A new study by the Center for Violence Prevention (CVP) at Children’s Hospital of Philadelphia, in collaboration with principal investigator Jungwon Min, PhD, MS from the University of Pennsylvania School of Nursing, revealed that youth perceptions of firearm availability are deeply influenced by their surroundings and personal experiences with violence. The findings, reported recently in the American Journal of Preventive Medicine, documents a substantial link between exposure to neighborhood firearm violence, participation in fighting and adolescents' perceived ability to acquire a firearm outside their homes.
Firearms are the leading cause of death among children and teens in the United States, overtaking car crashes since 2020. Approximately 30 million children in the US reside in households with firearms, and nearly 5 million live in homes where guns are both loaded and unlocked. Concurrently, there has been a significant rise in mental health challenges among young people, heightening the risk of suicide and accidental shootings. For leaders at CVP, this underscores the critical need for improved firearm safety measures, which is why researchers are focused on solutions aimed at preventing unnecessary violence and fatalities.
"Our findings highlight the urgent need to consider environmental and behavioral risk factors – not just household firearm ownership – when assessing youth firearm risk,” said Joel Fein, MD, MPH, the study’s senior author and co-director of CVP at CHOP. “Understanding how young people perceive access to firearms can inform targeted interventions, especially in emergency settings where at-risk youth are already seeking care.”
The study examined 23,334 emergency department visits between 2013 and 2024 by teenagers aged 14-18 years who underwent behavioral health screenings. Researchers connected self-reported data on perceived firearm accessibility and psychosocial risks to police-reported shootings and the Child Opportunity Index, a measure of economic, educational and environmental resources for children, at the census tract level.
Researchers found that teens in neighborhoods with high firearm violence are more likely to believe they can access firearms outside their homes, even if they don't have them at home. Fighting accounts for 32% of the connection between neighborhood gun violence and perceived firearm availability outside the home, elevating the complex risks youth face in violent areas.
However, the authors believe that crucial intervention points can make a difference. They suggest that emergency departments universally screen not only for firearm possession but also emphasize the critical importance of universal screening for perceived access and past fighting behavior. CHOP recently embarked on a quality improvement initiative with behavioral health patients at its Philadelphia and King of Prussia hospital emergency departments that improved firearm safety conversations.
“Protecting children from firearm violence isn’t just a safety measure – it’s a moral imperative,” said Polina Krass, MD, MSHP, a co-author and CVP Research Scholar. “Every action we take is a step towards preserving families and hope.”
This project was supported by Clinical Futures, a Research Center of Emphasis at Children’s Hospital of Philadelphia.
Min et al. “Neighborhood Firearm Violence, Psychosocial Risks, and Youth Firearm Perception.” Am J Prev Med. Online June 3, 2025. DOI: /10.1016/j.amepre.2025.107741.
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A new study by the Center for Violence Prevention (CVP) at Children’s Hospital of Philadelphia, in collaboration with principal investigator Jungwon Min, PhD, MS from the University of Pennsylvania School of Nursing, revealed that youth perceptions of firearm availability are deeply influenced by their surroundings and personal experiences with violence. The findings, reported recently in the American Journal of Preventive Medicine, documents a substantial link between exposure to neighborhood firearm violence, participation in fighting and adolescents' perceived ability to acquire a firearm outside their homes.
Firearms are the leading cause of death among children and teens in the United States, overtaking car crashes since 2020. Approximately 30 million children in the US reside in households with firearms, and nearly 5 million live in homes where guns are both loaded and unlocked. Concurrently, there has been a significant rise in mental health challenges among young people, heightening the risk of suicide and accidental shootings. For leaders at CVP, this underscores the critical need for improved firearm safety measures, which is why researchers are focused on solutions aimed at preventing unnecessary violence and fatalities.
"Our findings highlight the urgent need to consider environmental and behavioral risk factors – not just household firearm ownership – when assessing youth firearm risk,” said Joel Fein, MD, MPH, the study’s senior author and co-director of CVP at CHOP. “Understanding how young people perceive access to firearms can inform targeted interventions, especially in emergency settings where at-risk youth are already seeking care.”
The study examined 23,334 emergency department visits between 2013 and 2024 by teenagers aged 14-18 years who underwent behavioral health screenings. Researchers connected self-reported data on perceived firearm accessibility and psychosocial risks to police-reported shootings and the Child Opportunity Index, a measure of economic, educational and environmental resources for children, at the census tract level.
Researchers found that teens in neighborhoods with high firearm violence are more likely to believe they can access firearms outside their homes, even if they don't have them at home. Fighting accounts for 32% of the connection between neighborhood gun violence and perceived firearm availability outside the home, elevating the complex risks youth face in violent areas.
However, the authors believe that crucial intervention points can make a difference. They suggest that emergency departments universally screen not only for firearm possession but also emphasize the critical importance of universal screening for perceived access and past fighting behavior. CHOP recently embarked on a quality improvement initiative with behavioral health patients at its Philadelphia and King of Prussia hospital emergency departments that improved firearm safety conversations.
“Protecting children from firearm violence isn’t just a safety measure – it’s a moral imperative,” said Polina Krass, MD, MSHP, a co-author and CVP Research Scholar. “Every action we take is a step towards preserving families and hope.”
This project was supported by Clinical Futures, a Research Center of Emphasis at Children’s Hospital of Philadelphia.
Min et al. “Neighborhood Firearm Violence, Psychosocial Risks, and Youth Firearm Perception.” Am J Prev Med. Online June 3, 2025. DOI: /10.1016/j.amepre.2025.107741.
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