Firearms and the Pediatrician
Dr. Webb started the presentation by orienting attendees to the epidemiology of pediatric gun violence in the U.S., including the racial and ethnic disparities in pediatric firearm mortality. Guns are now the number one cause of death in U.S. children. While the tendency is to focus on school-based gun violence, this narrative overlooks the harsh reality that 72% of pediatric victims of mass shootings die in incidents of domestic violence. It also neglects the role of firearms in pediatric suicide. From 2011 to 2020, firearms accounted for 45% of pediatric suicides, a fact Dr. Webb used to emphasize the importance of incorporating firearm safety into suicide-prevention efforts. She also touched on the complex drivers behind the epidemiologic data which leaves certain populations, such as Black youth and members of the LGBTQIA+ community, at significantly higher risk of dying by firearm-related homicide and suicide, respectively.
The remainder of the time was spent examining the role of screening for firearm access and secure storage counseling in the prevention of pediatric gun injury and death. Dr. Webb highlighted the American Academy of Pediatrics’ transition from pursuing “the safest home for a child or adolescent” as pursuit of a home without firearms, to a focus on harm reduction. The purpose of routine screening is to identify homes that already have firearms present, so the message should be tailored as such. In cases when the safest cannot be achieved, safer is still better than unsafe.
Dr. Webb closed by encouraging providers to familiarize themselves with different safety and storage mechanisms so they can provide adequate counseling. She also shared examples of how they can get involved in advocacy efforts in their institutions, communities, and beyond.
Key Takeaways
- School-based gun violence is a very real issue, but most of pediatric firearm deaths are a result of domestic-violence incidents, with significant racial and ethnic disparities.
- Firearms play a large role in pediatric suicide, making firearm safety an essential component of suicide-prevention efforts.
- Clinicians should actively screen all patients and families for access to firearms, and counseling should be focused on secure storage and injury prevention.
Dr. Bakkum is a pediatric hospitalist and clinical instructor of pediatrics at the University of Michigan C.S. Mott Children’s Hospital in Ann Arbor, Mich.