Faust Jeremy Samuel, Chen Ji, Bhat Shriya, Otugo Onyekachi, Yaver Miranda, Renton Benjamin, Chen Alexander Junxiang, Lin Zhenqiu, Krumholz Harlan M
Department of Emergency Medicine, Mass General Brigham, Division of Health Services Research, Harvard Medical School, Boston, Massachusetts.
Yale New Haven Hospital, Center for Outcomes Research and Evaluation, New Haven, Connecticut.
JAMA Pediatr. 2025 Jun 9. doi: 10.1001/jamapediatrics.2025.1363.
Firearms are the leading cause of death in US children and adolescents, but little is known about whether the overall legal landscape was associated with excess mortality after a landmark US Supreme Court decision in 2010.
To measure excess mortality due to firearms among US children aged 0 to 17 years after the McDonald v Chicago US Supreme Court decision (2010).
DESIGN, SETTING, AND PARTICIPANTS: An excess mortality analysis was conducted using the US Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (WONDER) database before and after McDonald v Chicago, the landmark 2010 US Supreme Court decision on firearms regulation. States were divided into 3 groups based on legal actions taken before and since 2010, most permissive, permissive, and strict. Firearm mortality trends before (1999-2010) and after (2011-2023) were determined and compared across the 3 groups for all intents and by intent (homicide and suicide). Subgroup analysis by observed race and ethnicity was conducted. For each US state, pre-and post-McDonald v Chicago all-intent pediatric firearm mortality incident rates were compared. These data were analyzed January 2011 through December 2023.
The pre- and post-McDonald v Chicago legal landscape.
Excess mortality during the post-McDonald v Chicago period.
During the post-McDonald v Chicago period (2011-2023), there were 6029 excess firearm deaths (incidence rate [IR], 158.6 per million population; 95% CI, 154.8-162.5) in the most permissive group. In the permissive group, there were 1424 excess firearm deaths (IR, 107.5 per million person-years; 95% CI, 103.8-111.3). In the strict group, there were -55 excess firearm deaths (IR, -2.5 per million person-years; 95% CI, -5.8 to 0.8). Non-Hispanic Black populations were had the largest increase in firearm mortality in the most permissive and permissive state groupings. Four states (California, Maryland, New York, and Rhode Island) had decreased pediatric firearm mortality after McDonald v Chicago, all of which were in the strict firearms law group.
States in the most permissive and permissive firearm law categories experienced greater pediatric firearm mortality during the post-McDonald v Chicago era. Future work should focus on determining which types of laws conferred the most harm and which offered the most protection.
枪支是美国儿童和青少年死亡的主要原因，但对于2010年美国最高法院一项具有里程碑意义的裁决后，整体法律环境是否与超额死亡率相关，人们知之甚少。
衡量2010年美国最高法院麦克唐纳诉芝加哥案裁决后，美国0至17岁儿童因枪支导致的超额死亡率。
设计、背景和参与者：利用美国疾病控制与预防中心的广泛在线流行病学研究数据（WONDER）数据库，在具有里程碑意义的2010年美国最高法院关于枪支管制的麦克唐纳诉芝加哥案前后进行了超额死亡率分析。根据2010年前后采取的法律行动，将各州分为3组，最宽松组、宽松组和严格组。确定并比较了3组在1999 - 2010年之前和2011 - 2023年之后所有意图以及按意图（杀人及自杀）划分的枪支死亡率趋势。按观察到的种族和族裔进行了亚组分析。比较了美国每个州在麦克唐纳诉芝加哥案前后所有意图的儿科枪支死亡率发生率。这些数据于2011年1月至2023年12月进行分析。
麦克唐纳诉芝加哥案前后的法律环境。
麦克唐纳诉芝加哥案之后期间的超额死亡率。
在麦克唐纳诉芝加哥案之后的时期（2011 - 2023年），最宽松组有6029例超额枪支死亡（发病率[IR]，每百万人口158.6例；95%置信区间，154.8 - 162.5）。在宽松组，有1424例超额枪支死亡（IR，每百万人口年107.5例；95%置信区间，103.8 - 111.3）。在严格组，有 - 55例超额枪支死亡（IR，每百万人口年 - 2.5例；95%置信区间， - 5.8至0.8）。在最宽松和宽松的州分组中，非西班牙裔黑人人口的枪支死亡率增幅最大。四个州（加利福尼亚州、马里兰州、纽约州和罗德岛州）在麦克唐纳诉芝加哥案之后儿科枪支死亡率有所下降，所有这些州都属于严格枪支法律组。
在麦克唐纳诉芝加哥案之后的时代，枪支法律最宽松和较宽松类别的州，儿科枪支死亡率更高。未来的工作应侧重于确定哪些类型的法律造成的危害最大，哪些提供的保护最多。
