Research In Action

Injuries have long been the leading cause of death for youth in the United States, surpassing all other causes combined. While motor vehicle crashes (MVCs) were historically the leading cause, firearm-related deaths overtook MVCs as a leading cause of death in 2019. Non-Hispanic Black children, in particular, experience higher rates of firearm-related fatalities. However, looking at overall rates doesn’t fully reveal which populations are most affected by specific types of injuries and their causes. Understanding the mechanisms behind these injuries requires a deeper look at demographic factors such as age, sex, race, and ethnicity. 

A study published in JAMA Pediatrics last month aimed to examine trends in firearm and MVC fatalities over time, with a focus on mechanisms and at-risk populations. 

What They Did

This cross-sectional study analyzed firearm and MVC fatalities among U.S. children and youth aged 0 to 19 years from 2011 to 2021. Data from the Centers for Disease Control and Prevention’s Web-Based Injury Statistics Query and Reporting System was used to analyze death rates caused by firearms and MVCs stratified by demographic factors (age, sex, race, ethnicity) and intent of injury (e.g., homicide, suicide, unintentional). 

What They Found

Overall, trends in firearm related deaths significantly rose from 2011-2021, particularly between 2018-2021. Deaths from MVCs did not rise significantly during the study period, though there was an increase in 2020 and 2021.

Firearm Related Deaths: Homicide

• Firearm homicides among children and youth aged 0-19 years increased by 87.0% from 2011 (1.99 per 100,000) to 2021 (3.72 per 100,000).
• Fatalities occurred most frequently among 15-19 year olds.
• Black males had the highest firearm homicide rates, with a significant annual percent change (APC) of 33% since 2018. 
• Black females had a 45% APC from 2019-2021.
• Hispanic males had overall lower rates comparatively but showed a notable APC of 22% from 2018-2021.

Firearm Related Deaths: Suicide

• Suicide by firearms rose 68% from 2011 to 2021, and among youth 10-19 years, firearm deaths increased across all racial and ethnic groups over time.
• Black females had the highest APC increase in firearm suicide rates- 22.0% from 2016 to 2021.
• American Indian or Alaska Native (AI/AN) males had the highest overall firearm suicide rates in 2020 (24.29 per 100,000 among 15-19-year-olds).
• Asian, Hawaiian Native, and Pacific Islander males had the greatest APC of 15.6% from 2012 to 2017.
• The relative firearm suicide rate for Black males aged 15-19 years nearly tripled from 2011 to 2021.

Unintentional Firearm Shooting Fatalities

• The study reported a 24% relative increase in unintentional firearm shooting fatalities during the study period.
• Black males experienced a more than 200% relative increase in fatalities.

Motor Vehicle Collision Fatalities

• MVC fatalities decreased year after year from 2011 to 2019, but then increased from 2019-2021. 
• MVCs were the leading cause of death among children aged 0-9 years, accounting for 8,177 deaths during the study period. 
• Black youth overall had the highest APC increase from 2019-2021. 
• AI/AN males aged 15-19 years had the highest fatality rate in 2021. AI/AN females had a negative APC from 2011 to 2018 but then the highest APC increase from 2018-2021. 

What This Means

This study highlights significant racial, ethnic, and gender disparities in youth fatalities from firearms and motor vehicle collisions. Black youth, particularly males aged 15-19, face disproportionately high firearm homicide and MVC rates, while firearm suicides are rising among Black females. American Indian/Alaska Native youths also experience elevated MVC rates. Clinicians play a critical role in prevention by incorporating safety counseling, mental health screening, and advocacy into practice. The sharp increase in fatalities underscores the need for data-driven tailored interventions addressing intersectional risks and systemic inequities. Collaboration with communities and policymakers is vital to reduce these disparities.