Defining the Full Spectrum of Pediatric Firearm Injury and Death in the United States: It is Even Worse Than We Think

Authors

Bindi J Naik-Mathuria
Cary M Cain
Elizabeth A Alore
Liang Chen
Lisa A Pompeii

Publication Date

7-1-2023

Journal

Annals of Surgery

DOI

10.1097/SLA.0000000000005833

PMID

36825500

PMCID

PMC10249597

PubMedCentral® Posted Date

2-24-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Adolescent, Child, Humans, United States, Firearms, Suicide, Cross-Sectional Studies, Wounds, Gunshot, Population Surveillance, disparities, epidemiology, firearm injury prevention, firearm violence, gun violence, injury, nonfatal, pediatric firearm violence

Abstract

OBJECTIVE: To characterize the full spectrum of pediatric firearm injury in the United States by describing fatal and nonfatal injury data epidemiology, vulnerable populations, and temporal trends.

BACKGROUND: Firearm injury is the leading cause of death in children and adolescents in the United States. Nonfatal injury is critical to fully define the problem, yet accurate data at the national level are lacking.

METHODS: A cross-sectional study combining national firearm injury data from the Centers for Disease Control (fatal) and the National Trauma Data Bank (nonfatal) between 2008 and 2019 for ages 0 to 17 years. Data were analyzed using descriptive and χ 2 comparisons and linear regression.

RESULTS: Approximately 5000 children and adolescents are injured or killed by firearms each year. Nonfatal injuries are twice as common as fatal injuries. Assault accounts for the majority of injuries and deaths (67%), unintentional 15%, and self-harm 14%. Black youth suffer disproportionally higher injuries overall (crude rate: 49.43/million vs White, non-Hispanic: 15.76/million), but self-harm is highest in White youth. Childreninjuries, 12 to 14 years by suicide, and 15 to 17 years by assault. Nonfatal unintentional and assault injuries, homicides, and suicides have all increased significantly ( P < 0.05).

CONCLUSIONS: This study adds critical and contemporary data regarding the full spectrum and recent trends of pediatric firearm injury in the United States and identifies vulnerable populations to inform injury prevention intervention and policy. Reliable national surveillance for nonfatal pediatric firearm injury is vital to accurately define and tackle this growing public health crisis.