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Journal Issue: Children, Youth, and Gun Violence Volume 12 Number 2 Summer/Fall 2002

Children, Youth, and Gun Violence: Analysis and Recommendations
Kathleen Reich Patti L. Culross Richard E. Behrman

The Economic and Psychological Toll of Youth Gun Violence

In addition to the human toll, gun violence among young people imposes significant financial and psychological costs on society. For children and youth, these costs can be especially high; those exposed to gun violence are at risk for significant and lasting psychological effects. Moreover, children do not have to be injured themselves to experience these negative effects. Exposure to gun violence at home, at school, in the community, or through the media all can cause harm.

Economic Costs

The most obvious economic costs associated with gun violence in the general population are health-related, in the form of increased medical costs due to injury and death. Other economic costs include those associated with strengthening law enforcement to combat gun crime, and prosecuting and incarcerating gun offenders.

Together, these costs total an estimated $4 billion to $5 billion annually.46 However, the article by Cook and Ludwig in this journal issue notes that these costs account for only a small share of the total costs of gun violence to society. Other, less tangible costs related to gun violence—such as higher taxes to ensure public safety, higher housing costs as families move to areas that are perceived as safe from gun violence, and the psychological costs associated with fear—make up most of the costs of gun violence.

Such costs affect not only the families of gun violence victims, but all Americans, through increased taxes, decreased property values, limits on choices about where to live and work, and concerns about safety, particularly children's safety. These intangible costs can be difficult to quantify, but Cook and Ludwig argue that the costs of gun violence can be considered equivalent to the value that people place on safety from gun violence. Therefore, they estimate the costs of gun violence by assessing how much Americans would be willing to pay to reduce or eliminate gun violence from their lives.

A 1998 national survey that asked people about their willingness to pay for policy interventions to reduce gun violence found that the average American household was willing to pay $239 a year to reduce the threat of gun violence in its state by 30%. Based on these answers, Cook and Ludwig estimate that the total annual cost of gun violence in the United States is $100 billion, of which $15 billion is attributable to costs associated with gun violence against children and youth.

Psychological Costs

Just as the economic costs of gun violence are substantial, so are the psychological costs. Children exposed to gun violence, whether they are victims, perpetrators, or witnesses, can experience negative psychological effects over the short and long terms. Psychological trauma also is common among children who are exposed to high levels of violence in their communities or through the media. The article by Garbarino, Bradshaw, and Vorrasi in this journal issue details common effects associated with exposure to gun violence, including sleep disturbance, anger, withdrawal, posttraumatic stress, poor school performance, lower career aspirations, increased delinquency, risky sexual behaviors, substance abuse, and desensitization to violence. All of these effects can make children and youth more prone to violence themselves, feeding a continuing cycle of violence within some families, peer groups, and communities.

Arguably, every child in the United States is exposed to gun violence through media coverage of shootings, films and television shows, and violent video games that allow young people to shoot lifelike targets on the screen. More than 1,000 studies have documented a link between violent media and aggressive behavior. Children exposed to media violence have been shown in experimental studies to become more aggressive, to view more favorably the use of aggression to resolve conflicts, to become desensitized to violence, and to develop a belief that the world around them is a frightening place.47

However, the children and youth at highest risk for psychological trauma from gun violence are those exposed to it directly: children who are injured, who witness gun violence at close proximity, or who are exposed to high levels of gun violence in their homes, schools, or communities.48 School and community violence are particularly worrisome because they can affect large numbers of children at one time.

A December 2001 study of 119 African American seven-year-olds living in inner-city Philadelphia, for example, found that three-quarters had heard gunfire, one-third had seen someone shot, and one-tenth had someone in their own family or household who had been shot or stabbed. Among children in the study, exposure to higher levels of violence was correlated with more anxiety, greater likelihood of depression, lower self-esteem, lower grade point average, and more absences from school. More than 60% of the children worried that they might be killed or die, and 19% sometimes wished they were dead.49

Despite widespread recognition of the psychological costs to children and youth associated with gun violence, physicians and mental health professionals have been slow to develop treatments that help young people cope with gun-related trauma. Even children and youth who are injured often go without psychological help. One group of doctors has observed, “When patients present with suicide attempts, evaluation for future risk and follow-up treatment are considered standard practice. However, individuals treated for violent injuries generally receive no further evaluation.”50

Government, schools, and health care practitioners should work together to ensure that children and youth who are exposed to gun violence get the psychological help they need. Two examples of innovative programs discussed in this journal issue include a pioneering project developed at the University of California, Los Angeles, that provides school-based group therapy for adolescents who have sustained or witnessed violent injury,48 and a collaboration between the New Haven Police Department and Yale University School of Medicine to train police officers in how to deal with children who are victimized by or witnesses to violence.51 Additional programs are needed to help youth overcome gun-related psychological trauma, especially because treating traumatized young people may make them less prone to violent acts in the future.


Policymakers, mental health professionals, and educators should develop, implement, and evaluate treatment programs that help youth exposed to gun violence cope with trauma.