. Firearm Ownership and Violent Crime in the U.S.: An Ecologic Study. Am J Prev Med. 49(2):207-14
Morrissey TW. 2017 Associations between active shooter
incidents and gun ownership and storage among families with young children in
the United States. Prev Med. 2017 Jul;100:50-55.
Pham TB, Schapiro LE, John M, Adesman A. 2017. Weapon
Carrying Among Victims of Bullying. Pediatrics. 140(6). pii: e20170353.
Prickett KC, Martin-Storey A, Crosnoe R. 2014. State firearm
laws, firearm ownership, and safety practices among families of preschool-aged
children. Am J Public Health. 104(6):1080-6.
Resnick S, Smith RN, Beard JH, Holena D, Reilly PM, Schwab
CW, Seamon MJ. 2017. Firearm Deaths in America: Can We Learn From 462,000 Lives
Lost? Ann Surg. 266(3):432-440.
Rhee PM, Moore EE, Joseph B, Tang A, Pandit V, Vercruysse G. 2016. Gunshot wounds: A review of ballistics, bullets, weapons, and myths. J Trauma Acute Care Surg. 80(6):853-67
Romer D, Jamieson PE, Jamieson KH. 2017. The Continuing
Rise of Gun Violence in PG-13 Movies, 1985 to 2015. Pediatrics. 139(2).
Rosenbaum JE. 2012. Gun utopias? Firearm access and
ownership in Israel and Switzerland. J Public Health Policy. 33(1):46-58.
Safavi A, Rhee P, Pandit V, Kulvatunyou N, Tang A, Aziz H,
Green D, O’Keeffe T, Vercruysse G, Friese RS, Joseph B. 2014. Children are
safer in states with strict firearm laws: a National Inpatient Sample study. J
Trauma Acute Care Surg. 76(1):146-50; discussion 150-1.
Salhi C, Azrael D, Miller M. 2021. Parent and Adolescent
Reports of Adolescent Access to Household Firearms in the United States. JAMA
Sen B and Panjamapirom A. 2012. State background checks
for gun purchase and firearm deaths: an exploratory study. Prev Med. 55(4):346-350.
Siegel M, Negussie Y, Vanture S, Pleskunas J, Ross CS, King
C 3rd. 2014. The relationship between gun ownership and stranger and
nonstranger firearm homicide rates in the United States, 1981-2010. Am J Public
Simckes MS, Simonetti JA, Moreno MA, Rivara FP, Oudekerk BA,
Rowhani-Rahbar A. 2017. Access to a Loaded Gun Without Adult Permission and
School-Based Bullying. J Adolesc Health. 61(3):329-334.
Stefanopoulos PK, Pinialidis DE, Hadjigeorgiou GF,
Filippakis KN. 2017. Wound ballistics 101: the mechanisms of soft tissue
wounding by bullets. Eur J Trauma Emerg Surg. 43(5):579-586.
Swedler DI, Simmons MM, Dominici F, Hemenway D. 2015. Firearm Prevalence and Homicides of Law Enforcement Officers in the United States. Am J Public Health. 2015 Oct;105(10):2042-8.
Vaughn MG, Nelson EJ, Salas-Wright CP, DeLisi M, Qian Z.
2016. Handgun carrying among White youth increasing in the United States: New
evidence from the National Survey on Drug Use and Health 2002-2013. Prev Med. 88:127-33.
Wiebe DJ, Krafty RT, Koper CS, Nance ML, Elliott MR, Branas
CC. 2009. Homicide and geographic access to gun dealers in the United States.
BMC Public Health. 9:199.
Zeoli AM, McCourt A, Buggs S, Frattaroli S, Lilley D,
Webster DW. 2017. Analysis of the Strength of Legal Firearms Restrictions for
Perpetrators of Domestic Violence and Their Association With Intimate Partner
Homicide. Am J Epidemiol. 2017 Nov 29. doi: 10.1093/aje/kwx362. [Epub ahead of
Image credits for “Gun violence”
“Stop gun violence” photo by Tony Webster / flickr
Image of shooting aftermath by Tiocfaidh
ár lá 1916/flickr
Image of shot-up sign by John Savage/flicker
Image of child silhouette against wall by Boris Thaser/flicker
Image of child with gun by Pedro Alonso / flickr
content last modified 6/11/2021
Copyright © 2006-2021 by Gwen Dewar, Ph.D.; all rights reserved.
For educational purposes only. If you suspect you have a medical problem, please see a physician.