Many of us haven't been in each other's homes for a while now, but pretty soon we'll be getting together inside again.  And our children will be heading inside, in their friends' houses.   People store guns inside.   Are you certain that nobody owns a gun in any of the places your child plays?   If they do own a gun, are you certain they store it safely?   If not, you need to ask.   That's one issue we discuss in this interview with Dr. Nina Agrawal, a board-certified pediatrician who has expertise in violence against children.  She co-founded the Gun Safety Committee for the American Academy of Pediatrics in New York State, and is leading the Gun Violence Prevention Task Force for the American Medical Women’s Association.   Another issue is the gun violence that is primarily faced by children of color, which turns out to affect a far greater number of children.   And how is this all linked to the Peloton recall?  You'll have to listen in to find out...   Jump to highlights here:

• (01:00) Indoor playdates are ramping up...will your child be safe?
• (02:29) Introducing Dr. Nina Agrawal, pediatrician and co-founder of the American Academy of Pediatrics' Gun Safety Committee in New York State
• (02:58) Understanding how big is the scope of gun violence against children
• (06:15) The Dickey Amendment: Explaining the massive lack of data and research on gun violence and safety
• (11:24) The ways that gun violence affects children that we might not expect
• (12:32) “I get woken up at night to the sound of gunshots.”
• (17:09) The racial disparity in how children are affected by gun violence
• (20:46) More people purchased guns in 2020, and there are more first-time owners too
• (23:39) The statistical likelihood of children coming to harm if they live with a firearm in their household
• (27:00) Just telling kids not to touch guns doesn't work (even if you think of your child as one who is 'sensible,' and you've talked with them about gun safety)
• (30:45) The Asking Saves Kids Campaign helps to keep kids safer
• (33:06) The surprising link between children involved in gun violence and the Peloton treadmill recall
• (36:07) In American culture, banning all guns can't be the answer
• (40:52) Effective Child Access Laws
• (41:45) How to create safer environments for children through building communities

[accordion] [accordion-item title="Click here to read the full transcript"] Jen Lumanlan  00:02 Hi, I'm Jen and I host the Your Parenting Mojo Podcast.   Jen Lumanlan  00:06 We all want her children to lead fulfilling lives, but it can be so hard to keep up with the latest scientific research on child development and figure out whether and how to incorporate it into our own approach to parenting. Here at Your Parenting Mojo, I do the work for you by critically examining strategies and tools related to parenting and child development that are grounded in scientific research on principles of respectful parenting. If you'd like to be notified when new episodes are released, and get a free guide called 13 Reasons Why Your Child Won't Listen To You & What To Do About Each One, just head over to YourParentingMojo.com/SUBSCRIBE. You can also continue the conversation about the show with other listeners in the Your Parenting Mojo Facebook group. I do hope you'll join us.   Jen Lumanlan  01:00 Hello, and welcome to the Your Parenting Mojo Podcast. And today we're going to discuss a topic that I think is about to come into parents' consciousness in a way that it really hasn't as much over the last year. And for some of us, that's a result of our privilege. And I was reflecting that as vaccinations for children become more available, we're probably going to start moving towards indoor play dates without parents being around because when my daughter went into when we went into sort of lockdown, she was young enough that she wasn't really doing playdates indoors with other people in anyone else's houses. And so I never really felt as though I needed to ask, "Are there guns in your house?" because I was always there to supervise. And so of course, over the last year, she's played with a lot of kids on our street, and they're always outside and I can always hear them. And so the danger doesn't seem to be there in the same way for me in those outdoor playdates scenarios. But of course, as vaccinations become available, and these things start to move inside, I don't know which of my friends has guns in their houses. And if I'm kind of uncomfortable asking about this, I'm guessing that a lot of parents haven't even thought about it and don't have it on their collective radar yet. So I wanted to bring that up into our consciousness before we actually need it. And then, of course, there's another issue here as well, that we're going to delve into fairly deeply today, which is that gun violence is becoming increasingly common in a wide variety of settings that children live in and are exposed to, and that this can have really big impacts on them. And that that isn't necessarily talked about or studied nearly as much.   Jen Lumanlan  02:29 And we have a very special guest here with us today to talk about these issues. Dr. Nina Agrawal. She's a pediatrician who is board certified in Child Abuse Pediatrics, and she has expertise in Violence Against Children. She was on the faculty at Columbia University in Child and Adolescent Health. She co-founded the Gun Safety Committee for the American Academy of Pediatrics in New York State, and she's leading the Gun Violence Prevention Task Force for the American Women's Association. Welcome Dr. Agrawal.   Dr. Nina Agrawal  02:56 Thank you so much for having me, Jen.   Jen Lumanlan  02:58 All right. So I wonder if we can maybe start by just understanding how big is the scope of this problem, and piggybacking on that, how much do we know about how big is the scope of this problem, and why don't we know as much as we might want to know?   Dr. Nina Agrawal  03:12 Right, great question. Right now, guns are the leading cause of death in children 1 to 19 years of age. Before it was motor vehicle accidents.   Jen Lumanlan  03:22 Yeah.   Dr. Nina Agrawal  03:23 Now it's firearm. So it's something that's a health issue. It's a public health issue. It's a safety issue affecting all children.   