The effect of gun control laws on hospital admissions for children in the United States

Jun Tashiro · Rebecca S. Lane · Lawrence W. Blass · Eduardo Alfonso Perez · Juan E. Sola

28 citations0/0 files storedThe Journal of Trauma: Injury, Infection, and Critical Care

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Gun Ownership and Violence Research Injury Epidemiology and Prevention Homicide, Infanticide, and Child Abuse

Abstract

BACKGROUND: Gun control laws vary greatly between states within the United States. We hypothesized that states with strict gun laws have lower mortality and resource utilization rates from pediatric firearms-related injury admissions. METHODS: Kids' Inpatient Database (1997-2012) was searched for accidental (E922), self-inflicted (E955), assault (E965), legal intervention-related (E970), or undetermined circumstance (E985) firearm injuries. Patients were younger than 20 years and admitted for their injuries. Case incidence trends were examined for the study period. Propensity score-matched analyses were performed using 38 covariates to compare outcomes between states with strict or lenient gun control laws. RESULTS: Overall, 38,424 cases were identified, with an overall mortality of 7%. Firearm injuries were most commonly assault (64%), followed by accidental (25%), undetermined circumstance (7%), or self-inflicted (3%). A small minority involved military-grade weapons (0.2%). Most cases occurred in lenient gun control states (48%), followed by strict (47%) and neutral (6%).On 1:1 propensity score-matched analysis, in-hospital mortality by case was higher in lenient (7.5%) versus strict (6.5%) states, p = 0.013. Lenient states had a proportionally higher rate of accidental (31%) and self-inflicted injury (4%) versus strict states (17% and 1.6%, respectively), p < 0.001. Assault-related injuries were proportionally lower in lenient (54%) versus strict (75%) states, p < 0.001. Military-grade weapons were more common in lenient (0.4%) versus strict (0.1%) states, p = 0.001. CONCLUSIONS: These findings highlight the importance of legislative measures and their role in injury prevention, as firearm injuries are entirely avoidable mechanisms of injury. Lenient gun control contributes not only to worse outcomes per case, but also to a more significant and detrimental impact on public health. LEVEL OF EVIDENCE: Epidemiologic study, level III.

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References

2013Firearm Legislation and Firearm-Related Fatalities in the United States 2015Firearm-Related Injury and Death in the United States: A Call to Action From 8 Health Professional Organizations and the American Bar Association 2012Silencing the Science on Gun Research 2003Firearm availability and homicide: A review of the literature 2000Firearm Availability and Homicide Rates across 26 High-Income Countries 2013The effect of race and gender on pediatric surgical outcomes within the United States 2015Effects of changes in permit-to-purchase handgun laws in Connecticut and Missouri on suicide rates 2013Primary payer status is significantly associated with postoperative mortality, morbidity, and hospital resource utilization in pediatric surgical patients within the United States

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