Stopping gun violence: What do we owe to our children?

© 2018 GWEN DEWAR, PH.D., ALL RIGHTS RESERVED

Kids get killed by firearms all over the world, but the United States has a special problem with gun violence.

Politicians have failed to take action. Is this because there is nothing to agree about?

No. There are plenty of facts to guide us. If adults find this common ground and cooperate, they can start to make the world much safer for children.

Taking measure of the crisis

A snapshot of gun deaths in 2010 tells the story.

When Erin Grinshteyn and David Hemenway analyzed firearm mortality in 23 affluent countries (including Canada, Germany, Japan, Australia, and the United Kingdom), they found that kids were much more likely to be killed by firearms in the United States (Grinshteyn and Hemenway 2016).

Compared with other wealthy nations, the U.S. gun homicide rate for children under the age of 14 was 19-22 times higher. For youth between 15 and 24 years of age, the U.S. rate for gun homicide was 49 times higher. 

How many kids die? What are the circumstances?

Hospitals and medical examiners keep records, so we know the answer. Based on national data collected between 2002 and 2014, Katherine Fowler and her colleagues (2017) found that

  • approximately 5790 children are treated for gunshot wounds each year,
  • approximately 1300 kids die of gunshot wounds each year,
  • boys, older kids, and minority children are disproportionately affected, and
  • most child and teen firearm deaths are homicides.

For young children, the homicides usually occur in a home, often in the context of intimate partner violence. For teenagers, homicides happen in a variety settings, and are frequently accompanied by the commission of other crimes.

Other causes of firearm death are suicide and accidents -- the result of kids playing with guns, or handling weapons they didn't realize were loaded.

Grim as these details are, they don't illustrate the total cost of gun violence.

In addition to the children injured or slain, there are the kids who lose siblings, parents, friends, neighbors, and classmates. There are children whose families have been upended by gunshot injuries, psychological problems, medical bills, and lost wages. How many kids are affected?

I haven't been able to find any hard data addressing this question. But a large, national study conducted in 2013-2013 offers us a hint of how prevalent gun violence is the lives of U.S kids:

Thirteen percent of teens aged 14-17 said they had seen or heard a shooting in their lifetimes (Finkelhor et al 2015).

So it's clear that the United States has a problem. What can be done  -- in the U.S. and elsewhere -- to prevent firearm deaths?

While funding for gun violence research has been greatly reduced since the U.S. Congress passed the 1996 Dickey Amendment, many researchers have continued to work on the problem, and their studies offer clear guidance.

So we can't fail to act on the grounds that there is no basis for agreement, no possibility for consensus.

That's a phony excuse. There are at least five observations about child gun violence  that any reasonable person can accept. These should be the basis for cooperation -- a starting point for making changes that everyone can agree on.

  1. Military-style rifles, often called assault weapons, are especially deadly. But most kids are killed by handguns. So if we want to save lives, we need to take measures that address the threat posed by all firearms.
  2. Many kids live in households where firearms aren't stored safely. Surveys consistently reveal that 30-65% of gun-owning parents say they don't keep their firearms as gun safety experts recommend -- unloaded and locked away. 
  3. A substantial number of teens say they have carried a gun, or have ongoing access to a loaded firearm without adult permission. The rate is especially high among kids who have been extensively bullied. This suggests we need to we need to identify and treat kids with aggressive behavior problems, and prevent bullying at school.
  4. When state governments enforce strong gun regulations, fewer kids die. There is ample evidence showing that firearm deaths are more common in places where regulations are weak. 
  5. We need to reinstate funding for research on gun safety and gun violence. If we're serious about finding solutions, we need to make an investment, and support rigorous research.

Here are the details.

1. Yes, military-style rifles are especially deadly, but most kids are killed by handguns. So if we're serious about protecting youth, we need to address the threat posed by all firearms. 

Many mass shootings have been committed with military-style rifles, like the AR-15. These weapons can wreck far more devastation than handguns, and not merely because they are designed to minimize recoil, or because they can be used with high-capacity magazines and bump stocks.

What makes these weapons especially deadly is the speed and power of their bullets. Compared to a 9mm gun, the AR-15 fires bullets that travel two to three times faster, and can deliver 7 times as much kinetic energy on impact. Their bullets twist and deform in ways that magnify the damage, and as they travel through the body, these high energy bullets push the surrounding tissues apart in an explosive, destructive wave (Stephanopoulos et al 2017; Rhee et al 2016).

