Children’s hospitals play a vital role in keeping kids safe, and firearm injury prevention requires their leadership. Firearm injuries are now the leading cause of death for children in the United States, surpassing motor vehicle accidents and other longstanding threats to child health.
Each year, approximately 4,000 children and adolescents die from firearm-related injuries, and an additional 15,000 sustain nonfatal injuries. Pediatricians and hospital staff who care for these children see the consequences firsthand, from families devastated by loss to young survivors facing lifelong physical and emotional challenges.
Children’s hospitals are trusted institutions in their communities, serving as leaders in health and safety. When a threat to child health reaches this level, hospitals must respond. Addressing firearm injury prevention requires the same commitment given to cancer, congenital conditions, and other top pediatric health concerns. While there is no single solution, hospitals can take meaningful steps by supporting research, engaging in prevention efforts, and strengthening partnerships with community organizations.
The research gap
Firearm injury prevention research is significantly underfunded and disproportionately low compared to other leading causes of child mortality.
Between 2008 and 2017, firearm injury research received just $12 million per year — only 3.3% of what would be expected based on mortality burden — while motor vehicle crash research received $88 million and pediatric cancer research $335 million annually.
The CDC reports that firearm death rates in children increased by more than 50% from 2019 to 2021, yet research into the epidemiology, long-term effects, and intervention strategies remains limited. Without the necessary funding and institutional support, progress in this field lags behind other public health efforts.
Children’s hospitals can be part of the solution by funding and facilitating research that deepens our understanding of risk factors and effective prevention measures.
Community partnerships
Prevention efforts are most effective when they are community driven. Grassroots organizations and local leaders have long been on the front lines of reducing firearm injuries, often without adequate resources or institutional support. We need to learn from them, lift them up, and ensure they have what they need to continue making a difference.
At our hospital, we have seen the impact of strong partnerships with committed community partners. These collaborations have strengthened our safety programs, allowing us to distribute more than 3,000 free gun locks in just four months and provide culturally sensitive education on safe storage practices.
Beyond distributing gun locks, our hospital has integrated lethal means counseling and secure storage device provision into care for children admitted with behavioral health needs. Over the past five years, these programs have reached hundreds of families, offering critical resources at moments when they are needed most. These types of initiatives, when incorporated into hospital policies, can significantly reduce risk and improve outcomes for children and families.
Hospital-based interventions
Proactive hospital-based interventions can save lives. Hospital-based violence intervention programs (HVIPs) have emerged as an evidence-based approach to breaking cycles of violence and reducing firearm-related injuries. These programs identify patients at high risk for future violence — often those treated for violent injuries — and provide intensive case management, mentorship, and social services.
Studies have shown that HVIPs can significantly reduce hospital recidivism and reinjury rates among participants. By expanding HVIPs and embedding them into pediatric trauma and acute care systems, hospitals provide crucial support to youth most impacted by firearm violence.
The cost of inaction
The economic and societal costs of firearm injuries are staggering. Firearm injuries cost the U.S. health care system more than $1 billion annually in direct medical expenses alone. When factoring in long-term rehabilitation, mental health care, and lost productivity, the financial burden grows exponentially.
But beyond the financial implications, the real cost is in young lives lost and futures altered. Pediatricians and hospital staff witness this impact every day, from grieving families to children who must navigate new physical and emotional realities after a firearm injury.
The path forward
Children’s hospitals can make a difference. By incorporating firearm injury prevention into existing safety initiatives, supporting much-needed research, and fostering strong community partnerships, hospitals can help turn the tide on this growing public health crisis. Progress does not require sweeping changes overnight — small, strategic steps can have a lasting impact. Prevention is possible, and by taking action now, children’s hospitals can help ensure a safer future for all kids.
