In the midst of the global COVID-19 pandemic, attention has drifted away from the endemic problem of firearm-related morbidity and mortality in the US. The Centers for Disease Control and Prevention reported in 2019, the most recent year for which data were available, that 39 707 people died of firearm-related injuries, of whom 19.8% were children and youth aged 5 to 24 years. The number of nonfatal injuries is not accurately known because of the lack of comprehensive data. As reported by Barrett and colleagues in this issue of JAMA Pediatrics, communities with high rates of poverty are disproportionately affected by firearm violence. Nearly 1 in 7 children lived in poverty in 2019, but poverty was disproportionately experienced by Alaska Native or American Indian children (20.6%), Black children (26.5% lived in poverty in 2019), and Hispanic children (20.8%) compared with White children (8.3%). The pandemic and social justice movements have heightened attention to the structural racism in the US that has led to more poverty and higher death rates from many diseases and injuries in these populations. Firearm-related homicides among youth aged 5 to 24 years are among the causes of death with the greatest disparities, with the 2019 rate of 38.64 fatalities per 100 000 Black boys and men compared with 3.54 fatalities per 100 000 White boys and men, and 4.65 fatalities per 100 000 Black girls and women compared with 0.82 fatalities per 100 000 White girls and women.
Clinical Practice Guidelines