Nearly one-quarter of child and adolescent victims of firearm homicide were killed in their own homes from 2020-2021, including nearly two-thirds of child victims aged 12 and under, UCLA-led research finds.
The findings, to be published Sept. 26 in the peer-reviewed JAMA Surgery, also found that rates of in-home firearm homicide have more than doubled among children and adolescents since 2010. They found that these cases were often linked with intimate partner violence and child abuse. Parents were the most common assailants for these homicides.
These data suggest that Extreme Risk Protection Orders (ERPOs), also known as red flag laws, domestic violence-related relinquishment firearm laws, and potential policies linking child abuse investigations with firearm relinquishment may be potential tools to protect children.
While mass shootings and community gun violence involving child and adolescent victims tend to garner the most attention, pediatric firearm homicides in the home remains understudied despite representing a major cause of child and adolescent mortality, said Dr. Jordan Rook, a resident in General Surgery at the David Geffen School of Medicine at UCLA and the study's lead author. The researchers sought to fill that gap with a look at the factors associated with these deaths.
"This research shows that traditional home-based firearm injury prevention like safe storage such as locking guns away, may not be enough to prevent many of these tragic cases," Rook said. "Instead, policies that address risk factors for in-home homicide like intimate partner violence and child abuse, and which remove firearms from high-risk households, may be effective prevention strategies. This will be the focus of our future research."
The researchers examined data on nearly 2,200 firearm-related homicides involving children and adolescents aged 17 and younger from the Centers for Disease Control and Prevention's National Violent Death Reporting System (NVDRS) Restricted Access Database. For their primary analysis, they examined 48 states and the District of Columbia from 2020 and 2021. To identify trends of in-home firearm homicide, they examined data from 14 states--Colorado, Georgia, Kentucky, Maryland, Massachusetts, New Jersey, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, Utah, Virginia, and Wisconsin—which unlike the other states, had continuously contributed statistics to the NVDRS from 2005 to 2021. Data for Florida and Hawaii were unavailable because they only began contributing to the database in 2022.
Of total firearm homicides among children and adolescents, 536 (24%) occurred at home and 1,660 (76%) outside the home. For younger children aged 12 and younger, nearly two-thirds (63%) were killed at home. Among in-home homicides, 23% were associated with murder-suicide, 20% were linked to child abuse, and 17% were precipitated by intimate partner violence. Assailants were identified in 310 of the in-home homicides. Of those, 42% were committed by a parent. Rates of firearm homicide occurring in children's homes increased from 0.18 homicides per 100,000 children and adolescents in 2010 to 0.38 per 100,000 in 2021.
The researchers note some study limitations. Those include missing data in the NVDRS such as details on the circumstances surrounding some homicides; the 2020-2021 data coincided with the COVID-19 pandemic, a limitation that the researchers addressed by assessing the temporal trends reflected in the 14 states' data; and some incidents may have been misclassified due to the NVDRS data's reliance on medical, coroner and police records.
Study co-authors are Dr. Whitney Orji and Dr. Catherine Juillard of UCLA, Dr. Savannah Walker of the University of Arkansas, Dr. Sindhu Mannava of Michigan State University, Dr. Katherine Marsh of the University of Virginia, Dr. Heather Hartman of Nemours Children's Hospital, Dr. Garret Zallen of PeaceHealth Medical Center and Shriner's Hospital, Dr. Marion Henry of the University of Chicago, Dr. J. Leslie Knod of the University of Connecticut, Dr. Joanne Baerg of Presbyterian Health System, and Dr. Bindi Naik-Mathuria of the University of Texas.
The study was conducted with the American Pediatric Surgical Association and the American Academy of Pediatrics Advocacy Committee.
