Rates and Correlates of Handgun Access Among Adolescents Seeking Care In An Urban Emergency Department

Background/Purpose: Access to a handgun increases the risk of suicide and homicide among adolescents; however, the risk factors of youth reporting handgun access have yet to be determined. Predictors for handgun access among youth can be used to target injury prevention strategies.

Methods: In this observational cross-sectional study performed in the emergency department of a large urban hospital, 14 to 18-year-old youths completed a 139-item survey involving weapons-related behaviors, sexual activity, substance use, violent behavior, and injury. Patients presenting with suicide attempt, sexual assault, or unstable vital signs were excluded. The variable of interest was self-reported handgun access. Bivariate analyses were used to identify significant predictors, which were included in a logistic regression model predicting handgun access.

Results: A total of 3050 adolescents completed the survey, with 480 (12.2%) refusing to participate and 417 (12%) missed due to logistics. One-third of the sample (32.9%) reported access to a handgun. All variables except receipt of public assistance and reason for visit were significant in the bivariate analysis. In the logistic regression, age, gender, race, and employment were the demographic predictors of access. Substance abuse, sexual activity, prior injury by a gun, and serious physical and group fighting were all related to adolescent handgun access. Reason for ED visit (medical/injury) was not a predictor of access.

Conclusions: This study is the first to demonstrate associations between multiple common risk factors, handgun access, and injury in adolescents seeking care in an ED for chief complaints outside of intentional injury.