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Your Parenting Mojo - Respectful, research-based parenting ideas to help kids thrive - Jen Lumanlan 20th June 2021
139: How to keep your child safe from guns (even if you don’t own one)
00:00:00 00:44:54

139: How to keep your child safe from guns (even if you don’t own one)

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 don't the parents make sure she goes to bed at the right time, the parents might be seen as well, this parent is failing this child, maybe the child gets referred for a special services, because special education because she can't concentrate because she can't focus because she didn't sleep at night. And so all of a sudden, we see all of these potential ramifications happening down the line of something that seems completely unrelated, like what teacher in school is going to make the connection necessarily between this child who is being referred for special services and the fact that there are gunshots in her neighborhood at nighttime. It's such a broader issue. And we tend to focus so tightly on the individual child, like why is this child struggling? And they must need special help, when actually we just ignore the broader society these children live in right.   Dr. Nina Agrawal  17:09 Yeah, I think that's a great, great point is that, you know, there's exposure, and then there's buffering that exposure, and what are the variables that buffer that exposure and that toxic stress? You know, that damage that might come to that child? And so, you know, the, you know, we talked about resilience? What is resilience? Is resilience, internal? Is it internal and external? Is it something that we can do in the children's environment to help them be stronger? So, you know, I think the exposure element came to light when it was the Parkland youth. They you know, for the most part, you know, they grew up in a in a suburban community with resources, a resource community. They came from economically advantaged families. They were very verbal children, or verbal use. And that was very, that was a game changer. And those kids told us, look, I am depressed, I am suicidal, because of the exposure because I've lost friends. I'm scared that this is going to happen to me. So the trauma of that exposure became real. And this is real in black children growing up in the South Bronx, like my little patient, but she's not getting the resources nor the recognition, like you said that the fact she's not doing well in school is not because she's you know, it's not that she's not capable. It's that she's in an environment that doesn't allow her to learn.   Jen Lumanlan  18:38 Yeah, yeah. And even deeper on what you said about the Parkland children. You know, we're paying attention to them, because they're expressing this in words that we choose to hear in language. Maybe there are black children who express it through acting out, we know what is what is seen as acting out in school. They're expressing this trauma, this post traumatic stress disorder and the other stuff that's going on. And we see that as misbehavior as something that they need to correct as a problem. And not as an expression of "I am hurting." There is something here that is hurting me. And we choose to kind of turn the other way and say, you know, you have a problem. We're going to you're going to deal with it. We're going to suspend you, expel you, whatever, because you're misbehaving. I mean, it's just when you say it like that, that we listen to the Parkland children. And it's so clear that we don't listen to other children. What, how does that sit with you?   Dr. Nina Agrawal  19:31 Yeah, I've thought about this a lot. You know, and I think what it is I think about these things, because how can we change things? How can we change the language? How can we change policy, and I think language matters. And when we talk about the children, you know, like the Parkland children, like how do we create a safer school environment for children? You know, they talk about it in the schools. The lawmakers talked about it. Research has been devoted to this. How do we make Schools safer? But yet, when it comes to Black children in these economically disadvantaged communities, we don't talk about is how do we make these children safer? We talk about it as violence prevention. We started out with a different baseline. Okay, it's violent. How do we bring down the violence? rather than, you know, how do we make the environment safer for these children as well. They both deserve to be safer with the children, the black children in these under-resourced communities. They don't feel safe getting from school to home, they might feel safer in school. It's all their environment, however you define it where children live, where they go to school, where they play, they should feel free in all of these areas. Yeah,   Jen Lumanlan  20:46 Yeah, absolutely. Okay. And so, so we're making some progress here, not enough. On the other side of this gun purchases are up. Gun