Firearm injury is now the leading cause of death of children and adolescents in the United States. This has fueled intensifying prevention and data collection efforts to reduce, and hopefully eliminate, this devastating public health crisis. However, most existing data about adolescent use of firearms has focused only on urban youth.
Researchers from the Social Development Research Group (SDRG), a School of Social Work research and innovation center, have found that adolescents living in rural Washington state generally understand what constitutes acceptable firearm carrying behavior. These study findings about rural adolescent firearm experience, norms and behaviors were recently published in the journal JAMA Network Open.
“We wanted to know if there were differences in risks for adolescents in terms of firearm injury when they grow up in rural settings,” said Margaret Kuklinski, director of SDRG and a co-investigator on the study.
“What we know from urban areas is that adolescents carry firearms for a number of reasons, including perceived safety and threat,” Kuklinski explained. “And we also know that firearm carrying in urban areas has been associated with behaviors that are not necessarily positive. We suspected that rural contexts for carrying firearms were different.”
The motivation to fill the gap in the literature around rural adolescent firearm use is what brought Kuklinski and other researchers together. The study is a collaboration between the University of Washington, Washington State University and Seattle Children’s Hospital, and is led by Ali Rowhani-Rahbar, a professor in UW’s Department of Epidemiology.
All agreed that more information was needed to better inform prevention and health promotion strategies. “Risk and prevalence of adolescent firearm related injury, including suicides, are even higher in rural areas than in urban areas,” said Kuklinski. “We’re going to have a much better chance of meaningful impact if we understand what the current behaviors and norms are. What is their current understanding of safety? What are their friends doing? What do their parents think is ok? We want to make sure we are on target with our approaches.”
The study used a mixed-methods design, gathering both qualitative and quantitative data from 93 adolescents living in rural Washington state. Participants were 12-19 years old, and enrolled in either a county or tribal 4-H youth development program. Roughly half of participants had carried a handgun at some point in their lives. Researchers used surveys, focus groups and individual interviews to gather their perspectives.
Researchers found that study participants generally understand what constitutes acceptable firearm carrying behavior and are typically engaging with firearms in prosocial ways like hunting, recreation and sport. “These young people are involved in positive activities in their communities. They took in messages and norms from their parents and community,” said Kuklinski. “They typically don’t use firearms in aggressive or violent ways. They also already understood that it was important not to carry firearms at school or in public.”
Study participants were very engaged and willing to share. “This is a very sensitive topic. Our team spent a lot of time building relationships and engaging the youth,” said Kuklinski. Those efforts paid off, as evidenced by honest and open responses from participants. “I think this was a very important part of the study – discovering how much young people want to be heard,” Kuklinski explained. She shared a quote from one participant who said that “nobody asks us these questions. It’s good to be able to voice our opinions and somewhat be heard by people.”
Next steps include building on this existing research to further support firearm injury prevention in rural homes. Rates of firearm related suicides have surged in the last two decades, particularly in rural areas. Given the availability of firearms in rural communities, Kuklinski stressed the importance of learning more about help-seeking behavior. “I think we need to learn more from these very articulate and thoughtful young people so that we can make inroads to reducing firearm injury and death,” she said. “We need to have these conversations about hard things.”
This study is part of a larger project at SDRG funded by the Centers for Disease Control and Prevention called Culture, Longitudinal Patterns, and Safety Promotion of Handgun Carrying Among Rural Adolescents: Implications for Injury Prevention. The project has resulted in roughly a dozen published papers.
“SDRG has been focused on prevention and health promotion for a long time,” said Kuklinski. “We know that we can prevent harmful things like early substance use, mental health problems, violence, antisocial behavior and delinquency by taking a preventive approach.” For her, one of the biggest study takeaways is the importance of prosocial activities. “When you have young people involved in positive activities like 4-H, they are more likely to be on a path to healthy outcomes. Engaging young people in a range of activities that build and strengthen positive social connection at home, school and across the community needs to remain at the center of our work.”