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A child or youth is injured by a firearm every day in Ontario


Every day a child or youth is shot in Ontario and 75 per cent of those injuries are unintentional, according to a new study from the Institute for Clinical Evaluative Sciences (ICES) and The Hospital for Sick Children (SickKids).

In the study, published today in CMAJ, researchers examined data representing all children and youth up to 24 years of age living in Ontario anytime between 2008 and 2012 and found an average of 355 firearm injuries occur every year.

“It takes a study like this to bring an issue like firearm injuries among children and youth in our province to light. Most paediatricians in Ontario probably have not seen families who have been impacted by the effects of guns, but I think we would all agree than one child or youth injured by a gun is too many. The majority of these injuries are unintentional and are entirely preventable, making this an important public health problem that needs to be addressed with targeted prevention programs,” says Dr. Astrid Guttmann, senior author on the study, chief science officer at ICES and staff paediatrician and senior associate scientist at SickKids.

This population-based study included more than four million children and youth in each of the five study years and examined all firearm-related injuries in hopes of identifying potential at-risk groups of children and youth including the growing immigrant and refugee populations in Canada, as well as those living in urban and rural areas.

The researchers found:

  • Of the 355 firearm injuries per year, approximately 23 to 25 children or youth die from those injuries (approximately seven per cent).
  • Canadian-born youth, particularly males have the highest rates of unintentional firearm injury compared with immigrant youth. Canadian-born males have 12.4 unintentional injuries per 100,000 people versus immigrant males with 7.2 unintentional injuries per 100,000 people.
  • Twenty-five per cent of firearm injuries are assault-related.
  • The risk of being a victim of firearm assault is 43 per cent higher for refugees than for Canadian-born youth. Refugees were victims of firearm assault 4.7 per 100,000 people versus non-refugees at 2.4 firearm assaults per 100,000 people.
  • Immigrant children and youth from Africa are almost three times as likely, and those from Central America are more than four times as likely, to be a victim of firearm assault compared with Canadian-born youth.
  • Those living in rural settings are twice as likely to experience unintentional firearm injury compared to those living in urban settings, who are more likely to be victims of gun violence.

“As paediatricians, part of our role is to ensure the safety and well-being of our patients. Our findings indicate that this is a conversation we should be having with our patients and their families, particularly with these newly-identified high-risk populations,” says primary author Dr. Natasha Saunders, staff physician in paediatric medicine and associate scientist at SickKids.

Saunders adds that there is little Canadian research on children and guns, and the research that is available has mostly focused on children who have died as a result of a firearm injury.

“Death is clearly a devastating outcome, but near-misses are also a devastatingly significant issue. Our data looks beyond just death as an outcome and provides an important first look at the true impact of guns on children in Ontario. It is our hope that understanding the numbers will contribute to efforts that are already being made to reduce the number of victims of both unintentional firearm injuries in Canadian-born children and youth, as well as firearm assault in subgroups of immigrant children and youth,” she says.

Also today, the Canadian Paediatric Society released its updated position statement on firearm safety, which includes several recommendations for clinicians like asking patients whether they have firearms in their home, particularly for kids who are struggling with mental health issues. The statement also includes recommendations for government.

This work is an example of how SickKids and ICES are contributing to making Ontario Healthier, Wealthier and Smarter.

“Risk of firearm-related injuries among children and youth of immigrant families,” was published today in CMAJ.

Author block: Natasha Saunders, Hannah Lee, Alison Macpherson, Jun Guan and Astrid Guttmann.

The Institute for Clinical Evaluative Sciences (ICES) is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. For the latest ICES news, follow us on Twitter: @ICESOntario

The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric health-care institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally. Its mission is to provide the best in complex and specialized child and family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system. SickKids is proud of its vision for Healthier Children. A Better World. For more information, please visit www.sickkids.ca. Follow us on Twitter (@SickKidsNews) and Instagram (@SickKidsToronto).


Deborah Creatura
Media Advisor, ICES
[email protected]
(o) 416-480-4780 or (c) 647-406-5996

Suzanne Gold
The Hospital for Sick Children (SickKids)
[email protected]
416-813-7654, ext. 202059

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