P0104 - Pediatric Firearm Deaths: Who, Where, and How?

Background: Over 3,000 youth die by firearms in the United States (U.S.) each year. Yet, little is known about the location of these incidents, firearm ownership, firearm user (shooter), and firearm storage. This knowledge may help prevent firearm-related fatalities.

Objective: To describe pediatric firearm fatalities in terms of location, firearm ownership, firearm user (shooter), and firearm storage.

Methods: We conducted a cross-sectional study of all firearm fatalities reported in the National Violent Death Reporting System (NVDRS) for youth ages 0-19 years in the U.S. from 2005-2017 (16-37 states contributed data depending on year). We categorized deaths by intent (homicide, suicide, unintentional [self-inflicted or inflicted by other person]) and by age (<1 year, 1-9 years, 10-14 years, 15-19 years). We calculated descriptive statistics for the location of death, firearm ownership, firearm storage, and the relationship between the victim and the shooter. Chi-square tests were used for between-group comparisons for firearm storage status; only cases with data available for firearm storage were included in these comparisons.

Results: During the study period, 11,256 firearm deaths among youth age 0-19 years were reported in NVDRS. There were 6,279 homicides (56% of NVDRS-reported firearm deaths), 4,276 suicides (38%), and 701 unintentional deaths (6%). Of unintentional deaths, 250 (36%) were self-inflicted. The location of death was the victim’s home for 19% of homicides, 69% of suicides, and 50% of unintentional deaths. The firearm was owned by a parent or family member in 21% of homicides, 67% of suicides, and 55% of unintentional deaths. Firearms were more commonly stored not locked and loaded than locked and unloaded across all three intents (homicide 79% vs. <10%, p<0.001, suicide, 37% vs 19%, p<0.001, and unintentional 84% vs. <7%, p<0.001). (Table) For homicides, the shooter was the parent for 17 children < 1 year old (68%), 195 children 1-9 years old (77%), 92 children 10-14 years old (41%), and 70 children 15-19 years old (5%). For non-self-inflicted unintentional deaths, the shooter was a parent or other family member for 59 children 1-9 years old (80%), 47 children 10-14 years old (50%), and 35 children 15-19 years old (20%).

Conclusions: Pediatric firearm suicide and unintentional deaths occur predominantly in the child’s home with a family member’s gun. Across all intents, firearms were not stored in the safest manner (i.e., locked and unloaded) in the majority of cases, implying safe storage might help prevent many pediatric firearm deaths. Improving firearm safety and proper safe storage, potentially through parental education or other means, may reduce pediatric firearm fatalities in the United States.