Update: Firearm Injuries and Deaths in Children and Adolescents – A Call to Action

Dr. Nancy Kelly authored a policy brief on July 15, 2014 emphasizing the importance of family counseling and legislative advocacy in preventing pediatric injury and death from firearms. Since then, the American Academy of Pediatricians (AAP) has updated their recommendations regarding keeping our children safe from gun violence. Additionally, new bills have been filed for consideration during the 84th meeting of the Texas Legislature that have the power to impact pediatricians and their patients positively or negatively. Recent tragic events in Boston shed light on the need for increased firearm regulations, especially in health care settings.


According to a 2014 AAP publication, gun-related injury is the second leading cause of death in American youth. As Dr. Kelly previously mentioned, pediatric firearm-related death is twice as common as death from pediatric cancer, 5 times more common than death from pediatric heart disease, and 15 times more common than death from pediatric infections. The numbers are staggering; and this led the AAP to enhance their advocacy efforts toward improved policies that will keep children safe. Their priorities are as follows:

  • Firearm safety: Enact stronger gun laws, including an effective assault weapons ban; mandatory background checks on all firearm purchases; and a ban on high-capacity ammunition magazines.
  • Prevention and public health: Allow federal agencies to conduct research on the causes and prevention of gun violence, and stand by the President’s clarification that the Affordable Care Act does not prohibit doctors from asking their patients about guns in the home. 
  • Access to mental health services: Improve the identification of mental illnesses through increased screening, addressing inadequate insurance coverage and high out-of-pocket costs that create barriers to access, strengthening the overall quality of mental health access, and expanding the Medicaid reimbursement policy to include mental health and developmental services.
  • Reducing gun violence in the media and educating children: Develop quality, violence-free programming and constructive dialogue among child health and education advocates, the Federal Communications Commission, and the television and motion picture industries, as well as toy, video game, and other software manufactures and designers, to reduce the romanticization of guns in the popular media as a means of resolving conflict.


From January to June 2015, the Texas legislature is meeting and several bills relate to firearm laws in our state. It is our job as pediatricians to be the voice for our patients and spread awareness about the need for legislation that is likely to prevent firearm-related injury and death. One bill that is particularly concerning regarding the well-being of our patients and fellow healthcare professionals is House Bill (HB) 695. This proposed act would allow Texans with concealed handgun licenses to take weapons into hospitals and nursing homes. As we know, no diagnostic test, no medicine, and no surgical procedure are successful 100% of the time. Treatment plans do not always go according to our wishes, and sometimes even when they do they are not on par with the families’ expectations. The hospital is a very emotional place and behavior of patients and their families is not always rational. To allow concealed weapons into hospitals could have catastrophic consequences for both pediatric and adult patients, as well as healthcare professionals and hospital employees. Let’s join the fight against firearm violence and reach out to our legislators, voicing our hopes that they too will prioritize the health and safety of our state’s children.


For more information about the AAP recommendations:



For more information about the proposed HB 695:



TJ Benson, MD


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