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Fewer children killed by guns in states with strict gun laws, study finds

November 26, 2018

SAN JOSE, Calif. -- States that have more laws restricting youth access to guns have lower rates of child and teen deaths from shootings, a study by researchers at Stanford University School of Medicine has found.

“We focus so much of the gun discussion on federal law, but there is a lot we can do at the local and state level to influence change,” said researcher Dr. Stephanie Chao, assistant professor of surgery at Stanford.

California, Illinois and Maryland -- with the strictest laws requiring families to keep guns unloaded and locked up -- had only half as many gun deaths as states with the least restrictions, such as Alaska, Arizona and Alabama. States with strict laws had an average of 2.6 deaths a year per 100,000 children, compared with five deaths per 100,000 in less restrictive states. California experienced 2.36 deaths per 100,000 children -- the very low end of the spectrum.

There was an even more pronounced difference in firearm suicide rates. Suicides by shooting were four times less common in states with strong restrictions, with 0.63 pediatric suicides per year, compared to 2.57 suicides in states with less restrictive laws.

The findings show that state-level legislation plays an important role in reducing pediatric firearm-related deaths. The lead authors of the study, to be presented on Nov. 5 at a conference of the American Academy of Pediatrics in Orlando, Fla., are former graduate student Sriraman Madhavan and postdoctoral scholar Dr. Jordan Taylor.

“No one wants guns in the hands of children. This is probably the one area where everyone can agree,” Chao said.

While 27 states have child access protection laws, she said, “there is a tremendous opportunity for these 23 other states to implement some form of prevention.”

There is a range in the stringency of laws. Some states just require safe gun storage and handling; others, such as California, say that an adult can be prosecuted if a minor gains access to a neglectfully stored firearm.

But any law aimed at reducing children’s access to guns leads to a decline in deaths, the study found.

This finding held true even after controlling for differences between states in socioeconomic factors such as poverty, unemployment, substance abuse and high school graduation rates, said Chao, a pediatric surgeon and the medical director of trauma care at Lucile Packard Children’s Hospital Stanford.

Her role includes investigating how to prevent serious childhood injuries, and she conducted the research because she knew that laws sometimes don’t have their intended effect.

Firearm-related injuries are the second leading cause of pediatric death in the U.S., claiming 2,715 lives each year. Of those deaths, 62.1 percent were homicides and 31.4 percent were suicide. A child is 82 times more likely to die in our country of a firearm injury than in any other developed nation, according to Chao.

Research in adults has suggested that laws are protective. A 2013 paper in JAMA Internal Medicine found that states with the most laws on gun ownership, including Massachusetts and New Jersey, have 42 percent lower rates of death from guns than those with the least restrictions, including Utah and Oklahoma.

Chao’s team examined the firearm laws of all 50 states, then assessed the overall stringency of each state’s gun laws as of 2014 using a metric called the Brady score, named for James Brady, who has advocated for gun control since being permanently disabled in the 1981 assassination attempt on President Ronald Reagan.

Scores ranged from -39 in the least strict state, Arizona, to +76 in the strictest state, California. The states were divided into four groups based on their Brady score. They also evaluated whether each state had child access prevention laws, which were classified in two groups: legislation that requires storing guns safely (locked or unloaded, or both), and laws that impose liability for failing to prevent minors from gaining access to guns.

States’ scores were significantly linked to gun deaths in children ages 0 to 19 between 2014 and 2015, even after controlling for other factors.

While this finding is a correlation and does not prove cause and effect, it should be considered by lawmakers when proposing policy changes, Chao said.

“With more children dying in these states,” she said, “there may be an opportunity for prevention.”

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