O3243: Associations between child firearm possession and child suicide and homicide in U.S. states

Background: Firearm injuries are the leading cause of death among children in the United States. Approximately one third of U.S. households with children own at least one firearm, and increased firearm access has been associated with more homicides and suicides in children. State childhood access prevention laws aim to reduce unintentional firearm injuries and deaths, suicides, and violent crime among youth chiefly by reducing children's access to stored guns, and stricter laws are associated with decreased mortality. While evidence is primarily based on adult or household levels of firearm ownership, there has been limited evaluation of child-specific firearm possession and child firearm mortality.

Methods: We compiled data from two government agencies, the Centers for Disease Control and Prevention and the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF). Firearm-related deaths, crude rates of firearm deaths, guns traced from a crime scene, and firearm license information were compiled for children younger than 18 from the years 2014 to 2022. Correlation and regression modeling were used to analyze whether child firearm possession was associated with child death rates for each state per year in our study period.

Results: Data from all 50 states were included. Child gun possession was significantly correlated with a higher number of absolute deaths for firearm-related suicides (r = 0.53, p < 0.05) and firearm-related homicides (r = 0.83, p < 0.05). After adjustment for child population per state, no significant association was observed for suicide rate (r = -0.06, p > 0.05), but a significant association remained for homicide rate (r = 0.77, p < 0.05) (Figure 1). Regression analysis using per capita gun licensees showed that child firearm possession was highly predictive of mortality (t = 9.1, p < 0.05) while per capita licensees were less predictive (t = 6.82, p < 0.05). Heat and dot density geographic maps were created based on state suicide and homicide rates and gun license rates averaged over the study period.

Conclusion: We identified a strong association between firearm possession and firearm homicides in children from 2014 to 2022. This is the first study to examine the relationship between firearm mortality and firearm possession nationally in children. While firearm tracing appears to be a good proxy for gun possession in child homicides, better proxies may be helpful in assessing suicide mortality.