Nav: Home

US regions with stricter gun laws have lower rates of pediatric injuries due to firearms

September 15, 2017

CHICAGO - New research shows regions of the United States that have the strictest gun laws also have the lowest rates of childhood firearm injuries, with the Northeast region of the U.S. having the lowest rates of child injuries due to guns.

The study abstract, "Geographic Regions with Stricter Gun Laws Have Fewer Emergency Department Visits for Pediatric Firearm-Related Injuries: A Five-Year National Study," will be presented Friday, Sept. 15, at the American Academy of Pediatrics National Conference & Exhibition in Chicago.

For the study, researchers compared regional firearms laws to the number of firearms-related injuries in regional emergency departments. Using national data from the Nationwide Emergency Department Sample from 2009-2013, researchers analyzed 111,839 emergency department visits for pediatric firearm-related injuries across the U.S., broken down by state and region.

"Our research confirms that regions that have stricter gun laws have a significantly lower rate of firearm injuries among children," said Monika Goyal, MD, MSCE, an assistant professor of pediatrics and emergency medicine at Children's National Health System and The George Washington University.

For their analysis, researchers ranked each region in the U.S. using the Brady Gun Law Score, which scores all 50 states based on policy approaches to regulating guns and ammunition, such as background checks on gun sales, reporting lost or stolen firearms, and restricting the purchase of weapons among high-risk populations. A higher regional median Brady Gun Law Score indicates stricter gun laws. The Northeast region of the U.S. received the highest score at 45, with the Midwest and Western regions next at 9, while the South received the lowest score at 8.

Researchers then compared the regions' Brady Gun Law Score to the number of pediatric emergency department visits for firearm injury. They found that the regions with higher Brady scores also had lower rates of emergency department visits for firearm injuries among children and teens, suggesting that stricter gun laws are correlated with lower firearm injury rates among youths.

Researchers found that firearm injury rates in the Northeast decreased during the study period and that the Northeast had the lowest rate: 40 firearm injuries to children and teens per 100,000 emergency department visits. This was followed by the Midwest, with a rate of 62 injuries to children and teens per 100,000 visits, and the West at 68 injuries to children and teens per 100,000 visits. The South at 71 injuries per 100,000 visits had the highest rates of visits for pediatric firearm injuries.

During the study period, firearm-related emergency department visits remained consistent at a rate of 65 injuries to children and teens per 100,000 pediatric visits or 22,368 visits per year, on average. Of those injuries, the average age of emergency department patients seen for firearm injuries was 18 years of age, and most of those seen were male. Researchers found that during the study timeframe, 6,500 patients died and more than one-third of these children and teens were admitted to the hospital for their injuries.

"Our study highlights the regional variations in gun laws," says Dr. Goyal. "It also suggests how gun laws may help to reduce the number of pediatric firearm victims being treated in the emergency department each year."
The abstract, available below, will be presented by Shilpa Patel, M.D., M.P.H., an assistant professor of pediatrics and emergency medicine at Children's National Health System and The George Washington University - whom Dr. Goyal mentors - on Friday, Sept.15, from 3:00 p.m. to 3:15 p.m. CT in McCormick Place West, Room S101.

Please note: only the abstract is being presented at the meeting. In some cases, the researcher may have more data available to share with media, or may be preparing a longer article for submission to a journal.

The American Academy of Pediatrics is an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit

Abstract Title: Geographic Regions with Stricter Gun Laws Have Fewer Emergency Department Visits for Pediatric Firearm-Related Injuries: A Five-Year National Study

Purpose: Firearm-related injuries are a leading cause of morbidity and mortality among children and adolescents. States with more restrictive gun laws have fewer firearm-related pediatric fatalities. Our objective was to investigate the association between regional firearm legislation and pediatric firearm-related injuries presenting to the emergency department (ED). Methods: Repeated cross-sectional analysis using the Nationwide Emergency Department Sample (NEDS) from 2009-2013. National estimates of rates of firearm-related visits in children ? 21 years were calculated using annual census data to evaluate trends over time and by geographic region (Northeast, South, West and Midwest). State-level Brady Gun Law Scores were used to calculate median regional scores and measure the association between median regional gun law scores and firearm-related ED visits through multivariable linear regression. Results: During the 5-year study period, there were 111,839 [95% CI: 101,248,122,431] ED visits for pediatric firearm-related injuries nationwide (22,368 per year). The mean age was 18.0 years (SD 17.9-18.0), majority were male (89.3%), and publicly insured (38.5%); 6.1% (6,866) resulted in death, and 30% (33,280) resulted in hospital admission. Overall, firearm-related ED visits remained consistent over time, at a rate of 65 per 100,000 pediatric ED visits, until 2013, when there was a slight decrease to 51 per 100,000 (p-trend = 0.048). Rates of firearm-related pediatric ED visits varied by geographic region (Figure 1). Rates in the Northeast decreased during the study period (p-trend?.0001). The Northeast had the lowest rate, representing 40 (95% CI 34, 45) per 100,000 ED visits. This was followed by the Midwest, with a rate of 62 (95% CI 26, 66) per 100,000. The West (68; 95% CI 61, 74) and the South (71; 95% CI 64, 77) had the highest rates of ED visits for pediatric firearm injuries per 100,000 visits. In comparison to the Northeast, odds of firearm related-ED visits were higher in the South (aOR 1.8; 95% CI 1.4, 2.3) and the West (aOR 1.7; 95% CI 1.3, 2.2). There were no observed differences over time in mortality rates, overall or by region. A higher regional median Brady Gun Law Score (Northeast-45, South-8, West-9, Midwest-9), indicating stricter gun laws, was associated with a lower rate of firearm-related ED visits (p=0.03; Figure 2). Conclusions: Regional differences exist in pediatric firearm related injuries. Furthermore, regional differences in ED visit rates are associated with gun law scores. Regions with higher scores, and thus stricter gun laws, had fewer ED visits for pediatric firearm-related injuries than those with lower scores, and therefore, weaker laws. Studying the role of regional gun culture and its impact on firearm legislation at the regional level is an important next step in advocating for changes to firearm legislation and reducing pediatric firearm-related injuries.

