US rates of firearm-related death are vastly higher than that of other high-income countries. Further, firearms are now the second-leading cause of death among American children and black children are 10 times more likely to be killed by guns than white children. Currently, there exists tremendous variation among US states between the types of firearm-related laws employed and the number of firearms per capita. Similarly, US states have widely discrepant rates of firearm-related death among both their juvenile and overall populations. We set out to determine how rates of gun ownership and firearm-related laws correlated with firearm-related mortality among juveniles at the state level. Potentially confounding factors were also assessed. We extracted data for 17 different measures of state-level gun ownership, guns per capita and specific firearm-related laws from the Bureau of Alcohol, Tobacco, Firearms and Explosives, National Rifle Association and a recent national survey. Population and poverty data were recorded from the U.S. Census Bureau and U.S. Department of Labor, respectively. Gifford Law Center rankings, a relative measure of the strictness of each state’s gun laws, were also recorded. Firearm-related age-adjusted mortality rates among juveniles were collected from the Centers for Disease Control and Prevention. We used linear regression to model the relationships between mortality and all four continuous measures: ATF registered weapons, ATF federal firearm licensees, Giffords Center rankings, and gun-ownership rates. Six covariates considered in the full model included state-level poverty and unemployment rates, measures of mental health and total population. The final model included a reduced set of covariates, which were statistically significant (p<0.05) from the full model. Cluster analysis was also performed to group states based on their similarities on 22 variables. Age-adjusted firearm-related mortality was found to positively correlate with both Giffords Center Rankings (R-squared: 0.502; p-value: 8.53e-09) and gun ownership rates (R-squared: 0.469; p-value: 4.005e-08). In the crude model, age-adjusted mortality was found to be significantly associated with both Giffords Center rankings (R^2=0.502; P<0.0001) and gun ownership rates (R^2=0.469; P<0.0001). In the adjusted model, more ATF registered weapons (P<0.001), higher incidence of poverty (P<0.0001), and lower state-level population (P<0.0001) were significant predictors of an increased risk of age-adjusted firearm mortality. Cluster analysis demonstrated firearm-related mortality to be positively correlated with poor mental health in Cluster 1 states (lenient firearm regulations), while being negatively correlated with poor mental health in Cluster 2 state (strict firearm regulations). States with higher rates of gun ownership and more lenient gun laws are statistically proven to have significantly elevated levels of firearm-induced mortality among their juvenile populations. Further analysis of state-level legislation could potentially help determine which laws are most effective in reducing rates of gun ownership and, more importantly, diminishing the incidence of gun-related juvenile death.

Figure 1

Gun Ownership Rates vs. Pediatric Firearm Mortality

Giffords Gun Strength Ranking vs. Pediatric Firearm Mortality

Figure 1

Gun Ownership Rates vs. Pediatric Firearm Mortality

Giffords Gun Strength Ranking vs. Pediatric Firearm Mortality

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