purchases are up in the last year, specifically, 32% of households had guns in the US in 2016. It's now 39%. We have 120 and a half guns for every 100 people in the US, which is more than twice as much as the second highest country, which is Yemen. And there was an article on this just the other day in the times and they interviewed people who were working at gun stores and stores that have gun counters and talking to the employees and saying, well, who is buying guns? And these employees are saying, well, it's not the usual people, it's not our usual clientele. This is now white people coming in. People who have never seen a gun in real life before. Who have absolutely no idea how to hold it, what to do with it, and they're telling the store owners, we're going to be locking down, we're constrained to our homes, we want to keep safe. And so and that fits with a Gallup poll that it published in 2018, that found that the percentage of people who believe that having a gun in the home makes it a safe place to be rose from 35% to 63%. Between 2000 and 2014. I mean, you you already gave away the lead here, right, which is that the guns are not safe, their homes are not safer when they have guns in them. So what's going on here? Why is there such a disconnect?   Dr. Nina Agrawal  22:10 Right, I think it's the lack of a public health approach. And, you know, we saw this with COVID. And that when you don't have a central approach from the CDC, you know, issuing prevention guidelines, you know, people, you know, make up their own theories, and you know, to fit whatever their needs are, and you can't blame them. Right, if they don't have the information, they can act on it, and they may not trust the information that they're getting. So we need to have a public health campaign that gives, you know, evidence-based guidelines. It's not based on politics. It's based on what the science says. And if the science says that safe storage, decreases injuries in your children and that we all like as doctors, as school providers, we all embark upon that campaign, I think we can make a difference. But the problem is, it's very varied right now. I do want to say, though, you know, it's who's buying the gun. So, you know, we are seeing more people buy guns, but it's also in the other the populations that weren't buying guns, like Black people are buying guns legally. Asian people are now buying guns legally. And you actually can't blame them. You know, like, why should I be a sitting duck? If so, and so has a gun, and I don't. So I think, you know, we need to equalize this. Guns need to be kept out of the wrong hands on all ends.   Jen Lumanlan  23:39 Okay. Okay. And so, so as the rate of gun ownership increases, there are going to be more children living in houses that have guns. It seems unlikely that only people who don't have children are buying all of these guns. And so there have been a bunch of studies done actually, obviously, a lot of them fairly old now, because of the stifling of the research. But in 1994, more than 22 million children lived in homes in the US that had guns. 55% of these people who responded to a survey reported that they had one or more firearms in an unlocked place. Thirteen percent had firearms stored, unlocked and loaded. And so they're incredibly accessible to young children. And these numbers may actually be an underestimate, because people know you're not supposed to have loaded firearms in house for children. And so they may not have reported truthfully on the survey. And so in another survey, parents will say, Oh, yeah, this it's important. I need to store my gun safely and 85% of them will say yes, safe storage is important, and then they'll go on to say, but they don't do it themselves. And so I think at the heart of this is is a misunderstanding of what children are capable of and that if we just tell them you know, I we have a gun, don't touch the gun, then the children won't touch the gun. What do you think about that?   Dr. Nina Agrawal  24:53 Yeah, there definitely is lack of knowledge in this area. The NRA, the National Rifle Association, had the Eddie Eagle campaign, and that was tailored to children. And you know, look, don't touch the gun, you know, or if you do have a gun, this is the way to handle it safely. It didn't work. There's no evidence behind it. There's no science that says that we were able to reduce injuries and deaths in children because of that campaign. What works is educating parents. If you educate parents on safe storage, not gun control, safe storage, and keeping the gun unloaded loft with the ammunition in the separate place, you can reduce unintentional injuries and suicide injuries in youth. But again, that message needs to get out there. What we mean by gun safety, we mean gun storage, safe birch, I'm sorry.   