1 in 4 Youths with Assault Injury Owns a Gun
Urban youth who land in the emergency department (ED) from assault-related
injuries often own guns and exhibit other risks for further violence, a study
showed.
Almost one-quarter of 14- to 24-year-olds treated for assault injuries at one
center reported having a gun in the prior 6 months, Patrick Carter, MD, of the
University of Michigan in Ann Arbor, and colleagues found.
Firearm possession was associated with higher odds of having been in a recent
serious fight, of using drugs, and of having an aggressive attitude that
increases the risk of retaliatory violence, the group reported in the August
issue of Pediatrics.
"Future prevention efforts should focus on minimizing illegal firearm access
among high-risk youth, nonviolent alternatives to retaliatory violence, and
substance use prevention," the researchers concluded.
"Previous research has demonstrated the immediate post-injury time is an
ideal time to capitalize on a teachable moment with preventive interventions,"
they added.
Routine office-based discussion about restricting access to guns whenever
seeing a patient with a history of assault-related injury might be worthwhile
but is unlikely to really have an impact, Robert Sege, MD, PhD, of Boston
Medical Center, suggested in an accompanying editorial that called for more
research and federal
"The continued high incidence of firearms deaths in the U.S. is a national
disgrace," he wrote. "Despite declining rates over the past decade, firearm
injuries remain the second leading cause of death for young Americans, trailing
only motor vehicle crashes."
The researchers surveyed 689 14- to 24-year-olds treated at the major Level 1
trauma center in Flint, Mich., for assault-related injuries as part of a larger
longitudinal study.
On the computerized screening survey, 23% of the youth reported firearm
possession in the prior 6 months, most obtained illegally (83%).
Among those with guns, 42% said they carried it outside the home and 22% had
a highly lethal automatic or semiautomatic weapon.
Those two findings together suggest "opportunities for improved law
enforcement around firearm diversion and improved policies around weapon access
among high-risk youth," the researchers noted.
The most common reason given for having a gun was protection (37%), followed
by "holding it for someone" (10%), and because their friends carry guns
(9%).
The majority of participants with firearms were seen in the ED due to
injuries sustained by their peers (67%); most of the rest had intimate
partner-related violence as a cause of injury (15%).
Just 3% had threatened someone with a firearm during the incident that
resulted in their injury; 3% of the gun owners also reported having been seen in
the ED for mental health reasons within the prior year.
Factors significantly associated with gun possession in the multivariate
analysis were:
- Male gender, with an adjusted odds ratio of 2.76
- Higher socioeconomic status, with 51% higher aOR for those not receiving public assistance
- Illicit drug use, with an aOR of 1.63
- Retaliatory attitudes, with an aOR elevated by 58%
- A serious fight within the prior 6 months, with an aOR of 1.73
Race was not a significant factor, but actually trended toward lower odds
among African-American youth.
African Americans account for half or more of the population in Flint, which
has crime and poverty rates comparable to Detroit and Oakland, Calif.
"It is important to note that few youth were involved in a gang," Carter and
colleagues wrote.
Limitations included inability to draw causal connections between attitudes
and gun possession, limited generalizability based upon the single urban site
and highly diverse population studied, and use of self-reported data.
Sexual assault, child abuse, and suicide ideation or attempts were excluded,
which may have underestimated the true rate of firearm possession.
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