Jen Lumanlan  03:34 Okay. And yeah, I actually hadn't seen those latest statistics, the peer reviewed papers I was looking at from 2018 still showed it in that number two position, so. So that's an unfortunate development over the last couple of years that that position has switched then. And it doesn't affect everybody equally, right? It affects some children more than others.   Dr. Nina Agrawal  03:53 Yes, definitely. Racially, it affects Black children disproportionately. Blacks, and then Hispanics, and then White children.   Jen Lumanlan  04:00 Okay. And I noticed that actually, the way that this data is collected, we might think, Oh, it's fairly easy to understand how prevalent this kind of thing is, how prevalent injuries are. And actually, there's a couple of different ways of estimating it. But the most common way is using data from the Centers for Disease Control, which is sampled from 100 hospitals. And I'm just thinking, Okay, there are 1000s of trauma centers that are dealing with this kind of thing. Can a sample of 100 hospitals give us a complete picture of what the actual prevalence rates for this are?   Dr. Nina Agrawal  04:34 Right? Yeah, as with a lot of injuries in children, it's a combination of hospital data and mass data and media. We're increasingly using media data. There's a gun violence archive that looks at shootings in communities, and then the CDC data. I think one of the problems with the CDC data is that it doesn't include non fatal injuries and only includes fatal injuries. So we're missing a lot of children who suffered non fatal injuries and understanding those so that we can prevent them.   Jen Lumanlan  05:09 Yeah. Okay. And I think when a lot of parents think about guns, one thing that they may be most kind of afraid of the immediate fear is of a mass shooting. Because there's get so much publicity, right? Is that the thing that we should be the most afraid of statistically speaking?   Dr. Nina Agrawal  05:25 Statistically, definitely not. It's 1% of shootings. So much more common is homicide, and suicide, and unintentional injuries. And then mass shootings are a small percentage, but they gain the most immediate attention. And because again, the most immediate attention, they gain the most resources - prevention resources. And so we have children dying every day from homicide and suicide and yet, we're really not devoting the investing in prevention of deaths in those children due to firearms.   Jen Lumanlan  06:00 Yeah, okay. And I think a big reason why we're not investing as much in the pieces of this that really matter are that we don't understand it well enough. And there's a reason we don't understand much about gun violence, right? Can you tell us about that reason.   Dr. Nina Agrawal  06:15 I love telling the story. It's a story that's not known and once people hear about it, they're like, Oh, my God, this makes sense. So anyhow, enough of the preamble. What it is, is that in 1994-95, there's a study that came out in the New England Journal of Medicine that found that if you had a gun in your home, you're a gun owner, you or somebody else in your home are more likely to die or get injured from that firearm, rather than protect yourself from an intruder. So, most people a lot of people keep it for self protection. It actually doesn't work that way.You know, the statistics tell you you're actually more danger from hurting yourself or somebody that you care about in your home. And so this study was published in the New England Journal of Medicine. The NRA was not happy about it, because that would affect firearm sales. And they, you know, they basically lobbied Representative Dickey of Arkansas, and Representative Dickey inserted a amendment called the Dickey Amendment after his name, saying that no funds can be used by the CDC or the NIH eventually went to the NIH that could be used to advocate or promote gun control. And so what they did is this Congress took away money from the CDC that had been used for firearm prevention research and earmarked it for concussions. And the CDC doesn't have this pot of money where they can use it indiscriminately. It has to be earmarked for a certain, you know, injury or health issue. And so then basically, they had very limited funding and research plummeted. And it you know, that Dickey Amendment created a chilling effect on the entire research community, because funding is so limited for research and, you know, people didn't want their funding taken away for other things that they could do research on. So gun violence research plummeted. And with that, are solutions. So this was in 1996, the Dickey Amendment passed. And every year, it gets reapproved. And there have been efforts through certain presidential administrations to try and repeal it, but it just keeps going on and on and more recently, in 2019, for the first time, the CDC was appropriated $25 million for gun violence prevention research. And I just want to make a distinction between gun control and gun violence prevention. And the distinction is that public health issues are not trying to control an injury or an illness. We're trying to create safety when it comes to injuries. So just like we don't say highway control, we say highway safety. We don't say cars control, we say car safety. We don't say cribs control, we say crib safety. So this is gun safety. We understand that you can have guns, but we just want them to be safe around children.   Jen Lumanlan  09:22 Yeah. Okay. Thank you for that. And I just want to pull out some pieces of what you said, particularly for listeners who are outside the US. So what we're talking about here is that the CDC is the Centers for Disease Control, and NIH is the National Institute for Health and that these organizations fund scientists working in academia to conduct studies on a whole array of things related to health, but specifically here we're talking about gun safety issues. And the NRA, the National Rifle Association, which has an enormous amount of lobbying power here in the US, and that they had approached Jim Dickey and said, You know, this is this is something that you need to be with us on and he agreed. And I was actually interested to see that he has more recently flipped on that. And he has regretted his role in the stifling the research. He didn't want there to be more gun control. And that was why he advocated for that, because he, he was, I think, worried that the research was going to lead to ammunition, I guess, as it were, for people who wanted gun control to put that into effect. But he now says that he regrets his role in stifling the flow of research on that. So it's encouraging to see that we are now starting to see the spigot loosened and some money flowing through.   