We stratified annual firearms mortality rates at the state level by intent, based on ICD-9 and ICD-10 classifications. Interactions between laws and age groups were stratified the age of the child at death into 2 groups: 0 to 9 years and 10 to 14 years. We did not study young people aged 15 to 19 because (1) none of the CAP laws apply to young people aged 18 to 19; (2) After 2007, WISQARS suppressed data for cells smaller than 10 in size, which affected the available data for one-year age groups. and (3) data from the compressed mortality file are grouped into 5-year age groups (i.e., 10-14 years and 15-19 years), and therefore data were not only available for adolescents aged 15-17 years for the study period. A, states with recklessness laws and states with negligence laws, on average per year since the law was passed. The vertical line at 0 indicates the first year of the adoption of the law. The thinnest sections of the line for recklessness laws since the enactment of the law -9 to −4 indicate 1 to 4 states and for negligence laws in the years following the passage of the law -9 2 states. The thinnest section of the line for recklessness laws in the years following passages 23 to 25 indicates 1 to 2 states. B, States without laws to prevent children`s access (CAP), on average per calendar year.
The strength of the line is proportional to the number of states that provided data in a given year. Twenty-five States adopted CAP laws between 1989 and 2000. Between 1991 and 2016, there were 13,697 firearm deaths among children aged 0 to 14 years. Recklessness laws were not associated with changes in pediatric firearm mortality rates. Overall, neglect laws were associated with a significant reduction in firearm deaths among children aged 0 to 14 years, with a relative reduction in all firearm deaths of 13% (95% CI, -18% to -7%), a relative reduction in firearm-related homicides of 15% (95% CI, -22% to -7%), a relative reduction in firearm suicides of 12% (95% CI, -20% to -2%), and a relative reduction in unintentional firearm deaths of 13% (95% CI, -24% to -1%). The strictest negligence laws were associated with a 59% unintentional reduction in firearm deaths (95% CI, -68% to -49%). A total of 3929 deaths (29% of all firearm-related deaths) were linked to states that had not adopted the strictest form of CAP laws on negligence. We identified six qualifying studies on the impact of CPA laws on unintentional injuries or firearm deaths. Cummings et al. (1997a) found a significant effect consistent with these laws that reduces unintentional firearm deaths in children aged 14 years or younger, uncertain effects on unintentional injuries in persons aged 15 to 19 years, and a suggestive effect consistent with CAP laws that reduce unintentional firearm injuries in persons aged 20 to 24 years. Years.
In four age groups, Lott and Whitley (2001) used a overlapping data set, but found three uncertain effects and one suggestive effect consistent with CAP laws that increase unintentional firearm deaths in children aged 5 to 9 years. Gun legislation is politically controversial, and there is currently no federal law to prevent children`s access (PAC). Twenty-nine states and Washington, D.C., have implemented various forms of CAP legislation. The intent of the CAP legislation is to restrict minors` access to firearms by imposing criminal liability on adults who do not properly secure firearms. CAP legislation varies considerably from country to country. In fact, the Giffords Law Center has superimposed these laws according to legislative language.7 For example, California and Massachusetts base adult criminal liability on negligent storage when a child “may” or “probably” has access to a firearm,8 9 while states such as Utah and Georgia have more legal leniency. In these lighter states, criminal liability is incurred only if parents or guardians intentionally provide a firearm to a minor, knowing that the minor will use the firearm to commit a crime.10 11 Variation in legal language (i.e., the force of the law) may result in differences in the expected outcome of reducing firearm injuries and deaths. Previous studies on the effectiveness of CAP legislation have generally examined the issue in absolute numbers. For example, Cummings et al12 reviewed all safe storage laws and found that camp laws reduced unintentional shooting deaths in children under the age of 15.
