Firearms Are Leading Cause of Death Among U.S. Youth

Newswise — Firearms are now the leading cause of death for children and adolescents 0-19 years of age, with a staggering 83 percent increase in youth firearm fatalities over the past decade, according to a commentary published in Lancet Child and Adolescent Health. Nearly two-thirds of youth firearm deaths were from homicides. Strikingly, Black youth had an unprecedented 40 percent increase in firearm fatalities between 2019 to 2020.

These tragic statistics come in the wake of the elementary school shooting in Texas earlier this week, pointing to the urgent need to take action to prevent more youth from dying by firearms.

“We must reverse this deeply troubling and unacceptable trend in youth firearm fatalities, especially among youth of color,” said co-author Karen Sheehan, MD, MPH, Pediatric Emergency Medicine physician and Medical Director of Patrick M. Magoon Institute for Healthy Communities at Ann & Robert H. Lurie Children’s Hospital of Chicago, and Professor of Pediatrics, Medical Education and Preventive Medicine at Northwestern University Feinberg School of Medicine. “We need more funding allocated to research-based prevention efforts so that we can save young lives before it’s too late.”

The authors also note that although firearm fatality rates started to rise in 2014, the dramatic societal upheaval of the COVID-19 pandemic likely accelerated this increase with the escalation of mental health stressors and existential despair experienced by youth. The seismic shift in youths’ lives during the pandemic occurred in the context of a decades’ long void of prevention efforts to decrease firearm injuries and deaths.

After Congress passed the Dickey Amendment in 1996, federal funding of firearm research was effectively halted, until 2019 when $25 million in research funding was appropriated. This pales in comparison to research funding for other pediatric diseases and does not meet the current needs to advance the field. Congress has continued to fund firearm research at this same level for the last three years, while studies estimate that $600 million should be appropriated in fiscal years 2022-2026 for data infrastructure and research funding for firearm injury prevention research.

“In addition to better understanding the risk and protective factors for firearm injuries and deaths, more funding is essential to develop, implement, and evaluate firearm injury prevention interventions at the individual, hospital, community, and policy levels,” said co-author Samaa Kemal, MD, MPH, Pediatric Emergency Medicine Fellow at Lurie Children’s.

Research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through Stanley Manne Children’s Research Institute. The Manne Research Institute is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report. It is the pediatric training ground for Northwestern University Feinberg School of Medicine. Emergency medicine-focused research at Lurie Children’s is conducted through the Grainger Research Program in Pediatric Emergency Medicine.

Study Identifies Predictors Of Severe Outcomes In Children With COVID-19

A new international study offers a clearer picture of the impact of COVID-19 infection and the risk of severe outcomes on young people around the world.

The study was co-led by a team of researchers from the University of Calgary’s Cumming School of Medicine (CSM), Ann & Robert H. Lurie Children’s Hospital of Chicago, and University of California-Davis Medical Center.  It followed more than 10,300 children at 41 emergency departments in 10 countries including Canada and United States, Italy, Spain and Australia.

Researchers followed more than 3,200 children who visited hospital emergency departments and tested positive for COVID-19. Approximately 3 percent (107 total) of those diagnosed with COVID-19 experienced severe outcomes within two weeks of their visit to an emergency room. In addition, 23 percent (735 total), were hospitalized for treatment. Severe outcomes included cardiac or cardiovascular complications, such as myocarditis (inflammation of the heart), as well as neurologic, respiratory, or infectious problems. Four children died. The study was published in JAMA Network Open.

“The study sought to quantify the frequency of and risk factors for severe outcomes in children with COVID-19,” says study co-lead Stephen Freedman, MD, a paediatrician and professor at the CSM.  “We found that older age, having a pre-existing chronic condition and symptom duration were important risk factors for severe outcomes.”

Researchers also found children deemed healthy at an initial emergency department visit rarely deteriorated significantly after the first visit.

“Fortunately, the risk of developing severe disease in children with COVID-19 discharged from the emergency department is very low,” says study co-lead Todd Florin, MD, MSCE, director of Research in Emergency Medicine at Ann & Robert H. Lurie Children’s Hospital of Chicago and associate professor of Pediatrics at Northwestern University Feinberg School of Medicine. “Our findings can provide reassurance to parents and clinicians for children well enough to be managed in the community, while also providing important insights on which children may be at particular risk for severe outcomes.”

Although asthma has previously been suggested as a risk factor for severe outcome, this study was not able to confirm a link. It also did not find that very young infants were at a higher risk for severe outcomes.

“With emergency departments across the world seeing an influx of patients due to the COVID-19 pandemic and stressing capacity, this study will help address the surge by providing an estimate of the risk among pediatric COVID-19 patients screened in emergency department,” said Nathan Kuppermann, MD, MPH, chair of Emergency Medicine at University of California Davis Medical Center and co-lead of the study. “It will support emergency physicians triage of pediatric patients more efficiently by knowing who has risk factors for severe outcomes and focus advanced level care to those who do.”

The study occurred within the Pediatric Emergency Research Network, a global consortium of the world’s major pediatric emergency care research networks. It received support from the Canadian Institutes of Health Research, Alberta Innovates, Alberta Health Services and the University of Calgary. It also received COVID grant funding from the University of California Davis, Cincinnati Children’s Hospital Medical Center and Ann and Robert H. Lurie Children’s Hospital of Chicago. Dr. Anna Funk, PhD, an epidemiologist and UCalgary postdoctoral fellow, was lead author of the study.

“There are no specific evidence-based treatments and therapies for children at this time and detailed research data describing outcomes in young people with COVID-19 has been lacking, so this study offers important insights that we believe will be helpful to front-line care providers treating children with COVID-19,” adds Freedman.

Research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through the Stanley Manne Children’s Research Institute. The Manne Research Institute is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report. It is the pediatric training ground for Northwestern University Feinberg School of Medicine.

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