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Years Of Declining Pediatric Firearm Injuries Reversed By Rise In Self-inflicted And Unintentional Injuries At Home
Adrian Camarena1, Lea Hoefer2, Kelly Twohig2, Ann Polcari2, Robert Keskey2, Danielle LaVigne2, Kenneth Wilson2, *Mark Slidell2, David Hampton2
1Duke, Durham, NC;2The University of Chicago, Chicago, IL

Background (issue): Despite high morbidity and mortality of pediatric firearm injury, there remains a paucity of literature on the subject. We hypothesized that rising gun ownership over the past decade would lead to changes in geographic location of injury and racial demographics of pediatric firearm injuries.
Methods: The 2007-2018 ACS TQP-PUF yielded 33,821 children <18 years old, who sustained firearm related injuries. Incidence rates and trends in demographic and survival data were analyzed using chi-squared tests and linear regression.
Findings: We observed a 33.7% decline in pediatric firearm injuries from 2007-2014 (p<0.001), followed by a 39.6% rise from 2014-2018 (p=0.001). From 2007-2018 injuries sustained at home rose from 25.7% to 38.9% (p<0.001), while street injuries declined (35.5% to 29.6%, p=0.012). Self-inflicted, and unintentional injuries increased 97% (p<0.001) and 36.3% (p<0.001) respectively. Overall survival declined from 88.6% to 84.8% (p=0.024). Black children were disproportionately injured (Black: 55.9%, white: 24.4%, Asian: 0.6%, multiracial: 12.3%, p<0.001). White children were more likely to suffer from self-inflicted and unintentional injury (15.9% and 36.1%, respectively p<0.001).
Conclusions (implications for practice): Pediatric firearm injuries declined in the streets and rose in the home. Overall, Black and Latino children are disproportionately affected by gun violence. White children were more likely to suffer from self-inflicted and unintentional injuries. These trends are concerning and call for further research into firearm safety laws in the United States as it pertains to the health of children.


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