Jen Lumanlan  25:47 Yeah, yeah. And just to make it super clear, for any parent who's thinking, Well, my kids different, my kid could tell the difference, my kid would never would never touch a real gun. Because I've told them not to do it, there was a fascinating study that he did, where the researchers had two water pistols and a real gun in drawers in a room. And the gun had a radio transmitter on it, that would make a light flash when the trigger was pulled hard enough to actually pull it if it was really enabled. And it was a really small study, admittedly, it was only 29 kids, they were all boys, 72% of them found the gun and 76% of those handled it, and 16 of them pulled the trigger. And about half of the boys who found the gun, were not sure if it was real or not, more than 90% of the boys who had handled the gun or pulled the trigger reported that they'd received some kind of safety instruction. So putting all of that together, children cannot tell if a gun is real or not. If they find the gun, they are probably going to handle it. And even if you have told them not to touch a gun, if they find the gun, they're probably going to do it. So I just want to reiterate what you're saying that teaching our children to not touch guns is not enough. It's probably necessary, do you think, but not enough?   Dr. Nina Agrawal  27:00 It's necessary, just like anything else, like don't touch a hot stove. You know, things that may cause injuries. But you know, I talked about this with like lead paint, you know, like, we kept on making lead paint. And you know, you could tell kids don't eat the paint, but they're going to do it. We just stopped making the lead paint, and we need to make the paint safer. So what does that mean? Like with guns, you put a trigger lock on it, you put it you lock it up, because just telling a kid don't touch it doesn't work for really anything. And I guess to go to your study that you're talking about, there's a really great TV special with Diane Sawyer, where they put two boys in a room with a real gun, and they instructed the boys don't touch it. Don't... you know, they told them over and over again, don't touch it. And then they leave them alone in the room and there was a camera and they're both looking at it. They're both looking at it. And then one kid picks it up. And the other kids, I don't think we should do that. And the kids still the other kids still picks it up. And I think he does, like, you know, like motion on the trigger. So even if it is even if you tell a kid not to touch a real gun, you know, it's it's the same thing like with kids, like they want what they you know, what could be perceived as something they can't have?   Jen Lumanlan  28:17 Mm hmm. Yeah, and it's almost like the marshmallow test. Right. But like, if they can wait 15 minutes, they can have two marshmallows, and a lot of them can't do it. So um, okay, so then we talked about educating parents and you've talked about a public health and public safety campaign is this advertising or the the primary way that I see this discussed in the literature is that pediatricians are supposed to be the ones delivering this message and that when your kid goes for their well-baby visit, the pediatrician is supposed to give you advice on this and most pediatricians are not trained in this. They have no idea what to do what to say. And so this advice is not happening right now. Do you see that as a viable way of getting this information through? Are there other more effective ways?   Dr. Nina Agrawal  28:58 Just like a public health campaign requires multiple messengers, I do think it does belong and the pediatrician in the pediatrician sphere, and for normalizing it from birth on just like, you know, we talked about the stove, you know, don't leave your baby near a stove. Well, the babies aren't crawling yet. But you know, hey, start, like making your room safe, or your house safe, because one day your child will get there. And we all know that children move quickly, and they're there before you know it, and then you're in the hospital. Before you know it with an injury that was preventable. It happens. But what can we do to prevent those things from happening? Because guns are highly lethal. And so like other unlike the other ones, like a burn, you can treat but guns, you may not have that opportunity. So yeah, I think that doctors do need to do prevention, but they don't really have the language to do it. And it's become this touchy thing about how to approach we do injury prevention all the time, but we don't really have the language to do this one because it's been politicized. Really, it should be policy. You know, as far as a play day, it becomes like, hey, my kids coming over your house. And you know, we asked about pools, if your child can't swim, we asked about nuts, if your child's allergic, it's the same thing. I just want to make sure my child is safe. And do you have any guns in the house? So I probably wouldn't just say the one thing about guns, but put it in all of the the typical injury things we ask about. And the other thing is, is that we have to meet people where they are. And it may not be, is there a gun in your house, it may be just provide the education and say, you know, if you do have a gun, this is what you know, this is what I recommend for safe storage.   