Children & Adolescents

We analyzed the relationship between firearm availability and unintentional gun death, homicide and suicide for 5-14 year-olds across the 50 states over a ten-year period.  Children in states with many guns have elevated rates of unintentional gun deaths, suicide and homicide.  The state rates of non-firearm suicide and non-firearm homicide among children are not related to firearm availability.

Miller, Matthew; Azrael, Deb; Hemenway, David.  Firearm availability and unintentional firearm deaths, suicide, and homicide among 5-14 year olds.  Journal of Trauma.  2002; 52:267-75.

We analyzed data from the Arizona Childhood Fatality Review Team comparing youth gun suicide with suicide by other means.  Children who use a firearm to commit suicide have fewer identifiable risk factors for suicide, such as expressing suicidal thoughts.  Gun suicides appear more impulsive and spontaneous than suicide by other means.

Azrael, Deborah; Hemenway, David; Miller, Matthew; Barber, Catherine; Schackner, Robert.  Youth suicide: Insights from 5 years of Arizona child review team data.  Suicide and Life Threatening Behavior.  2004; 34:36-43.

This article uses data from various locations to describe the circumstances of infant homicides.  Guns are almost never used to kill infants.  The perpetrator is virtually always caught, and often is the one calling the police.

Fujiwara, Takeo; Barber, Catherine; Schaechter, Judy; Hemenway, David.  Characteristics of infant homicides in the U.S.: Findings from a multi-site reporting system.  Pediatrics.  2009; 124:e210-17.

At family practice clinics in rural Alabama, over 400 parents were separated from their children, and both were asked questions about guns in the home.  We found that over 1/3 of parents who reported that their son had not handled a household gun were contradicted by the child.

Baxley, Frances; Miller, Matthew.  Parental misperceptions about their children and firearms.  Annals of Pediatric and Adolescent Medicine.  2006; 160:542-47.

We analyzed data from a telephone survey of over 5,800 California adolescents conducted in 2000-01.  We found that one-third of adolescents reported handling a firearm, 5% without adult supervision or knowledge.  Smoking, drinking and parents not knowing the child’s whereabouts in the afternoon were associated with unsupervised gun handling.  These events usually occur away from home, with friends.  Half involve shooting the gun.

Miller, Matthew; Hemenway, David.  Unsupervised firearm handling by California adolescents.  Injury Prevention.  2004; 10:163-68.

We evaluated a year-long comprehensive, community-based campaign in a small Midwestern city that promoted the importance of parents asking adults in whose homes their children play or visit about household firearms and their safe storage.  Attitudes and behavioral intentions changed modestly, but not significantly, in the expected direction.  In addition, most parents believed that asking about firearms is a good idea and few would feel uncomfortable if another parent asked about firearms in their home.  However, they overestimated the likelihood that asking about firearms would be offensive to other parents.

Johnson, Rene M; Lintz, Jenny; Gross, Daniel, Miller, Matthew; Hemenway, David.  Evaluation of the ASK campaign in two Midwestern cities.  ISRN Public Health.  2011 Dec 1;2012.

The public health approach provides innovative ideas for protecting children from firearm injury.

Hemenway, David.  Protecting children from firearm violence.  Big Ideas for Children: Investing in our Nation’s Future.  2008; 203-210.

Using data from the National Violent Death Reporting System for 16 states from 2005 to 2012, we estimate that there were 110 unintentional firearm deaths to children 0-14 annually in the U.S. during this 8 year time period, 80% higher than reported by the Vital Statistics.  The large majority of children are shot by an adult who is not a family member.

While children are typically shot by other children, victims aged 2-4 are usually shooting themselves.  While many boys aged 11-14 are shot unintentionally at a friend’s house, this is not the case for girls and children aged 10 years and under.

This article received the Jess Krauss award as the best article in Injury Epidemiology for the year 2015.

Hemenway D, Solnick SJ.  Children and unintentional firearm death.  Injury Epidemiology.  2015: 2:26-31.