Dr. Nina Agrawal  10:35 Yes, for sure. Yeah, right before he actually died. But right before he died, he became before he died. Well, before he died, he became friends with the person who is Head of the CDC at the time and together, they tried to advocate for Gun Violence Prevention Research.   Jen Lumanlan  10:53 Yeah. Okay. All right. So so thank you for, for telling us that story. And it's always amazing how the politics ends up impacting our view of public health issues. And, and I think that seeing this as a public health issue is really at the core of your approach here. And part of that is because of the way that gun violence impacts children. So I wonder if you can tell us more about your ideas and your research and thinking on how gun violence impacts children and how we should be thinking about it?   Dr. Nina Agrawal  11:24 Yes, I think we need to think about gun violence in children more broadly. We have been in the research setting, we've been thinking about his injuries and deaths. How do we prevent an injury? How do we prevent a death? And we're making some headway in that, but what we want is, you know, we're making headway in certain areas. So suicide and accidental injury. So like the toddler who picks up a gun on a play date, how do we prevent that from happening? We haven't made a lot of inroads in homicide affecting children. And that is the most common intent in children and youth. So we haven't made a lot of inroads and prevention of homicide. The other thing that we don't talk about his exposure to gun violence. And when I was working in the Bronx, you know, as a pretty some of I was working in the South Bronx, and it was a busy ER, a lot of people come in with gunshot wounds, but the ones that we weren't, weren't coming in or weren't presenting to medical attention, were the kids who are having mental health problems because of exposure. You know, they're having anxiety they're having, they're having depression.   Dr. Nina Agrawal  12:32 I am actually authoring a book chapter on exposure. And in that included this anecdote of a five year old that I was interviewing, and I asked her about eating and sleeping and you know, school, and she said, she didn't sleep well. Why not? And she goes, she told me there were noises that kept her up at night. I was like, Well, what were those noises and not expecting her to say this. She said they were gunshots. And I was like, Well, what do you do she when that happens? And she said, Well, I get a snack, and I go back to sleep. And it was this five year old living in this, this world of trauma in her bedroom. So the gun violence is going on physically outside her bedroom, but it's coming through into her home, it's coming through into her development and and her health. And what happens to those kids and from the adverse childhood experiences studies, we know that those violent exposures affect children's health across the long term. And they you know, they may develop academic problems, behavioral problems in adolescence, with gun violence, they may become victims and perpetrators. And then later on in life, if they don't die from gun violence, they may have chronic health issues. So basically, you know, what happens before age five children see and hear can affect their brains and their lives, the trajectory of their lives forever.   Jen Lumanlan  14:04 Yeah, yeah. And so to dig a little more deeply into some of those things that you mentioned, firstly, you said that, we've made some progress on the things like the accidental deaths and the suicides, which primarily impact White children. And we have not made so much progress on the homicides aspect, which primarily does not impact White children. It's primarily Black children. And so there's a very racially differentiated issue right on where we focused our attention where we've been able to make progress on this.   Dr. Nina Agrawal  14:34 Yeah. And, again, you know, unintentional injuries where a toddler picks up a gun is, again, a very small percentage of gun violence in children. The biggest bucket is homicide, but within that bucket, we haven't made a distinction between unintentional homicide and intentional homicide. So we see this in the news all the time. You know, people are children and even adults getting hit by stray bullets, and they see the wrong place at the wrong tie but is it that person's, you know, I guess it's like, where does the onus? Is it that person, he shouldn't have gone to that restaurant, he shouldn't have gone to that place, the child didn't go into that playground. So I think we need to make a distinction between the unintended target and the intended target. Because the dynamics are going to be different. The environments may be the same, but you know, a mother of a five year old, you know, getting shot by a stray bullet, like, how can we help her keep her child safe? Can we say, you know, look, maybe this area of your neighborhood is not safe. Or maybe we need to go to the community leaders and say, like, hey, this playground is not safe for our children. There's shootings that happen there. They're drug deals that happen there. Let's make this safe. So, you know, there's work that says that it's found that [unrecognized] of safe green spaces, reduces shootings in communities. And I think that is, I think that's a very viable way of keeping children safer.   Jen Lumanlan  16:03 Yeah. And also thinking back to that five year old who's saying, you know, I get woken up at night, and what I'm hearing is gunshots and, and thinking about how that's gonna play out in that five year olds, academic career, you know, maybe she's asleep at school the next day, because she couldn't, she couldn't sleep at nighttime. And then it's like, well, what are the parents doing? Why...