Pediatricians affiliated with the Miller School of Medicine and the Mailman Center for Child Development discuss the effects of gun violence on the health of children and adolescents.
In the United States, more than one-third of children live in homes where guns are present, reports the American Academy of Pediatrics (AAP), increasing the likelihood of gun-related accidents and suicide. A Pew Research study published in 2021 indicated that 40% of adults in the United States live in homes with a gun.
With the number of firearms in the United States today, Dr. Oneith Cadiz, assistant professor of clinical pediatrics at the University of Miami Miller School of Medicine, said she was not surprised to learn that the leading cause of child and adolescent deaths from 2019 to 2020 was gun violence. Over the past three years, Cadiz said, the COVID-19 pandemic has led to an increased sense of uncertainty and isolation that often makes people want to buy a gun because they think it might. give them more security.
“Since 2019, access to firearms and the incidence of mental health disparities have increased,” said Cadiz, who is also director of the Injury Free Coalition for Kids of Miami. “But without intervention, we can’t expect changes…and that’s why we keep seeing these kinds of horrific events.”
Cadiz said she has always believed in legal reforms, such as stricter background checks before people can buy guns, as well as encouraging everyone to practice safe gun storage at home. Many of these suggestions are also supported by the AAP.
Survivors face guilt, depression
In the clinics where she treats children and teaches aspiring doctors, Cadiz has seen the destructive impact of gun violence on young victims and on children who have lost siblings and family members to shootings. Cadiz is also a parent who lives in Parkland, Florida, and has friends and neighbors whose children were at Marjory Stoneman Douglas High School in 2018 when an expelled teenager brought an assault rifle to campus and killed 17 people, injuring 17 others.
She said it is difficult for anyone to recover from direct experience of gun violence and that she generally understands survivor guilt, as well as anxiety and depression. Therefore, she spends more time talking with patients who have experienced gun violence to understand what kind of support they might need, and then connects them with a mental health provider.
“Children are forever changed by this,” she said. “But it’s up to us to identify the kind of help they need, provide them with tools to manage their emotions and help them reintegrate into everyday life. Because coming out of a gun violence situation, they’re constantly on edge.
Additionally, as part of its healthy child exams, Cadiz makes a point of asking questions about arms at home, which it and the AAP encourage all pediatricians to do. In particular, Cadiz suggests that parents store firearms in locked safes without ammunition. It even provides families with gun locks provided by the Injury Free Coalition for Kids.
“We try to make it part of the culture, just like when we ask kids what they eat during an exam,” she said. “Are we doing a better job? Yes. Can we do even better? Yes.”
A positive development Cadiz said it has seen following the increase in gun violence is a greater focus on mental health in medicine. Now, she hopes lawmakers will respond with more funding for those resources.
“We have reached the point where the victims far outnumber those who commit these crimes,” she said, “so we need to focus our efforts on the mental health support needed by both parties.”
Techniques needed to improve security
Many of his colleagues, who deal with children’s mental health, side with Cadiz.
The horrific mass shootings in Buffalo, New York, and Uvalde, Texas, “challenge us as a society,” said Jeffrey P. Brosco, professor and associate director of the Department of Pediatrics and associate director of the Mailman Center for Child Development.
Noting that the country has dramatically reduced the number of deaths from traffic accidents over the past two decades, he called for using the same techniques to improve gun safety and save thousands of lives.
“Public health research clearly shows that when a country reduces access to guns, children and their families are safer,” Brosco said.
Alan Delamater, a clinical psychologist for children and adolescents at the Mailman Center, agreed.
“The most important factor in explaining the fact that firearms are the leading cause of death among children and adolescents today is the sheer number of weapons available and the ease of access that people, including the kids, have it,” he explained.
Another troubling fact: gun violence disproportionately affects young adults, men, and racial and ethnic minorities, said Viviana Horigian, professor of public health sciences at the Miller School.
“Of all firearm deaths in nearly two dozen populous high-income countries, 82% occur in the United States. And 91% of children killed by firearms in this group of countries are from the United States. How is it possible?” Horigian said, citing statistics from the American Public Health Association’s fact sheet and a 2015 American Journal of Medicine article comparing violent death rates around the world.
She called for the implementation of established public health measures to help reduce the problem of gun violence, such as defining and tracking the problem, identifying risk factors, developing and testing interventions, and the widespread dissemination and adoption of these interventions.
“You might be surprised, but this public health model — the one we follow for any other disease — is not followed for gun violence,” Horigian said. “For example, Congress only recently authorized funds for research into this problem. Without proper research, we won’t know what works.
After Columbine, Sandy Hook and now Uvalde, “if we haven’t reached our tipping point yet, will we?” asked Judy Schaechter, professor emeritus and former chair of the Miller School’s Department of Pediatrics, who is also a longtime gun violence prevention advocate. Schaechter is now president and CEO of the American Board of Pediatrics.
Schaechter has offered the following gun safety tips to keep kids safe.
- If you have kids and a gun at home, lock up the gun and store ammunition in a separate, locked place.
- If your children are visiting someone else’s house, just as you might ask if there will be an adult present or if there is a dog in the house, ask if there are guns and ask how they are stored.
- If someone you know, such as a family member or friend, owns a firearm and may be at risk due to mental health issues, try talking to them about storing or removing them. gun safety. You can offer to store the weapons for a while until your friend gets better. Studies suggest that people are more likely to accept this suggestion when it comes from another gun owner.
Additionally, June 21 is ASK Day, which stands for Asking Saves Kids, Cadiz said. This is an opportunity to remind parents and caregivers of the importance of asking questions about firearms in the home to prevent unintentional firearm injuries. A question as simple as “Is there an unlocked gun in your house?” can save your child’s life.
— Robert C. Jones Jr. contributed to this report.