Infectious Disease

Study links gun violence with pediatric emergency medical visits for mental health

September 27, 2021

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Source:

VasanA, et al. JAMA pediatrician. 2021; doi: 10.1001 / jamapediatrics.2021.3512.

Disclosure:
Vasan reports that outside of the work submitted, he has received grants from the Academic Pediatric Association and the Agency for Healthcare Research and Quality.

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A study published in JAMA Pediatrics linked exposure to gun violence to an increase in pediatric emergency room visits for mental health problems, particularly among children who witnessed such acts.

Aditi Vasan, MD, MSHP, a lecturer in pediatrics at the University of Pennsylvania’s Perelman School of Medicine and a pediatrician at Children’s Hospital of Philadelphia, said it was “important” to consider the secondary effects of gun violence on children exposed to shootings.

“As a pediatrician, I’ve seen patients in the clinic, hospital, or emergency room who came with symptoms of anxiety, depression, or insomnia, or other symptoms of PTSD,” Vasan told Healio. “And then when I asked them when the symptoms started, they told me that they started after a classmate or friend or someone in their school or neighborhood was shot and many of my colleagues at the Philadelphia Children’s Hospital and the ER have similar ones Stories. And that really motivated us to conduct the study to try to quantify the effects of violence exposure on children’s mental health. “

Vasan and colleagues studied ED use in children in 12 Philadelphia zip codes from 2014 to 2018. Of the 128,683 ED encounters for children ages 0-19, only children with one or more ED visits in the 60 days prior visited or after a shooting in the neighborhood – there were 2,629 shootings during the study period – who lived within a quarter of a mile from the shooting were included in the study (n = 54,341).

After considering age, gender, race and ethnicity, median household income by zip code, and insurance, the researchers found that children who lived within an eighth of a mile – or two to three blocks – from a shootout had greater chances of mental health had. associated ED presentations over the next 14 days (adjusted OR, 1.86 [95% CI, 1.20-2.88]), 30 days (aOR, 1.49 [95% CI, 1.11-2.03]) and 60 days (aOR, 1.35 [95% CI, 1.06-1.72]).

“This effect was greatest for children who lived near the shooting for the 2 weeks immediately following the shooting and for children who were exposed to multiple shootings,” said Vasan. “Our results really show that symptoms of mental disorders in children can appear within days of a single shooting.”

Vasan said the results showed the importance of identifying symptoms of gunshot-related trauma in children.

“For providers, I think this really highlights the importance of having universal trauma-informed care in the emergency room and clinics in communities where shooting is common, and really recognizing that many children who come with mental symptoms may have been exposed a shootout, even if they don’t report it as a reason for coming, ”said Vasan. “It is important to consider this trauma and its possible effects and let them know that there are mental health resources that can help.”

Vasan also said that lasting solutions would require a twofold community-based process.

“We’re talking about two ways to counteract this impact. The first is to reduce and mitigate the mental health symptoms associated with this exposure. And that’s what we talked about in terms of trauma-informed care and the connection between patients and psychological support. The second is that we primarily reduce children’s exposure to gun violence, and we can do this through evidence-based strategies such as retention programs, background check laws, and violence prevention programs. That is something that we encourage and support providers for. “

Reference:

VasanA, et al. JAMA pediatrician. 2021; doi: 10.1001 / jamapediatrics.2021.3512.

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