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Youth firearm injury and violence 

Introduction

Youth firearm violence includes any injury or death due to firearms, including suicide, homicide and community violence, school/mass shootings, teen dating violence, and unintentional injury. “Youth” can be defined in various ways. CDC data include people ages 10-24 (CDC, 2022), and some large studies include youth aged zero to 19. 

Since 2020, firearms have been the leading cause of death for U.S. children and youth aged zero through 19 (Goldstick et al., 2022). Among youth under 18, the number of firearm-related injuries, and firearm-related deaths, increased by 57% and 50%, respectively from 2011-2021 (Panchal, 2022). Male youth are more than four times more likely to die by firearm than female youth (Panchal, 2022). 

All forms of youth violence can lead to long-lasting consequences. The mental health effects of youth exposure to firearm violence can include anxiety, depression, emotional dysregulation, impaired cognitive functioning, disrupted eating or sleeping, posttraumatic stress disorder, low self-esteem, suicidal thoughts, and alcohol or drug use (CDC, 2022; Garbarino et al., 2001; Zimmerman et al., 2013). 

Types of youth firearm injury and violence

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Unintentional injury

Unintentional injuries are injuries that result from being shot by a firearm without evidence of intentional harm. Youth are especially at risk for unintentional firearm injuries and death in their home if firearms are not stored securely (Kaufman et al., 2023). A national survey of the U.S. found that 40.4% of U.S. adults with children living in their homes had at least one firearm (Miller and Azrael, 2022). Further, 4.6 million youth live in homes where at least one firearm is stored unlocked and with ammunition loaded (Miller and Azrael, 2022). Youth aged 5-14 living in urban areas are most likely to experience unintentional firearm injuries (Herrin et al., 2018). Youth often report having handled firearms even when their caregivers believe they do not know where they are kept (Salhi et al., 2021).

Suicide

In 2020, suicide was the tenth leading cause of death for 5 to 9-year-olds, the second leading cause of death for 10 to 14-year-olds, and the third leading cause of death for 15–24-year-olds in the U.S. (CDC WISQARS).Youth have a three times higher risk of suicide when there is a firearm in the home compared to when there is not (Kaufman et al., 2023). The firearm used most often (57-77% of the time) belongs to a family member or intimate partner (Johnson et al., 2010; Kaufman et al., 2023). Due to the high lethality of firearms, firearm suicide attempts nearly always result in death (Conner et al., 2019).

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Homicide and community violence

Nationally, homicide is the most common cause of youth firearm deaths (Kaufman et al., 2023). Historical inequities in health, wealth, education, and policy have played a role in how violence affects youth. Racial disparities are closely linked with the presence and impact of firearm violence (Kaufman et al., 2023). Black youth under 18 are particularly at risk of firearm-related homicides: this population makes up 46% of youth firearm deaths despite being only 14% of the population (Panchal, 2022). People of color are not more likely to perpetrate or be a victim of firearm violence due to individual traits; rather, racial and ethnic minority groups have higher rates of firearm violence due to longstanding inequitable socioeconomic conditions (Sheats et al., 2019).

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School and mass shootings

Mass shootings are defined as four or more individuals killed or injured due to a firearm, excluding the perpetrator. Mass shootings resulting in the injury or death of youth aged 0-12 are most commonly related to domestic or intimate partner violence, while the injury or death of youth aged 13-17 is often related to community violence (Fowler et al., 2017). 

School firearm violence, also called school shootings, includes any shooting incidents, regardless of the number of victims, that occur on school property and result in fatal or non-fatal injuries. From 2014 to 2022, school shootings made up 1.4% of all mass shootings (Barnard et al., 2023). Typically, these events are when a perpetrator shoots others, though suicide, if occurring on school property, is also considered a school shooting. The U.S. has recorded 2,486 school shootings from 1970 to 2022 with 760 people killed and 2,090 injured (Kaufman et al., 2023).

School shootings make up less than 1% of youth firearm deaths (Kaufman et al., 2023) but are nonetheless tragic, shocking, fear-inducing, and ultimately preventable. More than 75% of school shooters have acquired their firearms from their home or that of a relative (NTAC, 2019). Storing firearms safely can help prevent school shootings.

Safe2Tell Colorado is an anonymous reporting system. It allows youth to anonymously report any concerning incident (e.g., bullying, suicidal ideation, presence of a gun) (Safe2Tell, 2022).

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    The scope of the problem in Colorado

    • From 2001-2021, 52.5% of firearm deaths among Colorado youth aged 0-19 were suicide, 40.2% homicide, and 3.3% unintentional injury (CDC, WISQARS).
    • 32.3% of Colorado middle and high school students report they can access a loaded firearm with or without their parent’s permission (McCarthy et al., 2023). 
    • From 2004-2022, 39.6% of the 1,047 suicide deaths among youth 10-18 in Colorado involved firearms (Colorado Suicide Dashboard).
    • There have been 37 school shootings in Colorado since 1970, resulting in 57 injuries and 32 total deaths, including perpetrators. Of those deaths, 15 occurred at the mass shooting at Columbine High School in 1999 (Reidman, 2023).
    • From 2001-2020, nine youth died in school shootings in Colorado (2.4% of all firearm homicide fatalities for youth ages 5-19) (Reidman, 2023).
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    Prevention approaches

    Witnessing firearm injury or death can also significantly impact youth and the communities in which they live (Schonfeld et al., 2020). This trauma can permeate through communities, present as fear and hypervigilance, and impact youth’s physical and psychological health as well as learning and development outcomes such as test scores, rates of graduation, and absenteeism (Hurt et al., 2001).

    Fortunately, there are multiple approaches to preventing firearm injury and death among youth. Access to firearms (whether from home, friends, or other sources), youth firearm carrying, and exposure to firearms in schools and neighborhoods are important contributors to youth firearm injury or violence. Limiting unsupervised youth access to firearms is important; this includes ensuring secure firearm storage at home and, when appropriate, using voluntary out-of-home storage options. 

    Policies like Child Access Prevention Laws aim to increase secure storage by holding adults liable when children gain access to firearms C.R.S.§18-12-108.7. Colorado Revised Statutes (C.R.S.) are posted on the Colorado Legal Resources Public Access Website.

    Other policies intended to limit youth firearm access include minimum age requirements for purchase (C.R.S. §18-12-108.5).

    Efforts to reduce the upstream risk factors that contribute to adverse youth mental health outcomes and community-based violence can reduce mass shootings and school violence. Similarly, increasing the upstream protective factors (e.g., supportive school environments) can prevent mass shootings and school violence.

    Education about firearm safety is also important; families who engage in hunting or other firearm-involved activities should ensure youth understand firearm responsibility and safety. In healthcare settings, providers can provide education on secure home firearm storage and can counsel caregivers on lethal means safety. Providers can also proactively screen and assess youth and young adults for suicide or homicide risk via Hospital-based Violence Intervention Programs. 
     

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    References

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