Children who survive shootings face huge health barriers, costs, study finds

Oronde McClain was 10 years old when he was hit by a stray bullet on a Philadelphia street corner.

The bullet shattered the back of his head, splitting it into 36 pieces. McClain’s heart stopped and he was technically dead for 2 minutes and 17 seconds.

Although the hospital team revived McClain, he never fully recovered. Doctors removed half of his skull and replaced it with a gel plate, but the shrapnel remained.

The shooting left him in a coma for seven weeks and in a wheelchair for nearly two years. Bullies at school magnified his pain, mocking his speech and the helmet he wore to protect his brain. McClain said he attempted suicide several times as a teenager. He remains partially paralyzed on his right side and suffers from seizures and post-traumatic stress disorder.

“The dead get funerals and balloon releases. The survivors get nothing,” said MacLean, now 33.

However, significant medical needs continue to exist among gun violence survivors and their families.

read more: Most Americans say they or a family member have faced gun violence, survey finds

Child and adolescent survivors were twice as likely as other children to develop a pain disorder in the year after being shot, said Zirui Song, associate professor of health care policy and medicine at Harvard Medical School and co-author of the book “Child and Adolescent Survivors.” twice as much. A new study in Health Affairs. The study found that gunshot survivors aged 19 and younger were 68% more likely than other children to be diagnosed with a mental illness and 144% more likely to develop a substance use disorder.

According to the Centers for Disease Control and Prevention, gunshot wounds were the leading cause of death among people ages 1 to 19 in the United States in 2020 and 2021. In 2022, more than 48,000 Americans of all ages were shot and killed. On average, approximately 85,000 Americans survive gunshot wounds each year.

“The public hears about mass shootings and the number of deaths,” Song said. “Far more people are affected by gun violence than die.”

According to a KFF survey, a majority of Americans say they or a family member have experienced gun violence, including witnessing a shooting, being threatened by a gunman, or being shot.

“We are now a nation of survivors, and we have an unfulfilled obligation to help families and communities heal physically and emotionally,” said Megan Ranney, dean of the Yale School of Public Health.

Medical costs increased by an average of $35,000 for each young person who was shot compared to those who were not shot. The study, based on data from employer-sponsored health insurance plans, shows that the more severe the injury, the greater the cost and extent of medical complications.

watch: New survey shows most young Americans feel unsafe and support stricter gun laws

Although McClain’s mother had health insurance through her employer, the plan did not cover the cost of his wheelchair. Insurance wouldn’t cover the cost of dance or theater classes, which his therapist recommended he take to improve his speech and movement. Although his grandparents helped pay for the medical bills, his family still held fundraisers to cover the additional out-of-pocket expenses.

Laney, who was not involved in the study, said the study is one of the first to assess the impact of child shootings on the entire family.

Parents of children with gunshot wounds have a 30% higher rate of mental illness compared with parents of uninjured children. Their mothers received 75% more mental health checks than other mothers.

Ranney noted that caregivers of shooting survivors often ignore their own needs. In this study, parents and siblings of injured children visited them less frequently for routine medical care, laboratory tests, and surgeries.

Doctors can now save most gunshot victims, said Jessica Beard, a trauma surgeon at Temple University Hospital who was not involved in the study.

“We have more experience dealing with gunshot wounds than even many battlefield surgeons,” said Beard, who is also the research director of the Center for Gun Violence Reporting in Philadelphia. “Surgeons from the military will be stationed in hospitals in Philadelphia to learn how to perform combat surgery.”

Gunshot injury survivors often require ongoing care from physical therapists, occupational therapists, prosthetic manufacturers, and others, which can create additional hardships for rural residents who may need to travel long distances multiple times per week to access professional services. Even in major U.S. cities, the best hospitals and health systems to treat gunshot survivors may be out of reach for families who rely on public transportation.

Using public transportation was especially difficult when McClain was in a wheelchair. He said he felt lucky that his grandfather could drive him to the hospital in the first few years after the shooting. Later, when McClain was able to walk, he took two buses and a subway to the hospital. Today, McClain drives herself to care and receives health insurance through her employer.

Laney said the psychological damage from child shootings may be worse than research suggests. She said negative attitudes surrounding mental illness may prevent some patients from admitting they have depression, so their struggles aren’t documented in doctors’ medical records or payment records. Likewise, children who fear punishment may not tell doctors about illegal drug use.

watch: Many children who survive gun violence face barriers to mental health care

McClain said he only saw a therapist once or twice. “I would scream at the doctor,” McClain said. “I said, ‘Don’t tell me you know how I feel, because you don’t understand.'”

Yet McLean found purpose in his experience.

Last year, he co-produced a documentary called “They Don’t Care About Us, or Do They Care About Us?” ” He works at the Gun Violence Reporting Center in Philadelphia. In the film, young survivors talk about wearing hoodies to hide their scars, traveling the world in a wheelchair and battling infertility caused by their injuries. McClain is now working to improve news coverage of gun violence by creating a directory of shooting survivors willing to share their stories.

“My therapy is helping people,” he said. “Every day I have to wake up and save someone.”

McClain said survivors are the forgotten victims of the national gun violence epidemic. Many people feel abandoned.

“They roll you out of the hospital like you’re living a normal life,” McClain said. “But you never live a normal life. You’re in this club you don’t want to be in.”

KFF Health News is a national newsroom that produces in-depth journalism on health issues and is one of KFF’s core operating programs – an independent source of health policy research, polling and news. Learn more about KFF.

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