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A public health crisis: Newly published study assesses firearm reinjury among children 

Introduction written by Kim Furlow, communication programs manager, Institute for Public Health


According to a 10-year WashU study recently published in the Annals of Internal Medicine, firearm injuries are the leading cause of death among U.S. children from birth to age 17. The study examines the factors associated with recurrent firearm injury among children who experience nonfatal injury in St. Louis.

“Just like other diseases (e.g. COVID, flu), using public health methods, firearm injuries can be tracked, treated, and ultimately prevented,” said co-author, Kristen Mueller, MD. “However, the state of Missouri does not publicly report non-fatal firearm injury rates. We also know that most kids who survive (make it) to the hospital after a firearm injury go on to survive their hospital visit so, a big reason to conduct this study was to better understand the burden of the disease of firearm injury and reinjury in St. Louis kids.”

The study involved assessing the firearm injuries of more than 1,300 children from birth to age 17 who were admitted to one of four partner level I trauma hospitals. According to Mueller, “96% of these children survived their initial firearm injury, which is great, but it also means that there were 1,287 kids and their families who were dealing with the trauma of a violent injury in need of support.” The analysis also shows that the risk for a second firearm injury was 6% within one year of the initial firearm injury, increasing to 14% by five years after the initial injury.

In addition to illuminating important information such as a “public health knowledge gap around non-fatal firearm injuries” in the region, the study provides information on which children in St. Louis are at high risk for subsequent firearm injuries (multiple firearm injuries over time.) Mueller and team also leveraged data from WashU’s Life Outside of Violence (LOV) program as part of the study. The LOV program provides counseling, case management, and other services to patients aged 8-30 years, with a violent injury (e.g. firearm injury, stabbing, blunt assault), who are admitted to one of four partner hospitals.

“The study findings help those of us who work in partner hospitals (e.g., doctors, nurses, social workers), to [find connections] for additional services that promote safety and healing, and that help prevent reinjury after hospital-based care for a violent injury,” said Mueller.

Life Outside of Violence is the first hospital-based intervention program in the nation to incorporate three research universities (WashU, Saint Louis University and University of Missouri-St. Louis) and four hospitals (Barnes-Jewish Hospital, SSM Health St. Louis University Hospital, St. Louis Children’s Hospital and SSM Health Cardinal Glennon Children’s Hospital.) Read the study:

Factors Associated With Recurrent Pediatric Firearm Injury: A 10-Year Retrospective Cohort Analysis

Zoe M. Miller, MSW, MPH; Benjamin P. Cooper, MPH; Daphne Lew, PhD, MPH; Rachel M. Ancona, PhD, MS; Vicki Moran, PhD; Christopher Behr, MD; Marguerite W. Spruce, MD; Lindsay M. Kranker, MD; Michael A. Mancini, PhD; Matt Vogel, PhD; Doug J.E. Schuerer, MD; Lindsay Clukies, MD; Megan L. Ranney, MD, MPH; Randi E. Foraker, PhD, MA; and Kristen L. Mueller, MD