The stories are heartbreaking: In June 2017, a 6-year-old boy in Spartanburg, South Carolina shot his 4-year-old sister to death after the gun the boy was holding accidentally went off. That same month, a 9-year-old girl from Indiana was killed when a gun held by her father, 33-year-old Eric Hummel, inadvertently discharged. According to reports, the girl's last words were "Don't play with guns."
The list of children maimed or killed by guns seems endless, and three new studies are helping shed additional light on who some of the young victims are — and more importantly — where the live. Why does that matter? Because regionality specific-information suggests that doctors and other public health officials should tailor their approach to reducing firearm-related injuries based on certain areas of the country.
The first study, led by Dr. Bradley Herrin, a pediatrician at the Yale School of Medicine, concluded that the age a child is injured by a gun is closely related to where they live — specifically, in an urban or rural area. A summary of the study, "Hospitalizations for Firearm Injuries in Children and Adolescents in the U.S.: Rural Versus Urban," will be presented Monday, Sept. 18, at the American Academy of Pediatrics National Conference & Exhibition in Chicago.
Using statistics compiled by the Kids' Inpatient Database, which contains information on hospital stays for those younger than 21, researchers found older teens (those between 15 and 19) living in urban areas were the ones most likely to be hospitalized for gun injuries, but among younger children (ages 5 to 14) the rate of hospitalization was higher in rural areas.
While earlier studies have looked at firearm injuries as they relate to income levels, gender, race and other demographic information, Herrin's is the first to study gunshot hospitalization rates based on urban versus rural areas. He and his research partners culled through nearly 22,000 instances in which children were hospitalized.
They found, overall, that teens in urban areas are more likely to be victims of firearm violence during an assault, but children in rural settings are more likely to be injured accidentally. The research also determined that, even though 15- to 19-year-olds living in the city are more likely to be hospitalized from a firearm used in an assault, those same teens are less likely to be hospitalized from gunshot injuries due to suicide attempts compared to teens in rural areas.
"Compared with other causes of death in the United States, there is a relative scarcity of research on understanding the epidemiology of firearm injuries, and this is particularly true for the pediatric population," Herrin said in a statement. "This study helps to build our understanding of the problem by providing more detailed data on hospitalizations for firearm injuries in different pediatric age groups in both urban and rural communities."
The study is one of several in recent years that have looked at the relationship between guns and children. A second study found regions of the United States with the strictest gun laws also have the lowest rates of childhood firearm injuries. The study also is being presented at the American Academy of Pediatrics National Conference & Exhibition in Chicago.
The researchers behind "Geographic Regions with Stricter Gun Laws Have Fewer Emergency Department Visits for Pediatric Firearm-Related Injuries: A Five-Year National Study" compared firearms laws in each region to the number of firearms-related injuries in those regional emergency rooms. They then ranked each area in the U.S. using the Brady Gun Law Score, which grades the states based on things like gun and ammo regulation, background checks on gun sales and restrictions on weapons in high-risk populations. A high Brady Gun Law Score equates to strict gun laws. The Northeast region received the highest score, followed by the Midwest and Western regions. The South came in with the lowest score.
Researchers then compared the regions' Brady Gun Law Scores to the number of pediatric emergency department visits for firearm injuries. They determined that those regions with highest Brady scores also had lowest rates of ER visits for firearm injuries among children and teens.
"Our study highlights the regional variations in gun laws," Dr. Monika Goyal, assistant professor of pediatrics and emergency medicine at Children's National Health System and the George Washington University, says in a statement. "It also suggests how gun laws may help to reduce the number of pediatric firearm victims being treated in the emergency department each year."
Still a third study found that guns are now the third-leading cause of death for children in the United States. On average, according to "Childhood Firearm Injuries in the United States," a comprehensive analysis of firearm-related deaths and injuries published in the June 2017 issue of the journal Pediatrics, 5,790 American children go to the emergency room each year for gun-related injuries, while 1,297 of those children die.
The researchers also discovered that children in the South and Midwest are more likely to be killed by those using a gun than in other parts of the nation. Most homicides are "multi-victim events" and usually involve a person a child knows. Older children are more likely to be shot and killed in the context of crime and violence. The majority of children, regardless of age, are killed unintentionally by a "shooter playing with a gun."
There is some good news. The study's authors conclude that between 2002 and 2014, the number of unintentional firearm deaths among children declined, as did firearm suicides between 2002 and 2007. However, researchers did see an uptick in the rate of suicide by gun from 2007 to 2014.
All three studies, among others, underscore the need for more comprehensive, scientifically proven solutions to gun injuries and deaths.