Just as new data shows that gun violence has surpassed car crashes as the leading cause of death among U.S. youth, one study says gun intervention programs should focus on younger children — especially in rural areas.

Researchers at the University of Washington this month published their research into handgun use among children and young adults in rural areas. They surveyed more than 2,000 young people in seven states, including Oregon and Washington, from the age of 12 to 26.

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The study reveals differences in urban and rural handgun culture among children and young adults. Among those differences, they found that handgun use was higher among rural participants than those surveyed in urban studies. They also found handgun use began at a younger age for rural youth, and it tended to increase with age.

And while these rural participants showed higher rates of formal gun safety training, the study notes that rates of firearm suicide are significantly higher in rural areas than in urban areas.

Lead author Ali Rowhani-Rahbar, a professor of epidemiology at the University of Washington School of Public Health, told OPB’s Think Out Loud that these findings illustrate the need to develop gun violence prevention strategies that are specific to rural culture.

“There are some programs out there, but many of them are geared towards urban settings,” Rowhani-Rahbar said.

Almost all existing interventions, the study notes, focus on factors associated with crime, a framework that may not apply to all or even most youths in rural settings. Since handgun use tends to begin earlier among rural children, it suggests having intervention programs geared toward younger ages in rural areas.

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“The focus should be on when and how to intervene, because there are inflection points throughout somebody’s life in the course of development where you need to intervene to prevent the risk of harm,” Rowhani-Rahbar said.

This study primarily focused on how often participants carried handguns; Rowhani-Rahbar said their next step is to dig into the “why” behind handgun use.

“We are in the process right now of conducting more focus groups and interviews and conversations with youth and young adults to really understand better the context in which this behavior occurs,” he said.

Rowhani-Rahbar began his career as a vaccine epidemiologist, but he changed his academic focus after the 2012 mass shooting at Sandy Hook Elementary School in Newtown, Connecticut.

“After Sandy Hook, I felt as a public health risk scholar and a researcher, I should probably spend some time on this, and the rest of it really is history,” he said. “But when I started, the landscape was grim in that there were not lots of funding opportunities to really do this type of work.”

Despite high levels of gun violence in the U.S. compared to other developed countries, gun violence research was limited for nearly two decades by a federal provision called the Dickey Amendment.

In 1996, the amendment mandated that “none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control,” a mandate pushed by the National Rifle Association. Until about 2015, the CDC interpreted the amendment as a total prohibition of using government funds to research gun violence — so it avoided the research altogether.

As a result, there are few long-term studies into why and how different communities in the United States use guns, and what could be contributing to the country’s gun violence.

The CDC’s most recent mortality data shows that there were 45,222 firearm-related deaths in 2020 — a new peak, and a 14% increase from the year before. The increase was mostly driven by homicides, which rose by a staggering 34% from the previous year.

Locally, the Portland metro area has seen a drastic increase in homicides and shootings. Portland counted 91 homicides in 2021, breaking a record set in 1987, and Portland shootings have tripled since 2019.

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