Children's National Health System, Washington, District of Columbia;
Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia; and.
Pediatrics. 2019 Aug;144(2). doi: 10.1542/peds.2018-3283. Epub 2019 Jul 15.
Firearms are the second leading cause of pediatric death in the United States. There is significant variation in firearm legislation at the state level. Recently, 3 state laws were associated with a reduction in overall deaths from firearms: universal background checks for firearm purchases, universal background checks for ammunition purchases, and identification requirement for firearms. We sought to determine if stricter firearm legislation at the state level is associated with lower pediatric firearm-related mortality.
This was a cross-sectional study in which we used 2011-2015 Web-based Injury Statistics Query and Reporting System and Census data. We measured the association of the (1) strictness of firearm legislation (gun law score) and (2) presence of the 3 aforementioned gun laws with pediatric firearm-related mortality. We performed negative binomial regression accounting for differences in state-level characteristics (population-based race and ethnicity, education, income, and gun ownership) to derive mortality rate ratios associated with a 10-point change in each predictor and predicted mortality rates.
A total of 21 241 children died of firearm-related injuries during the 5-year period. States with stricter gun laws had lower rates of firearm-related pediatric mortality (adjusted incident rate ratio 0.96 [0.93-0.99]). States with laws requiring universal background checks for firearm purchase in effect for ≥5 years had lower pediatric firearm-related mortality rates (adjusted incident rate ratio 0.65 [0.46-0.90]).
In this 5-year analysis, states with stricter gun laws and laws requiring universal background checks for firearm purchase had lower firearm-related pediatric mortality rates. These findings support the need for further investigation to understand the impact of firearm legislation on pediatric mortality.
在美国，枪支是导致儿童死亡的第二大主要原因。州一级的枪支立法存在显著差异。最近，有 3 项州法律与枪支导致的总死亡人数减少有关：枪支购买的普遍背景调查、弹药购买的普遍背景调查，以及枪支身份识别要求。我们试图确定州一级更严格的枪支立法是否与儿童枪支相关死亡率的降低有关。
这是一项横断面研究，我们使用了 2011-2015 年基于网络的伤害统计数据查询和报告系统以及人口普查数据。我们测量了（1）枪支立法的严格程度（枪支法评分）和（2）存在上述 3 项枪支法与儿童枪支相关死亡率之间的关联。我们进行了负二项回归，考虑了州一级特征（基于人口的种族和民族、教育、收入和枪支拥有）的差异，得出与每个预测因子变化 10 分相关的死亡率比，并预测了死亡率。
在 5 年期间，共有 21241 名儿童死于枪支相关伤害。枪支法较严格的州的枪支相关儿童死亡率较低（调整后的发病率比 0.96 [0.93-0.99]）。对于已实施枪支购买普遍背景调查的法律≥5 年的州，儿童枪支相关死亡率较低（调整后的发病率比 0.65 [0.46-0.90]）。
在这项为期 5 年的分析中，枪支法较严格的州和要求枪支购买普遍背景调查的州的枪支相关儿童死亡率较低。这些发现支持进一步调查，以了解枪支立法对儿童死亡率的影响。
