Black children and kids from low-income households, regardless of race or ethnicity, face the highest risk of being hurt or killed by firearms, a Southern Illinois University School of Medicine doctor found in a national study published by one of the world’s leading medical journals.
Dr. Ruchika Goel, a blood-diseases and cancer specialist at SIU’s Springfield campus, was lead author of the study, which appeared in the May issue of The Lancet Regional Health – Americas.
Goel said the federally funded study – which also involved researchers at Johns Hopkins University, collaborators at Cornell and Yale universities and two of the largest blood suppliers in the country, American Red Cross and Vitalant – offers an “unprecedented analysis stratified by race and ethnicity and highlights stark socioeconomic disparities nationally in firearm injuries.”
The study followed the 2022 publication of data in The New England Journal of Medicine that showed gun-related injuries for the first time becoming the No. 1 cause of death in American children and adolescents in 2020 – ahead of motor-vehicle crashes and causes that included cancer, drowning and drug overdoses.
The United States was the only Western country with that distinction, according to the Kaiser Family Foundation, which made its comparison available online at bit.ly/KaiserPediatric.
There were a total of 4,357 pediatric gun deaths in 2020, according to the U.S. Centers for Disease Control and Prevention.
U.S. gun deaths among people of all ages reached new peaks in 2020 and 2021 – 42,222 and 48,830, respectively, the CDC said. Researchers have found that firearm violence increased during the COVID-19 pandemic, but they aren’t predicting whether deaths will drop as the pandemic wanes.
The Lancet study, led by SIU and Johns Hopkins, provided more specifics on the toll of gun violence in children, confirmed the existence of disparities and provided evidence of the need for more research and collaboration by policymakers across the political spectrum, Goel said.
“This study is really raising awareness and bringing out the absolute magnitude of this,” she said. “The medical and social impact of firearm injuries on children and adolescents is profound, conferring long-lasting physical and mental disabilities that require intense medical interventions. It should be considered a national public health emergency.”
The study examined national data on almost 10,000 combined emergency room visits and hospitalizations for children through age 17 in 2019.
Black children and children from ZIP codes with lower household income were overrepresented, compared to their share of the pediatric population, when it came to firearm injuries, especially unintentional injuries and assaults.
More than half of all gun-related hospitalizations of children in 2019 were among Black children, according to the study. Only 1.7% of gun-related hospitalizations of Black children were related to likely suicide attempts, while suicide attempts were linked to 16.6% of all gun-related hospitalizations among white children.
Looking at the data another way, white children represented 19.6% of all gun-related pediatric hospitalizations and 56% of the gun-related suicide attempts.
And regardless of race or ethnicity, children living in ZIP codes with the lowest median household incomes – $44,000 per year or less – represented more than half of pediatric ER visits for gun injuries.
Data on gun-related ER visits and hospitalizations weren’t available at the state level. But Goel and her colleagues, who plan to look specifically at Illinois numbers in follow-up research, found regional differences in the Lancet study.
States in the South, including Texas and Oklahoma, had the highest gun-related pediatric hospitalization rates, followed by the Midwest, including Illinois, and part of the Great Plains region. Northeastern and Western states had the lowest rates.
The scientists didn’t speculate much about reasons for the income and racial disparities in gun-related injuries and deaths, such as more violent neighborhoods or access to guns. Goel said there needs to be more research on these topics.
But regarding Black children, she and her colleagues wrote: “There are several systemic factors driving these disparities, including underlying racial segregation; disparities and inequities in health likely deepen the racial disparities” in firearm-related violence.
Mining “big data” from national databases for research is a specialty of Goel’s. She is a native of India and a naturalized U.S. citizen who completed medical school in her home country, residency training in Pittsburgh and a fellowship in hematology oncology at Johns Hopkins in Baltimore.
She also serves as a senior medical director at Arizona-based Vitalant, one of the nation’s largest nonprofit blood and biotherapies health care organizations. It serves hospitals and patients across the country.
Goel, 41, has been on the faculty at SIU for five years and is associate vice chairperson for research in the internal medicine department. She is a past medical director of ImpactLife, the nonprofit regional blood center based in Davenport, Iowa, that serves Springfield and much of central Illinois.
Goel said the idea for the Lancet study originated about nine months ago when she was talking at home with her twin daughters, Anvi and Asmi Agarwal, who were 11 at the time.
The girls had just started sixth grade at Franklin Middle School in Springfield. Goel talked with her daughters about their concerns regarding school shootings, active-shooter drills at Franklin and the recent news that gun violence had become the No. 1 cause of death of children in America.
Those talks led to Goel discussing the issue with her colleagues at SIU and Johns Hopkins about the need for a deeper dive into data about pediatric ER visits and hospitalizations after gun injuries and deaths, she said.
Goel credited SIU School of Medicine Dean and Provost Dr. Jerry Kruse, SIU Chief Medical Officer Vidhya Prakash, internal medicine department chairperson Dr. John Flack and Dr. Aziz Khan, executive director of the Simmons Cancer Institute at SIU Medicine for supporting and advocating for her research.
Goel said she supports policy initiatives to quell gun violence that have been proposed by the American Academy of Pediatrics.
The initiatives include a comprehensive data system for gun injuries and deaths, stricter gun laws, universal background checks, a ban on assault weapons, mental health screenings, violence-prevention programs and more education on safer gun storage at home.
Dr. Richard Austin, associate director of SIU’s emergency medicine residency training program, said Goel’s research findings largely match what he has seen as a practicing physician in the ER of Springfield Memorial Hospital.
“It shows that no population is exempt from this problem,” Austin said. “The more that we can bring data to the table, the more likely it is that we can have a public discussion of this issue. People are going to have to have uncomfortable conversations on whether the right to bear arms is absolute and what we can do to prevent injuries.”
This article appears in Growing a garden for children.
Garbage article