NASHVILLE, Tenn. (WKRN) — Recent data from the Centers for Disease Control and Prevention (CDC) shows that the number of children killed by gunfire increased 50% between 2019 and 2021, but in Tennessee, pediatricians have been seeing that number rise for much longer.

“We haven’t just been seeing this for a couple of years. Our increase has been over the past decade,” said Dr. Kelsey Gastineau, MD FAAP, pediatric hospitalist at Monroe Carell Jr. Children’s Hospital at Vanderbilt in Nashville.

Each year in Tennessee just over 100 kids are killed by gunfire, and Gastineau said at least three times that number are injured. While the American Academy of Pediatrics has been sounding the alarm for years, Gastineau said the problem has only continued to grow.

“That number is only going up every single year,” she said of child gun deaths in Tennessee. “Looking at the data, it’s doubled since 2010, which is the most startling statistic. This is the first time we’ve seen mortality not go down for children, but rather has been increasing.”

Nationwide, the number of gun deaths among children and teens under the age of 18 is in the thousands. According to a Pew Research Center analysis of the latest annual morality statistics from the CDC, child gun deaths rose from 1,732 in 2019 to 2,590 in 2021.

The number of children and teens killed by gunfire in 2021 was higher than at any point since at least 1999. Homicide was the leading cause of child gun deaths that year at about 60%. It was followed by suicide at 32% and accidents at 5%.

Mass shootings account for only about 1% of child gun deaths in the United States. Gastineau said that national data mirrors what pediatricians have seen in Tennessee and at Monroe Carell, with many homicides linked to community violence.

Monroe Carell primarily treats patients from Middle Tennessee, but sometimes also has patients from other parts of the state and across state borders.

“I became a pediatrician because I wanted to help kids grow and learn and develop,” Gastineau said. “But it was in my training that I realized part of that was going to be firearm injuries because I kept seeing it over and over again.”

Gun injuries occur among every single age group of children, but Gastineau said the primary cause tends to vary by age. In the youngest age group, unintentional injuries are seen at a much higher percentage. However, it starts to shift when children reach school age.

“Unintentional injuries are still there but that’s when we start to see kids die from suicide and homicide,” said Gastineau, who added that the age group with the “highest rising firearm-related suicides is 10 to 14.”

Gastineau said some people have pointed to the COVID-19 pandemic as a potential cause. In 2020, guns overtook car crashes as the leading cause of death among the nation’s children, and Gastineau said the trauma center at Monroe Carell did see a spike while kids were at home.

However, based on a recent study in the Journal of the American Medical Association, she said the cause doesn’t boil down to “one singular issue.” Rather, Gastineau said there are “dual crises” impacting youth in Tennessee and across the nation.

“We as pediatricians are seeing more and more firearm injuries coming in,” she said. “But we’re also seeing more and more children with mental health crises coming into our outpatient clinics, our emergency departments and in our hospitals, and those things are absolutely linked.”

Another common thread appears to be “easy access” to unsecured firearms, Gastineau said. Previous research has shown that when firearms are securely stored the risk of death from unintentional injury is reduced by 85% and death due to suicide is reduced by 78%.

“We know that 30 million children across the country are in homes with firearms, and here in Tennessee one in two households with kids have firearms,” Gastineau said. “So, this is a big deal, and we really need to be talking about it.”

In Fall of 2022, Vanderbilt’s Center for Child Health Policy polled more than 1,000 Tennessee parents about the storage of firearms and firearm-related school safety measures.

More than 87% agreed that “a gun should be stored securely in a lock box or safe,” and more than 78% agreed that “a gun should be stored securely with a cable lock or trigger lock.”

Another 83% of Tennessee parents agreed that schools are safer if one or more school resource officers work in the school and 71% agreed that schools would be safer if background checks were expanded to all gun sales. Only 35% agreed that schools are safer if teachers are armed.

“Every single instance of gun violence for a child impacts their ability to grow, to learn and to develop,” Gastineau said. “So, pediatricians, parents, schoolteachers, everyone knows that there are common sense solutions and now is the time to start enacting them.”