Citation

Nelson EW. Pediatrics 2017; 140(1): e2017-1300.

Affiliation

Department of Pediatrics, University of Vermont Children's Hospital, Burlington, Vermont eliot.nelson@uvmhealth.org.

Copyright

(Copyright © 2017, American Academy of Pediatrics)

DOI

10.1542/peds.2017-1300

PMID

28630117

Abstract

Firearm injuries are an all-too-common way of death for children and youth in the United States. As Fowler et al report in the current issue, firearm injuries are the third leading cause of death for all children aged 1 to 17 years. Although firearm injury mortality rates for these children declined gradually from 2006 to 2013, they have risen again over the past 2 years, now accounting for over 10% of all deaths among these ages in 2014 and 2015.2 An even grimmer picture appears if we extend the age range through the teen-aged years to age 19, because firearm injury rates rise steeply in late adolescence; among children and youth aged 1 to 19, firearm injuries accounted for over 14% of all deaths in 2015. Thus, more than 1 out of every 7 children aged 1 to 19 who died of anything died of a gunshot wound. Only motor vehicle traffic injuries claim more of these lives, and those rates have fallen ∼50% since 2000, whereas firearm mortality dropped only 10%.

The value of Fowler’s report lies not only in its updating of basic statistics on child firearm deaths but also in providing deeper insight into circumstances and factors involved with these deaths than we have had from past reports3,4 by using information from the National Violent Death Reporting System. By including a focus on nonfatal firearm injuries treated in emergency rooms, the authors also remind us of the fuller scope of these injuries and the toll they exact.

Some points may warrant further discussion or clarification. Unintentional injury (UI) deaths, although only a small portion of the total, have indeed been under-counted in vital statistics data, as the authors suggest. Authors of a recent study use National Violent Death Reporting System analyses to estimate that UI firearm death rates in children less than age 15 are ∼80% higher than they have been reported because of mis-classifications of some UIs as homicides.

Language: en