Alyssa Silver's interest in studying gun-related injuries in kids was prompted by her son's reaction to a t-shirt. When he was in kindergarten, she bought him a glow-in-the-dark dinosaur shirt. But instead of being excited, he was cautious. "He was nervous to wear it because in school they do drills where they have to hide in the corner with the lights off in case bad people with guns are in the building. He is afraid if his shirt glows the bad people will see him," says Silver, who is an attending physician and assistant professor of pediatrics at the Children's Hospital at Montefiore/Albert Einstein College of Medicine in New York City.
"This was heartbreaking to me, so I wanted to look into the true scope of the problem and raise awareness of the need to stop this epidemic of gun violence in our country," she says. Gun violence in the United States is notoriously difficult to study, in part because of a 20-year-old Congressional ban on funding for research that might be seen as advocating for gun control. The hyper-charged political atmosphere around guns has also made public-health researchers leery of wading into the fray—though that may be changing.
This weekend, Silver will be adding to the data on gun violence when she presents a paper which found that more than 5,800 American children were hospitalized as a result of gun injuries in 2012—that's roughly 16 kids a day, or one every 90 minutes. And it doesn't include those who died without being admitted to the hospital, like the 20 kids who were murdered in the 2012 Sandy Hook Elementary School shooting.
That 16-hospitalizations-a-day stat is from a new study that she'll present at the 2017 Pediatric Academic Societies meeting in San Francisco on Sunday. For the paper, Silver and her team used a database that tracks hospital stays for patients 19 and younger (including rural and non-teaching hospitals) and looked for diagnosis codes for gun-related injuries. There are four subtypes: unintentional, suicide attempt, assault, or undetermined.
Again, because the database only tracks admissions, it doesn't include kids who were shot and died outside the hospital, or in the emergency room. But "of those who are hospitalized, our study showed that on average, more than one child hospitalized with gun-related injuries dies per day," Silver says. It's not clear how many children die by firearms, though the Centers for Disease Control and Prevention says that guns killed more than 33,000 people and injured another 81,000 in 2014.
Researchers found a number of other disturbing patterns by combing through the database. Nearly 88 percent of gunshot patients were male, 84 percent were between the ages of 15 and 19, and 54 percent were black. More than half lived in zip codes where the median household income was in the bottom 25 percent and 53 percent of the patients had federally-funded Medicaid for their health insurance. "Previous data has shown that with respect to gun-related injuries, there are clear socioeconomic and racial disparities that exist and have not really improved over time. Our data reinforces these disparities," Silver says. Gun violence is yet another health hazard that disproportionately affects lower-income people of color.
For the patients under age 15, most of the injuries (57 percent) were accidental, like those heartbreaking stories about one sibling shooting another or a child shooting themselves. But among 15- to 19-year-olds, most shootings were the result of assault. On average, patients spent six days in the hospital at an average cost of more than $22,000 a day. Overall, the national cost for these hospital stays was an estimated $130 million. The study hasn't yet been published in a peer-reviewed journal.
It's hard to confront a problem you don't understand, and Silver believes that more understanding is the only way forward when it comes to gun violence: "We need more research on ways to help keep children safe from gun violence and ways to keep them safe from firearm-related injuries." And that means more funding.
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