Fatal shooting of St. Paul teenager part of nationwide increase in gun deaths among children

[MUSIC PLAYING] CATHY WURZER: There is an investigation going on today in Saint Paul, after three teenagers were shot overnight near Hazelwood Street on East Maryland Avenue. One girl died. She is the 27th homicide of the year in Saint Paul. That girl is also part of a disturbing trend of gun deaths among children. A report out today by the American Academy of Pediatrics finds firearm deaths among children has skyrocketed in the US.

From 2011 to 2021, there's been an 87% increase. In 2021 alone, 2,590 children died of firearm injuries. It makes it the top cause of accidental death in children in this country. Joining us right now is Dr. Anupam Kharbanda. He's the Chief of Critical Care Services and a pediatric emergency medicine physician based at Children's Minnesota. Doctor, thank you for your time.

ANUPAM KHARBANDA: Yes, thank you for having me.

CATHY WURZER: I want to start by getting your reaction to this disturbing report.

ANUPAM KHARBANDA: It's really appalling. And it highlights that gun violence is a public health emergency. I am also not that surprised. This is building on several years of data now that is showing gun violence has been increasing among pediatric patients. This report builds on a article from this past March that was published in JAMA that highlighted the increasing rates of gun violence and follows on a press conference that we had at Children's this past April, highlighting a very similar issue.

CATHY WURZER: Because you've been in pediatric medicine for a while, does this report follow what you're seeing in the ER?

ANUPAM KHARBANDA: I think that we, in our emergency departments here at Children's, and across the state, we have seen an uptick across the state in gun violence. As you started in the report, there was more shootings in Saint Paul, as well as in Minneapolis. And in our state, there has been an uptick in gun violence among adolescents. And many of these are now fatal. And we should note that gun violence is the number one cause of death in the adolescent age group. So certainly, we are seeing the repercussions in our emergency departments.

CATHY WURZER: And do we know, are these children being shot by someone else? Are they in the line of fire? Or do they get guns, and are they playing with them, and the gun goes off, and they are shot? What do we know?

ANUPAM KHARBANDA: It's, again, an excellent question. And what the data supports nationally is that the rate of fatal injuries among pediatric patients has been driven by two arms. One is suicides. And there has been a dramatic increase in fatal suicide attempts, as well as homicides.

And in the homicides, it's clearly gang related violence or those who are getting access to firearms. So how is it-- is it someone's shooting them, or are they getting access to guns? I don't think the data can tease out. But clearly, we know that suicide among adolescents and homicides among adolescents have drastically increased since the pandemic.

CATHY WURZER: In April of this year, you were part of this group of, gosh, 160 pediatric health care professionals signing a letter calling on state lawmakers to take action to prevent gun violence. And the letter cited this recent data, that twice as many kids in Minnesota die from gunshots than cancer in 2021. Lawmakers, as you know, did pass some more gun safety regulations this past session. Do you think that's enough?

ANUPAM KHARBANDA: I think it's an excellent start. I think the measures passed by Governor Walz, meaning the expanded background checks and some of the red flag laws, were incredibly important. The thing is that needs to happen, and the American Academy of Pediatrics has pointed out the following, an assault weapon ban, even further stronger background checks, especially for checking for those with any mental health concerns, more education on safe gun storage-- this is an often an issue that we hear about in the media of a gun that is kept in a place that a younger child can get to-- and then more funds for gun violence prevention research.

And finally, I would add, that what we have noted in this data that came out yesterday was that non-fatal injuries actually decreased. And the theory was that those non-fatal injuries decreased because of good legislation, meaning more helmets being used by those who bike, more car seats, and more use of seatbelts. So we know that if as a community we do things to prevent injuries, they can be dropped. So if we focus in on gun violence research and safe practices to store the guns and preventing assault weapons to getting in the hands of adolescents, this will reverse the trend.

CATHY WURZER: We've been focusing, Doctor, on those children who have died because of firearm violence. But I'm wondering, I know you've seen patients who have survived. Do you think society understands, even if you survive a gunshot wound, there can be long lasting effects? Isn't that right?

ANUPAM KHARBANDA: Absolutely. There's the immediate physical effects on that patient from, obviously, a prolonged hospital stay. But the traumatic mental health impact is lifelong. And it is something that as a society and as a community impacts their ability in school and their interaction with peers. And I think that really the evidence has not gotten into, and the research has not gotten into, how impactful that could be on our patients. We do know. And I can tell you personally, I know that this is impactful on the individual level.

CATHY WURZER: And how about the impact on the doctors and nurses who have to-- your job is to try to save this little life?

ANUPAM KHARBANDA: Anytime you have an injury to anyone, it's obviously difficult on the staff. The patients who come in with and who are not resuscitatable are even more impactful. There's the grieving family. There's the friends. And the staff feels emotionally connected to those patients. And any time we cannot save someone, you have this group-based trauma that exists for the entire staff. So I am very supportive of your comment, that if we can find a way to reduce gun violence, it will not only impact the families, it will improve the rate of burnout among our physicians and clinicians.

CATHY WURZER: Final question, because you brought up gun violence prevention efforts. Is there anything that institutions like Children's can do to prevent firearm injuries and deaths?

ANUPAM KHARBANDA: Yeah, so we've done a few things. One, we've tried to build these coalitions among pediatric hospitals within our state. We've lobbied the legislature and the governor for this. We've been an advocate in our state to try to expose why there should be an assault weapon ban, why we need even stronger background checks, why we need items such as gun storage to be put in place, as well as gun buybacks, these things to remove the guns from the streets, get them out of their hands, so they are less likely to cause an injury.

These are all things that Children's is promoting. As the sole pediatric level one trauma center, the freestanding pediatric level trauma center in the state, we see this as our obligation to the pediatric patients in our community. And it's something that we are focused in on promoting. But we need partners. And we need help. And I hope that this conversation that you're starting today, or helping to lead today, will invigorate people to realize that this is a absolute public health emergency. We have to do everything we can to try and mitigate this curve because the number of patients that are dying is astronomical.

CATHY WURZER: Doctor, I appreciate your perspectives. Thanks for the work you do, and appreciate your time as well.

ANUPAM KHARBANDA: Thank you so much for your time as well.

CATHY WURZER: Dr. Anupam Kharbanda is the Chief of Critical Care Services and a pediatric emergency medicine physician based at Children's Minnesota.