Gun Violence and Pediatrics

Gun Violence and Pediatrics
Lisa McReynolds
Legislative Advocacy
PGY-2 Ambulatory/Outpatient Block
September 14, 2010 Noon Conference
Happy Primary Election Day- go vote!
Gun Violence Statistics
• 8 children killed daily by guns
• 48 injured seriously
• 40% American households have guns
(compared to pets, which do we ask about)
• 1.7 million children live with unlocked/loaded
guns in the home (that’s 40% of the 40%)
• Access to these guns increases rates of
suicide and accidental injury
• 75% of kids know where “hidden” guns are in
the home
• Homicide 2nd leading cause of death in
teens, 1st leading in Black teens
• 9484 Americans murdered by guns last year
• 3% of direct medical expenses are due to
• Total cost to society yearly for gun violence
$100 billon dollars medical costs, costs of the
criminal justice system, security precautions
such as metal detectors, and reductions in
quality of life because of fear of gun violence.
• Of which $15 billon attributable to firearm
injuries in children
• In homes were there are guns there is higher
rate of injury and suicide, and guns are more
likely to do harm than offer protection
Why should we care
• Violence is clearly a major public health
problem, and it disproportionately
affects children/young adults
• Preventable cause of death/injury
• Studies have shown pediatricians can
influence and help
State of Current Gun Legislation- New York
• Considered one of the stricter states re: purchase,
possession and carrying of handguns
• NYC has further laws for carrying of concealed
Proposed NY Legislation- two of many
Gun Dealer Responsibility Act
(A 1093 Paulin/S 1715 Schneiderman)
• Requires the creation and imposition of responsible commercial
practices, stringent record keeping and reporting to prevent gun
sales to criminals.
• A recent report demonstrated that states with strong gun dealer
regulations have fewer guns end up in the illegal market and
used in crimes than states with weak gun dealer regulations.
• A small number of gun dealers, 1%, are responsible for nearly
60% of crime guns nationally.
5-Year Renewable Gun Permit
(A 801a Paulin/S 1598 Schneiderman)
• Requires permit holders to renew and restate important
information about their eligibility to possess handguns and the
number possessed.
• Reforms NYS’ lifetime handgun license law requiring review of
licensee’s subsequent criminal convictions, mental health status,
or character fitness in years subsequent to the initial issuance of
a permit.
• Provides regular confirmation that licensees remain qualified to
possess a handgun and ensures the integrity of the licensing
system with updates of current information.
State of Current Gun
Legislation- New Jersey
Some Proposed NJ Legislation
• A754
Clarifies that BB Guns are not
firearms under New Jersey law.
• A988
Establishes " Gun-free" and "weapon
free" zones around certain school and public
• A1809
Makes it a crime to sell or
possess products or materials designed to
alter firearms to look like toy Guns.
What does the AAP have to
• In 2009 the AAP re-wrote their statement
about the role of the pediatrician in youth
violence prevention
• Pediatricians should know and practice
Connected Kids: Safe, Strong, Secure, which
is their primary care violence prevention
protocol and that we should serve as
advocates in violence prevention
What do the studies show
• Olson et al. 2006 Injury Prevention
• Surveyed almost 2000 pediatricians in
1994 and 2000
• Most think it’s important but don’t do it
• Varied by some interesting
demographics of the providers
Barkin et al.
• Pediatrics 2008
• RCT for three AG topics
• First national RCT to demonstrate
effectiveness of brief office based
violence prevention
• Specifically looking at cable locks for
Cowden et al
• Pediatrics 2009
• Adopted Connected Kids in Head Start
Programs with Success
Finch et al.
• 2007 Maternal Child Health
• Also surveyed providers
• Not enough time to incorporate violence
• Don’t feel confident giving this AG
• Don’t think it will change behaviors
What can we do
ASK Campaign- partnership with PAX
Anticipatory Guidance- Connected Kids
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QuickTime™ and a
TIFF (Uncompressed) decompressor
are needed to see this picture.
References Continued
Barkin SL, Finch SA, Ip EH, Scheindlin B, Craig JA, Steffes J, Weiley V, Slora E, Altman D,
Wasserman RC. Is office-based counseling about media use, timeouts, and firearm storage
effective? Results from a cluster-randomized, controlled trial. Pediatrics. 2008
Committee on Injury, Violence, and Poison Prevention. Policy statement--Role of the
pediatrician in youth violence prevention. Pediatrics. 2009 Jul;124(1):393-402.
Cowden JD, Smith S, Pyle S, Dowd MD. Connected kids at Head Start: taking office-based
violence prevention to the community. Pediatrics. 2009 Oct;124(4):1094-9.
Finch SA, Weiley V, Ip EH, Barkin S. Impact of pediatricians' perceived self-efficacy and
confidence on violence prevention counseling: a national study. Matern Child Health J. 2008
Kunkel P, Thomas CJ, Seguin C, Dereczyk D, Rajda C, Brandt MM. A hospital-based violence
prevention tour: a collaborative approach to empower youth. J Trauma. 2010 Feb;68(2):289-93.
Laraque D; American Academy of Pediatrics Committee on Injury, Violence, and Poison
Prevention. Injury risk of nonpowder guns. Pediatrics. 2004 Nov;114(5):1357-61.
Loh K, Walton MA, Harrison SR, Zimmerman M, Stanley R, Chermack ST, Cunningham RM. Prevalence
and correlates of handgun access among adolescents seeking care in an urban emergency
department. Accid Anal Prev. 2010 Mar;42(2):347-53.
Olson LM, Christoffel KK, O'Connor KG. Pediatricians' involvement in gun injury prevention.
Inj Prev. 2007 Apr;13(2):99-104.
Wright MA, Wintemute GJ, Claire BE. Gun suicide by young people in California: descriptive
epidemiology and gun ownership. J Adolesc Health. 2008 Dec;43(6):619-22.