Ef­forts aim to pre­vent gun in­juries

The Register Citizen (Torrington, CT) - - NEWS - By Ed Stan­nard

As seat­belts, car seats and other auto safety fea­tures have be­come com­mon, the fa­tal­ity rate for young peo­ple from car crashes has dropped sig­nif­i­cantly over the years.

The doc­tors who treat chil­dren and ado­les­cents who have been vic­tims of gun­fire, as well as those who work to keep young peo­ple safe, want to see a sim­i­lar de­cline in deaths and in­juries from firearms.

In 2014, the rate at which young peo­ple died from firearms in­juries and car crashes was about the same: 1.76 per 100,000 died be­cause of guns vs. 1.75 from car ac­ci­dents. Since then, both rates have be­gun to rise.

“The things we’ve done for cars, the fact that you have to be safe when you’re in your car … I think we can ap­ply that same tem­plate to firearm safety,” said Dr. Kirsten Bech­tel, comed­i­cal di­rec­tor of the In­jury Pre­ven­tion, Com­mu­nity Out­reach and Re­search Pro­gram at Yale New Haven Hospi­tal.

A ba­sic way to do that is by “re­duc­ing ac­cess to firearms to peo­ple who won’t safely use a firearm. It’s all about safety,” she said. When it comes to guns, the goal should be “to store them safely and to keep them away from peo­ple who should not have them,” she said.

Since 2011, 85 youths un­der 18 have been treated for gun­shot wounds at Yale New Haven Hospi­tal. Seven of those vic­tims died, but that num­ber doesn’t in­clude vic­tims who died be­fore they could be brought to the hospi­tal.

Not all gun­shot vic­tims treated at Yale New Haven come from the city. As a Level 1 trauma cen­ter, pa­tients suf­fer­ing se­vere gun­shot wounds may be taken to the hospi­tal from other parts of the state, even from as far as Water­bury, Dod­ing­ton said.

In 2018, nine of 78 gun­shot vic­tims treated at the hospi­tal were un­der 18, with one dy­ing of his wounds. That was Ethan Song, the 15-year-old boy from Guil­ford who died Jan. 31, 2018. The Water­bury state’s at­tor­ney ruled he ac­ci­den­tally shot him­self at a friend’s house.

Ac­cord­ing to Dr. James Dod­ing­ton, also co-med­i­cal di­rec­tor of the hospi­tal’s In­jury Pre­ven­tion, Com­mu­nity Out­reach and Re­search Pro­gram, “the ma­jor­ity of those pa­tients do fall be­tween the ages of 18 and 35,” with very few fa­tal­i­ties among vic­tims un­der 18.

“They’re very small num­bers in the grand scheme of things,” Dod­ing­ton said of younger vic­tims. Con­necti­cut is “a very low-risk state” for chil­dren dy­ing of firearms, and al­most none of them is a vic­tim of homi­cide.

“Thank­fully, we see very few firearms-re­lated in­juries in New Haven and the state of Con­necti­cut in our sys­tem,” Dod­ing­ton said.

On July 16, 2017, how­ever, a 14-year-old New Haven boy, Tyrick Keyes, was shot on Bas­sett Street. His killer has not been found.

At Bridge­port Hospi­tal, there were 35 shoot­ing vic­tims un­der 18 be­tween 2014 and 2018, one of whom died, ac­cord­ing to Dr. Justin Cahill, qual­ity of­fi­cer for the hospi­tal’s Depart­ment of Emer­gency Medicine. Those un­der 18 to­taled about 11 per­cent of all shoot­ing vic­tims seen at Bridge­port Hospi­tal dur­ing those five years, Cahill said.

The one fa­tal­ity was 12-year-old Clin­ton How­ell, who was shot in the chest Dec. 18, 2018, on Wil­low Street in Bridge­port. Po­lice said the tar­get of the shoot­ing was his cousin. Ta­jay Cham­bers, 18, was charged with mur­der with spe­cial cir­cum­stances in Clin­ton’s slay­ing.

“Prob­a­bly weekly at least we’ll see a gun­shot, not al­ways of a young per­son,” Cahill said. “It’s pretty rare that we’ll see some­one as young as this 12-year-old.”

The Bridge­port area also is served by St. Vin­cent’s Med­i­cal Cen­ter, which in 2018 treated nine gun­shot vic­tims be­tween 15 and 18 years old, with no fa­tal­i­ties, ac­cord­ing to spokes­woman Danielle Swift.

All the doc­tors said the med­i­cal treat­ment needed is just part of the dif­fi­culty when a young per­son suf­fers a firearm in­jury. “When it’s a child, deal­ing with that emo­tion­ally with the par­ents in­volved and other fam­ily mem­bers, it’s al­ways an emo­tion­ally charged sit­u­a­tion,” Cahill said.

Gun­shot in­juries cre­ate more than phys­i­cal wounds too. “When you get shot, you’re at high risk for PTSD, sub­stance abuse,” Bech­tel said. She pointed to sta­tis­tics say­ing that as many as 30 per­cent of those in­jured by gun­shots suf­fer from post-trau­matic stress dis­or­der or de­pres­sion six months af­ter the event. Other prob­lems in­clude a risk of drop­ping out of school, prob­lems with author­ity and in so­cial re­la­tion­ships and a higher rate of sui­cide at­tempts.

Na­tion­ally, ac­cord­ing to a 2017 ar­ti­cle in the jour­nal Pe­di­atrics, about 1,300 youths up to age 17 are killed and al­most 5,800 are treated for firearms in­juries each year. The study showed that in 2007, two trends re­versed course.

