Suicide is a leading cause of death in the United States (U.S.), with firearms being the predominant method. This study examines the racial disparity and disproportionality of pediatric firearm suicide from 2014 to 2018 in 17 U.S. states. We used the National Violent Death Reporting System to quantify the burden of pediatric firearm suicide by race/ethnicity and gender and assessed themes among decedents aged 10 to 17 years. Racial disparity and disproportionality were measured using the Disparity Index and Disproportionality Representation Index, respectively. Decedents were primarily non-Hispanic White (NHW, 77.5%) and male (84.0%). NHW children died at a rate that was 1.3 times greater than expected based on their proportion in the general population and were 2.6 times more likely to die by firearm suicide than non-Hispanic Black (NHB) children. NHB children were less likely to disclose suicide intention, suggesting that this group may require more active screening intervention. Qualitative analysis revealed unsafe firearm storage as a common theme among these deaths. Differences in age with respect to social media use and precipitating factors such as bullying and arguments with parents were also identified as contributing factors. Results of this study support the expansion of interventions such as lethal means restriction counseling and implementation of safer firearm storage laws.

中文翻译：

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美国儿童持枪自杀的差异：2014 年至 2018 年国家暴力死亡报告系统分析

自杀是美国的主要原因，而枪支是主要的自杀方式。本研究调查了 2014 年至 2018 年美国 17 个州儿童持枪自杀的种族差异和不成比例。我们使用国家暴力死亡报告系统按种族/民族和性别量化儿童枪支自杀的负担，并评估了 10 至 17 岁死者的主题。种族差异和比例失调分别使用差异指数和比例失调代表性指数来衡量。死者主要是非西班牙裔白人（NHW，77.5%）和男性（84.0%）。NHW 儿童的死亡率比按其在总人口中所占比例计算的预期高出 1.3 倍，死于枪支自杀的可能性是非西班牙裔黑人 (NHB) 儿童的 2.6 倍。NHB 儿童不太可能透露自杀意图，这表明该群体可能需要更积极的筛查干预。定性分析显示，不安全的枪支储存是这些死亡事件的一个共同主题。社交媒体使用方面的年龄差异以及欺凌和与父母争吵等诱发因素也被认为是促成因素。这项研究的结果支持扩大干预措施，例如致命手段限制咨询和实施更安全的枪支储存法。