A recent University of Iowa study investigating weapon-related injuries and deaths among children in Croatia shows that, following the end of a war, a high rate of firearms injuries and death in children continues at least five years. Corrine Peek-Asa, MPH, PhD, co-lead of the study and a professor of occupational and environmental health at The University of Iowa College of Public Health talks about the study and how it affects us:
What prompted this study on war’s impact of firearms injuries to children?
It’s housed in a larger ongoing training project that is a partnership between The University of Iowa and the central and southern European countries. This is one of 12 programs funded by the National Institutes of Health. The goals are to build training and infrastructure in trauma response and injury prevention activities.
We work with all the former countries of Yugoslavia, where there has been political unrest throughout their history, most notably the recent third Balkan War that has impacted the citizens’ health and well-being. We don’t know much about the long-term affects of war on injuries and injury deaths. We were interested in trying to measure some of these deaths, especially focusing on children.
As we began to look at the direct war death on children, we saw that there were also a lot of injuries to children from weapons that were not related to the war—homicides, suicides, and unintentional weapons related injuries. Because we noted so many, we were interested in following up on a hypothesis and measuring how those were playing out.
What statistics did you look at as part of the study?
We first examined mortality files, which was a challenge because Croatia does not have a computerized death certificate system. We looked at individual reports which have details about the cause and manner of death, as well as the age and other information about the decedent. We also used population statistics to measure deaths per population. Those were a challenge because during the war, and even after the war, there were large out fluxes of Croatian citizens accompanied by large influxes of refugees. It was very difficult to track the population and we do have some uncertainty in those numbers.
What were the findings of the study?
We found that during the war, 17 percent of all childhood injury deaths were due to operations of war, and those were children who were civilians, not active soldiers. We thought that was high and it shows that the war did affect the citizenry in a very large way.
We found that for the five years following the war, childhood weapon-related homicides and suicides increased more than three-fold, and unintentional weapon-related deaths increased by more than six-fold. These rates stayed high for at least five years after the war and didn’t start going down until seven to 10 years after the war. We think that some of those decreases were due to some aggressive governmental campaigns to buy weapons back and educate the citizens about gun safety.
Were there any surprises in the documentation?
The first surprise was the level of increases we found and how long they persisted after the war. People’s daily lives returned to normal fairly quickly, but they were still affected by the types of arms that were now available but hadn’t been before. The second thing that really struck us was these were deaths were primarily due to small arms, even though Croatia had the second largest number of land mines per square meter in the world–second only to Cambodia.
Do those findings relate to every child no matter where they live?
All children need a safe environment in order to thrive. This study has primary importance:
- For children who live in areas where there is political unrest, which is a considerable portion of the world
- Where violence-prevention efforts need to expand beyond those that focus specifically on the political unrest
- To integrate child maltreatment prevention, interpersonal violence prevention, and suicide prevention, with a focus on all of these on children’s mental health
What are the next steps in this research?
We have a large infrastructure that we’re building, working with these countries. We have several ongoing studies. One is a project to educate pediatricians in Croatia about childhood injury prevention in general, but also with a focus on violence prevention. We also have a large study going on in Serbia looking at the effects of the war and especially on NATO sanctions on roadway infrastructures and how this affects road traffic injuries, which are the leading cause of injury death throughout the world. |
