Firearm storage patterns in US homes with children

Schuster, Mark A.; Franke, Todd; Bastian, Amy M.; Sor, Sinaroth; Halfon, Neal

doi:10.2105/ajph.90.4.588

Cited by 138 publications

(37 citation statements)

References 51 publications

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“…22-25 Nationally, it is estimated that a firearm is present in 35% of U.S. households with at least half of these being handguns. 26,26 This estimate of firearm and handgun ownership is believed to be consistent in households with children. 26,27 The prevalence of firearm ownership varies geographically and is highest in the South and Midwest and lowest in the Northeast.…”

Section: Discussionmentioning

confidence: 75%

“…26,26 This estimate of firearm and handgun ownership is believed to be consistent in households with children. 26,27 The prevalence of firearm ownership varies geographically and is highest in the South and Midwest and lowest in the Northeast. 28 Gun ownership in Wisconsin is one of the highest in the nation, with a 48% prevalence of firearm ownership and a 42% handgun ownership.…”

Section: Discussionmentioning

confidence: 75%

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Health Disparities Analysis of Critically Ill Pediatric Trauma Patients in Milwaukee, Wisconsin

Cassidy

Lambropoulos

Enters

et al. 2013

Journal of the American College of Surgeons

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Background Injury is the leading cause of childhood morbidity and mortality in the U.S. The associated costs exceed 20 billion dollars annually. This study examines disparities in disadvantaged populations of critically injured pediatric patients admitted to a level 1 pediatric trauma center. Study Design A retrospective study was conducted of all trauma patients admitted to the pediatric intensive care unit (PICU) at a level 1 pediatric trauma hospital from 2005-2009. Results Data on 324 patients were analyzed and 45% of patients were Caucasian, 33% African American 12% Hispanic and 10% other. There was no difference in age, Glasgow Coma Scale (GCS) or Injury Severity Score (ISS) across ethnic groups. The mortality rate was 12%. A higher percentage of Caucasians were commercially insured and from the highest income quartile than non-Caucasians (p<0.001). African Americans had the highest rate of penetrating trauma and intentional injury compared to other ethnicities (p<0.001). Nearly 75% of firearm injuries were clustered in 7 zip codes with the lowest median household incomes. The home was the most common location for firearm injuries. Children involved in assaults were more likely to have a single parent (67%) than two parents (26%, p<0.001). Both ethnicity and payer status were significantly associated with mortality. Conclusions Significant disparities in socioeconomic status exist in severely injured pediatric patients treated in the PICU. These disparities were associated with adverse outcome. These results should inform community and public health efforts to identify the areas and populations at highest risk for violence related injuries.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 75%

Health Disparities Analysis of Critically Ill Pediatric Trauma Patients in Milwaukee, Wisconsin

Cassidy

Lambropoulos

Enters

et al. 2013

Journal of the American College of Surgeons

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“…Because respondents were primarily women and gun owners are more often men, 24 we created three categories to represent these factors (female respondent, adult male in home; female respondent, no adult male in home; male respondent). These three categories were incorporated in regression models, with “female respondent, adult male in home” as the reference group, to ameliorate potential confounding attributable to the association between a keeping a firearm in the home, the respondent’s sex and household composition, and risk factors for self-harm or other violence.…”

Section: Methodsmentioning

confidence: 99%

Firearm Ownership and Acquisition Among Parents With Risk Factors for Self-Harm or Other Violence

