Department of Epidemiology, School of Public Health, University of Washington, Seattle.
Harborview Injury Prevention and Research Center, University of Washington, Seattle.
JAMA Pediatr. 2019 Jan 1;173(1):37-43. doi: 10.1001/jamapediatrics.2018.3624.
Firearm injuries and fatalities among children are an important public health problem. Children living with an adult misusing alcohol may be at a heightened risk for self-harm or unintentional injury, highlighting the need to investigate the association between household firearm storage and adult alcohol misuse.
To characterize household firearm presence among children by various sociodemographic characteristics, and to assess the association between children living in a home with an unsafely stored firearm and an adult reporting alcohol misuse.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional investigation uses data from the 2013 and 2016 Behavioral Risk Factor Surveillance System in the state of Washington, a program that administers a telephone survey statewide to randomly selected noninstitutionalized adults at least 18 years of age about their health-related risk behaviors, chronic health conditions, and use of preventive services. The 2013 and 2016 data included 5241 responses to the firearm ownership and storage module and the Random Child Selection module (intended for a randomly selected child younger than age 18 years and reported by an adult living in the same household). Data for this study were collected from January 1 through December 31, 2013, and January 1 through December 31, 2016. Data were analyzed from March through May 2018.
The primary outcomes were a child's residence in a firearm-owning home, the manner in which household firearms were stored, and the adult respondent's alcohol consumption.
Among the 3443 children living in a non-firearm-owning household, 50.7% were male (all values given as a percentage only are weighted); among those reporting specific age, the weighted mean age was 9.3 years (unweighted mean [SD], 10.1 [5.2] years). In the 1756 children living in a firearm-owning household, 52.5% were male; among those reporting specific age, the weighted mean age was 9.1 years (unweighted mean [SD], 9.8 [5.4] years). An estimated 470 000 children (29.4%; 95% CI, 27.3%-31.7%) in the state resided in a firearm-owning household. Among them, 258 000 children (54.6%; 95% CI, 51.5%-57.6%) lived with at least 1 firearm that was not stored safely (ie, not locked and unloaded). Firearms were more likely to be stored unsafely in homes in which an adult reported alcohol misuse (prevalence ratio: 1.20; 95% CI, 1.07-1.35).
Children living in a household with an adult who misuses alcohol may be more likely to live with an unsafely stored firearm, which is concerning given the association between adult alcohol misuse and children's risk for sustaining injury.
儿童的枪支伤害和死亡是一个重要的公共卫生问题。与滥用酒精的成年人一起生活的儿童可能面临更高的自我伤害或意外伤害风险，这突显了调查家庭枪支存储与成人酒精滥用之间关联的必要性。
根据各种社会人口统计学特征，描述儿童家庭枪支拥有情况，并评估居住在枪支存放不安全家庭中的儿童与报告酒精滥用的成年人之间的关联。
设计、地点和参与者：本横断面研究使用了华盛顿州 2013 年和 2016 年行为风险因素监测系统的数据，该系统通过电话向全州至少 18 岁的非机构化成年人进行调查，询问他们与健康相关的风险行为、慢性健康状况和使用预防服务的情况。2013 年和 2016 年的数据包括对枪支拥有和储存模块以及随机儿童选择模块（旨在为报告的 18 岁以下的随机儿童选择，由居住在同一家庭的成年人报告）的 5241 次回复。本研究的数据收集时间为 2013 年 1 月 1 日至 12 月 31 日和 2016 年 1 月 1 日至 12 月 31 日。数据分析于 2018 年 3 月至 5 月进行。
主要结果是儿童居住在拥有枪支的家庭中、家庭枪支存放方式以及成年受访者的酒精消费情况。
在 3443 名居住在非枪支拥有家庭的儿童中，50.7%为男性（所有百分比均为加权值）；在报告特定年龄的儿童中，加权平均年龄为 9.3 岁（未加权平均[SD]，10.1[5.2]岁）。在居住在枪支拥有家庭的 1756 名儿童中，52.5%为男性；在报告特定年龄的儿童中，加权平均年龄为 9.1 岁（未加权平均[SD]，9.8[5.4]岁）。据估计，该州有 47 万名儿童（29.4%；95%CI，27.3%-31.7%）居住在枪支拥有家庭中。其中，25.8 万名儿童（54.6%；95%CI，51.5%-57.6%）居住在至少 1 支未安全存放的枪支（即未上锁和未卸下弹药）的家庭中。在报告酒精滥用的成年人家中，枪支更有可能存放不安全（流行率比：1.20；95%CI，1.07-1.35）。
与滥用酒精的成年人一起生活的儿童可能更有可能居住在存放不安全的枪支的家庭中，鉴于成年人酒精滥用与儿童受伤风险之间存在关联，这令人担忧。
