The Daily Item, Sunbury, PA

April 30, 2013

Gun violence: a pediatric public health crisis

Daily Item

---- — "When I was a boy and I would see scary things in the news, my mother would say to me, 'Look for the helpers. You will always find people who are helping.' To this day, especially in times of disaster, I remember my mother's words and I am always comforted by realizing that there are still so many helpers-so many caring people in this world." -- Fred Rogers

Over and over again, unspeakable acts of gun violence occur in our society. The last time, the heinous nature of the crime seemed heightened because its victims were tiny, innocent school children and grown-ups who dedicated their lives to teaching and helping them.

Since 2002, St. Louis Children's Hospital has cared for 771 children injured or killed by gunfire; 35 percent were younger than 15. These include the recent 12-year old accidently killed by his friend when playing with his grandfather's pistol kept under his pillow; the 2-year old boy paralyzed when his father accidentally discharged his gun during loading; the 5-year old caught in a cross-fire as she sat on her front porch; the 10-year old killed by his mother overwhelmed with mental illness; and the 4-year old who found a handgun in a closet at home, placed the barrel into his mouth and pulled the trigger as he had often done to get a drink from his water-pistol.

In 2010, seven American children age 19 and younger were killed every day by gun violence. This is twice the number of children who die from cancer; five times the number from heart disease, and 15 times the number from infections. This is the equivalent of 128 Newtown shootings. Remember that the outrage of Newton occurs daily in U.S. cities, suburbs, and rural areas.

It has been estimated that at least 38 percent of American households have a gun. In homes with children younger than 18, 22 percent store the gun loaded, 32 percent unlocked, and 8 percent unlocked and loaded. The children in these homes know the gun is present and many handle the gun in the absence of their parents.

Children who received gun safety training are just as likely to play with and fire a real gun as children not trained. In one study, 8-12 year old boys were observed via one-way mirror as they played for 15 minutes in a waiting room with a disabled .38 caliber handgun concealed in a desk drawer. Seventy-two percent discovered the gun and 48 percent pulled the trigger; 90 percent of those who handled the gun and/or pulled the trigger had prior gun safety instruction.

Rather than confer protection, careful studies find guns stored in the home are 44 times more likely to be involved in an accidental death, homicide by a family member, or suicide than against an intruder. In 2009, suicide was the third leading cause of death for American youth, with firearms the most common method used. The American Academy of Pediatrics has concluded, "the most effective measure to prevent suicide, homicide, and unintentional firearm-related injuries to children and adolescents is the absence of guns from homes and communities."

Firearm-related deaths are among the top three causes of death among American youth. From a public health point of view, the origins of gun violence are many. The convergence of apparently too-easy access to firearms; a generation increasingly desensitized to gun violence and its real consequences through regular exposure to slaughter during video games, movies and television; and mental health problems, particularly among adolescents and young adults, often contributes to deaths from firearms in this country.

The American Academy of Pediatrics has long advocated specific measures to prevent violence to children. Those measures include banning the sale of assault weapons and high-capacity ammunition magazines to the public, stricter firearms safety laws and background checks, limiting children's exposure to media violence as in movies and video games and greater support for mental health services.

As a nation, we have it in our power to protect our children from gun injuries, as other countries have done. Doctors, teachers, city and state officials, gun owners, families and young people must come together with a creative and meaningful commitment to improving our society.

Pediatricians, parents, teachers and all who care for children need to continue to look for ways to comfort, support, nurture and protect them. Please contact your legislators to show support for legislative changes recommended by the American Academy of Pediatrics that will keep our children safer. Please look to all the helpers and try to help.

Pat Bruno, M.D., Selinsgrove