Nov 7, 2023 - Health

Kids who survive shootings — and their families — face greater health burdens

Change in diagnosed disorders per 1,000 people among youth survivors of firearm injury
Data: Health Affairs; Note: Includes people ages 0–19 years enrolled as dependents on their insurance plan for at least one year before and one year after sustaining a firearm injury. Based on 2007-2021 commercial health insurance claims data; Chart: Axios Visuals

Young survivors of shootings face a litany of physical, psychiatric and substance abuse disorders that can combine to drive up their health costs almost 2,000%, according to new research.

The big picture: Guns have become the leading cause of death among kids, but many more survive being shot. Their needs offer a rare and detailed look at the cumulative consequences of gun violence and the burden it places on survivors, their families and the health system.

By the numbers: Using a trove of claims data for employer-sponsored insurance, researchers in Health Affairs compared over 2,000 child and adolescent shooting survivors and 6,000 family members with much larger control groups that did not suffer gun injury between 2007-2021.

  • In the year after being shot, survivors had a 117% increase in pain disorders including musculoskeletal pain and headaches compared with the control group, with a 293% increase for those more severely wounded.
  • There was a 68% increase in psychiatric disorders, such as PTSD and mood disorders, with a 321% increase among those with worse injuries.
  • Substance use disorders rose 144% percent — and cases rose regardless of the severity of the injury.
  • Emergency room visits for gun injuries among kids doubled during the pandemic, according to separate research published Monday in Pediatrics.

There is also an impact on families' mental health and even the types of care they got in the aftermath of a child surviving a shooting, researchers found in the Health Affairs study.

  • Diagnosed psychiatric disorders among mothers and fathers increased by about 30% — and the increases were much larger among parents of children who died.
  • Mothers had a 75% increase in mental health visits, while other routine care like office visits and lab tests declined slightly for themselves and the siblings of survivors.
  • That was consistent with a "crowding out" effect when more acute health care needs arise, researchers said.

What they're saying: "Our study shines light on the substantial effects incurred not just directly by victims and survivors of gun violence, but indirectly by parents and siblings who, we found, often relinquish their own routine health care to the more acute health needs of the family," senior study author Chana Sacks, co-director of the MGH Gun Violence Prevention Center, said in a statement.

Survivors' health care costs also soared 17-fold to nearly $35,000 on average over the course of a year. Two-thirds of the cost was in the first month after being shot, while survivors used more health care across the board — including more visits to doctor's offices, ER trips, imaging and mental health services.

  • Insurers covered the vast majority of the care, but families were on hook for about 5% of the cost.

Between the lines: Researchers looked at claims data for workplace health insurance only, so the results don't include kids without insurance or those enrolled in Medicaid — a major source of coverage, especially for children of color.

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