Using data from the National Violent Death Reporting System, we examined homicides by children aged 0-14. Nearly 90% of the perpetrators were boys, over 90% were aged 11-14, and most used guns. We created five categories which accounted for over 70% of the events. These categories are: (1) the Caretaker, a juvenile, often an older brother, is given the responsibility of caring for an infant. The homicide typically occurs in the residence and blunt force is used (no guns); (2) Impulsive shooting during play, in which the child typically shoots a sibling or friend. Except for some notation of momentary anger, these cases look much like unintentional firearm fatalities; (3) Robbery, a group of youth are trying to steal money, usually from an adult; (4) Group assault, a group of youth are fighting, usually with other youth; (5) Killing an adult family member, typically a parent or grandparent. Creating a typology of events is useful both for understanding the problem and determining solutions.

Hemenway, David; Solnick, Sara J. The epidemiology of homicide perpetration by children. Injury Epidemiology. 2017; Dec 4(1): 5-

A large longitudinal cohort study of adolescents by Kim in Social Science & Medicine (2017) found that gaining easy access to a firearm in the home was associated with increased depression among girls and increased fear in schools. We discuss many relevant studies (e.g., a meta-analysis of 78 studies found that the mere presence of weapons increases aggressive thought, hostile appraisals and actual aggression). We conclude: “My hope is that Kim’s 2018 study of the psychological effects of gun ownership will be a seminal investigation, leading to increased interest in the psychological effects–both positive and negative–of firearms on all members of the household, as well as members of the surrounding community.”

Hemenway, David. Easy home gun access and adolescent depression. Social Science & Medicine. 2018; 203:60-63.

Using the NVDRS (2005-2014), we read narratives of homicides to children age 2-14 to determine which were IPV-related. Two types of such homicides are (1) the perpetrator also kills (or attempts to kill) the intimate partner (54% of the IPV cases), and (2) intimate partner conflict (e.g., divorce, separation, custody) precedes the homicide (46% of IPV cases). Overall, 20% of child deaths were IPV-related. Compared with other perpetrators of child homicide, IPV-related perpetrators were more likely to be White, use a firearm, and die by suicide.

Adhia A, Austin SB, Fitzmaurice GM, Hemenway D. The role of intimate partner violence in homicides of children aged 2-14 years. American Journal of Preventive Medicine. 2019; 56:38-46.

From NVDRS data (2003-2016), the perpetrators of 7% of the homicides were ex- or current spouse, boyfriend or girlfriend. 90% of the victims were female. Common reasons were jealousy, broken relationship, pregnancy—combined with access to a firearm.

Adhia A, Kernie MA, Hemenway D, Vavilala MS, Rivara FP. Intimate partner homicide of adolescent victims. JAMA Pediatrics. 2019; 173:571-77.

In our 2019 national survey, 280 parents and their adolescents (aged 13-17) separately answered questions about firearm access in their home. In households where parents said these teenagers could not access a firearm, 22% of the adolescents reported they could access the firearm in less than 5 minutes, and another 15% said it would take 5 minutes to an hour.

Salhi C, Azrael D, Miller M. Parent and adolescent reports of adolescent access to household firearms in the United States. JAMA Network Open. 2021; 4:e210989.

In this Commentary, we use Vital Statistics data to report a change in the leading cause of death for 1-24-year-olds in the United States. For more than six decades motor vehicles had been their leading cause of death, but because of improvements in motor vehicle safety, and increases in the lethality of firearms, in 2017 guns surpassed motor vehicles as the leading cause of death for this age group.

Lee LK, Douglas K, Hemenway D. Crossing lines: a change in the leading cause of death among US children. New England Journal of Medicine. 2022; 286:1485-1487.

Over 680 gun owners with children responded to questions from our 2019 National Firearm Survey. 12% said that a child in their home could access and load one of their guns when they were not present.

Berrigan J, Azrael D, Miller M. Parental perceptions of their children’s access to household firearms. Journal of Pediatrics. 2023; 255:154-58.

Using NVDRS data (2017-2018), we examined child perpetrators of violent death. We estimate that annually, 82 children become homicide suspects, 624 commit suicide, and 71 are the shooter in an accidental gun death. Overall, in these violent deaths, the large majority of the perpetrators and victims are male, and over 80% of all the deaths occur at home. Dividing the states into 3 levels of firearm ownership, children in the lowest level states are less likely to be perpetrators of each of the types of violent death, largely due to lower rates of firearm death.

Solnick SJ, Hemenway D. Child perpetrators of homicide, suicide, and unintentional firearm fatalities in the United States. In: The Routledge International Handbook of Juvenile Homicide 2024 (pp. 274-287). Routledge.