For nearly 60 years, the leading cause of death in children and teens in the US were motor vehicle accidents (MVAs). But over the last few decades, we’ve seen a reduction in MVA-related deaths as cars have become safer and driver education has improved. In addition, pushes by organizations like the National Highway Traffic Safety Administration have led to safer car seats and increased compliance in their use. 

In 2020, this changed when the number of gun-related deaths surpassed those related to MVAs, and ever since, firearms have remained the #1 killer of children in America. As you absorb this horrific statistic, you’re likely thinking of the astounding number of mass shootings that the US has experienced so far this year. However, while these are the shootings that usually make the news, research shows that most children are killed in smaller, day-to-day incidents. Just this year alone, more than 1300 children and teens have been killed by guns. Among these are children who died after discovering unsecured firearms, children who accidentally shot a friend or sibling, children who were killed by celebratory shots on New Year’s Day, and the heartbreaking list goes on. 

The topic of gun control has been a hot one for years, but party lines aside, it’s undeniable that this a public health crisis. So, let’s approach it as one. In this article, we’ll take a look at the key factors contributing to this crisis, explore related social determinants of health, examine the racial breakdown of gun violence victims, and provide essential tips for prevention.

1. Risk Factors for Gun-Related Death
   As healthcare providers, it’s so very important that we familiarize ourselves with the risk factors associated with gun-related deaths and use these as tools to identify and educate patients who are at increased risk.

Accessibility of Firearms
People who own a firearm and keep it in their home are at a greater risk of unintentional shootings and youth suicides, many of which are the results of insecure gun storage and failure to ensure that firearms are inaccessible to children.

Mental Health Issues
The relationship between mental health and gun violence is complex and requires more research, which is currently being pursued by various agencies. Untreated or unmanaged health conditions can increase the risk of firearm-related incidents. Early intervention and mental health support are critical resources.

Peer Influence
At a time when bullying among children and teens is on the rise and facilitated by social media platforms and technology, it’s critical to be aware of the dynamics of peer influence. Peer pressure and conflicts can lead to impulsive actions, and are correlated with increased rates of suicidality and self-harm.

Socioeconomic Factors
Poverty, economic inequality, structural racism, structural inequity, and lack of access to education and resources can all contribute to gun violence. 

Social Determinants of Health
While this overlaps with socioeconomic factors, several social determinants of health play a key role in understanding the factors that contribute to gun violence among children and teens. These include:

• Poverty and economic disparities
• Lack of access to healthcare
• Community safety
• Education
• Family dynamics
  
  

2. Racial Characteristics of Gun Violence Victims
   As is the case with many public health issues, Black children and teens are disproportionately affected by gun violence. In 2020, the gun-related death rate for Black children and teens was nearly three times higher than that of white children and teens. Hispanic children and teens also face a higher risk of gun violence compared to their white counterparts. In 2020, the gun-related death rate for Hispanic children and teens was 1.5 times higher than that of white children and teens. Addressing racial disparities involves a multifaceted approach, including community engagement, culturally competent care, and eliminating systemic barriers that contribute to these disparities.
   
   
3. Prevention Strategies
   To combat the escalating problem of firearm-related deaths among children and teens, healthcare providers can take several proactive steps:
   
   
1. Gun Safety Education
   Promoting gun safety education for both parents and children, including emphasizing responsible firearm ownership and secure storage is a critical step. Organizations such as the American Academy of Pediatrics and CDC have useful resources for education.
   
   
2. Mental Health Support
   Providers should encourage mental health awareness and provide resources for children and teens dealing with mental health challenges. NAMI and NIMH are great places to start. 
   
   
3. Community Outreach
   Collaborating with community organizations to address the social determinants of health that contribute to gun violence can be a useful step in reducing these disparities.
   
   
4. School-Based Programs
   Consider supporting and educating patients on available school-based programs that focus on conflict resolution, anti-bullying initiatives, and safe school environments.

The alarming rise of firearms as the leading cause of death in children and teens since 2020 is a dire concern for healthcare providers and society at large. Understanding the risks, social determinants of health, and racial disparities involved is essential to combating this issue effectively. By adopting proactive prevention strategies and advocating for change, healthcare providers can contribute to a safer future for the nation’s youth, where children and teens can thrive without the threat of gun violence.