Health Matters: Firearm safety - a pediatrician's perspective
Nationally, firearms are present in 38 percent of American households. Of those guns, 21.7 percent are stored loaded, 31.5 percent are stored unlocked, and 8.3 percent of households store at least one gun unlocked and unloaded. I ask all families in my practice about gun ownership and of that total, about one-third of the families do own at least one gun. While almost all of the families do report keeping them locked and unloaded, it is always helpful to review basic safety regarding firearms storage.
The absence of firearms is the most effective way to prevent firearm related injury and death. Keeping guns out of homes is the most reliable way to prevent firearm-related injury and death.
If you do keep firearms, store them unloaded and unlocked. A large multi-site study found that, for households with firearms, keeping guns locked and unloaded has protective effects of 73 percent and 70 percent respectively, with regard to both unintentional injury and youth suicide. Ammunition should be stored in a separate location. Trigger locks, cable locks, lock boxes, gun safes all can save lives. In fact, cable locks are available at no cost at Just So Pediatrics. Call our practice if you would like a free cable lock.
I once asked a young patient if there was a gun in his home and he answered, "Yes." I asked, "Is it locked?" He answered, "Yes, but I know where the keys are." I asked another question: "Does your dad know that you know where the keys are?" Answer: "No." Be careful how you store the keys!
Don't trust your kids to stay away from firearms, as children of all ages are curious or fascinated by guns. Adults must keep firearms away from kids. Children cannot be expected to resist the temptation to touch, to explore. Even well-behaved children forget the rules.
Consider, a tired dad came home from his job in law-enforcement. He put his firearm high up a shelf and fell asleep in his easy chair. The jumps and bumps of his sons were not wild enough to wake him and the kids managed to get the firearm down. In his curiosity, the 4-year-old forgot past "Do Not Touch" warnings. He broke the rules and picked up the firearm. It went off and killed his younger brother.
According to the Children's Defense Fund, in 2015 a shooting by a toddler occurs an average of once a week. There is no question that the father in this story had received training on firearm safety, yet, his weapon was stored unlocked and loaded. I am sure he did not think it was accessible. I always remind parents that kids are curious and they know their way around their homes.
Discuss guns with your children. Talk to them about the dangers of guns — and how they are strictly "off-limits." Remember, warning children about guns is not as effective as preventing access. Kids forget warnings when they are curious. Parents, even if you do not have a firearm in your home, it is quite likely that your children will visit homes with firearms. More than one third of accidental shootings of children take place while visiting friends, neighbors or other relatives.
Families of depressed people face special challenges. I advise the parents of people with mood disorders, alcohol/drug abuse, or a history of suicide attempts to remove firearms from the home.
Suicide is the third leading cause of death in 15- to 19-year-old youth. Risk factors for suicide include a history of feeling bullied or humiliated, of being stigmatized because of race, religion, learning differences, transgender identification, or sexual orientation. Living in a home with a firearm is also a risk factor: suicide rates are three to five times higher in homes with guns.
Many youth who attempt or commit suicide were not thought to be at risk by their friends and families. I remember an active elementary student, who grew to be the proud member of the high school football team. He hosted an early season party at his home. Without the knowledge of his parents, alcohol was served. The rules for the team were clear: "Any player caught drinking was off the team." The host's parents discovered the drinkers. The parents stated that they were disappointed and that they would tell the coach. Many of the key players were among the drinkers. It was obvious that there would be no football that year. Later that night, the teenage host, over-whelmed by team loyalty and anger, shot himself with a hunting rifle.
The football player could have killed himself without a gun. Teens are sensitive and peer-oriented. Teens often act on impulse. Access to the gun made completion of the suicide more likely. Of the common methods for attempting suicide, use of firearms is the most lethal, with a 90 percent mortality rate. It has been repeatedly documented that safe-storage (unloaded, locked, with ammunition stored separately) decreased the suicide rate significantly for youth who live in homes with firearms.
Injury from firearms is one of the leading causes of preventable death among children. Children and adolescents often act first and think later. It is the responsibility of adults to keep the guns away from kids because we cannot expect kids to stay away from guns.
Susan Slowinski, MD, is a board-certified pediatrician at Just So Pediatrics, a member of BMH Physician Group. Located at 19 Belmont Avenue, Brattleboro, Just So Pediatrics specializes in the care of infants, children, and adolescents. In addition to regular hours, new evening and Saturday hours are available on most Tuesdays and Wednesdays until 8pm and some Saturdays 8 a.m. to noon. To learn more about the practice, visit bmhvt.org or call 802-251-8626.
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