A study looking at nearly two decades of data shows firearm-related injuries have surpassed motor vehicle collisions as the leading cause of death for U.S. youths ages 0-19.
The data also reveal widening racial inequities, with Black youths disproportionately affected by firearm violence.
Researchers analyzed firearm injury mortality data compiled by the Centers for Disease Control and Prevention’s Web-based Injury Statistics Query and Reporting System between 2001 and 2019. They reported their findings in “Pediatric Firearm Injury Mortality Epidemiology,” (Andrews AL, et al. Pediatrics. Feb. 28, 2022, https://doi.org/10.1542/peds.2021-052739).
Overall, approximately 60% of youth deaths from firearm injuries are homicides, 35% are suicides and 4% are due to unintentional injuries.
In 2019, Black youths had a firearm mortality rate 4.3 times higher than that of White youths and a firearm homicide rate over 14 times higher than that of White youths.
Although firearm injury was the second-leading cause of death for all youths in 2016, it was the leading cause of death for Black youths and has been since at least 2001. Non-Hispanic Black youths have a higher rate of firearm-related homicide deaths when compared to their White, Hispanic, American Indian and Asian American peers.
“There is no biologic plausibility for these disparities but rather they are a reflection of racist systems and policies that perpetuate inequities in violent injuries and death,” the authors wrote.
Overall, firearm injury mortality increased during the study period from 3.63 per 100,000 in 2001 to 4.15 per 100,000 in 2019. During the same period, motor vehicle crash deaths among youths decreased from 9.08 to 3.99 per 100,000.
From 2001-’19, the firearm homicide rate among youths increased from 2.19 to 2.48 per 100,000, and the suicide rate increased from 2.24 to 2.79 per 100,000. The firearm suicide mortality rate was higher among non-Hispanic White children, increasing from 2.74 to 3.69 per 100,000. At least one-third of firearm deaths are due to suicide in youths ages 10-19 years.
Meanwhile, the unintentional firearm mortality rate decreased from 0.22 to 0.14 per 100,000 during the study period. Unintentional injury represents a large portion of deaths in youths ages 0-4 years, and the proportion decreases as youths get older.
U.S. youths also have a higher risk of dying from firearm injury than their peers in other countries. In 2015, the U.S. accounted for over 90% of all firearm deaths among children ages 0-14 years in high-income countries.
The AAP recommends families do not keep guns in their home. Those who do have a gun should keep it locked and unloaded with ammunition locked separately.
The study authors said physician counseling on secure storage of guns is part of a comprehensive public health approach needed to combat gun-related deaths among youths. Other strategies include hospital-based violence intervention programs, community engagement and legislative advocacy.
“Evidence-based solutions exist, and pediatric healthcare providers are poised to contribute meaningfully to a comprehensive public health approach to reducing these preventable deaths,” the authors concluded.