The Impacts of Firearm Violence Exposure on Youth in the U.S: Building the Evidence and the Solutions

Firearm violence persists as a public health crisis in the United States (U.S.). Approximately 100,000 individuals are shot with firearms every year, over 40,000 of whom succumb to their firearm-related injuries (Centers for Disease Control and Prevention, 2024). And these numbers don’t include the thousands of youth who are exposed to indirect forms of firearm violence: for example, witnessing gunfire or losing a parent or other family member to gun violence. Data from the Washington Post estimate that more than 383,000 school-aged youth have been exposed to gun violence specifically in K-12 schools since the Columbine mass shooting in 1999 (Cox, et al., 2019). Firearms are currently the leading cause of death among children and teens in the U.S. and this violence is disproportionately placed on youth of color. Indeed, racial disparities in exposure to firearm violence among youth have long persisted in the U.S., but recent research has highlighted that these disparities in childhood gun violence exposure have only gotten worse since the onset of the COVID-19 pandemic (Martin et al., 2022).

At the same time, there has also been a corresponding increase in adverse childhood experiences (ACEs) in the U.S. ACEs are broadly defined as “potentially traumatic events that occur during childhood” and are events that specifically disrupt a child’s sense of daily safety and stability. An extensive body of research on exposure to ACEs has been linked to dozens of negative outcomes over the life course (Felitti, et al., 1998) and recent data estimate that nearly 35 million children are exposed to at least one ACE. Moreover, this burden, like so many other public health issues, are disproportionately carried by youth color.

A few years ago, researchers reviewed 20-years’ worth of literature on ACEs and on firearm violence exposure specifically during childhood to assess whether such experiences with firearm violence ought to be categorized as an ACE (Rajan et al., 2019). And there has been a simultaneous growing body of research devoted to better understanding the impact of firearm violence specifically on different child outcomes and across different developmental stages. Much of this novel and critical work is reflected in the deeply thoughtful articles presented in this special issue of Youth & Society.

Indeed, in this new body of research, we see how the evidence regarding our understanding of the impacts of different types of firearm violence across geography, communities, and developmental stages impact adolescents in different ways, the disparities that persist, those that are emerging, and new prevention and intervention levers we have opportunities to invest in and pull as we collectively work toward identifying solutions to the persistence of this crisis in our nation.

For example, in work by Weigend Vargas et al. (2024), the authors draw on data from the National Fatality Review Case Reporting System to explore trends in firearm suicide among adolescents across a 16-year period. Their study findings underscore that the majority of suicide deaths are among older males (15–18 years). However, Asian/Pacific Islander/Native Hawaiian non-Hispanic adolescents comprise a larger proportion of the younger adolescents (ages 10–14 years) who died by suicide during this period. The need for preventive efforts that account for racial and ethnic groups continues to be needed. As does the need for screening for suicide risk among younger adolescents and across urban, suburban, and rural areas. In other new work exploring trends, Rafail (2024) serves as one of the few studies to specifically explore fatal police shootings among youth. Tragically, as we see with many other types of firearm violence, this study highlights that Black youth are disproportionately killed by police firearm violence in comparison to their white peers. And in new research that builds on our understanding of systemic factors that drive firearm violence outcomes, E. Lee, Stilwell, et al. (2024) draws on a large sample of Black youth who reported recently using drugs and seeking care within an urban emergency department to evaluate a pathway from residential segregation to youth firearm aggression. Moreover, this excellent study then describes the ways in which neighborhood disadvantage and exposure to violence mediate this relationship.

Some of the findings presented in this special issue also broaden our understanding of specific interventions and, one might argue, challenge our own presumptions about youth and what drives their perceptions of safety. For example, work by Moss et al. (2024) explores the associations between firearm-related beliefs and perceived ease of firearm access with firearm exposure and police violence exposure. This study collected data from youth in New Orleans, LA. And they specifically found that all types of firearm exposure (whether direct or indirect) are associated with the belief that more community gun ownership would increase safety. Thus, and in line with the existing evidence base in our field, the authors call for an increase to more thoughtfully attend to increasing youth perceptions of safety via evidence-informed community-based preventive efforts. Similarly, research presented in Weybright et al. (2024) draws on data collected from rural adolescents who are at heightened risk for firearm-related harms. Via this qualitative study, we are able to better understand how teens specifically in rural communities define firearm-related terms; thus shedding light and clarity on how this group perceives firearm violence.

Encouragingly, much of the research that this special issue presents is an opportunity to explore and learn about new evidence-informed interventions; whether in schools, communities, and via specific legislative changes. For example, in a new study by Sullivan et al. (2024), the authors draw on data from over 250 African American adolescents to identify specific protective factors (including school developmental assets, family prosocial involvement in school, among several others) that are related to either community violence exposure or peer victimization and that, when implemented, could effectively contribute to youth violence prevention efforts. And novel research presented in Lee et al. (2024) identifies pathways through which exposure to firearm violence of different types contribute to both the development and exacerbation of Post-Traumatic Stress Disorder (PTSD) symptoms among adolescents. Indeed, this work is incredibly important for identifying the specific types and timing of mental health support and interventions are needed as we consider how best to support children and adolescents in the aftermath of exposure to firearm violence of different kinds. Of course, firearm violence prevention necessitates continued conversation about access to firearms for proscribed users. And Crifasi et al. (2024) uses data from the National Center for Health Statistics to evaluate the impact of repealing firearm purchaser licensing laws on firearm homicide and suicide rates among those ages 15 to 24 years. Their critical findings highlight that the implementation of these laws was found to be significant associated with lower rates of violence.

In sum, this body of new, interdisciplinary, novel, and thoughtful research reflects the very best of our growing field of firearm violence prevention and the many nuances embodied by this public health crisis. One could argue there is no greater or more pressing issue than addressing firearm violence and its impact on youth; given the scope or bandwidth of this as a public health issue. And the work presented here affords us opportunities to grow the possibility of effective solutions.

Firearm violence has particularly devastating and unique impacts on youth due to their vulnerability and developmental stage. Overall, the impacts of firearm violence on adolescents are multifaceted and far-reaching, encompassing physical, emotional, and developmental consequences that can have lifelong implications. Efforts to address firearm violence must include measures to protect and support youth who are most vulnerable to its effects. This emerging body of research adds critical new insights.