Presented at the Third Annual Barsan Emergency Medicine Research Forum

1. Firearm-safety Among Children
& Teens Consortium
(FACTS)

2. Firearms #2 cause of Pediatric Morbidity and Mortality in the U.S.
Causes of Death Total # deaths Rate/ 100,000
All Injury 29,455 29.3
#1 MVC 8,615 8.57
#2 Firearm 7,981 7.94
#3 Drug Overdose/ Poisoning 5,485 5.46
Fatality rates stable at 2.65/100,000 children over the last decade.
Graph: Firearm and Injury Center at Penn. 2011. “Firearm Injury in the United States.”

3. Firearm Homicide
• Highest burden of injury is among youth populations
• Firearm violence is 2nd
leading cause of death
• Leading cause of death among African-American youth
• Peak incidence for homicide is youth and emerging
adult populations
CDCP. WISQARS. 2010. http://www.cdc.gov/injury/wisqars/index.html.

4. International Comparisons
• U.S. Firearm homicide rate
o 19.5 times higher 22 other
developed nations
o 15-24 year olds = 42.7
times higher

5. Firearm Suicides

6. Firearm Suicides
• Suicide is the 3rd
leading cause of death for young adults in the U.S.
• Among completed suicides, firearms are the most common method
(54%)
• Firearm suicides are fatal in 90% of cases
• Handguns are the most frequent method of firearm suicide (70%)
• Two Peaks of Incidence
o Youth < 25 y/o
o Elderly > 65 y/o (CDCP WISQARS 2010; Firearm and Injury Center at
Penn. “Firearm Injury in the United States”; Elnour 2008)

7. Unintentional Firearm Deaths
• Small proportion of total number
of firearm fatalities
• Unintentional firearm fatalities
disproportionally affect children
o 16% of all unintentional firearm
deaths occurring among youth < 20
• Highly Preventable

8. Gun Safety – Where is the Vision?
• Era of the jungle or shared responsibility of user and
manufacturer
• Gun injury a winnable battle?
• Vision zero ala Sweden
o no one suggested in Sweden they get rid of cars.......

9. CDC and Gun Safety
• The 1997 appropriations bill stated, "None of the funds made
available for injury prevention and control at the CDC and
Prevention may be used to advocate or promote gun control."
o Congress also threatened more funding cuts if the gun research
continued.
• 4/2013 $10 million that Obama asked Congress to provide for
gun-violence research to CDC lifting this ban.
o Funds not appropriated....

10. A Lost Generation of Research
In 2014
• Fewer than 12 active experienced U.S. investigators with
careers focused primarily on firearm injury only two physicians
• 1973-2014, 8 NIH Firearm Injury Prevention Research Awards
o In comparison, cholera, polio, diphtheria, and rabies have received 320
research awards
• Firearms =12.6% of the deaths 0-17,
o <0.3% of the publications,
o with only 25 publications TOTAL on firearms in 1991
o 33 publications in 2009.

11. Firearm-safety Among Children & Teens Consortium (FACTS)
• Aim #1: define a pediatric-specific firearm injury research
agenda
• Aim #2: pilot studies to provide preliminary data that informs
large-scale studies

12. Firearm-safety Among Children & Teens Consortium (FACTS)
• Aim #3: Establishing THE web-based searchable data archive
for childhood firearm injury 2) Enhancing and improving
pediatric firearm injury data collection in existing pediatric
datasets such as the PECARN core data project and the
PECARN registry database
• Aim #4: Build a cadre of national research scholars that will
serve as an emerging pipeline for future research.

13. 6 Research Resources to Jumpstart the Field of Firearm Safety
among Children & Adolescents
1. Creation of a research agenda for the field;
2. Completion of 5 pilot projects to support five large-scale research
proposals;
3. A web-based data archive and searchable research repository on
childhood firearm injury;
4. Enhanced data collection opportunities on childhood firearm
injuries through existing national networks (e.g., PECARN);
5. A cadre of new researchers (postdoctoral and doctoral students)
6. A webinar series to inform researchers nationally in this topic area.

14. Firearm-safety Among Children & Teens Consortium (FACTS)
STAKEHOLDER ADVISORY COMMITTEE
Members represent gun owners/trainers, law
enforcement, education, community groups, and mental
health
LEADERSHIP TEAM
Rebecca Cunningham Marc
Zimmerman
Patrick Carter
Lynn Massey - Managing Director
Laney Rupp - Coordinator
SURVEILLANCE &
EPIDEMIOLOGY
WORKGROUP
Point: Patrick Carter
David Hemenway
Steve Hargarten
Ali Rowhani-Rahbar
Lynn Massey
RISK & PROTECTIVE
WORKGROUP
Point: Marc
Zimmerman
Charlie Branas
Jesenia Pizarro
Daniel Lee
Laney Rupp
SECONDARY
PREVENTION & LONG
TERM HEALTH
WORKGROUP
Point: Megan Ranney
Peter Ehrlich
Rinad Beidas
Lynn Massey
PRIMARY PREVENTION
WORKGROUP
Point: Maureen Walton
Frederick Rivara
Cheryl King
Quyen Ngo
Eric Sigel
Mark Ilgen
Lynn Massey
ENHANCING DATA
WORKGROUP
Point: Elizabeth Alpern
Lisa Prosser
Patrick Carter
Monika Goyal
Lynn Massey
POLICY ANALYSIS
WORKGROUP
Point: April Zeoli
Pat Carter
Monika Goyal
Jason Goldstick
Lynn Massey
DATA ARCHIVE &
REPOSITORY
Lead: Jukka
Savolainen
TRAINEES
Jonathan Jay
Carissa Schmidt
Rebecca Karb

16. https://open.umich.edu/find/open-educational-resources/medical/firearm-injury-
prevention