“My best friend was murdered while we were walking home from school.”

The once lively thirteen-year-old boy now slumped in the chair across from me, his words spilling out with newfound heaviness. As I looked at him during what was supposed to be a routine well-child check, I couldn’t shake the air of depression that suddenly choked the room. In the months that followed, I received a call from his school: he had become an absentee student, his once-cherished passion for sports forsaken for marijuana. The vibrant youngster I had cared for had been consumed by the aftershocks of trauma—a shadow of his former self.

As the summer winds down and the excitement of a new school year approaches, the goal of parents and pediatricians alike is to get happy and healthy kids in school. While the anticipation of starting a new school year usually brings joy, the looming reality of gun violence and school shootings has weighed heavily on my mind as a pediatrician. The recent tragic shooting of a faculty member at the University of North Carolina at Chapel Hill (UNC) on Monday, August 28, 2023, serves as a haunting reminder that going back to school does not mean going back to safety.

As pediatricians, we often ask our patients and families, “What are your concerns today?” to focus the visit. But what do you do when their concern is wanting to feel safe from gun violence in their schools and neighborhoods? Gun violence, as seen in my own patient, has psychological, physical, academic, economic, and community-level impacts. The very places that should be safe havens for learning and growth have become grounds for fear and anxiety.

According to the Centers for Disease Control and Prevention’s (CDC) 2022 provisional data, guns remain the leading cause of death for US children and teens (ages 1 to 19). In fact, the gun death rate among children and teens has increased by 87% over the past decade (2013-2022) with a total of 4,590 deaths in 2022. The CDC has also noted that there is a disproportionate impact of gun violence on children of color. Specifically, Black children and teens were 20 times more likely, while Hispanic/Latino children and teens were four times more likely, to die by firearm homicide compared to their White counterparts. Similarly, 2023 data from The Washington Post revealed that children of color face a heightened risk of school gun violence—Hispanic and Black students are two and three times more likely than White students. These alarming statistics underscore the fact that gun violence is a public health problem that has significant impacts on morbidity and mortality for children and their communities across the country. It also highlights the importance of addressing gun legislation and public health interventions from a health equity perspective.

As the nation grapples with the unsettling recurrence of school shootings and gun violence, pediatricians stand on the front lines straddling the realms of medicine and advocacy. Our country requires decisive action and policies to prevent gun violence in all forms. On an individual provider level, it is essential to counsel patients on gun safety and incorporate conversations on firearms into history-taking and visits. On a larger scale, it is important to advocate for passing stricter gun control policies. Policies like more robust background checks, the expansion of extreme risk protection orders (ERPOs), policies that would allow jurisdictions to temporarily remove firearms from individuals at risk of harming themselves or others, and restrictions on the sale of assault weapons and high-capacity magazines. These policy changes can help make schools and communities safer for kids—for all.

Every day, I ask kids what they want to be when they get older and what they are excited about going into third grade or eighth grade or college—but what do children have to look forward to when policies don’t change to protect them? Our children deserve better. Going back to school shouldn’t evoke fear.

I am a pediatrician who hopes that kids will one day be safe to go back to school—and get home safely.

Tasia Isbell is a medical resident.