I myself conduct considerable research in which the unit of analysis is the metropolitan area. This analysis seems to be conducted with the unit of analysis being the State (N = 50). Causal inference with such data is very hard, and the limitations are fierce. This article based on the abstract/presentation seems to ignore all of that. No lagging of the variables is hinted at. That means that the data are probably consistent with the idea that deaths of children in households lead to more guns in households. Also, the data seem consistent with the idea that a culture of violence in a state leads to both. And of course, this analysis seems on its face to ignore all the difficulties of the ecological fallacy. I would not want to criticize the authors of the abstract, but the article about it is pretty thin and unconvincing. best sam -----Original Message----- From: herb fox <[log in to unmask]> To: SCIENCE-FOR-THE-PEOPLE <[log in to unmask]> Sent: Sat, Nov 2, 2013 9:45 pm Subject: Kids & guns in the house A statistical analysis that gives Medical professionals the basis and obligation to ". . . talk to patients, particularly parents, about guns in the home . . . " hf A Deadly Mix: Kids and Guns in the House Published: Nov 1, 2013 By Charles Bankhead, Staff Writer, MedPage Today Reviewed by Zalman S. Agus, MD; Emeritus Professor, Perelman School of Medicine at the University of Pennsylvania Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal. ORLANDO -- The combination of children and guns in the same household contributed to a steady rise in gunshot wounds and deaths in children, according to a review of national data over a 12-year period. The number of children hospitalized for gunshot wounds increased from 4,270 in 1997 to 7,730 in 2009. In-hospital deaths among pediatric gunshot patients increased from 317 to 503 over the same period. Among gunshot wounds with known incident locations, 40% of the wounds occurred in the child's home. The data showed a significant association between gunshot wounds to children and the presence of one or more guns in the household. The association grew stronger when unsafe gun storage was included in the analysis (P=0.02 to P<0.01), although some of the numbers were small. "Handguns are responsible for most of the childhood gunshot wounds," Arin L. Madenci, MD, of the University of Michigan in Ann Arbor, said here at the American Academy of Pediatrics meeting. "Increasing household gun ownership correlated with increasing childhood gunshot wounds. There was a stronger likelihood of home gunshot wounds with unsafe storage practices." Approximately 2,700 children die of gunshot wounds each year. Precise data on the epidemiology of childhood gunshot wounds are difficult to find, in part, because of limitations in the CDC budget, which includes about $100,000 (of a $6 billion total) for the study of gun-related issues, he said. According to the Children's Defense Fund, the rate of gun-related deaths among children and teenagers in the United States is 3.24 per 100,000. That rate is 17 times greater than the rates of 25 other developed nations combined, said Madenci. The U.S. has the highest gun ownership per capita in the world (nine guns for every 10 people). Gun-related homicides involving children more than tripled from 1960 to 2010, he continued. Given the trends in gun ownership and childhood deaths attributable to gunshot wounds, Madenci and Christopher B. Weldon, MD, PhD, of Boston Children's Hospital and Harvard, hypothesized that household gun ownership would correlate with childhood gunshot wounds. To study the relationship, they relied on two sources of data: the CDC's Behavioral Risk Factor Surveillance System for estimates of household gun ownership and the Kids' Inpatient Database for childhood gunshot wounds. Hospitalizations involving childhood gunshot wounds and in-hospital deaths were tracked in 3-year intervals. Over the course of the study period, 31,156 children were hospitalized for gunshot wounds and 2,159 children died in hospital of gunshot wounds. For the proportion of hospitalizations with a known type of gun, handguns accounted for 77%, shotguns for 19%, and hunting or military rifles for 4%. Focusing on the 40% of gunshot wounds that occurred in homes, Madenci and Weldon examined the relationship between the presence of a gun in the home and at-home gunshot wounds involving children. They also identified the proportion of households with loaded guns and the proportion with loaded guns in unlocked storage. The investigators performed regression analysis to determine the relationship between the percentage of households with guns and the percentage of childhood gunshot wounds. Specifically, they calculated the percent change (up or down) in childhood gunshot wounds that would be expected with a 1% change in households with guns. The resulting beta regression coefficient reflected the change. Across the 50 states, the proportion of households with children and at least one gun ranged from 10% to 62%. The proportion with loaded guns ranged from 1% to 14%, and the proportion with loaded guns in unlocked storage from <1% to 7%. Comparing the household gun-related data and childhood gunshot wounds showed significant associations for all comparisons: Any gun - beta=0.7, 95% CI 0.3-1.1, P<0.01 Loaded gun - beta=1.7, 95% CI 0.3-3.2, P=0.02 Loaded gun in unlocked storage - beta=2.9, 95% CI 0.6-5.2, P=0.02 An analysis of the relationship between the percentage of gunshot wounds occurring in the home and the proportion of households with a gun and children produced beta values of 0.7 for any gun (P<0.01), 2.1 for loaded firearms (P=0.04), and 4.8 for loaded firearms in unlocked storage (P=0.01). The study provided more detailed information about trends in firearm injuries involving children than has been available in the past, said David Hemenway, PhD, of the Harvard School of Public Health. "The results are consistent with a number of other studies which have found that where there are more guns, particularly guns in the home, it's more likely that there will be danger for children," Hemenway told MedPage Today. "Also, how you store the gun makes a difference. Storing the gun unsafely increases the danger for both accidents and suicide to children 1 to 17 years of age." The data suggest actions that healthcare providers can take to help reduce the number of children injured and killed by guns each year. "The study suggests, consistent with other studies, that physicians should talk to patients, particularly parents, about guns in the home, so they can weigh the risks and benefits of having a gun in the home and also talk to patients about how to store a gun," said Hemenway.