Research Spotlight: Public Health Solutions to Reduce the Impact of Pediatric Gun Violence

Eric Fleegler, MD, MPH, from the Department of Emergency Medicine at Massachusetts General Hospital and senior researcher at MGH Gun Violence Prevention Center, is the senior author of a viewpoint published in JAMA Surgery, The Updated Haddon Matrix for Pediatric Firearm Injuries.

How would you summarize your study for a lay audience?

Firearms are the number one cause of death among children and teenagers in the United States, overtaking motor vehicle collisions in 2017. The Haddon Matrix, a public health praxis, has been successfully utilized to reduce motor vehicle injuries, and this paper applies the same framework to propose how to reduce pediatric gun violence. 

What question were you investigating?

How can we reduce the effects of gun violence among youth including homicide, suicide and unintentional injuries and death?

What methods or approach did you use?

We used the Haddon Matrix, the most commonly used paradigm in the injury prevention field.

The matrix enables us to look at firearm injury prevention at three time periods: Pre-event, event, and post-event, and to examine these time periods across four domains:

• The host (the person hurt or killed)
• The agent (the gun)
• The physical environment (the home, neighborhood, medical system
• The social environment (legislative and regulatory policies, social culture)

What did you find?

There are multiple interventions that could decrease pediatric gun violence including regulations that would bring “smart” guns to market that only allow authorized individuals to fire, tightly regulate sale of military style weapons, create universal child access prevention laws that require secure storage, and establish resources for de-escalation training, among other changes.

What are the implications?

These interventions could reduce pediatric firearm injuries and deaths and likely have the same beneficial effects on adults as well.

What are the next steps? 

The authors recommend calling your representatives at the state and federal level to push for legislation and regulation that can improve gun safety.

Paper cited: 

Lee LK, Laraque-Arena D, Fleegler EW. The Updated Haddon Matrix for Pediatric Firearm Injuries. JAMA Surg. Published online September 11, 2024. doi:10.1001/jamasurg.2024.2753