Pediatrics
Amber V. McKenna, MD
Resident Physician
University of Wisconsin Madison
Madison, Wisconsin, United States
Amber V. McKenna, MD
University of Wisconsin Madison
Madison, Wisconsin, United States
Firearm injuries are the leading cause of death in children. There is wide variation in state legislation on firearms. We evaluated the impact of the restrictiveness of state legislation on the pediatric firearm mortality rate to guide advocacy efforts.
Design: Data was obtained from the Center for Disease Control and Prevention from 2010-2021 for children 0-18 years. Fatal firearm injuries per state were included and stratified by intent (homicide, suicide, and unintentional). State ranking for restrictiveness of firearm legislation was obtained from Giffords Law Center to Prevent Gun Violence. Laws related to concealed carry and safe storage were analyzed with repeated measures mixed modeling.
Results: From 2010-2021, there were 28,472 pediatric firearm injury deaths, classified as homicide(16,649), suicide(9,784), unintentional(1,321), or other(718). There was a significant correlation between total deaths per 100,000 population and state gun law ranking each year, ranging from Spearman’s Rho correlation of 0.39, p=0.005 in 2012 to 0.69, p< 0.0001 in 2015. For concealed carry laws, states with no permit requirements had 5.72 deaths per 100,000, basic permit guidelines had 4.38 deaths per 100,000 (p< 0.0001), and strict permit guidelines had 2.19 deaths per 100,000(p< 0.0001). States requiring the use of a gun lock had 1.29 fewer deaths per 100,000 than states with no safe storage laws (p=0.004). Negligence-based child access prevention(CAP) states had 0.98 fewer total deaths and 0.77 fewer suicides per 100,000(total deaths p=0.04, suicide p=0.0005). States requiring safety design features had 1.78 fewer deaths per 100,000 (p=0.0087).
Conclusions: Over a 12 year period, states with lenient firearm legislation had higher mortality. States with no permit requirements for concealed carrying have higher mortality as do states with stand your ground laws. States requiring the use of gun locks, with negligence-based CAP laws, and requiring safety design features on firearms all have lower pediatric firearm mortality.
