Emergency room visits for firearm injuries among children doubled during the pandemic

Pediatric emergency department visits for firearm injuries became twice as common during the Covid-19 pandemic, according to research published Monday, in the journal Pediatrics.

From 2017 to early 2020, there were about 18 firearm-related visits every 30 days, which jumped to 36 visits every 30 days during the pandemic, from March 2020 through November 2022. The analysis was based on data from nine urban hospitals that participate in a research registry supported by the US Department of Health and Human Services.

“Really no child is immune to the growing risks of firearm violence in this country,” said Dr. Jennifer Hoffmann, lead author of the study and a pediatric emergency medicine physician at Ann & Robert H. Lurie Children’s Hospital of Chicago and assistant professor of pediatrics at Northwestern University Feinberg School of Medicine.

But the increases were particularly stark among Black and Hispanic children, widening an already existing disparity, she said. About two-thirds of all emergency department visits for firearm injuries during the pandemic were among children from the most disadvantaged neighborhoods.

Emergency department data about the intent of an injury is prone to misclassification, Hoffmann said, but other research suggests that the rise in firearm-related visits is likely a combination of accidental injuries, self-harm and assault among children.

“Many factors contributed to increased pediatric firearm injuries during the early pandemic. There was a period of increased firearm purchasing, there was economic uncertainty and there was an increase in mental health concerns among children,” she said. As some of those early stressors abated, schools reopened and life started to normalize, some experts expected that trends would improve.

Instead, there was a “pretty dramatic increase right at the start of the pandemic, and then those elevated levels of firearm injuries persisted,” Hoffmann said.

A policy statement published by the American Academy of Pediatrics last year emphasizes the importance of using harm reduction strategies to protect children against firearm-related injuries and death. Some recommendations include guidance for safer firearm storage at home, counseling for children at risk for self-harm and their families, as well as community-based violence intervention programs including .

A separate study published Monday in Pediatrics found that nearly 1 in 8 children who died from a firearm homicide were exposed to intimate partner violence. Most of those children were victims of a conflict between adults in their lives, often involving intimate partner violence and homicide of their mother. Others were teens killed by a current or former dating partner.

This study captured two decades of data, from 2002 to 2020, from US Centers for Disease Control and Prevention’s National Violent Death Reporting Systems.

In a related commentary, Dr. Maya Ragavan and Dr. Alison Culyba of the University of Pittsburgh and UPMC Children’s Hospital of Pittsburgh named intimate partner violence an “urgent pediatric health epidemic” and highlighted the link between interpersonal violence homicide and firearms.

As in the policy statement from the American Academy of Pediatrics, they emphasized the urgent need for “public health approach focused on evidence-based policies and practices.

“Health care, community, and policy-level solutions are critical to protect IPV survivors and their children and promote family- centered thriving,” they wrote.

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