Recent research from a team headed by HCP’s Associate Professor of Health Care Policy and Medicine Zirui Song, Professor of Health Care Policy Jose Zubizarreta, Director of Analysis Mia Giuriato, and collaborators Dr. Katherine Koh, Assistant Professor of Psychiatry, and Dr. Chana Sacks, co-director of the Gun Violence Prevention Center at Massachusetts General Hospital has captured nationwide attention. Their new study in Health Affairs builds on their previous work on the repercussions of gun violence on survivors and family members.

As stated by Song in KFF: “The public typically hears about mass shootings and the people who died.” But despite the tragedy of overwhelming numbers of deaths, “the population of people affected by firearm violence is much larger than deaths alone.” This includes survivors—two to three times as many as decedents—and their family members.

The team’s recent paper measures the clinical and economic impact of nonfatal firearm injuries in children and adolescents. It finds that survivors experience a 68% increase in psychiatric disorders, 144% increase in substance use disorders, and 117% increase in pain disorders in the year following injury, with the surge in health care needs fueling a $35,000 per person—or 17-fold—increase in health care spending, mostly paid by employers ultimately through wages.

In addition to youth survivors, the study takes a deep dive into the lasting repercussions of the injuries on their mothers, fathers, and siblings. It found a 30% increase in psychiatric disorders among parents of survivors with a 75% increase in mental health visits among mothers, along with mothers and siblings experiencing a reduction in their routine medical care, potentially an important crowd-out effect.

Finally, the study also provides new evidence on what happens to family members when kids died from gunshots. These fatal firearm injuries led to a much larger 2- to 5-fold increase in psychiatric disorders among parents and siblings, with a 15- to 87-fold increase in mental health visits among parents. 

Song expressed in a recent NY Times article: “Gunshot survivors and their families often experience long-lasting, invisible injuries, including psychological and substance use disorders with roots in the shared trauma they have experienced.”

Since 2020, firearms have become the leading cause of death among children and teens in the United States. The Health Affairs study highlights the profound ripple effect of these injuries on families and emphasizes that the impact is especially pronounced when the victim is a child.

For the clinical and policy communities, the study highlights the importance of the health care system recognizing and supporting families that experience gun-related trauma, given the significantly heightened risk they face for various health conditions following such events. For example, it emphasizes the important role medical professionals play in providing culturally competent, trauma-informed care for survivors and family members, even those who may not be inclined to initially engage with their usual clinicians. Counseling for practicing safe firearm storage and prevention is also key. Overall, the study emphasizes the crucial need for support, preventative measures, and more proactive care to mitigate the aftermath of such tragedies to families. Most Americans now say they or a family member has experienced gun violence.

The team’s research continues to be published by major media sources. Since the study first appeared in early November, Song and colleagues have been cited in the Boston Globe, NY Times, CNN, NBC News, Scientific American, TIME Magazine, and US News, among others.