Evidence to Assess Potential Policy-Oriented Solutions for Reducing Adolescent Firearm Carriage

* Abbreviation: NICS — : National Instant Criminal Background Check System Firearm injuries are the second leading cause of death among US children and adolescents from age 1 through 19 years of age, responsible for 3400 deaths and an estimated 18 000 nonfatal injuries annually.1,2 Since 2013, there has been an increase in firearm-related fatalities, with homicides and suicides increasing 37% and 48%, respectively.2 Mass school shootings, although responsible for a small amount of the overall firearm-related deaths, have also been increasing in frequency, with significant psychosocial and emotional impacts on families and surrounding communities.3,4 Economic costs for the acute care of pediatric firearm injuries are substantial, rising in recent analyses to nearly $400 million annually, before factoring in the costs for long-term medical care, lost wages, and legal proceedings.5 As a result of such trends, there has been greater societal awareness about this public health problem, especially as parents and policy makers now recognize that inaction on firearm safety has contributed to a situation in which high school students are now more likely to die of a firearm injury than any other cause of death.2 Despite research results demonstrating that firearm access and carriage are 2 of the most significant risk factors for pediatric firearm injuries,6–16 there has been little progress in developing effective evidence-based … Address correspondence to Monika K. Goyal, MD, MSCE, Children’s National Medical Center, 111 Michigan Ave NW, Washington, DC 20010. E-mail: mgoyal{at}childrensnational.org