Fact: 1,300 American children are killed by guns each year, making firearm injuries the third leading cause of death among zero to 17-year-olds.

That grim finding is unfortunately not newsworthy. Excellent resources, like FiveThirtyEight’s Gun Deaths in America, already paint a sobering picture of the topic in the U.S. But fewer resources focus specifically on contextualizing childhood gun deaths. A new study in the July 2017 issue of “Pediatrics” identifies patterns in childhood firearm deaths and injuries in order to develop more targeted, scientific solutions.

The study suggests that some risk factors for gun death are relatively static. For example, firearm homicides for both age groups are concentrated in the South and the Midwest, while firearm suicides are more evenly distributed across the country. But many of the risk factors changed with age, prompting the researchers to split the data across two age groups.

 

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Young children (zero to 12 years) were most likely to be shot in their homes (85 percent). Half of gun-related incidents involving young children had more than one victim. The perpetrators of these shootings tended to be older; two-thirds of them were over 25 years old. Forty-two percent of the perpetrators committed suicide after shooting. The overall picture painted by shootings of children in this age group is about domestic violence and the children caught up in it.

Older children (13 to 17 years) killed by guns presented a much different picture. Children in this age group were about as likely to be shot in the streets (38 percent) as at home (39 percent). Eighty-three percent of these shootings had only one victim, and the perpetrators of homicides were much more likely to be the same age as the victims.

For this group, the rate of firearm homicides was roughly equal to the rate of firearm suicides. The overall picture of shootings in this age group is a bit murkier than that presented by the younger age group – a mix of violent crime and self-harm.

It’s reasonably simple to explain the increases in death and injury rates as children age as a result of different social and cultural factors. Violent crime, for example, is frequently identified as a main cause of firearm deaths among older children, especially older boys. The “Pediatrics” report suggests that’s not the whole story.

At all ages, boys were significantly more likely to be killed or injured by guns, representing a total of 82 percent of gun deaths and 84 percent of emergency room visits. Older boys were six times as likely to be killed by a gun than older girls. Younger boys were 4.5 times as likely to be killed by guns than younger girls. Older boys were also six times more likely to commit suicide using firearms.

Some of the most surprising findings of the study are related to unintentional firearm deaths, which represent a much lower overall proportion of deaths than is often assumed (six percent of all firearm deaths in children ages zero to 17).

Also surprising was that, contrary to popular belief, older children were twice as likely to be killed by unintentional firearm injury than younger children. The majority of unintentional gun deaths for both groups occurred in a home. About half of unintentional firearm deaths resulted from playing with a gun (60 percent for younger children, 49 percent for older children).

The authors conclude that this more patterned view of gun deaths and injuries is a “first step” in developing tailored solutions to reduce gun injuries in the pediatric population.

A second step, suggested by Eliot Nelson in a companion piece, might be for pediatricians to acknowledge imperfect adoption of their own policy that “the safest home is one without firearms.” Acknowledging that households will continue to have guns and focusing on gun storage, Nelson argues, may help prevent many of the unintentional deaths and possibly even suicides included in the Pediatrics study.