St. Louis Docs’ Open Letter: Guns Are a Pediatric Issue

 Dr. David Jaffe (courtesy

We are writing today as pediatric emergency and trauma physicians to share our concern about the epidemic of gun violence that threatens the safety, health, and well-being of our children in St. Louis and in the United States . . .

Since 2002, St. Louis Children’s Hospital has cared for 771 children injured or killed by gunfire; 35 percent were younger than 15. These include the recent 12-year-old boy accidentally killed by his friend when playing with his grandfather’s pistol kept under his pillow, the 2-year-old boy paralyzed when his father accidentally discharged his gun during loading, the 5-year-old girl caught in a cross-fire as she sat on her front porch, the 10-year-old boy killed by his mother overwhelmed with mental illness, and the 4-year-old boy who found a handgun in a closet at home, placed the barrel into his mouth and pulled the trigger as he had often done to get a drink from his water-pistol. Many of these children died despite the heroic efforts of our highly trained pre-hospital, emergency, surgical and critical care staff.

In 2010, seven American children age 19 and younger were killed every day. This is twice the number of children who die from cancer, five times the number from heart disease, and 15 times the number from infections. This is also the equivalent of 128 Newtown shootings.

It has been estimated at least 38 percent of American households have a gun. In homes with children younger than 18, 22 percent store the gun loaded, 32 percent unlocked, and 8 percent unlocked and loaded. The children in these homes know the gun is present, and many handle the gun in the absence of their parents.

Children who have received gun safety training are just as likely to play with and fire a real gun as children not trained. In one study, 8-to-12-year-old boys were observed via one-way mirror as they played for 15 minutes in a waiting room with a disabled .38 caliber handgun concealed in a desk drawer. Seventy two percent discovered the gun, and 48 percent pulled the trigger; 90 percent of those who handled the gun and/or pulled the trigger had prior gun safety instruction.

Rather than confer protection, careful studies find guns stored in the home are more likely to be involved in an accidental death, homicide by a family member, or suicide than against an intruder. In 2009, suicide was the third leading cause of death for American youth, with firearms the most common method used. The American Academy of Pediatrics has concluded, “The most effective measure to prevent suicide, homicide, and unintentional firearm-related injuries to children and adolescents is the absence of guns from homes and communities.”

We concur with recent recommendations from more than a dozen national pediatric professional organizations, including the American Academy of Pediatrics, Academic Pediatric Association, and the American College of Surgeons in response to the Newtown school shooting. We called for action in three areas: reinstating and revising the ban on assault weapons and large ammunition magazines; improving quality and availability of mental health services; and reducing the exposure our children have to media violence. In addition, we called for increasing research on the relationship of these factors on the epidemic of death and injury to children caused by firearm violence and for ending restrictions to this research imposed by Congress.

We are gratified the plan President Obama recently announced addresses all of these issues. The president called for public support of these initiatives, and we strongly agree. As physicians who care for children and families devastated by gun violence, we know first-hand the importance of taking action that will begin to make the environment in St. Louis safer for our children. It has been done in many other economically advanced countries, and we can do it in the United States.

As Gabrielle Giffords said to Congress: “Too many children are dying. Too many children. We must do something. It will be hard, but the time is now. You must act. Be bold, be courageous. Americans are counting on you.” Our children are counting on us!

Dr. Robert M. Kennedy is an emergency pediatrician at St. Louis Children’s Hospital. Dr. David M. Jaffe [above] is chief of the division of pediatric emergency medicine at St. Louis Children’s Hospital. He is the current president of the Academic Pediatric Association. Dr. Martin S. Keller is director of trauma services at St. Louis Children’s Hospital.