Firearm-related death and injury among children and adolescents.

As the articles in this journal issue show, gun violence affects children and youth in many ways: psychologically, emotionally, financially, and legally. But first and foremost, gun violence affects children's physical safety. Therefore, this issue opens with an overview of the physical toll that firearms exact upon children and youth, reviewing the incidence of firearm-related injury and death among Americans under age 20. This article analyzes trends and current status in firearm death and injury, based on nationwide data collected by the federal government. Several key findings emerge from the data: Firearm death rates among children and youth in the United States have declined dramatically since 1993, but remain high compared with historical rates in this country and rates in other developed nations. A majority of these deaths are homicides. Certain groups of children and youth, especially adolescents, boys, minority youth, and those residing outside the Northeast, are particularly at risk for firearm death. The problem is most acute among black teenage males. Firearm injuries are much more likely to result in death than are other injuries for which children and youth visit emergency departments--a reflection of the extreme lethality of firearms. Given these findings, the authors call for a concerted effort to reduce youth firearm deaths to levels comparable to those of other industrialized nations, using a wide variety of approaches that span the public health, criminal justice, and educational spheres. They also recommend improved data systems to track firearm injury and death, so that researchers can better analyze these incidents and evaluate intervention strategies.