Gun Violence and Pediatrics

Lisa McReynolds

Legislative Advocacy

PGY-2 Ambulatory/Outpatient Block

September 14, 2010 Noon Conference

Happy Primary Election Day- go vote!

votesmart.org

http://www.elections.state.ny.us/

Gun Violence Statistics• 8 children killed daily by guns• 48 injured seriously• 40% American households have guns

(compared to pets, which do we ask about)• 1.7 million children live with unlocked/loaded

guns in the home (that’s 40% of the 40%)• Access to these guns increases rates of

suicide and accidental injury• 75% of kids know where “hidden” guns are in

the home

• Homicide 2nd leading cause of death in teens, 1st leading in Black teens

• 9484 Americans murdered by guns last year• 3% of direct medical expenses are due to assaults• Total cost to society yearly for gun violence $100

billon dollars medical costs, costs of the criminal justice system, security precautions such as metal detectors, and reductions in quality of life because of fear of gun violence.

• Of which $15 billon attributable to firearm injuries in children

• In homes were there are guns there is higher rate of injury and suicide, and guns are more likely to do harm than offer protection

Why should we care

• Violence is clearly a major public health problem, and it disproportionately affects children/young adults

• Preventable cause of death/injury

• Studies have shown pediatricians can influence and help

State of Current Gun Legislation- New York

• Considered one of the stricter states re: purchase, possession and carrying of handguns

• NYC has further laws for carrying of concealed firearms

www.bradycampaign.org

Proposed NY Legislation- two of manynyagv.org

Gun Dealer Responsibility Act

(A 1093 Paulin/S 1715 Schneiderman)• Requires the creation and imposition of responsible commercial

practices, stringent record keeping and reporting to prevent gun sales to criminals.

• A recent report demonstrated that states with strong gun dealer regulations have fewer guns end up in the illegal market and used in crimes than states with weak gun dealer regulations.

• A small number of gun dealers, 1%, are responsible for nearly 60% of crime guns nationally.

5-Year Renewable Gun Permit (A 801a Paulin/S 1598 Schneiderman)

• Requires permit holders to renew and restate important information about their eligibility to possess handguns and the number possessed.

• Reforms NYS’ lifetime handgun license law requiring review of licensee’s subsequent criminal convictions, mental health status, or character fitness in years subsequent to the initial issuance of a permit.

• Provides regular confirmation that licensees remain qualified to possess a handgun and ensures the integrity of the licensing system with updates of current information.

State of Current Gun Legislation- New Jersey

Some Proposed NJ Legislation

• A754 Clarifies that BB Guns are not firearms under New Jersey law.

• A988 Establishes " Gun-free" and "weapon free" zones around certain school and public properties.

• A1809 Makes it a crime to sell or possess products or materials designed to alter firearms to look like toy Guns.

What does the AAP have to say

• In 2009 the AAP re-wrote their statement about the role of the pediatrician in youth violence prevention

• Pediatricians should know and practice Connected Kids: Safe, Strong, Secure, which is their primary care violence prevention protocol and that we should serve as advocates in violence prevention

What do the studies show

• Olson et al. 2006 Injury Prevention

• Surveyed almost 2000 pediatricians in 1994 and 2000

• Most think it’s important but don’t do it consistently

• Varied by some interesting demographics of the providers

Barkin et al.

• Pediatrics 2008

• RCT for three AG topics

• First national RCT to demonstrate effectiveness of brief office based violence prevention

• Specifically looking at cable locks for guns

Cowden et al

• Pediatrics 2009

• Adopted Connected Kids in Head Start Programs with Success

Finch et al.

• 2007 Maternal Child Health

• Also surveyed providers

• Not enough time to incorporate violence prevention

• Don’t feel confident giving this AG

• Don’t think it will change behaviors

What can we do

• ASK Campaign- partnership with PAX

• Anticipatory Guidance- Connected Kids

• Advocate

• Vote

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References• http://www.njleg.state.nj.us/bills/BillsByKeyword.asp

• http://assembly.state.ny.us/leg/?by=k&qs=gun

• http://www.nyagv.org/

• http://en.wikipedia.org/wiki/Gun_laws_in_the_United_States_%28by_state%29#New_York

• http://en.wikipedia.org/wiki/Gun_politics_in_the_United_States#20th_century

• http://www.bradycampaign.org/

References Continued• Barkin SL, Finch SA, Ip EH, Scheindlin B, Craig JA, Steffes J, Weiley V, Slora E, Altman D,

Wasserman RC. Is office-based counseling about media use, timeouts, and firearm storage effective? Results from a cluster-randomized, controlled trial. Pediatrics. 2008 Jul;122(1):e15-25.

• Committee on Injury, Violence, and Poison Prevention. Policy statement--Role of the pediatrician in youth violence prevention. Pediatrics. 2009 Jul;124(1):393-402.

• Cowden JD, Smith S, Pyle S, Dowd MD. Connected kids at Head Start: taking office-based violence prevention to the community. Pediatrics. 2009 Oct;124(4):1094-9.

• Finch SA, Weiley V, Ip EH, Barkin S. Impact of pediatricians' perceived self-efficacy and confidence on violence prevention counseling: a national study. Matern Child Health J. 2008 Jan;12(1):75-82.

• Kunkel P, Thomas CJ, Seguin C, Dereczyk D, Rajda C, Brandt MM. A hospital-based violence prevention tour: a collaborative approach to empower youth. J Trauma. 2010 Feb;68(2):289-93.

• Laraque D; American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention. Injury risk of nonpowder guns. Pediatrics. 2004 Nov;114(5):1357-61.

• Loh K, Walton MA, Harrison SR, Zimmerman M, Stanley R, Chermack ST, Cunningham RM. Prevalence and correlates of handgun access among adolescents seeking care in an urban emergency department. Accid Anal Prev. 2010 Mar;42(2):347-53.

• Olson LM, Christoffel KK, O'Connor KG. Pediatricians' involvement in gun injury prevention. Inj Prev. 2007 Apr;13(2):99-104.

• Wright MA, Wintemute GJ, Claire BE. Gun suicide by young people in California: descriptive epidemiology and gun ownership. J Adolesc Health. 2008 Dec;43(6):619-22.