Discussions of guns in the home part of comprehensive preventive health care

This June, a law took effect in the state of Florida limiting physicians' ability to ask patients about firearm ownership. In September, a federal judge granted a preliminary injunction preventing enforcement of the law, citing that the law impeded doctors' Constitutional right to freedom of speech. An article to be published online Nov. 10 in the American Journal of Preventive Medicine reviews research about and analyzes available data around firearm injuries and prevention, and argues the importance of including firearm safety as part of physician-patient preventive care conversations.

"The role of the physician is to treat, and help prevent, injuries and disease that can occur from behaviors or environment," said Eric Fleegler, MD, MPH, of the Division of Emergency Medicine at Children's Hospital Boston and lead author of the paper. "We ask about gun ownership for the same reasons we ask about infant sleeping positions, car seats, pools, drugs, alcohol and tobacco. It is our responsibility to understand possible health risks and provide appropriate information to help patients make decisions to keep themselves and their families safe."

Research reviewed and data analyzed and presented by the authors found in part that:

• 35 percent of homes with kids report owning a firearm, representing more than 22 million children.
• 43 percent of these homes had at least one unlocked firearm.
• 13 percent kept firearms in a manner accessible and dangerous to children.
• A goal of Healthy People 2010, a U.S. government initiative, targeted reducing firearm fatality rates to 4.9 per 100,000. In 2007, the average was 10.4 per 100,000, more than double the goal, and the researchers found that only four out of the 50 states fell below this rate.

Research shows the practice of physicians asking about guns in the home, and process of relaying advice via conversations, is meaningful to parents. 90 percent of parents surveyed in one study said they would tell their child's doctor if they kept a gun in the home while 75 percent of gun owners said they would take a pediatrician's advice to keep guns locked and unloaded.

"Preventive care is meant to be collaborative and supportive," said Fleegler. "Discussions should be non-judgmental and cover the broad gamut - but the key is in order to adequately address health risks, we have to be able to talk."