In the Journals

Researchers identify significant lack of funding for pediatric firearm injury studies

Rebecca Cunningham
Rebecca M. Cunningham

Research focused on firearm-related injuries receives significantly less federal funding compared with other top causes of pediatric and adolescent mortality in the United States, according to study findings published in Health Affairs.

According to the study, at least $37 million is needed annually “for research funding to be commensurate with the mortality burden” — a 30-fold increase.

Rebecca M. Cunningham, MD, professor of emergency medicine at the University of Michigan Medical School, and colleagues noted that firearm-related injuries are the second-leading cause of death in children aged 1 to 18 years, accounting for approximately 2,500 deaths in 2017.

They also highlighted a 44% increase in firearm-related homicides and a 48% increase in suicides since 2013.

“For the past 2 decades, firearm injury prevention research was thought to be too political for agencies to fund,” Cunningham, who is also a leader on the Firearm Safety Among Children and Teens Consortium, told Infectious Diseases in Children. “There were also misperceptions that it was not allowable to do such research, which is simply not true.”

Cunningham and colleagues aimed to examine trends in federal research funding between 2008 and 2017 for leading causes of death among children and adolescents in the U.S. They pulled data from several federal sources, including the CDC’s Wide-ranging OnLine Data for Epidemiologic Research (WONDER) database, the federal Research Portfolio Online Reporting Tools and the National Institute of Justice’s website on funding.

During the study period, $88 million was given annually to study motor vehicle crashes, the leading cause of death among children aged 1 to 19 years. The third-leading cause of death in this age group — cancer — received $335 million annually during the study period.

However, firearm injuries were the focus of just 32 grants totaling $12 million during the study period — or $597 per firearm-related pediatric death, Cunningham and colleagues noted.

“Without funding, evidence-based solutions are not found,” Cunningham said. “For example, how could we find answers to decreasing car crashes without investing in transportation safety research? We can’t find answers to cancer if we don’t fund research to understand the disease.”

Similar to cancer, there are many areas of research related to firearm injuries that need to be funded, including suicide, homicide and accidental or unintentional injury, she said.

“Injury prevention and firearm injury prevention is a science, and we can find science-based solutions for prevention,” Cunningham said. “But it takes funding.”

Further analyses revealed that the amount of funding provided for firearm injury prevention was only 3.3% of what was predicted based on the pediatric and adolescent mortality burden. This lack of funding, the researchers wrote, resulted in fewer studies conducted concerning this topic than predicted by the mortality burden.

“This is the No. 1 cause of death among high school-aged students in the U.S. and No. 2 for those kids who live through infancy through age 18 years,” Cunningham said. “The past funding on this issue has shown, in essence, that we have not been trying as a country to save these kids from dying. Providers should know these stats and consider their role in advocating for the health of the children they care for who are not old enough to have their own voice.” – by Katherine Bortz

Disclosure: Cunningham reports funding from the NIH and CDC to study injury prevention. Neither directly funded this research.

Rebecca Cunningham
Rebecca M. Cunningham

Research focused on firearm-related injuries receives significantly less federal funding compared with other top causes of pediatric and adolescent mortality in the United States, according to study findings published in Health Affairs.

According to the study, at least $37 million is needed annually “for research funding to be commensurate with the mortality burden” — a 30-fold increase.

Rebecca M. Cunningham, MD, professor of emergency medicine at the University of Michigan Medical School, and colleagues noted that firearm-related injuries are the second-leading cause of death in children aged 1 to 18 years, accounting for approximately 2,500 deaths in 2017.

They also highlighted a 44% increase in firearm-related homicides and a 48% increase in suicides since 2013.

“For the past 2 decades, firearm injury prevention research was thought to be too political for agencies to fund,” Cunningham, who is also a leader on the Firearm Safety Among Children and Teens Consortium, told Infectious Diseases in Children. “There were also misperceptions that it was not allowable to do such research, which is simply not true.”

Cunningham and colleagues aimed to examine trends in federal research funding between 2008 and 2017 for leading causes of death among children and adolescents in the U.S. They pulled data from several federal sources, including the CDC’s Wide-ranging OnLine Data for Epidemiologic Research (WONDER) database, the federal Research Portfolio Online Reporting Tools and the National Institute of Justice’s website on funding.

During the study period, $88 million was given annually to study motor vehicle crashes, the leading cause of death among children aged 1 to 19 years. The third-leading cause of death in this age group — cancer — received $335 million annually during the study period.

However, firearm injuries were the focus of just 32 grants totaling $12 million during the study period — or $597 per firearm-related pediatric death, Cunningham and colleagues noted.

“Without funding, evidence-based solutions are not found,” Cunningham said. “For example, how could we find answers to decreasing car crashes without investing in transportation safety research? We can’t find answers to cancer if we don’t fund research to understand the disease.”

Similar to cancer, there are many areas of research related to firearm injuries that need to be funded, including suicide, homicide and accidental or unintentional injury, she said.

“Injury prevention and firearm injury prevention is a science, and we can find science-based solutions for prevention,” Cunningham said. “But it takes funding.”

Further analyses revealed that the amount of funding provided for firearm injury prevention was only 3.3% of what was predicted based on the pediatric and adolescent mortality burden. This lack of funding, the researchers wrote, resulted in fewer studies conducted concerning this topic than predicted by the mortality burden.

“This is the No. 1 cause of death among high school-aged students in the U.S. and No. 2 for those kids who live through infancy through age 18 years,” Cunningham said. “The past funding on this issue has shown, in essence, that we have not been trying as a country to save these kids from dying. Providers should know these stats and consider their role in advocating for the health of the children they care for who are not old enough to have their own voice.” – by Katherine Bortz

Disclosure: Cunningham reports funding from the NIH and CDC to study injury prevention. Neither directly funded this research.