Guns Became Leading Cause of Death for U.S. Children and Teens in 2020

Published: April 25, 2022

Guns killed more U.S. children and teens in 2020 than vehicle crashes, drug overdoses, or cancer, according to a research letter published Wednesday in the New England Journal of Medicine.

Researchers from the University of Michigan’s (U-M) Institute for Firearm Injury Prevention (IFIP) analyzed updated official mortality data from the Centers for Disease Control and Prevention (CDC) and found more than 4,300 people ages 1-19 died of firearm-related injuries in 2020 — a 29.5% increase from 2019 and more than twice as high as the relative increase in the general population. These deaths include incidents of suicide, accidental shootings and homicides.

Firearm-related deaths among all Americans were up 13.5%, totaling 45,222 deaths. This change was largely driven by firearm homicides, which saw a 33.4% increase. Homicides made up the majority of firearm deaths among children and teens, and most who were killed by firearms were 14 and older.

A study published in February found gun ownership increased during the pandemic, according to NBC News. As a result, more than five million children under 18 became newly exposed to guns in their households from Jan. 2019 to April 2021.

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Jason Goldstick, a research associate professor at U-M and co-author of the letter, said the CDC’s mortality data does not encapsulate the full scale of gun violence among kids and teens.

“For every fatal firearm injury, there’s a bunch of nonfatal firearm injuries,” he said. “There’s not really great data on nonfatal shootings in the U.S.”

Figure 1. Leading Causes of Death among Children and Adolescents in the United States, 1999 through 2020. (Source: University of Michigan)

Drug overdoses and poisoning also increased by 83.6% among children and adolescents, becoming the third leading cause of death. The rates of other leading causes of death have remained relatively stable since the previous analysis, says the letter, which “suggests that changes in mortality trends among children and adolescents during the early Covid-19 pandemic were specific to firearm-related injuries and drug poisoning.” COVID accounted for 0.2 deaths per 100,000 children and adolescents in 2020.

The number of car-related deaths — the former leading cause of death among children and teens — has dropped drastically over the last 20 years. Patrick Carter, associate professor of emergency medicine at U-M and co-author of the letter, said motor vehicle deaths have fallen due to car safety improvements and research that documents ways to make highways safer despite an increase in cars on the road, USA Today reports.

“Changing behavior, improving the safety of the vehicle, improving the roads and educating our drivers better — that’s all through evidence-based-driven research,” Carter said. “What we have seen with firearms is that we haven’t been able to — until just recently — apply that same type of evidence-based research to the problem of firearms.”

“Injury prevention science played a crucial role in reducing automobile deaths without taking cars off the road, and we have a real opportunity here to generate a similar impact for reducing firearm deaths through the application of rigorous injury prevention science,” Goldstick echoed.

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