Guns and Kids: What is "Responsible Gun Ownership"?

A new study finds that teaching kids about safe gun practices may lead to risky firearm storage behaviors.

We’ve got to talk about kids’ access to guns. I know this is a charged issue. In this space, I often editorialize – I give my thoughts and impressions of a medical study with an understanding that reasonable discourse is still possible at least when it comes to healthcare.

But guns are different. Some of you may think an Associate Professor of Medicine and Public Health is a great person to discuss the gun issue, as it is firmly a medicine and public health problem. Some of you may think guns have absolutely nothing to do with either of my specialties and I should stay in my lane.

But I don’t want to avoid this. We don’t know all the details surrounding the most recent school shooting in Georgia, but we do know that the weapon used by the 14-year-old shooter had been in his home. Some reports suggest it was actually his gun, given to him as a gift from his father. And this week, we have some hard data on how gun owners with kids think about the relationship between kids and guns. Let’s try to figure this out.

I think the best thing I can do with this subject is stick to the facts as much as possible, and flag carefully where I am drawing inference. So let’s get started.

Fact #1: Firearm-associated injuries are the leading cause of death in children and adolescents in the US, outpacing motor vehicle accidents since 2020.  A bit more than half of these are death from suicide.

Source: Goldstick et al. NEJM 2022

Fact #2: Children with guns in the home are more likely to die from suicide. This meta-analysis from the Annals of Internal Medicine estimated the risk of completed suicide is 3.2 times higher when a gun is in the home, and the risk of homicide is two times higher.

Source: Anglemyer et al. Annald of Int Med. 2014

Fact #3: Studies show that four storage practices are associated with a lower risk of a child being harmed by a gun in a home. Guns should be locked safely, stored unloaded, and stored in a different location than ammunition, which should also be locked. Each of these factors were associated with a 50% to 70% reduction in the risk of a child being harmed by a firearm.

Looking at these data, it makes me think of the concept of “responsible gun ownership” – just to be clear I’m moving out of facts and into inference now. None of these reductions are 100%. Given the risk associated with owning a gun in a house with children, is there a way to do it safely? Truly safely? Or is that a pipe dream. Is it akin to talking about “responsible tiger ownership” or something.

One thing I have heard from gun owners – and yes while I do not personally own a gun I am friends with quite a few people who do – is that, when there are kids in the home, responsible gun ownership is not just about locking guns away safely. It’s about teaching kids what responsible gun use looks like and providing clear guidance on when and how gun use is acceptable.

And that sounds pretty good to me – a little education is never a bad thing.

Unless that education gives parents a false sense of security. And that’s what has me worried after reading this paper, from JAMA Pediatrics, that came across my desk this week.

Source: Paruk et al. JAMA Pediatrics. 2024.

This is a rather simple survey study – a representative sample of gun-owning adults with children in their home from 9 states which I’ve shown here.

The survey was fairly detailed, going into the type of firearm, the characteristics of the parents and the family, as well as the storage of the guns.

Overall, you can see that a majority of parents reported discussing firearm safety with their kids. Half had demonstrated proper firearm handling. A third had taught their kids how to shoot a firearm.

This is all fine – until you look at the association between teaching your kids about guns and safe gun storage. What the authors found was striking: Parents who said they taught their kids about proper firearm handling or taught their children to shoot a firearm, were up to twice as likely to have at least one gun unlocked and loaded in the house.

That’s the data. The inference is that these parents feel safer having educated their children about guns, and thus feel more comfortable leaving a loaded gun unlocked.

This scares me a bit since the data linking safe storage of firearms with safe kids is so strong. But the data we don’t have is the relative impact of unsafe storage among gun-educated vs uneducated children. There’s an argument to be made that maybe these kids are fine – they know enough about the gun to respect the gun. 

But we’d do well to remember that kids make mistakes. Kids are impulsive and irrational. Kids can develop depression, schizophrenia, and psychosis without their parents being fully aware. And a kid who knows how to use a gun and who has free access to a gun, may in fact be particularly dangerous in the right circumstance.

That’s an inference, of course.

But the facts remain clear. There are millions of kids living in houses with guns. These kids are at higher risk for dying from a gun. Safe storage mitigates that risk. Whether education mitigates the risk of unsafe storage remains an open question.

We can always say wait for more data. But the precautionary principal is pretty clear on this one. If you own a firearm, and you have a child in the house, no matter how well you’ve taught that child to respect the weapon, how knowledgeable they are about it, how safe they have demonstrated they can be with it, please lock it up, unloaded, and lock ammo up elsewhere. Keep the tiger in the cage.

A version of this commentary first appeared on Medscape.com.