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Trends in youth risk behaviours and firearm injury in the USA over 20 years
  1. Justin S Hatchimonji1,
  2. Danielle R Hatchimonji2,
  3. Lisa Allee3,
  4. Dane R Scantling3
  1. 1Division of Traumatology, Emergency Surgery, and Surgical Critical Care, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
  2. 2Center for Healthcare Delivery Science, Nemours Children's Health, Wilmington, Delaware, USA
  3. 3Division of Trauma and Acute Care Surgery, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
  1. Correspondence to Dr Justin S Hatchimonji, Division of Traumatology, Emergency Surgery, and Surgical Critical Care, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA; justin.hatchimonji{at}pennmedicine.upenn.edu

Abstract

Background Firearm injuries are the leading cause of death in children and adolescents in the USA. We hypothesised that high rates of risky behaviour in high school students are associated with firearm injury and death in this population.

Methods We obtained data from the Youth Behaviour Risk Survey of the Centers for Disease Control and Prevention (CDC) and combined it with data from the CDC Web-based Injury Statistics Query and Reporting System, CDC Wide-ranging Online Data for Epidemiologic Research and American Community Survey, 2001–2020. We examined trends over time using a non-parametric test for trends.

Results The percentage of high school-aged youth carrying a weapon in the preceding 30 days ranged from 13.2% in 2019 to 18.5% in 2005, without a statistically significant trend over time (p=0.051). Those carrying a weapon to school peaked at 6.5% in 2005 and steadily downtrended to 2.8% in 2019 (p=0.004). Boys consistently reported higher rates of weapon carriage, with white boys reporting higher rates than black boys. Firearm homicides among adolescents 14–18 years showed no significant change, ranging from 4.0 per 100k in 2013 to 8.3 per 100k in 2020. This varied considerably by sex and race, with black boys suffering a rate of nearly 60 per 100 000 in 2020 and white girls rarely exceeding 1/100 000 during the study period.

Conclusion Self-reported weapon carriage among teens in the USA has steadily downtrended over time. However, shooting injuries and deaths have not. While the former suggests progress, the latter remains concerning.

Level of evidence Level III; retrospective cohort study.

  • Firearm
  • Youth
  • Adolescent
  • Violence

Data availability statement

Data are available in a public, open access repository. WISQARS can be found at: https://wisqars.cdc.gov/YRBS can be found at: https://www.cdc.gov/healthyyouth/data/yrbs/index.htm

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Data availability statement

Data are available in a public, open access repository. WISQARS can be found at: https://wisqars.cdc.gov/YRBS can be found at: https://www.cdc.gov/healthyyouth/data/yrbs/index.htm

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Footnotes

  • Presented at Meetings at which this material has been presented: National Research Conference on Firearm Injury Prevention, Washington, DC, November 2022.

  • Contributors JH, DH and DS: conceptualisation and study design. JH and DH: data collection. JH and DS: data analysis and interpretation. JH, DH and DS: drafting of manuscript. LA: critical review and revision. JH is the guarantor of this study, accepting full responsibility for the work and/or conduct of the study, had access to the data, and controlled the decision to publish.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • 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.