In recent years, an alarming trend has emerged in the United States. Since 2020, firearms (gun) have become the leading cause of death among children and teenagers, surpassing even car accidents, according to data from the U.S. Centers for Disease Control and Prevention. In 2022, more than 4,500 young lives were lost to firearm injuries. But the tragedy doesn’t stop there; the ripple effects of these incidents have far-reaching consequences on survivors and their families, as revealed in a recent study published in the November issue of Health Affairs.
THE UNSEEN CONSEQUENCES
The study, conducted by Professor Zirui Song and his colleagues at the Blavatnik Institute at Harvard Medical School, sheds light on the often overlooked aftermath of firearm injuries among youth. It is considered one of the most comprehensive studies to date, delving into the devastating effects of both non-fatal and fatal firearm injuries on young individuals and their families.
What makes this study stand out is its focus on children and adolescents, a group often omitted or combined with adults in previous research. The findings demonstrate that the impact on family members is even more profound when a child experiences a firearm injury than when another family member is injured.
Professor Song states, “Gunshot survivors and their families often experience long-lasting, invisible injuries, including psychological and substance-use disorders rooted in the shared trauma they have endured. It’s crucial for clinicians to recognize that these families are at increased risk for these conditions, so they can receive the support and care they need.”
WIDESPREAD IMPACT
The study analyzed commercial health insurance claims and compared three key groups:
Child and adolescent gunshot survivors (2,052 individuals) were compared with a control group of similar young people (9,983 individuals) who did not experience gun injuries.
Family members of survivors (6,209 individuals, including parents and siblings) were compared with peers who did not have such an experience (29,877 individuals).
Family members of young people who died from firearm injuries (265 individuals) were compared with those who did not experience such a loss (1,263 individuals).
IMPACT ON SURVIVORS AND THEIR FAMILIES IS SIGNIFICANT:
Youth survivors had a 68 percent increase in psychiatric disorders and a 144 percent increase in substance use disorders compared to the control group. They also incurred an average of $34,884 more in healthcare spending in the first year alone, which is 17 times more than their pre-injury spending.
Parents of injured children experienced a 30 percent increase in psychiatric disorders compared to parents whose children did not sustain gunshot injuries.
Surprisingly, there was a slight reduction in routine medical care among mothers and siblings of firearm victims, potentially due to prioritizing urgent care for the injured child.
Siblings of survivors did not show an increase in mental health care visits or diagnoses, suggesting that the mental health effects of gun violence on close family members are often overlooked.
GRIEVING PROCESS
Unsurprisingly, family members who lost a child or sibling to firearm injuries experienced even more dramatic effects. They had more than twice as many psychiatric disorders after their loss compared to before it. Fathers, in particular, saw a sharp increase, with more than five times as many psychiatric disorders in the months following the fatal shooting of a child. Mothers of children who were killed had a 15-fold increase in mental health visits, while fathers, who rarely sought mental health care before losing their child, exhibited an 87-fold increase in mental health visits.
The study’s authors believe that these findings can assist clinicians in identifying those in need of help more promptly, improving screening for mental health issues not only among survivors but also among their siblings, parents, and other family members. This trauma-informed approach is crucial and is being incorporated into medical training.
PROMOTING GUN SAFETY
The researchers emphasize the importance of gun safety, as children and teenagers are increasingly exposed to firearms. Living in a home with firearms has been shown to increase the risk of firearm injuries, and millions of children in the U.S. live in households with firearms, some of which are kept loaded and unlocked. Medical professionals play a vital role in promoting gun safety, and several professional organizations have developed policies and procedures to counsel families on firearm safety.
As Professor Song notes, “Clinicians have opportunities to help prevent firearm injuries from happening. In addition to patching up the injured and treating the traumatized, they can make a difference in preventing these tragic incidents.”
