We’re Ignoring the No.1 Childhood Health Crisis

Guns now kill more American children than car crashes, cancer, drugs or any other single cause, based on multiple analyses of data that do not include recent school shootings. The burgeoning childhood health crisis, unique to this country, has pediatricians facing a challenge they never expected when they signed up to care for kids, and frustrated that virtually nothing is being done to curb it.

That’s not some liberal viewpoint. It’s what pediatricians and other physicians are saying.

“When I became a pediatrician, I never thought that I would care for so many children who had been shot,” said Annie Andrews, MD, a pediatrician and assistant professor of pediatrics at the Medical University of South Carolina. “But as a hospital-based doctor for the past 12 years I’ve seen it happen again and again.”

The statistics are staggeringly sad

Gun-related deaths among those 18 and younger outpaced car-crash deaths for that age group starting in 2019, Andrews and her colleagues report in a new study in the journal Pediatrics.

A separate recent study found youth gun deaths soared 83 percent in the past decade. The picture is bleakest for Black youth, who experienced a 40% rise in gun deaths just from 2019 to 2020, researchers conclude in the journal Lancet Child and Adolescent Health. “We must reverse this deeply troubling and unacceptable trend in youth firearm fatalities, especially among youth of color,” said the study’s co-author, Karen Sheehan, MD, a pediatric emergency medicine physician at the Lurie Children’s Hospital of Chicago.

“The increasing firearm-related mortality reflects a longer-term trend and shows that we continue to fail to protect our youth from a preventable cause of death,” a separate group of two medical doctors and a statistician from the University of Michigan wrote recently in the New England Journal of Medicine.

There’s some serious irony in this crisis.

As youth firearm deaths rose over the years, mortality among children due to motor vehicle accidents fell, in part due to laws mandating practical solutions: seat belts, car seats, airbags, and reasonable regulation on manufacturers and sellers to ensure vehicles are at least somewhat safe and appropriate for their intended use.

Stronger gun laws save kids’ lives

This childhood health crisis is unique to this country, in part because there are more guns in civilian hands in America than there are citizens. No other country comes close to our level of gun ownership on a per-capita basis. But those sheer numbers are only part of the problem. Lack of reasonable regulation is the elephant in the nation.

The science on gun laws and firearm deaths is clear: Stricter gun legislation — not bans but measures like background checks, gun licensing and gun-dealer regulations — help protect children and other family members.

Youth deaths by firearm were 35% lower in states that had, for at least five years, required universal background checks for purchasing guns, one study found.

“Our findings demonstrate a powerful association between the strength of firearm legislation and pediatric firearm-related mortality,” said study team member Monika Goyal, MD, a researcher at Children’s National Health System. “This association remains strong even after we adjust for rates of firearm ownership and other population variables, such as education level, race/ethnicity, and household income.”

Gun-related homicide and suicide rates are lower in states that have stricter gun regulations, including “laws regulating dealers, background checks, licensing, reporting of lost or stolen guns, multiple purchases, and gun design and manufacturing standards” researchers reported in the journal JAMA Internal Medicine. In states with lax gun laws, gun-death rates were lower in certain counties—only those that were surrounded by states with tighter regulations, the study found.

Will we ever have the will to fix this?

For whatever reasons — and there are many — childhood health has taken a deadly back seat to absolutist positions on gun rights and gun politics.

Prior to 2020, a majority of Republicans, Democrats and Independents supported sticter gun laws, including background checks, a federal database for gun ownership, and bans on assault weapons, according to a Pew Research survey.

In a November 2021 Gallup Poll, support for stricter gun laws remained strong among Democrats at 91%, but it plummeted to just 24% among Republicans and 45% among Independents. The shift coincided with near-doubling in gun purchases during the pandemic. Did America suddenly become a more dangerous place? For children, absolutely yes.

Barring new legislation, however, the lack of gun laws can be seen as a contributing cause, if not a primary cause, of the tragic, preventable childhood health crisis. The imperfect example of laws around car manufacturing, ownership and operation suggest that children would be safer if the purchaser and owner of a gun were ever-so-slightly inconvenienced by a little education, a license, and maybe some regulation on just how powerful the thing can be.