Jen Lumanlan  30:45 Okay. Okay. So we're sort of, we're coming at this from two different perspectives here a little bit where we're talking about how the pediatrician might influence the parent or encourage the parent to change their own storage practices in their own house. And then there's also the how do we talk to other parents about this? And, and I think you studied the effectiveness of the Asking Saves Kids campaign, right, which is the idea of asking when your child is playing in another place, if there are guns available to them? What did you find out about the effectiveness of that program?   Dr. Nina Agrawal  31:15 Yeah, I studied it in the South Bronx, we asked parents of children being seen in our clinic and our pediatric clinic, you know, about the asking Safe Kids information, where, you know, again, it's making sure if there's a gun where your child plays, that it's safely stored. They overwhelmingly wanted gun safety education from their physician. Ninety-six percent. But only 11% received it from their pediatrician. So there's a gap in what parents want and what they're getting.   Jen Lumanlan  31:47 Okay, yeah, I can imagine based on positions, discomfort and lack of training and all the rest of it. And also, when we're thinking about who do you ask. If I'm the mother, it's possible that I'm going to be interacting with another mother making plans for a playdate. And there was a study I found that said that women who are frequently not the primary gun owners, and that they often don't know what guns are in their house and how they're being stored. So if I'm having this conversation with another mother, it's entirely possible that that person doesn't know the complete picture of what's going on in their house. So do I need to like have this message go out to both parents? Or like, how do I navigate that which I hadn't even considered?   Dr. Nina Agrawal  32:33 Yeah, I think that's a great point. I think you go for the parent that you have. And you ask them to distribute it to all caregivers, whoever's taking care of your child. That's what we tend to do, whether it's a babysitter or the grandmother or the father, but I do want to take a note that or make note that domestic violence from firearms is a public health issue as well. And so I think it is an area we don't talk about enough, you know, screening mothers for domestic violence related to firearms.   Jen Lumanlan  33:06 Yeah, yeah. And then just sort of while we're on this topic of issues in the home as it were, you said something we had a call two weeks ago just to check that the alignment was right with the kinds of topics that you're studying and what I was looking to cover on this episode and you said something that just caught my attention so much, you were talking about how Peloton Treadmills are being recalled. That one child has died as a result of interacting with the Peloton Treadmill 72 reports have been received about users, children, pets, other objects getting pulled onto the back of the treadmill. Of course any death of a child is tragic but what what does this Peloton recall say to you?   Dr. Nina Agrawal  33:45 Yeah, I was watching the news and they said you know there's been a recall on Peloton treadmills because kids are getting hurt. It's just as basic as that kids are getting hurt. Whether it be an injury or a death each each single one was important. With guns it's 10 children per day. So what does that say about you know about the safety I guess the safety policies in place for each of these industries. Peloton is regulated right by it could be the Consumer Product Safety Commission, but there are different entities in the federal government that regulate consumer products. Firearms is the only one that falls outside of this. It is not... the sale is regulated of firearms but not the safety firearms. So if a two year old picks up a firearm, drops it it discharges and hurts him or somebody else. You would think that should be a recall on that firearm. And look what can we do? Do we need to put micro stamping on it? Do we need to put a lock on it so that a child is unable to injure themselves or others from that firearm? Again that's a gap. And we need to repeal that protection from immunity for the gun industry. They need to be held accountable and they need to put safety mechanisms in place. It can't be voluntarily. It doesn't happen with any industry voluntarily. It didn't happen with cars. You know, data found that if you put a child in a car seat, they're more likely to be safer. If you put a seatbelt in a car, you're more likely to be safer. We didn't get rid of the car. We just made it safer for that child to be in the car. Same thing with firearms.   