What evidence exists on the effectiveness of child access prevention and safe‑storage laws in reducing pediatric firearm deaths?
Executive summary
A substantial body of peer-reviewed research and major policy reviews conclude that child access prevention (CAP) and safe‑storage laws are associated with reductions in pediatric firearm injuries and deaths, with stronger laws generally showing larger effects [1] [2]. However, heterogeneity in law language, study design, and potential confounders means the evidence is associative rather than uniformly causal, and important caveats remain [3] [2].
1. What the studies collectively show: association, not simple causation
Multiple reviews and multi‑decade analyses report that the presence of CAP or safe‑storage laws correlates with fewer pediatric firearm fatalities and nonfatal injuries: a 2024 rapid review found 79% of qualifying studies showed decreases and none showed increases associated with CAP laws [1], and RAND’s synthesis identified several state‑time fixed‑effects studies linking CAP laws to reduced unintentional injuries or deaths [2]. Large empirical studies across decades (1991–2016 and similar windows) report statistically significant relative reductions in child firearm fatalities where more stringent CAP laws exist [4] [5].
2. How big the effect tends to be
Quantitative estimates vary by study and outcome, but pooled and individual analyses commonly report meaningful reductions: one synthesis put decreases in pediatric firearm deaths in the range of roughly 8%–19% for safe‑storage CAP laws [6], while the JAMA Pediatrics analysis attributed substantial fractions of pediatric firearm deaths to the absence of strict CAP laws—for example, estimating that absence of the most stringent laws was associated with reductions in unintentional deaths by a population attributable fraction consistent with large relative reductions [4].
3. Why policymakers expect CAP laws to work — plausible mechanisms
Researchers point to clear behavioral mechanisms: children often know where household firearms are stored and frequently handle unsecured guns, and nearly 90% of unintentional pediatric firearm deaths occur in the home typically involving unsecured, loaded firearms—so laws that incentivize locked/unloaded storage plausibly reduce opportunities for accidental shootings and impulsive suicides [4] [3]. RAND and law‑review work note that laws change the legal and social environment, potentially shifting storage behavior even when direct enforcement is limited [2] [7].
4. Law language and enforcement matter — stringency correlates with effect
Not all CAP laws are the same: “reckless provision” laws that only criminalize directly giving a gun to a minor are weaker than negligent‑storage provisions holding owners liable when a child could access a weapon, and studies repeatedly find greater effectiveness for stricter statutes including felony options or explicit safe‑storage mandates [8] [7] [9]. The rapid review and other analyses emphasize that magnitude of effect is proportional to CAP law stringency [1] [8].
5. Who benefits most — disparities and targeted findings
Some analyses indicate differential benefits across demographic groups and contexts: research from 2015–2019 found states with the strongest CAP laws had lower firearm death rates among Black children under 19, suggesting CAP laws can reduce inequities in pediatric firearm mortality when robustly implemented [10]. Still, heterogeneity across states and interactions with broader gun‑policy strength matters: studies find stricter overall gun laws correlate with dramatically lower all‑intent pediatric death rates as a group [11].
6. Limits, uncertainties, and critiques of the evidence
Despite consistent associations, researchers caution about methodological issues: variation in legislative language, limited data on enforcement and compliance, potential residual confounding (poverty, overall crime, cultural factors), and a reliance on observational designs mean causality cannot be claimed with absolute certainty [3] [2]. Some older or single studies raise concerns about bias or weak methods, prompting re‑ratings in systematic reviews [2]. Moreover, reductions in some intents (unintentional, suicide) are clearer than for homicides, where associations are less consistent [12].
7. Practical takeaways for policy and research
The preponderance of evidence supports CAP and safe‑storage statutes as an effective component of a broader strategy to reduce pediatric firearm deaths, particularly when laws are specific about negligent storage and paired with education and enforcement; stronger laws are associated with larger reductions [1] [4]. Still, continued investment in better data, randomized or quasi‑experimental evaluations of implementation, and attention to equity and enforcement patterns is required to move from association to firmer causal inference and to optimize which legal language and complementary programs work best [2] [3].