Background Increases in paediatric firearm-related injuries during the COVID-19 pandemic may be due to changes in where children and adolescents spent their time. This study examines changes in the frequency of paediatric firearm-related encounters as a function of schooling mode overall and by race/ethnicity and age group at a large trauma centre through 2021.
Methods We use data from a large paediatric and adult trauma centre in Tennessee from January 2018 to December 2021 (N=211 encounters) and geographically linked schooling mode data. We use Poisson regressions to estimate smoothed monthly paediatric firearm-related encounters as a function of schooling mode overall and stratified by race and age.
Results Compared with pre pandemic, we find a 42% increase in paediatric encounters per month during March 2020 to August 2020, when schools were closed, no significant increase during virtual/hybrid instruction, and a 23% increase in encounters after schools returned to in-person instruction. The effects of schooling mode are heterogeneous by patient race/ethnicity and age. Encounters increased among non-Hispanic black children across all periods relative to pre pandemic. Among non-Hispanic white children, encounters increased during the closure period and decreased on return to in-person instruction. Compared with pre pandemic, paediatric firearm-related encounters increased 205% for children aged 5–11 and 69% for adolescents aged 12–15 during the school closure period.
Conclusion COVID-19-related changes to school instruction mode in 2020 and 2021 are associated with changes in the frequency and composition of paediatric firearm-related encounters at a major trauma centre in Tennessee.
Data availability statement
Data may be obtained from a third party and are not publicly available. Data contain personal health information from hospital records and are not publicly available.
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Correction notice This article has been corrected since it was first published online. Table 2 has been updated.
Contributors TM conceptualised and designed the study, conducted analyses, drafted the initial manuscript, reviewed and revised the manuscript, and is responsible for the overall content as guarantor. KG contributed to the conceptualisation and design of the study, interpretation of results, the initial draft of the manuscript and reviewed and revised the manuscript. JOW contributed to the conceptualisation and design of the study, collected and prepared the data and reviewed and revised the manuscript. JHH and ABS contributed to the conceptualisation and design of the study and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Funding No funding was secured specifically for this study. This work was supported in part by the William Long Fellowship to KG.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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