SALT LAKE CITY — Firearms are a leading cause of death for U.S. children and about 7% of children in the U.S. live in households with at least one gun that is loaded and unlocked, according to the Journal of Urban Health.
But in the aftermath of several high-profile mass shootings, University of Utah Health researchers have found that doctors are not discussing gun safety during well-child visits, a study published in medical journal JAMA Pediatrics notes.
“Across the board, both the resident pediatricians and the attending pediatricians asked about smoke alarms much more frequently than they did about securing guns in the home,” Carole Stipelman, lead researcher of the study and associate professor of general pediatrics at the U. School of Medicine, said.
“Doctors are not taught how to talk about gun safety in medical school. It’s completely absent from the curriculum.” — Carole Stipelman
In the months following the 2017 Las Vegas shooting and the 2018 Stoneman Douglas High School shooting, researchers found a drop in the frequency that doctors documented responses to the gun safety questions.
For pediatricians like Stipelman, talking to parents about gun safety in the home is like talking about bike helmets, car seats or smoke alarms.
Researchers discovered this trend after adding questions for doctors to ask during routine visits at the pediatric clinic regarding whether there are guns in the home and if the guns are locked. Afterward, U. researchers examined records from 16,576 clinic visits at the University of Utah Health’s Pediatric Clinic between January 2017 and July 2018.
Despite major physician organizations like the American Academy of Pediatrics recommending that doctors should inquire about gun safety in the home during appointments, Stipelman found that doctors still aren’t doing so.
Researchers found that physicians who are younger and less experienced showed a steady decline in their frequency of asking about securing guns in the home following a mass shooting, according to Stipelman.
Prior to the Las Vegas and Parkland, Florida, shootings, resident doctors asked about guns in the home approximately 70% of the time. In the months following the shootings, that number declined to 50% of the time.
Stipelman theorized that doctors might be avoiding the topic because questions around guns in the home can potentially weaken the bond of trust between doctors and patients.
Another factor, she said, could be that not enough doctors are trained when it comes to approaching the topic of gun safety or might not have knowledge about trigger locks or other safe storage practices. If they doctors aren’t familiar with the devices, doctors can lack confidence in their ability to discuss the matter with families, according to Stipelman.
“Doctors are not taught how to talk about gun safety in medical school. It’s completely absent from the curriculum,” she said.
Researchers stated that “further work is needed to identify and overcome barriers that prevent physicians from discussing gun safety with patients.”
In the last decade, child suicides by firearms have increased by 82%, according to Centers for Disease Control and Prevention data. Researchers noted that safe gun storage practices could “decrease the occurrence of self-inflicted or unintentional firearm injuries to children.”
As the number of child suicide by firearms rises, Stipelman said it’s important for doctors to understand the relationship between firearms and children.
“We need to educate our young doctors about how to talk about it, how to approach the discussion in a collaborative way,” she said.
“Safe storage of guns and ammunition may decrease the occurrence of self-inflicted or unintentional firearm injury to children, and interventions by pediatricians may increase safe firearm storage,” researchers noted.
In the past, states like Florida have introduced a “physician gag law” to prevent doctors from discussing gun ownership with patients.
Jessie Mandle, senior health policy analyst at Voice for Utah Children, said it’s unfortunate that gun safety is too sensitive of a topic to some health care providers, who play a critical role in helping children thrive during a time of development.
When heath care providers ask questions about whether a child is getting enough food or needs assistance, she said, “providers want to make sure that kids are healthy and protected and safe, and that encompasses a range of factors and circumstances” including gun safety.
“We need to make sure that providers and pediatricians have the support they need to make referrals and to reconnect families with resources around this topic as well,” Mandle said.
She said, oftentimes, it could be hard to ask questions about gun safety if doctors aren’t aware of the resources to refer families to.
Mandle urged there needed to be broader conversations across all Utah families — including gun owners and non-owners alike — to talk about how to best keep kids safe and protected.