Variation in Pediatric and Adolescent Firearm Mortality Rates in Rural and Urban US Counties
- 1 June 2010
- journal article
- research article
- Published by American Academy of Pediatrics (AAP) in PEDIATRICS
- Vol. 125 (6), 1112-1118
- https://doi.org/10.1542/peds.2009-3219
Abstract
OBJECTIVE: We examined whether firearm mortality rates among children varied across US counties along a rural-urban continuum. METHODS: US vital statistics data were accessed for all pediatric (age: 0–19 years) firearm deaths from 1999 through 2006. Deaths were analyzed according to a modified rural-urban continuum code (based on population size and proximity to metropolitan areas) assigned to each county (3141 counties). RESULTS: In the 8-year study period, there were 23649 pediatric firearm deaths (15190 homicides, 7082 suicides, and 1377 unintentional deaths). Pediatric nonfirearm mortality rates were significantly higher in the most-rural counties (adjusted rate ratio: 1.36 [95% confidence interval [CI]: 1.13–1.64]), compared with the most-urban counties. The most-rural counties demonstrated virtually identical pediatric firearm mortality rates (adjusted rate ratio: 0.91 [95% CI: 0.63–1.32]), compared with the most-urban counties. The most-rural counties had higher rates of pediatric firearm suicide (adjusted rate ratio: 2.01 [95% CI: 1.43–2.83]) and unintentional firearm death (adjusted rate ratio: 2.19 [95% CI: 1.27–3.77]), compared with the most-urban counties. Pediatric firearm homicides rates were significantly higher in the most-urban counties (adjusted rate ratio: 3.69 [95% CI: 2.00–6.80]), compared with the most-rural counties. CONCLUSIONS: Children in the most-rural US counties had firearm mortality rates that were statistically indistinguishable from those for children in the most-urban counties. This finding reflects a greater homicide rate in urban counties counterbalanced by greater suicide and unintentional firearm death rates in rural counties. Nonfirearm mortality rates were significantly greater outside the most-urban US counties.This publication has 12 references indexed in Scilit:
- Gun Storage Practices and Risk of Youth Suicide and Unintentional Firearm InjuriesJAMA, 2005
- Association of Selected Risk Factors with Variation in Child and Adolescent Firearm Mortality by StateJournal of School Health, 2004
- Urban–Rural Shifts in Intentional Firearm Death: Different Causes, Same ResultsAmerican Journal of Public Health, 2004
- Firearms and Suicide in the NortheastThe Journal of Trauma and Acute Care Surgery, 2004
- Household Firearm Ownership and Suicide Rates in the United StatesEpidemiology, 2002
- The Rural-Urban ContinuumArchives of Pediatrics & Adolescent Medicine, 2002
- Behavior-Oriented Approaches to Reducing Youth Gun ViolenceThe Future of Children, 2002
- Trends in adolescent suicide: misclassification bias?American Journal of Public Health, 2001
- Homicide Rates Among US Teenagers and Young AdultsJAMA, 1998
- Firearm and Nonfirearm Homicide Among Persons 15 Through 19 Years of AgeJAMA, 1992