More disturbing data on the emergence of firearms as a leading cause of death in children

April 25, 2022  |  General

I’ve written before how firearms injuries have emerged as a leading cause of traumatic death in children. A new study in the New England Journal of Medicine, as well as a good letter to the editor, examines this issue further. Note this is a difficult subject to study because Republican-controlled Congresses have legislated against even examining the question; it is truly an astonishing thing to try to prevent unfettered scientific study of a particular topic, presumably largely owing to lobbying efforts by the firearms industry and the NRA. Perhaps the recent civil settlement against the Remington company over the Sandy Hook mass shootings may allow change in this. We can only hope for now that it does.

As I described in my previous post, by 2016 firearms injury had risen to account for 15% of pediatric traumatic deaths, second only to motor vehicle accidents. These new data offer more insight into this disturbing trend. The graph below from the article displays the causes of pediatric deaths over the past two decades. It shows a couple of things. First, and most gratifying, it demonstrates a 50% drop in deaths from MVAs in children over the past 20 years. In the same period, however, there has been a 50% increase in pediatric deaths from firearms. The result is that gunshot deaths in children now exceed those from MVAs.

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The reasons for this reduction in MVAs are instructive:

Two decades ago, the CDC proclaimed the reduction in deaths attributable to motor vehicle crashes to be one of the most substantial public health achievements of the 20th century. Most important, the United States established an infrastructure permitting continuous improvements in motor vehicle safety. At the forefront of this effort has been the National Highway Traffic Safety Administration (NHTSA), a federal agency whose mission is to save lives and prevent injuries caused by road-traffic crashes. Firearms, however, are one of the few products whose safety isn’t regulated by a designated federal agency.

The point is that a dedicated approach to improving product safety, plus active measures to reduce the rate of injuries, can have have very large effects. The first step is to develop dedicated data systems to collect information, and articles like this are helpful first steps. But these are relatively crude measures; we need specific breakdowns regarding the particulars — trends, disparities, and associations — of firearm injuries. The example of automotive safety is again instructive:

To support automotive safety, the NHTSA and the nonprofit Insurance Institute for Highway Safety provide vehicle safety ratings using crash-test results and fatality data. Motor vehicle companies, which for decades resisted competing on the basis of safety, reversed course and now often advertise their vehicles’ safety features.

In spite of rising death rates from firearms, many states have actually made it easier to gain access to firearms, particularly for adolescents. It has been shown that states with looser regulation of firearms have higher rates of deaths from them. This should not surprise anybody, certainly not me. But there remains pervasive denial of this common sense and now established correlation. The authors’ conclusion is straightforward — starting with gathering more scientific data on the question.

As the progress made in reducing deaths from motor vehicle crashes shows, we don’t have to accept the high rate of firearm-related deaths among U.S. children and adolescents. Preventable deaths among young people not only are associated with tremendous medical costs, but take a great personal toll on families and communities. To reverse the trend of increasing firearm-related deaths among U.S. children, experts and policymakers should be intentional in their efforts to develop and implement a multipronged scientific strategy centered on continuous improvement.

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