Jen Lumanlan  35:29 Yeah. Okay. And I want to sort of tease out the distinction between what I see is what you're describing here, which is we're trying to make firearms safer. And what seems to be the American Academy of Pediatrics' stance, which is their official policy statement says "The safest home for children is a home without a gun." And yes, that may be fact. I mean, it is factually true. But that that part is not really under debate here. But is this stance likely to be the one that improves the safety of the largest number of children if parents who own guns just kind of stop listening to the AAP and or their pediatrician or anyone else they're getting this information from? Where do you kind of walk that line?   Dr. Nina Agrawal  36:07 Yeah, I think there's a move to meet people where they are. And while like you said, that is the safest place, but people can have firearms, and we just need to have them be safe in the presence of children. So I think we need to meet people where they are. Do they have a firearm? What kind of firearm is it? Why do they have that firearm? It's for hunting? We 'll you know what then you you can keep it safely stored, because you're not using it for self protection. We need to learn about firearms. So many of us don't know, like, what's it like to pull a trigger? What's it, you know, what are. a kind of 2 year old, you're all like, hang on, hold the gun. So I had gone to a gun show in New Hampshire, where I, you know, ask people about background checks and about safe storage. I saw a family of four with an adolescent and a baby that must have been like six months old. And, you know, I was just, I was playing, you know, like consumer, and they all believed in safe storage, background checks. You know, the mother said of her baby, like, of course, we keep it safe. Of course, we keep it locked up with the user. Like, of course, we're not buying in a, you know, an assault weapon, he wants to buy a rifle for hunting. You know, again, that's not my culture. But that is a culture. And I think we need to understand it. And I think we need to meet in the middle about keeping their children safe.   Jen Lumanlan  37:33 Yeah, yeah, absolutely. Great. Thank you for teasing that out a little bit. And so I kind of linked to this idea, I think, is the idea of pretend play with guns, either with fingers being held up or with, you know, BB guns or other gun like objects. And so we covered this a while ago in the show. And we talked to Dr. Diane Levine, who has spent a long time studying this, and basically told us that you can try and ban children from engaging in gun play/war play if you want to, but they're going to do it anyway. They're just going to push it underground. And if you support them in doing it, you can actually help them from getting out of these kind of bang, bang, you're dead storylines that they can otherwise end up just repeating over and over again, and help them to understand well, what aspect of this story is it that they're really exploring here? And how can we help you to explore that rather than necessarily focusing so much on the gunplay itself? And so I think the parents who are in the communities I work with are generally fairly comfortable with this approach. And sort of acknowledging also that even if their children are allowed to play with pretend guns, that we're never doing it in a public place. This is always something that's done in our backyard, partially in acknowledgement that our friends, if I'm white, and I have a friend over who isn't white, that they may not be as safe as my child is being out on the street and playing with a pretend gun. And that even if everybody involved is white, that in acknowledgment that not every child is safe to do this. So I'm wondering if you are aware of any evidence based reason why we might need to shift our thinking on that at all, or if you are comfortable with children playing with pretend guns?   Dr. Nina Agrawal  39:10 It's a really great question. I don't know of any research in that area. I think it is something that does need to be done. You know, we have there have been studies that looked at exposure to media violence, and they have found that media violence exposure in and of itself can result in perpetration, but as far as the pretend gun I don't recommend it. I think there are different place simulations you can you can do that don't involve you know, the ultimate goal is to kill somebody. Cause what it is you kill like, you shoot somebody what they fall back in there, you know, simulating death. I don't know if that's what we want to teach kids. It's kind of like cowboys and Indians. We used to do that, but we don't do that anymore. You know, robbers. We don't cops and robbers. We don't do that anymore. So I think we maybe need to think about other things that children can play.   