Recent tragedies in Las Vegas, Nevada, and Parkland, Florida have returned the topic of firearm safety to the forefront of societal and political discourse. Children and adolescents are particularly affected by firearm violence. The latest population data is sobering – nearly 12 firearm deaths per day in the United States in children ages 0-21 years old. The American Academy of Pediatrics (AAP) continues to call for legislative action to reduce the incidence of firearm-related violence. Initiatives championed by the AAP include: (1) banning assault-style weaponry, (2) banning Internet sale of firearms, and (3) requiring background checks prior to purchase of a firearm, to name a few.

How can pediatricians work to promote safety in their patient population? Efforts on both a political front through advocacy and on a personal scale via anticipatory guidance during well child examinations can create societal and individual change to improve the health and safety of all children.

Problem

• Nearly 1 in 5 deaths in American youth under-20 is firearm-related.
• Merely the presence of firearms in the home increases the risk of suicide among adolescents. The risk is even worse if the gun is kept loaded.
• A study of personal firearm storage revealed:
  • 21.7% of subjects kept their firearms loaded when stored at home
  • 31.5% of subjects stored their firearms in unlocked locations
  • 8.3% of subjects kept their firearms loaded AND stored in unlocked locations
• More than 75% of guns used in suicide attempts and unintentional injures of children ages 0-19 were stored in the residence of the victim, a relative, or a friend.
• Children as young as 3-years old can produce enough squeezing pressure to pull a trigger on a loaded gun

Solutions

• The most effective measure to prevent firearm violence is the absence of firearms in the home.
• Stricter regulations regarding access and purchasing of firearms
• Better storage of weapons including trigger locks and locked storage boxes
• Mechanistic alterations to make firing a weapon more difficult for children, such as increasing trigger pressures

Actions

• Advocacy
  • Send correspondence to your local state legislator to share your views on firearm safety and the need for stricter control of access and storage
    • The AAP has resources to find the contact information for your state legislators and a draft email here.
  • Engage with local schools and media to offer your experience and expertise.
    • The AAP has developed talking points regarding firearm violence in the pediatric population that can be found here.
  • The AAP recommends pediatricians address firearm safety as part of routine anticipatory guidance for families with children of all ages.
• Anticipatory Guidance
  • Always asked about firearms in the home. Where are they stored? Are they locked? Who has access?
  • Inform families that the safest homes are those without guns.
  • For homes with firearms, encourage families to take practice safe storage – store guns and ammunition separately and in locked containers.
  • Encourage removal of firearms in homes with adolescents, especially if there is a history of mood disorders, substance abuse and/or a history of suicide attempts.
  • Encourage parents to ask if there is a gun in the house before sending children to play at a friends’ home.

Firearm violence is a huge issue that will constantly provoke heated debate and passionate rhetoric from all sides. As pediatricians, we can take simple steps to inform parents and help protect the most vulnerable population of our society.

D. Alan Potts, MD

 

References:

• Firearm-Related Injuries Affecting the Pediatric Population. Pediatrics. Volume 130, Issue 5, November 2012.
• How Pediatricians Can Advocate for Children’s Safety in Their Communities. American Academy of Pediatrics. https://www.aap.org/en-us/advocacy-and-policy/Pages/How-Pediatricians-Can-Advocate-for-Childrens-Safety-in-Their-Communities.aspx
• Firearm-Related Injuries Affecting the Pediatric Population Speaking Points. American Academy of Pediatrics. https://www.aap.org/en-us/my-aap/advocacy/workingwiththemedia/speaking-tips/Pages/Firearm-Related-Injuries-Affecting-the-Pediatric-Population-Speaking-Points.aspx
• Giffords Law Center to Prevent Gun Violence. http://lawcenter.giffords.org/facts/statistics/x