Preventing Gun Deaths in Children – Judith S. Palfrey, M.D., and Sean Palfrey, M.D. N Engl J Med 2013; 368:401-403 January 31, 2013 DOI: 10.1056/NEJMp1215606

“As practicing pediatricians who have lost patients to gun violence, we join our colleagues in mourning the 20 children and their teachers who were killed in Newtown, Connecticut, on December 14, 2012. Our sadness is deepened by our knowledge that the deaths, terror, and post-traumatic stress of the relatives and friends left behind could have been prevented. Prevention is the core of pediatric work. We aim to protect children from all things that can harm them. Injuries are the biggest threat to U.S. children over 1 year of age. In 2010, gun-related injuries accounted for 6570 deaths of children and young people (1 to 24 years of age). That includes 7 deaths per day among people 1 to 19 years of age. Gun injuries cause twice as many deaths as cancer, 5 times as many as heart disease, and 15 times as many as infections (see graph) Causes of Death among Persons 1 to 24 Years of Age in the United States, 2010.). How can we prevent gun injuries? We know the behaviors that place children and adolescents at high risk. Little children explore their worlds without understanding danger, and in one unsupervised moment, an encounter with a gun can end in fatality. School-age children often enter the worlds created by television shows, movies, and video games. Because of their developmental age, school-age children don’t necessarily understand that people who are really shot may really die. A firearm in their hands can transform fantasy into tragedy. Even in our own lives, this risk has been manifest: to this day, one of us is haunted by the childhood memory of aiming a loaded rifle at a babysitter.”