Jen Lumanlan  40:05 Okay. All right. And then from a parent's perspective, if a parent is concerned about children's exposure to gun violence, whether it's their own child, or whether it's children in general, because ultimately what we want to do is to make the world a safe place for all children to grow up in, not just my individual child, what do you recommend? What kind of actions can we take that are maybe grounded in evidence, I know that there had been some places where child access prevention laws have been put into place, you know, people will lobby for them, and the research on whether these are effective is is extremely mixed. ]Because there are so many confounding variables involved. We don't know if the law is being enforced, or if people are actually changing their behavior. So I'm wondering if you can help us understand are the research based practices we can engage in to make the world safer for all children?   Dr. Nina Agrawal  40:53 Right, there is evidence, as we said, to support safe storage, and then it becomes the laws, the laws that are effective. And there was recent study that came out by a colleague Eric Siegler out of Boston Children's that found that when you did look at these Child Access Laws in different States, where there were higher penalties for violation of that, then that was more effective, or was more effective in reducing injuries and deaths in that State versus an area that had weaker laws or weaker penalties from the same law. If that makes sense.   Jen Lumanlan  41:30 Yeah. Okay. So parents should be advocating for safe storage laws in their states, is that the thing that we can focus on that's most useful in terms of reducing children's exposure to violence, or is there are there other things that should be our primary focus?   Dr. Nina Agrawal  41:45 What I've been interested in is creating safer environments for children. And so creating sort of this environmental health framework. You know, we talk about climate, we talk about noise pollution, I think we need to put firearms in that. I live, you know, in New York City in a nice neighborhood, but just a block over last week, my neighbor was in the news over gunshots at 4pm. That doesn't usually happen. But it happened. You know, my since the pandemic, I don't walk around at night, because it actually has not been safe. But now it's not safe in the daytime, you know, so I think we need to look at our environment, just not in our home, but our you know, our community. And I think we need to solve this as a community. So whether what, however you define your community, as a community of parents, to community of teachers, however you define that I think, you know, come together and figure out what solutions matter or would make a difference in your community, it's not going to be a one size fits all. And it's not going to be one thing either. I really love the work that Charles Branas, he's a gun researcher that in Philadelphia, they found that if you remediate blighted land, like abandoned buildings, create safe green spaces where you involve the community, you can reduce shootings, and you can reduce crime in that area. And ultimately, children can be safer in that neighborhood.   Jen Lumanlan  43:12 Okay, so this ultimately doesn't necessarily have to be about advocating for anything related to guns specifically, it could be a much broader picture of how do we make this a community that we all feel welcome in. And that if we can create that, then the gun violence issue sort of becomes less of a focus as it were.   Dr. Nina Agrawal  43:31 Yeah. And then I think the other part of that is after school programs. In New York City, they're trying to mandate that all children are eligible for after school programs, because it's like an added expense. That's a time where children can get into trouble. And so I think, you know, all parents could benefit from after school programs for their child, whether you're in a suburban environment or in an urban environment.   Jen Lumanlan  43:54 Yeah. Awesome. Well, thank you so much for being here and sharing your thoughts on this and your research and ideas and leaving us with some really some things that we can do. This is not about necessarily getting out a billboard and taking on the NRA. This is not what we're trying to do here. What we're trying to do is create communities that feel welcome to everybody. So thank you for sharing your time with us.   Dr. Nina Agrawal  44:15 Thank you so much for having me. It was a pleasure.   Jen Lumanlan  44:19 Thanks for joining us for this episode of Your Parenting Mojo. Don't forget to subscribe to the show at YourParentingMojo.com to receive new episode notifications, and the FREE Guide to 13 Reasons Your Child Isn't Listening To You and What to Do About Each One. And also join the Your Parenting Mojo Facebook group. For more respectful research based ideas to help kids thrive and make parenting easier for you, I'll see you next time on Your Parenting Mojo.   References: Agrawal, N., Rajan, S., Johnson, D., & Renneboog, C-L. (forthcoming). Exposure to violence involving a gun is an adverse childhood experience.   Alcorn, T. (2017). Trends in research publications about gun violence in the United States, 1960-2014. JAMA Internal Medicine 177(1), 124-126.   American Academy of Pediatrics (2021). 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