A study published in JAMA Pediatrics has revealed that states with the most permissive firearm laws experienced more than 6,000 excess deaths among children and adolescents in the 13 years following a pivotal 2010 Supreme Court decision. The research, led by Dr. Jeremy Faust of Harvard Medical School and Mass General Brigham, provides the most comprehensive analysis to date of how state gun policies affect pediatric mortality rates.

The study examined the period after McDonald v. Chicago, the landmark 2010 Supreme Court case that extended Second Amendment protections to state and local governments. This decision struck down Chicago’s handgun ban and triggered a wave of legislative activity across the nation, with some states enacting more permissive gun laws while others strengthened restrictions.

States like Alabama, Louisiana, and Texas enacted more aggressive laws expanding access to firearms, including concealed carry in churches and stand-your-ground provisions, while states like California passed stricter regulations.

Using data from the CDC’s Wide-Ranging Online Data for Epidemiologic Research (WONDER) database, researchers analyzed firearm mortality trends among children aged 0-17 years before (1999-2010) and after (2011-2023) the McDonald decision. The findings paint a devastating picture:

• Most permissive states: 6,029 excess firearm deaths (incidence rate of 158.6 per million population)
• Permissive states: 1,424 excess firearm deaths (incidence rate of 107.5 per million person-years)
• Strict law states: Actually saw a decrease of 55 deaths (incidence rate of -2.5 per million person-years)

In total, researchers found over 7,400 more pediatric deaths due to firearms than would have been expected based on pre-2010 trends. About 23,000 child firearm deaths occurred during the study period, compared to the expected 17,000.

The study uncovered particularly troubling trends for Black children and teens, who already face disproportionate risks from gun violence. Non-Hispanic Black populations experienced the largest increase in firearm mortality in both the most permissive and permissive state groupings. These existing disparities increased in permissive states but remained stable in states with stricter laws.

Among all 50 states analyzed, only four experienced statistically significant decreases in pediatric firearm mortality after the McDonald decision: California, Maryland, New York, and Rhode Island. Notably, all four states were classified as having strict firearm policies. These states demonstrated that strong gun laws can protect children even in an environment of increasing national gun violence.

The research comes as firearms have overtaken motor vehicle accidents as the leading cause of death for American children and adolescents. A child or teen is killed by gunfire in the U.S. every 2 hours and 48 minutes.