American Academy of Pediatrics

Related Emergency Department Articles:

Checklist for emergency department team's COVID-19 surge
After reviewing the literature on COVID-19 scientific publications the authors developed a checklist to guide emergency departments.
Why is appendicitis not always diagnosed in the emergency department?
A new study examines the factors associated with a potentially missed diagnosis of appendicitis in children and adults in the emergency department.
Providing contraceptive care in the pediatric emergency department
A new study found that two-thirds of female adolescents ages 16-21 seen in a pediatric Emergency Department (ED) were interested in discussing contraception, despite having a high rate of recent visits to a primary care provider.
Low back pain accounts for a third of new emergency department imaging in the US
The use of imaging for the initial evaluation of patients with low back pain in the emergency department (ED) continues to occur at a high rate -- one in three new emergency visits for low back pain in the United States -- according to the American Journal of Roentgenology (AJR).
Emergency department admissions of children for sexual abuse
This study analyzed emergency department admissions of children for sexual abuse between 2010 and 2016 using a nationwide database of emergency visits and US Census Bureau data.
30-day death rates after emergency department visits
Researchers used Medicare data from 2009 to 2016 to see how 30-day death rates associated with emergency department visits have changed.
Preventing smoking -- evidence from urban emergency department patients
A new study from the Prevention Research Center of the Pacific Institute for Research and Evaluation offers a more in-depth understanding of smoking among patients in an urban emergency department.
When a freestanding emergency department comes to town, costs go up
Rather than functioning as substitutes for hospital-based emergency departments, freestanding emergency departments have increased local market spending on emergency care in three of four states' markets where they have entered, according to a new paper by experts at Rice University.
Emoji buttons gauge emergency department sentiments in real time
Simple button terminals stationed around emergency departments featuring 'emoji' reflecting a range of emotions are effective in monitoring doctor and patient sentiments in real time.
Is caregiver depression associated with more emergency department visits by patients with dementia?
An observational study of 663 caregivers and the patients with dementia they care for suggests caregiver depression is associated with increased emergency department visits for their patients.
More Emergency Department News and Emergency Department Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Making Amends
What makes a true apology? What does it mean to make amends for past mistakes? This hour, TED speakers explore how repairing the wrongs of the past is the first step toward healing for the future. Guests include historian and preservationist Brent Leggs, law professor Martha Minow, librarian Dawn Wacek, and playwright V (formerly Eve Ensler).
Now Playing: Science for the People

#565 The Great Wide Indoors
We're all spending a bit more time indoors this summer than we probably figured. But did you ever stop to think about why the places we live and work as designed the way they are? And how they could be designed better? We're talking with Emily Anthes about her new book "The Great Indoors: The Surprising Science of how Buildings Shape our Behavior, Health and Happiness".
Now Playing: Radiolab

The Third. A TED Talk.
Jad gives a TED talk about his life as a journalist and how Radiolab has evolved over the years. Here's how TED described it:How do you end a story? Host of Radiolab Jad Abumrad tells how his search for an answer led him home to the mountains of Tennessee, where he met an unexpected teacher: Dolly Parton.Jad Nicholas Abumrad is a Lebanese-American radio host, composer and producer. He is the founder of the syndicated public radio program Radiolab, which is broadcast on over 600 radio stations nationwide and is downloaded more than 120 million times a year as a podcast. He also created More Perfect, a podcast that tells the stories behind the Supreme Court's most famous decisions. And most recently, Dolly Parton's America, a nine-episode podcast exploring the life and times of the iconic country music star. Abumrad has received three Peabody Awards and was named a MacArthur Fellow in 2011.