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Journal Article

Citation

Cook PJ, Parker ST. JAMA Netw. Open 2022; 5(4): e225136.

Copyright

(Copyright © 2022, American Medical Association)

DOI

10.1001/jamanetworkopen.2022.5136

PMID

35377432

Abstract

Firearm injury among youths is a public health problem that presents differently in rural and metropolitan (urban) areas. Ellyson and colleagues1 focus on handgun carrying by youths who grew up in rural areas. Handgun carrying by adolescents is a precursor to gun assault and homicide because these crimes typically occur away from home.2 However, interpersonal violence is a less pressing problem in rural areas than in urban areas. In this commentary, we broaden the focus to include suicide, which almost always occurs at home, and consider the need to limit access to guns by children and adolescents.

Of course, the growing propensity nationwide to carry guns is a public health concern. Ellyson and colleagues1 track self-reported handgun carrying in a cohort of youths. The first wave of interviews was in 2005, when respondents were 12 years of age, and subsequent waves were conducted in most years thereafter until 2019, when the respondents were 26 years of age. The sample of 2002 individuals was taken from students in 12 rural towns distributed across 7 states and was not designed to be nationally representative. In each interview, respondents were asked how often they had carried a handgun in the previous 12 months. Most respondents (70%) responded "zero" in every interview, and, indeed, only 14% of the original sample indicated in more than 1 interview that they had carried a handgun in the previous year. Some of those who were repeat handgun carriers had started young, although only 7.4% of the sample indicated that they had carried a handgun at 12 years of age, and still fewer (5.7%) at 13 years of age. The survey did not ask for details, and it is quite possible that the respondents were reporting legal incidents in which they were hunting or target shooting with a parent. Although the prevalence of handgun carrying was quite low, the main conclusion of the article is "that promoting handgun safety in rural areas should start early," in late childhood and the elementary school period.

In our view, "promoting handgun safety" by educating rural children is of limited value, especially given that the predominant gun problem for adolescents in rural areas is suicide. Indeed, firearm suicide rates are far higher in rural areas than in urban areas for youths aged 12 to 17 years in the United States.3 During the 21st century, the mean annual gun suicide rate among youths aged 12 to 17 years in rural areas has been 3.3 per 100 000, accounting for half of all suicides in that age group and twice the rate in urban areas.3 Since 2018, the gun suicide rate has increased to more than 5 per 100 000...


Language: en

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