Thus, there is a huge difference between between a military-style assault rifle injury and a hand gun wound. As trauma surgeon Peter Rhee notes in Wired, "One looks like a grenade went off in there. The other looks like a bad knife cut." It's crucial that we find ways to keep these weapons out of the hands of would-be shooters.

But as deadly as these military-style rifles are, we must also keep in mind: Most firearm deaths are caused by handguns. 

Between 2002 and 2013, 75% of firearm homicides in children and 85% of firearm homicides in teens involved handguns. Sixty percent of juvenile suicides involved handguns, and approximately 58% of deaths classified as "unintentional" involved handguns (Fowler et al 2017).

So if we are serious about preventing gun violence, we need to address handguns as well as military-style rifles and other firearms.

2. Surveys consistently indicate that many kids in the U.S. live in homes where firearms are kept unlocked. Some parents may believe their guns are safely hidden. But they're wrong.

If you have child attending school in the United States, chances are excellent that one of your child's classmate's lives in a home where guns are not stored as gun safety experts recommend: unloaded and in a locked cabinet or container.

Across surveys the numbers vary. But the estimates are consistently disturbing.

For instance, when researchers analyzed data collected by a nationally representative study of early childhood development, they found that approximately one fifth of households with children under the age of 5 contained firearms. Within this group, one third of the parents reported that they kept their guns unlocked (Martin-Storey et al 2015; Morrissey 2017).

In other surveys,  30-65% of parents living in households with firearms say they don't store their guns unloaded and locked away (Simonetti et al 2017; Crifasi et al 2018; Scott et al 2018, Durant et al 2007).   

In fact, an alarming portion of parents have admitted that they don't take either precaution. In one study, almost one in ten gun-owning parents made this admission (Johnson et al 2006).

What are these parents thinking?

Maybe they believe that locked storage is unnecessary because they've stashed their guns in a safe, secret hiding place. But one study -- that interviewed parents and children separately -- suggests how foolhardy this assumption can be.

Among parents who believed their kids didn't know where the family gun was hidden, almost 40% had children who claimed otherwise. And 22% of parents who said their kids had never handled a household firearm "were contradicted by their children's reports" (Baxley and Miller 2006).

Then there are communication problems between parents. If one parent is in charge of the family firearm, how much does the other parent really know?

In a survey of households with firearms, researchers distinguished between parents who personally owned a gun, and parents who weren't gun owners themselves but who lived with a gun-owning partner. When questioned about gun storage, only 2% of the non-gun-owning partners said the firearms were stored unlocked and loaded. But 9% of the gun-owning parents admitted to this (Asreal et al 2000).

It appears that some parents had false confidence that weapons were safely stored.

3. Self-reported gun-carrying and gun access among U.S. teenagers is substantial, and alarmingly high among kids who feel threatened, or believe that other students are bringing guns to school.

In a national survey of more than 228,000 secondary students (9th-12th grade), 6.7% of teens said they had carried a gun at least once in the previous 30 days (Xuan and Hemenway 2015).

A similar survey of slightly younger students (aged 12 to 17)  found that  3-4 %  had "carried a gun" at some time during the previous year (Vaughn et al 2016).

And a study of more than 10,000 kids (aged 12 to 18) found that 4%  -- 1 in 25  -- claimed to have access to a loaded gun (Simckes et al 2017).

That's worrying already, but the statistic about gun access represents the average rate for all kids in the survey. When researchers drilled down to a subset of kids -- those who said they had been bullied in some way -- the rate was twice as high.

Kids who said they were being bullied extensively -- both online and in person -- were 6 times as likely to say they could access a loaded gun without adult permission (Simckes et al 2017).

Other research supports a similar theme. In a national survey of high school students, researchers found that bullied teens were more likely to bring a weapon to school if they reported at least one of three experiences -- having been threatened or injured at school; having skipped school because it felt unsafe; and having been in a physical fight at school (Pham et al 2017).

Among kids who reported having all three experiences, 46% said they had carried "a weapon such as a gun, knife, or club" to school in the previous month (Pham et al 2017).

This survey didn't ask students to specify whether the weapon was a firearm or something else, like a knife. But other studies focusing on firearms have reported the same strong link: Kids are more likely to carry guns if they've been victimized or witnessed violence (Reid et al 2017).  