Ladapo

Elliott

Kanouse

et al. 2016

Academic Pediatrics

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Objective Recent policy initiatives aiming to reduce firearm morbidity focus on mental health and illness. However, few studies have simultaneously examined mental health and behavioral predictors within families, or their longitudinal association with newly acquiring a firearm. Methods Population-based, longitudinal survey of 4,251 parents of fifth-grade students in three US metropolitan areas; 2004–2011. Multivariate logistic models assessed associations between owning or acquiring a firearm and parent mental illness and substance use. Results Ninety-three percent of parents interviewed were women. Overall, 19.6% of families reported keeping a firearm in the home. After adjustment for confounders, history of depression (aOR 1.36, 95% CI 1.04–1.77), binge drinking (aOR 1.75, 95% CI 1.14–2.68), and illicit drug use (aOR 1.75, 95% CI 1.12–2.76) were associated with a higher likelihood of keeping a firearm in the home. After a mean of 3.1 years, 6.1% of parents who did not keep a firearm in the home at baseline acquired one by follow-up and kept it in the home (average annual likelihood=2.1%). No risk factors for self-harm or other violence were associated with newly acquiring a gun in the home. Conclusions Families with risk factors for self-harm or other violence have a modestly greater probability of having a firearm in the home compared with families without risk factors, and similar probability of newly acquiring a firearm. Treatment interventions for many of these risk factors may reduce firearm-related morbidity.

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“…Factors that contribute to violence include media exposure, 44–46 parenting behavior, 8–10 and firearm accessibility. 47–49 For example, 90% of children are now exposed to >2 hours of media per day, 44–46 and 60% of media content depicts violent acts. 50,51 Exposure to unsafely stored firearms is likewise a significant risk factor for childhood and adolescent injury.…”

Section: Discussionmentioning

confidence: 99%

“…47,48 Among homes with children and firearms, >40% have at least 1 unlocked firearm. 49 Data also indicate that substantial numbers of pediatric patients are exposed to excessive media and either live in or visit a home where a gun is present, 49,52–55 which allows the setting of a provider's office to serve as an opportunity to address these issues that affect children's health.…”

Section: Discussionmentioning

confidence: 99%

Is Office-Based Counseling About Media Use, Timeouts, and Firearm Storage Effective? Results From a Cluster-Randomized, Controlled Trial

Barkin

Finch²,

Ip³

et al. 2008

Pediatrics

236

146

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Objective The objective of this study was to determine whether patients' families' violence-prevention behaviors would be affected by their primary care practitioner's use of a violence-prevention clinical intervention during the routine well-child examination. Methods In this cluster-randomized, controlled trial (2002–2006), 137 Pediatric Research in Office Settings practices were randomly assigned and initiated patient recruitment for either an office-based violence-prevention intervention or a control group (educational handout on literacy promotion provided). Primary caregivers of children who were aged 2 to 11 years and presented for a well-child visit were surveyed at baseline and 1 and 6 months. Practitioners were trained to (1) review a parent previsit summary regarding patient-family behavior and parental concern about media use, discipline strategies, and children's exposure to firearms, (2) counsel using brief principles of motivational interviewing, (3) identify and provide local agency resources for anger and behavior management when indicated, and (4) instruct patient-families on use of tangible tools (minute timers to monitor media time/timeouts and firearm cable locks to store firearms more safely where children live or play). Main outcomes were change over time in self-reported media use < 120 minutes per day, use of timeouts, and use of firearm cable locks. Results Generalized estimating equation analysis revealed a significant effect at 6 months for decreased media use and safer firearm storage. The intervention group compared with the control group showed an increase in limiting media use to < 120 minutes per day. There was no significant effect for timeout use. There was a substantial increase in storing firearms with cable locks for the intervention group versus a decrease for the control group. Conclusions This randomized, controlled trial demonstrated decreased media exposure and increased safe firearm storage as a result of a brief office-based violence-prevention approach.

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Firearm storage patterns in US homes with children

Abstract: Health. Drs Schuster and Halfon are also with RAND, Santa Monica, Calif.Requests for reprints should be sent to Mark A. Schuster, MD,

Cited by 138 publications

References 51 publications

Health Disparities Analysis of Critically Ill Pediatric Trauma Patients in Milwaukee, Wisconsin

Health Disparities Analysis of Critically Ill Pediatric Trauma Patients in Milwaukee, Wisconsin

Firearm Ownership and Acquisition Among Parents With Risk Factors for Self-Harm or Other Violence

Is Office-Based Counseling About Media Use, Timeouts, and Firearm Storage Effective? Results From a Cluster-Randomized, Controlled Trial

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