291 Unintentional Firearm Deaths Among Youth in the United States

Abstract

Firearm-related injuries are a leading cause of death among children in the United States. Between 2004 and 2015, firearm deaths accounted for approximately one-fifth of all injury-related deaths. Our objective is to evaluate factors contributing to unintentional firearm deaths in children; in particular, factors related to firearm access. We obtained data on unintentional firearm deaths of children aged 0-18 years occurring from 2004 through 2016 documented in the National Fatality Review Case Reporting System (NFR-CRS). We included all unintentional deaths as determined by medical examiner. Descriptive analyses on demographics, psychosocial risk factors, type of firearm used, circumstances surrounding use, preventability and firearm storage were conducted. There were a total of 492 unintentional firearm deaths identified from 34 participating states during the study period. Mean age was 10±5 years, 84% (415/492) were male and 54% (264/492) were non-Hispanic white. Approximately 97% (475/492) of victims were shot by themselves, a family member or close contact; over half were shot at their own home (51%, 252/492). Few were found to have preceding mental health history (3%, 16/492) or substance abuse (7%, 36/492). Handguns were used in the majority of deaths (65%, 321/492) followed by shotguns (13%, 63/492) and hunting rifles (11%, 52/492). Over half of victims were found to be playing with weapon at time of death. Approximately 42% (211/492) of firearms were either not stored or stored unlocked, 46% (225/492) were stored with ammo, and 53% (263/492) were stored loaded. Most unintentional firearm deaths occur in the home setting by self-inflicted injuries or by a close contact. Preventative efforts should focus on further limiting household firearm access to children.