Based on data from 17 states, be­cause na­tional sta­tis­tics are not avail­able, the ar­ti­cle stated: “Child firearm homi­cide rates in­creased sig­nif­i­cantly from 2002 to 2007, in­creas­ing 17% … and ex­hib­ited a sig­nif­i­cant de­cline from 2007 to 2014, de­creas­ing 36%. … Child firearm sui­cide rates, on the other hand, showed a sig­nif­i­cant down­ward trend be­tween 2002 and 2007, de­creas­ing 23% … but then a sig­nif­i­cant up­ward trend be­tween 2007 and 2014, in­creas­ing 60% … to the high­est rate seen over the pe­riod ex­am­ined. Un­in­ten­tional firearm deaths ex­hib­ited a sig­nif­i­cant over­all de­crease be­tween 2002 and 2014.”

Ac­cord­ing to the pa­per, while the over­all rate of death by firearm was 1.76 per 100,000 youths, it was 1.5 per 100,000 for whites, 4.1 for blacks, 1.15 for His­pan­ics, 2.15 for Amer­i­can In­di­ans and 0.39 for Asians. Boys were more than four times as likely to die from firearms as girls — 2.84 per 100,000 vs. 0.64, ac­cord­ing to the re­port.

The rate for non­fa­tal firearms in­juries was 7.86 per 100,000, 71 per­cent of them the re­sult of as­sault, with the rest be­ing ac­ci­den­tal.

Young peo­ple suf­fer­ing firearms in­juries is far more of an Amer­i­can prob­lem than it is for the rest of the world. Ac­cord­ing to the Pe­di­atrics ar­ti­cle, 91 per­cent of all firearms deaths of chil­dren 14 and younger in high-in­come coun­tries oc­cur in the United States.

“Ap­prox­i­mately 19 chil­dren a day die or are med­i­cally treated in [a hospi­tal emer­gency depart­ment] for a gun­shot wound in the United States,” the ar­ti­cle stated. “The ma­jor­ity of these chil­dren are boys 13 to 17 years old, African Amer­i­can in the case of firearm homi­cide, and white and Amer­i­can In­dian in the case of firearm sui­cide.” Younger vic­tims are most of­ten in­no­cent by­s­tanders “caught in the cross­fire,” it said.

“In Con­necti­cut, we have very few peo­ple who die be­cause of un­in­ten­tional in­jury,” Bech­tel said. “We see very few kids die by sui­cide com­pared to the rest of the na­tion.”

On the other hand, ac­cord­ing to Dod­ing­ton, “the ma­jor­ity of in­ten­tional vi­o­lent in­jury” are in New Haven, Bridge­port and Hart­ford. “So we are work­ing with our hospi­tal and com­mu­nity to im­prove the care of vic­tims of vi­o­lence. We want to im­prove not only your care, but we want to co­or­di­nate with our com­mu­nity part­ners to pre­vent rein­jury.”

Young peo­ple who are vic­tims of shoot­ings are at high risk for be­ing in­jured again, Dod­ing­ton said, so Yale New Haven is work­ing with com­mu­nity part­ners to pre­vent firearms in­juries from oc­cur­ring.

“Yale New Haven as of 2019 has founded and be­gun to staff the first hospi­tal-based vi­o­lence in­ter­ven­tion pro­gram in the state,” Dod­ing­ton said. “Our goal is to serve vic­tims of vi­o­lence and give the best kind of clin­i­cal care and fol­lowup. … You need both hos­pi­tals and com­mu­nity part­ners to join to­gether to pre­vent vi­o­lence.”

Dod­ing­ton said doc­tors need to “in­ter­face with schools, youth ser­vices [to] both track and in­ter­vene [with] those who are both vic­tims of vi­o­lence and those who might be at risk of vi­o­lence or vi­o­lent in­volve­ment.”

Bech­tel said in­ter­ven­ing be­fore vi­o­lence oc­curs is key. “Just like with any in­jury, you have to kind of walk back­wards to un­der­stand how an ado­les­cent or a child got ac­cess to a gun,” she said.

“The over­ar­ch­ing goal is, we just want to in­ter­rupt some­body who is not sup­posed to ac­cess a gun from ac­cess­ing a gun,” she said.

While ac­ci­den­tal in­juries by firearms are rare in Con­necti­cut, “in the wake of Ethan Song’s death, the firearm-ac­cess laws will get even stricter here,” Dod­ing­ton said. The Gen­eral As­sem­bly will be tak­ing up a bill known as “Ethan’s Law,” spon­sored by state Rep. Sean Scan­lon, D-Guil­ford, and pro­moted by Ethan’s par­ents, Kristin and Mike Song, which would place re­spon­si­bil­ity for an ac­ci­den­tal firearm in­jury on the gun owner, whether the owner knew the weapon was loaded or not.

Both Bech­tel and Dod­ing­ton are mem­bers of the Na­tional Net­work of Hospi­tal-Based Vi­o­lence In­ter­ven­tion Pro­grams, which pro­motes pro­grams such as Na­tional ASK Day, when par­ents are en­cour­aged to ask oth­ers if they have an un­locked gun in their home, as well as gun buy­backs.

Brian A. Pounds / Hearst Con­necti­cut Me­dia

Pe­di­atric emer­gency medicine physi­cians, Dr. James Dod­ing­ton, left, and Dr. Kirsten Bech­tel, in their of­fices at Uni­ver­sity Tow­ers in New Haven.

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