Rates of gun assaults on children roughly doubled during the covid-19 pandemic, according to a study that looked at gun deaths and injuries in four major cities. Black children were the most frequent victims.

A wider analysis from Boston University included a review of gun assaults between mid-March 2020 and December 2021 in Chicago, Philadelphia, Los Angeles, and New York. It found that Black children were 100 times as likely as white children to be victims of fatal and nonfatal shootings. Pre-pandemic, they were 27 times as likely. Researchers excluded accidental shootings and incidents of self-harm.

Study author Jonathan Jay, who studies urban health, said the team looked at the rates to understand whether some children were at higher risk than others.

“We knew that children of color, even before the pandemic, were more likely than non-Hispanic white children to be shot, and we also knew that child gun victimization seemed to be increasing during the pandemic,” Jay said. “But no one had looked at how racial disparities in child victimization might have been changing.”

The researchers are still unpacking pandemic-specific factors that may have driven the change, he said. Some of the influences they’re considering include “stress associated with job losses, school closures, loss of access to certain kinds of services that closed down,” he said. “Also, really visible police violence, especially against people of color. Loss of loved ones and family members to covid-19 virus.”

As a Black teen in Philadelphia, Makhi Hemphill regularly thinks about the threat of gunfire, he said. The 16-year-old grew up in North Philly, an area that has seen roughly two dozen gun homicides this year and many more gun injuries.

He said he pays close attention to his surroundings when outside.

“I still have the thought in the back of my head to protect myself, ’cause of how this world is currently,” he said. “I don’t want anything bad to happen to me, and my mother doesn’t want anything bad to happen to me either.”

Philadelphia’s child gun assault rate jumped from about 30 per 100,000 children to about 62 per 100,000 during the pandemic.

Makhi said he thinks some teenagers argued with one another during the covid pandemic because they were spending too much time on social media and, for some, frustration and isolation led to violent behavior.

“People are at home, maybe their home is not their safe place,” he said. “They didn’t have that escape because they couldn’t leave home. So maybe they had a break or something like that.”

In 2020, firearms became the leading cause of death for American children, surpassing car crashes for the first time in decades, according to the CDC.

The National Institutes of Health estimates that 16.6 million U.S. adults purchased a gun in 2020, up from 13.8 million in 2019, according to an NIH analysis of the National Firearms Survey.

With covid, we’ve seen an increase in gun purchases and more guns in the home. So [children] were in places where there were now more guns, and probably more guns on the streets as well.”

Joel Fein, physician and co-director of the Children’s Hospital of Philadelphia’s Center for Violence Prevention

In late March, the Centers for Disease Control and Prevention released data showing there were 36% more average weekly emergency department visits for firearm injuries in 2021 than in 2019, with the largest increase among children 14 and younger.

Chethan Sathya, a trauma surgeon and the director of Northwell Health’s Center for Gun Violence Prevention, said its children’s hospital has seen a 350% increase in gunshot patients in the past year.

He said the data that’s emerging on child gun deaths should be a clear call to policymakers.

“Violence intervention groups are doing really great work,” he said. “These studies highlight that they’re needed more than ever. [Gun violence] disproportionately does affect and has affected Black kids, and it’s horrific. So how can we step up as a community to address the root causes?”

Within the hospital where he works in Queens, New York, Sathya said, prevention starts with asking all patients screening questions about firearm access and risk factors, and providing trauma-informed services to violently injured patients.

Kaliek Hayes, founder of a Philadelphia nonprofit called the Childhoods Lost Foundation, said he and other community leaders in neighborhoods where gun violence is prevalent are trying to reach children early so they don’t get swept up in the crisis.

That means connecting them to a network of after-school mentorship programs, athletic and arts opportunities, and career prep offerings.

“If we err on the side of getting in front of it before it happens, a lot of the numbers we’re seeing would be different,” Hayes said.

This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.