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. 2023 Jul 1;278(1):10-16.
doi: 10.1097/SLA.0000000000005833. Epub 2023 Feb 24.

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

Bindi J Naik-Mathuria  1   2 , Cary M Cain  3 , Elizabeth A Alore  4 , Liang Chen  2 , Lisa A Pompeii  5
Affiliations

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

Bindi J Naik-Mathuria et al. Ann Surg. .

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. Children <12 years are most affected by nonfatal unintentional injuries, 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.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Comparison of shooting intents between fatal and nonfatal pediatric firearm injuries.
FIGURE 2
FIGURE 2
Prevalence of injuries and deaths stratified by shooting intent.
FIGURE 3
FIGURE 3
Nonfatal and fatal temporal injury trends by shooting intent Curve estimate significance: *P <0.05; **P <0.001. Significant linear increase started in 2013 for fatal assaults, in 2014 for nonfatal assaults, and since 2008 for nonfatal unintentional and fatal self-harm injuries.
FIGURE 4
FIGURE 4
Temporal trends by shooting intent for children < and >12 years. Curve estimate significance: *P <0.05; **P <0.001.
See this image and copyright information in PMC

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