This Sunday, March 29, 2015, file photo provided by the Jefferson Police Department shows a gun involved in the accidental shooting of a 3-year-old in Jefferson, Ga. Shootings kill or injure at least 19 U.S. children each day, with boys, teenagers and blacks most at risk, according to a government study that paints a bleak portrait of persistent violence. Jefferson Police Department via Associated Press

Today, the American Academy of Pediatrics released a study that will be in the July issue of “Pediatrics” and its recommendations in response to the study. The “Childhood Firearm Injuries in the United States” is the largest study to look at the number of gun-related injuries and death in children and adolescents. It looked at numbers from National Vital Statistics System, the  National Electronic Injury Surveillance System and the National Violent Death Reporting System.

Here’s what it found:

On average 1,297 children a year die in the U.S. from gunshot wounds and 5,790 are treated for a gunshot wound. Death from a firearm is the third leading cause of death for children in the U.S. behind illness/congenital defect and motor vehicle injury. 53 percent of gun deaths in children were homicides, 38 percent were suicides, 6 percent were unintentional deaths, 3 percent were due to legal intervention or undetermined intent. Homicides deaths by firearms in children have declined but suicide deaths are on the rise. 4.2 percent of children ages 0 to 17 in the United States have witnessed a shooting in the past year. 82 percent of children killed by guns were boys. Children 13-17 years old had a 12 times higher rate of being killed by a firearm than children 12 and younger. Race mattered: The annual firearm homicide rate for African American children (3.5 per 100,000) was nearly twice as high as the rate for American Indian children (2.2 per 100,000), 4 times higher than the rate for Hispanic children (0.8 per 100,000), and ~10 times higher than the rate for white children and Asian American children (each 0.4 per 100,000). Suicide rate was highest for white and American Indian children (each 2.2 per 100,000): almost four times the amount for  African American (0.6 per 100,000) and Hispanic (0.5 per 100,000) children and over 5 times the rate for Asian American children (0.4 per 100,000). The rate of unintentional firearm deaths for African American children was twice as high (0.2 per 100?000) as the rate for white children (0.1 per 100,000) and 4 times the rate for Hispanic children (0.05 per 100,000). Southern states and parts of the Midwest had the highest rate of firearm homicides among children. Firearm suicides are more evenly distributed among states, but higher in Western states. In younger children, homicides often happen in a multivictim scenario and by family conflict. Older children were more likely to die from crime and violence. A shooter playing with the gun was the most common reason for an unintentional firearm death for all age children. Of children who committed suicide by firearm, 60 percent used a handgun, 42 percent had a crisis in the past, 71 percent had relationship problems, 34 percent were depressed, 26 percent had a clinically diagnosed mental health problem, 18 percent were receiving mental health treatment and 26 percent disclosed their intent to die by suicide to someone. Most spent 10 minutes or less thinking about it before they did it.

What are pediatricians supposed to do with all this information? And what are parents supposed to do?

Dr. Eliot W. Nelson of the University of Vermont wrote the academy’s response recommendations for its physicians:

Ask parents if there are guns in their house. Do not get in a debated about their rights to have a gun. Talk about safe storage practices such as a gun safe and lock, storing guns unloaded and storing bullets separately.