1. Mechcatie, Elizabeth MA, BSN


Only about one-third follow AAP safety guidelines.


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Millions of children continue to live in homes with firearms that are not safely stored, despite guidelines from the American Academy of Pediatrics (AAP) stating that guns be unloaded and locked up. Even in homes with children at risk for self-harm, adherence to recommended safety practices is inadequate, according to a recent study. The researchers found that in homes with children and guns, "the odds are roughly two to one that firearms are not stored in accordance with [the AAP] recommendations," whether or not the children had self-harm risk factors such as a history of depression.

Figure. Jennifer Gon... - Click to enlarge in new window Jennifer Gonzales and her son Jack Gonzales Farrell, 17, who shot himself with his father's gun, which was in an unlocked gun safe in a locked closet. He died two days later. Photo courtesy of Jennifer Gonzales.

Mortality data from 2015, the most recent year available, list suicide as the "second leading cause of death for children aged 10 to 17," the researchers said, with firearm injuries accounting for over 40% of the suicides.


To prevent suicides and other firearm injuries to children, the AAP since 1992 has pushed for safe firearm storage in the home, recommending that guns be unloaded and in a locked cabinet, with ammunition stored separately. To address a lack of information on whether homes with children who have risk factors for self-harm (besides depression, these include other mental health conditions and attention deficit-hyperactivity disorder) are more likely to comply with these recommendations, investigators in 2015 surveyed a nationally representative sample of adults about firearm safety practices in their homes.


From the nearly 4,000 responses, the researchers determined that about one-third of homes had firearms, and that firearms were present in a similar proportion of homes where children younger than 18 had or didn't have risk factors for self-harm (43.5% and 42.3%, respectively). Of the parents or caretakers of children with risk factors for self-harm, 34.9% said their firearms were stored locked and unloaded, compared with 31.8% of those living with children without these risk factors.


Considering the prevalence of firearms in homes in the United States, the investigators write that their findings "suggest that millions of U.S. children are placed at substantially higher risk of fatal firearm injury, especially suicide, than would be the case were parents to follow guidelines first put forward by the AAP more than a quarter century ago."-Elizabeth Mechcatie, MA, BSN




Scott J, et al Pediatrics 2018 Feb 21 [Epub ahead of print].