A study led by the Center for Violence Prevention (CVP) at Children’s Hospital of Philadelphia, in partnership with Jungwon Min, PhD, MS from the University of Pennsylvania School of Nursing, has found that young people’s perceptions of how easy it is to access firearms are strongly shaped by their environment and personal exposure to violence. The research was published in the American Journal of Preventive Medicine.
The study analyzed data from 23,334 emergency department visits between 2013 and 2024 by teenagers aged 14-18 who underwent behavioral health screenings. The researchers linked self-reported information about perceived firearm accessibility and psychosocial risks to police reports of shootings and the Child Opportunity Index, which measures resources available to children in specific neighborhoods.
According to the findings, teens living in areas with high levels of gun violence were more likely to believe they could obtain a firearm outside their home—even if there were no guns at home. Fighting accounted for nearly one-third of the connection between neighborhood gun violence and perceived access to firearms outside the home.
” 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, 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 also noted that since 2020, firearms have become the leading cause of death among children and teens in the United States—surpassing car crashes. About 30 million children live in homes with guns; nearly five million reside where guns are loaded and unlocked. At the same time, mental health issues among youth have increased, raising concerns about suicide risk and accidental shootings.
Researchers suggest that hospitals should screen not only for actual firearm possession but also for perceived access to firearms and history of fighting behavior. Children’s Hospital of Philadelphia recently began a quality improvement project focused on having better conversations about firearm safety with behavioral health patients at its emergency departments in Philadelphia and King of Prussia.
“Protecting children from firearm violence isn’t just a safety measure – it’s a moral imperative,” said Polina Krass, MD, MSHP, co-author and CVP Research Scholar. “Every action we take is a step towards preserving families and hope.”
This research 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.
