How gun violence affects a child’s health

Pediatricians affiliated with 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 a third of children live in homes with firearms, the American Academy of Pediatrics (AAP) reports, which increases the likelihood of gun-related accidents and suicides. 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 death of children and adolescents from 2019 until 2020 was gun violence. Over the past three years, Cádiz said, the COVID-19 pandemic has brought a greater sense of uncertainty and isolation that often makes people want to buy a gun because they think it will bring them greater safety.

“Since 2019, both access to firearms and the incidence of mental health inequalities have increased,” said Cadiz, who is also director of the Injury Free Coalition for Kids of Miami. “But without intervention, we cannot expect change … and that is why we continue to see these kinds of horrible events.”

Cadiz said it has always believed in legal reforms, such as stricter background checks before people can buy guns, as well as encouraging everyone to practice safe firearms storage at home. Many of these tips are also supported by the AAP.

Survivors face guilt, depression

In clinics where she treats children and teaches would-be doctors, Cadiz has witnessed the destructive impact of gun violence on young victims and on children who have lost siblings and family members to the 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 carried an assault rifle on campus and killed 17 people, injuring others. 17.

He said direct experience with gun violence is difficult for anyone to recover from and typically includes survivor’s guilt, as well as anxiety and depression. Therefore, she spends more time talking to patients who have experienced gun violence to understand what kind of support they might need and then connects them with a mental health provider.

“Babies have changed forever from this,” she said. “But it is our job to identify the kind of help they need and equip them with the tools to cope with their emotions and help them reintegrate into everyday life. Because coming out of a situation of armed violence, I am constantly at the limit ”.

Additionally, as part of her exams for healthy children, Cadiz is committed to asking about guns in the home, which she and the AAP encourage all pediatricians to do. In particular, Cadiz suggests that parents keep their weapons in locked safes without ammunition. She also offers gun locks to families provided by the Injury Free Coalition for Kids.

“We are trying to make it part of the culture, just like when we ask children what they eat in an exam,” she said. “Are we doing a better job? Yes. Could we do even better? Yup.”

One positive development Cadiz said it saw as a result of the rise in gun violence is a greater emphasis on mental health in medicine. He now he hopes lawmakers will respond with stronger funding for these resources.

“We have reached the point where the victims far outnumber those who are committing these crimes,” he said, “so we need to focus our efforts on the mental health support needed by both sides.”

Techniques needed to improve safety

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 president of the Department of Pediatrics and associate director of the Mailman Center for Child Development.


Noting that the nation has drastically reduced the number of road deaths over the past two decades, he called for the same techniques to be used to improve gun safety and save thousands of lives.

“Public health research is clear that when a nation reduces access to weapons, children and their families are safer,” said Brosco.

Alan Delamater, a clinical psychologist for children and adolescents at the Mailman Center, agrees.

“The most important factor in explaining the fact that firearms are the leading cause of death among children and adolescents today is the number of weapons available and the easy access that people, including children, have to them,” he explained. .

Another disturbing fact: Gun violence disproportionately affects young adults, males and racial and ethnic minorities, said Viviana Horigian, professor of public health sciences at Miller School.

“Of all gun deaths in nearly two dozen populous, high-income countries, 82 percent occur in the United States, and 91 percent of the children killed by firearms in this group of nations are from the United States. . How is it possible?” Horigian said, citing statistics from the American Public Health Association Fact Sheet and a 2015 American Journal of Medicine article that compared violent death rates around the world.

It called for the implementation of well-established public health measures to help reduce the problem of gun violence, such as problem definition and monitoring, identification of risk factors, development and verification of interventions, and widespread execution and the adoption of these interventions.

“You might be surprised, but this model of public health, the one we follow for any other disease, is not followed for gun violence,” Horigian said. For example, it was only recently that Congress authorized research dollars on this issue. Without adequate research, we will not know what works ”.

After Columbine, Sandy Hook and now Uvalde, “if we haven’t reached our tipping point yet, will we?” asked Judy Schaechter, an emeritus professor and former chair of the Miller School’s Department of Pediatrics, who is also a longtime advocate for the prevention of gun violence. Schaechter is now president and chief executive officer of the American Board of Pediatrics.

Schaechter offered the following gun safety tips to protect children.

  • If you have children and a gun in the house, close the gun and store the ammunition in a locked place.
  • If your kids are visiting someone else’s home, just like 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 from mental health problems, try talking to them about safe storage or removal of firearms. You could offer to keep the guns 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.

Also, June 21 is ASK Day, which stands for Asking Saves Kids, Cadiz said. It is an opportunity to remind parents and caregivers of the importance of asking about guns in the home to prevent inadvertent gunshot injuries. A simple question like “Is there an unlocked gun in your house?” can save your child’s life.

– Robert C. Jones Jr. contributed to this report.

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