Children aged 5 to 14 years in the United States have 11 times the likelihood of being killed accidentally with a gun compared with similarly aged children in other developed countries (Table 1).[4] The United States has been in this unenviable position for at least the past decade.[5] From 2003 to 2007, the yearly averages of unintentional firearm fatalities were as follows: 62 children aged 0 to 14, 89 youth aged 15 to 19, and 95 young adults aged 20 to 24 years.[6]
Not surprisingly, there are more accidental gun deaths in areas with more guns.[7–9] The differences are substantial. To illustrate, we compare accidental firearm deaths among the states most extreme in terms of firearm ownership levels. States are grouped so that the populations of the high and low gun states are equal. According to the Centers for Disease Control (CDC) data, between 2003 and 2007, the typical resident from the 15 states with the most guns (WY, MT, AK, SD, AR, WV, AL, ID, MS, ND, KY, TN, LA, MO, and VT) was 6 times more likely to die in a gun accident than a typical resident from the 6 states with the fewest guns (HI, NJ, MA, RI, CT, and NY). For example, although there were virtually the same number of children aged 5 to 14 years in both groups of states, 82 had died from accidental gunshot wounds in these high gun states, compared with 8 in the low gun states (Table 2).
Fatal injuries are only the tip of the iceberg. For every fatality from an accidental shooting, there are more than 10 people injured seriously enough in gun accidents to be treated in hospital emergency departments.[10] In other words, almost 20 people a day are shot unintentionally but do not die. This number does not include any of the more than 45 people per day who are treated in emergency rooms for BB/pellet gun wounds (2003–2007) or the many others injured by firearms in other ways (eg, powder burns, struck with a firearm, injured by the recoil of a firearm), many unintentionally.
One study of nonfatal accidental shootings found that the majority were self-inflicted, most involved handguns, and more than one third of the injuries required hospitalization. Injuries often occurred during fairly routine gun handling—cleaning a gun, loading and unloading, target shooting, and so on.[11] It is important to recognize that although some people are at higher risk for unintentional shootings than others, accidents can happen to anyone. No one is completely immune, as shown anecdotally by scores of stories of police, firearms safety instructors, firearms advocates, and other experts who have accidentally shot themselves or others.[12]
Overall, the evidence indicates that a gun in the home is a risk factor for serious accidental injury. When 34 injury prevention experts were asked to prioritize home injury hazards for young children, based on frequency, severity, and preventability of the injury, the experts rated access to firearms in the home as the most significant hazard.[13]