One youth shot almost every day in Ontario, study finds

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New Canadian research shows one young person is shot almost every day in Ontario, with the vast majority of injuries being unintentional. The study, which compared firearm injury rates between immigrants and non-immigrants, also found the two groups had similar rates of intentional firearm injuries. But certain immigrant groups – notably refugees and immigrants from Central America and Africa – had a higher likelihood of assault-related firearm injuries.

The findings, published Monday in the Canadian Medical Association Journal (CMAJ), do not offer an explanation of what's driving the number of injuries. But the authors suggest that public strategies should be created to promote firearm safety, particularly among those groups who might be at risk.

"The numbers are really high, so it's definitely a problem that we have to take seriously," said Astrid Guttmann, one of the study's authors who is chief science officer at Toronto's Institute for Clinical Evaluative Sciences (ICES) and a pediatrician at the Hospital for Sick Children. "Arguably, all of them [firearm injuries] could be prevented."

To do the study, Dr. Guttmann and colleague Natasha Saunders, a pediatrician at SickKids, looked at Ontario health data for people age 24 and younger from 2008 to 2012. The researchers defined immigrants as those with permanent residency or those born to a mother with permanent residency status.

They found the rate of unintentional firearm injuries was 12.4 per 100,000 among non-immigrant male youth, compared to 7.2 per 100,000 among their male immigrant peers. The rate of assault-related firearm injuries was 3.5 per 100,000 among male non-immigrant youth, compared to 5.5 per 100,000 in the immigrant group. The difference between the two groups in terms of assault-related injuries was not statistically significant, according to the authors. But among certain immigrants, the risk of being injured by a firearm was higher: a 43-per-cent increased risk among refugees and 68 per cent higher among immigrants from Central America.

"We don't know whether it's related to gun violence among gangs. We don't know the circumstances," said Dr. Saunders, who is also an associate scientist at the SickKids Research Institute and health researcher at ICES. "Those are really important questions."

The health data do not include information on the exact types of firearms involved in the injuries. While many studies look at the number of deaths that occur as a result of gun-related injuries, the new research is notable because it looks at injuries linked to firearms and shows just how common they are, the authors said.

On Monday, the Canadian Paediatric Society also issued a new statement urging doctors to warn families against keeping firearms in homes where children live as a way of preventing injury and death. Clinicians should routinely ask caregivers about whether there are firearms in the home and, if there are, to highlight the importance of safe storage as well as the risks. For instance, studies show that having a gun in the house is linked to an increased risk of unintentional injury, youth suicide, school shootings and gang violence, the statement said.

"Access and availability of firearms is a big risk factor for children and adolescents, for them to be killed in a variety of different ways," said Katherine Austin, lead author of the statement and a pediatrician who is a member of the Canadian Paediatric Society.

The new statement also urges governments to adopt tighter controls on guns to protect youth, such as measures to reduce illegal importation of firearms from the United States and new restrictions on semi-automatic weapons.

Dr. Austin said the figures in the new CMAJ study highlight the fact that firearm injuries are an all too common occurrence in Canada and that action needs to be taken to protect young people.

"We definitely have a problem," she said. "These are preventable injuries."