Originally published by 2 Minute Medicine® (view original article). Reused on AccessPediatrics with permission.

1. Despite a decrease in overall firearm ownership among families with young children in the household between 1976 and 2016, handgun ownership and firearm-related mortality among 1- to 5-year-olds rose.

2. Proportion of families with a handgun in the home was positively and significantly associated with child mortality.

Evidence Rating Level: 2 (Good)

Study Rundown:

Though the overall firearm-related child mortality rate has declined over the past several decades, firearm-related mortality among 1- to 4-year-olds nearly doubled between 2006 and 2016. These trends may be mediated by decreases in overall gun ownership, but a relative increase in handgun ownership, as young children may more easily unintentionally harm themselves with handguns than rifles. In this retrospective cohort study, researchers examined trends in death data from the National Vital Statistics System and firearm ownership data from 1976 to 2016. While the proportion of white families with young children owning a firearm dropped during the study period from around 50% to 45%, the proportion of these families who owned a handgun rose. Proportion of families with a handgun in the home was positively associated with child mortality. This association persisted when controlling for multiple demographic factors.

As population estimates based on ecological data, these findings are limited in their ability to produce causal inferences. Furthermore, researchers were unable to distinguish between types of firearm-related mortality. Nonetheless, the study is strengthened by its use of comprehensive, national databases. For physicians, these findings highlight the importance of assessing type of firearm ownership among families with young children and counseling on firearm safety, especially among families with handguns.

In-Depth [retrospective cohort]:

Researchers drew cause of death data from the National Vital Statistics System and firearm ownership data from the General Social. Data used pertained to white and African American families with a child 5 years or younger in the home between 1976 and 2016. They sought to examine the association between firearm ownership and fire-arm related mortality among 1- to 5-year-olds using vector autoregression models. Variables with known association to both firearm ownership and child injury risk were controlled, including living in rural area, living in the South, and parent educational attainment.

The proportion of white families with young children owning a firearm dropped from 50% in 1976 to 45% in 2016, with a low of 29% in 2002. Among these families, 49% in 1976 had a handgun, which rose to 72% in 2016. Among African American families with young children, 38% owned a gun in 1976 and 6% owned a gun in 2016. Proportion of families with a handgun in the home was positively associated with child mortality (B = 0.426).

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