And a study of Boston high school students (Hemenway et al 2011) suggests the potential for a literal arms race: Kids were more likely to report bringing guns to school if they believed that other students were carrying firearms.

Moreover, students "substantially overestimated the percentage of their peers who carried guns" and "believed it was easier for other youth to obtain guns than it was for them" (Hemenway et al 2011).

4. When governments enforce stricter gun regulations, fewer kids die.

The previous points suggest we need to do more to keep kids from getting their hands on guns, and we need to make school and other environments feel safe. Some of this can be accomplished through gun safety education, and through comprehensive programs aimed at reducing bullying and aggression.

But it's also clear that sheer availability matters. For example, in one study, researchers analyzed FBI homicide reports from all fifty U.S. states. They compared rates of gun ownership with rates of "non-stranger homicides" (deaths caused by people known the victims), and found a strong correlation:

For every 1% increase in a state's gun ownership rate, there was a 1.04% increase in non-stranger homicides (Seigel et al 2014).

If we enforce stronger laws to regulate gun ownership, can we save children's lives? There is ample reason to think so.

When researchers analyzed 15 years of firearm-related fatalities in the U.S, they found that fewer children die in states that have stronger gun regulations (Resknick et al 2017). 

In another large study, researchers found that kids in the United States were less likely to have been injured by firearms if they lived in a state with strong gun regulations (Safavi et al 2014). 

It's the trend for gun-related homicides in general. When Elinore Kaufman and her colleagues analyzed data collected by the Center for Disease Control in the 48 contiguous U.S. states, they found that counties in states with the weakest gun regulations had the highest rates of firearm homicide (Kaufaman et al 2018).

And internationally, researchers confirm that that regulations are linked with lower mortality. In a review of 130 studies conducted in 10 different countries, Julian Santaella-Tenoria and his colleagues found that "the simultaneous implementation of laws targeting multiple firearms restrictions is associated with reductions in firearm deaths" (Santaella-Tenorio et al 2016).

Which regulations are the most helpful? For some regulations, we simply don't have enough information to judge. We need more research.

But there is a great deal of support for at least one type of law: Mandatory background checks are consistently linked with lower firearm homicide rates (Sen and Panjampirom 2012; Wright et al 1999; Swanson et al 2016; Lee et al 2017). If background checks were strictly enforced throughout the U.S., and were required by private sellers as well as federally licensed sellers, it's likely that many child deaths would be prevented.

There is also evidence in favor of strong laws regulating the storage of guns in and around children. In particular, "child access prevention" (CAP) laws are linked with lower child firearm injuries -- but only if these laws impose liabilities on adults who store their guns negligently. Weaker laws (that merely prohibit adults from  deliberately or recklessly giving kids weapons) do not appear to be effective (Hamilton et al 2017; Simonetti et al 2015).

In addition, domestic partner deaths are less common in places where the law prohibits firearm access to people who've had a restraining order issued against them, or who have been convicted of violent misdemeanors (Diez et al 2017; Zeoli et al 2017; Sen and Panjampirom 2012). Given that young children often die in the context of domestic partner homicide, it's reasonable to think that such laws would protect kids too.

And studies show that permit to purchase laws and mandatory waiting periods are linked with fewer firearm deaths (Zeoli et al 2017; Diez et al 2017; Sen and Panjampirom 2012; Santaella-Tenorio et al 2016; Luca et al 2017).

5. To identify more ways to save lives, we need to support gun violence research

We still have more to learn, which is why it's important for the U.S. Congress to restore funding for the Center for Disease Control to support gun violence research.

There should be no controversy about it. Even Jay Dickey, the former congressman who introduced the Dickey Amendment in 1996, agrees.

In an interview with Steve Inskeep on NPR radio in 2015, Dickey said he hadn't anticipated the chilling effect that Congress' actions would have on research. He regrets he didn't take steps to prevent this. 

"I didn't follow through and say, we need - still need to do research," Dickey said. 

It's time for all of us to follow through.


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Image credits for "Gun violence"

"Stop gun violence" photo by Tony Webster / flickr

Image of shooting aftermath by Tiocfaidh ár lá 1916/flickr

Image of shot-up sign by John Savage/flicker

Image of child silhouette against wall by Boris Thaser/flicker

Image of child with gun by Pedro Alonso / flickr

image of high school students by kamera kızı/flickr




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