In the United States, gunshot wounds hospitalize about twenty children every day. Twenty children a day. That’s unacceptable.

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According to a new study based hospital records from 2009 (the most recent year for which records are available) indicate that firearms sent about 7,391 children younger than 20 to the hospital. Of these injured, 453 died.

More than half of the injuries involved an attack on the child, but almost one-third were unintentional. (Others were from suicide attempts or of undetermined causes.) Three out of four hospitalizations of kids younger than 10 were the result of accidental injuries.

“Some of these are school shootings, some are gang-related, some are related to fights or disagreements,” said Dr. John Leventhal, lead study author. “They all relate to access to guns.”

Boys are far more likely to suffer a gunshot wound, with nine out of ten cases involving male patients. The gunshot hospitalization rate for African-American boys is more than ten times that of Caucasian boys.

The authors of the study say parents should follow the American Academy of Pediatrics’ recommendation: the safest home for a family is a home without guns. Co-author Dr. Robert Sege, a pediatrician and director of the division of family and child advocacy at Boston Medical Center, added, “If there is a gun in the home, the gun should be stored unloaded and locked, and the ammunition should be stored separately.”

Dr. Georges Benjamin, executive director of the American Public Health Association, said, “We’ve made cars much, much safer without outlawing cars. A comprehensive strategy which makes firearms safer and people safer with their firearms would dramatically reduce firearm deaths and injuries.”