States with stricter gun laws have a lower incidence of firearm fatalities in children

States with stricter gun laws have a lower incidence of firearm fatalities in children

September 20, 2019  |  General

I have written previously on Kevin Pho’s useful KevinMD site about the alarming statistic that gunshot injuries are now the second most common cause of death among children. Between 2011 and 2015 there were over 21,000 children killed by guns. This recent study in the Pediatrics, the journal of the American Academy of Pediatrics, further analyzes the question; it compares pediatric firearm fatality rates among the various states and then tests for correlation between children killed and the degree of strictness or not of the state’s gun laws. There are extensive data on whole populations showing that stricter laws correlate with lower rates of firearms injuries, but pediatric fatalities have not been specifically investigated. Of course as a PICU physician, somebody who takes care of children shot by guns, the latter question is of great interest to me.

Central to the work is developing some sort of grading scale for strictness of gun laws. The authors didn’t use a scale they developed themselves — they used the 2011–2015 Gun Law Scorecard system from the Brady Campaign to Prevent Gun Violence. The higher the state gun law score, the stricter the firearms legislation. The authors also used what they termed secondary exposure variables. These were the presence or not of individual laws previously associated with lower mortality rates in the total population of adults and children: universal background checks for firearm purchase, universal background checks for ammunition purchase, and identification requirement for firearms (microstamping, ballistic fingerprinting). Their findings are best summarized in this graph from the paper. It plots gun law score against the rate of children killed by guns.

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The trend line for that graph is pretty striking. It’s clear increasing strictness of gun laws correlates with less children killed by guns. This also fits with the experience in other Western countries. See the example of Australia tightening their gun laws, which greatly reduced gun deaths.

The issue, of course, is that America has a gun culture unique in the Western world. Our courts have interpreted the rights of citizens to own guns quite broadly owing to the Second Amendment. It’s known the great majority of guns are owned by a minority of citizens. So the question is: How many dead children represent an acceptable price to pay for loose gun laws? Because it’s clear that, all slogans aside (e.g. “guns don’t kill people, people kill people”), looser laws lead to more deaths. The research is there. Now we have to decide if we want to do anything about it.

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