title: Mechanisms of pediatric trauma deaths in Canada and the United States: the role of firearms.
abstract: BACKGROUND
  This study aimed to determine whether firearms are a more prevalent cause of pediatric death in the United States than in Canada.
  
  
  METHODS
  All pediatric trauma deaths from 1991 to 1996 in Ontario and Missouri were reviewed. Socioeconomic data were compiled for the two jurisdictions.
  
  
  RESULTS
  During the period reviewed, there were 1,146 pediatric trauma deaths in Ontario (10.4 per 100,000 population) and 1,782 in Missouri (32.4 per 100,000 population). Firearm injuries accounted for 19% of the trauma deaths in Missouri and 0.5% of such deaths in Ontario. Overall, a child was 100 times more likely to die of firearm injury in Missouri (6 per 100,000 population) than in Ontario (0.06 per 100,000 population). The incidences of violent acts unrelated to firearms were similar between the two groups. Both populations were similar in terms of socioeconomic and education parameters, but differed in their rates for guns carried.
  
  
  CONCLUSIONS
  The significantly higher death rate from firearm injuries in Missouri likely reflects differing gun control attitudes and legislation, and provides a rationale for prevention and future investigation.
authors.affiliation: Department of Surgery, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Hackam
authors.forename: Mark V
authors.initials: MV
authors.lastname: Mazzioti
authors.forename: Richard H
authors.initials: RH
authors.lastname: Pearl
authors.forename: Gretchen M
authors.initials: GM
authors.lastname: Mazziotti
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Winthrop
authors.forename: Jacob C
authors.initials: JC
authors.lastname: Langer
mesh_terms: D002648:Child; D005389:Firearms / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D006801:Humans; D008923:Missouri / Q000453:epidemiology; D009864:Ontario / Q000453:epidemiology; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014948:Wounds, Gunshot / Q000401:mortality*