In recent years, a grim reality has emerged in the United States: firearms have become the leading cause of death for children and teenagers aged 1-17, surpassing illnesses and other injuries. This unsettling statistic highlights a stark divergence between the U.S. and other wealthy nations, raising critical questions about gun violence and child safety. Why is America such an outlier when it comes to children and guns, becoming the unfortunate “one percent” in this deadly comparison? And why aren’t effective measures being implemented to protect our youngest population?
For too long, motor vehicle accidents were the primary cause of accidental deaths among children. However, data from 2020 and 2021 reveal a disturbing shift. Firearms are now more likely to claim the lives of young Americans than car crashes, a trend that demands immediate attention. In 2021 alone, 2,571 children died from firearm-related incidents, translating to a rate of 3.7 deaths per 100,000. This represents a staggering 68% increase in fatalities since 2000 and a 107% jump since 2013, a recent low point.
Alt text: Bar chart comparing child and teen firearm mortality rates in the U.S. to peer countries, highlighting the significantly higher rate in the U.S.
While progress has been made in reducing motor vehicle fatalities among children—decreasing by 49% since 2000—the rise in firearm deaths is alarming. Deaths from poisoning, including drug overdoses, are also on the rise, but firearm deaths have become the undeniable number one injury-related killer of American children. Provisional data from the CDC for 2022 sadly confirms this continuing trend for a third consecutive year.
America’s Unmatched Firearm Mortality Rate: A Global Outlier
When comparing the U.S. to other large, wealthy nations, the disparity in child and teen firearm mortality is shocking. No other peer country lists firearms among the top causes of death for children, let alone as the leading cause. To ensure an accurate comparison, data for teenagers aged 18 and 19 are included with children aged 1-17 for all countries, due to international data availability.
The numbers are stark. The firearm death rate for children and teens (ages 1-19) in the U.S. is over 9.5 times higher than in Canada, the country with the second-highest rate among comparable nations. Teenagers in the U.S. (ages 18-19) face a firearm mortality rate of 25.2 per 100,000, while children (ages 1-17) experience a rate of 3.7 per 100,000. Even more disturbingly, the child firearm mortality rate in the U.S. is 5.5 times greater than the child and teen mortality rate in Canada.
Imagine the lives that could be saved. If the U.S. could reduce its child and teen firearm mortality rate to Canada’s level, an estimated 30,000 young lives could have been saved since 2010 – approximately 2,500 per year. This reduction would have decreased the overall child and teenage death rate in the U.S. from all causes by a significant 13%.
State Variations and the Impact of Gun Laws
Within the U.S., firearm mortality rates for children and teens (ages 1-19) vary considerably from state to state. From a low of 2.1 deaths per 100,000 in states like New York and New Jersey to a high of 17.6 deaths per 100,000 in Louisiana, the differences are dramatic. However, even states with the lowest rates still exceed Canada’s national rate by over threefold.
Alt text: Map of the United States showing state-level variations in child and teen firearm mortality rates compared to Canada’s rate, illustrating that even low-rate US states are higher than Canada.
While a comprehensive national firearm registry is lacking in the U.S., examining the correlation between the number of gun laws and child firearm deaths reveals a crucial insight. States with more restrictive firearm laws generally experience fewer child and teen firearm fatalities. Despite this correlation, these states still, on average, have significantly higher rates than Canada and other peer countries.
Canada, despite having the second-highest child and teen firearm death rate among comparable nations, maintains more restrictive firearm laws at the federal level compared to the U.S. The ease with which guns can be transported across state lines or obtained from unregistered sources in the U.S. further complicates efforts to reduce firearm violence, even in states with stricter regulations.
The Sheer Scale of the Problem: U.S. vs. Peer Nations
In 2020 and 2021, firearms were the leading cause of injury and illness-related deaths for U.S. children and teens (ages 1-19). In 2021, this translated to 4,733 young lives lost to firearms. Outside of Canada, firearms are not even among the top five causes of death for children and teenagers in other comparable countries. Motor vehicle accidents and cancer remain the primary causes of death for this age group in those nations.
Combining child and teen firearm deaths in the U.S. with those in other OECD countries with similar economic profiles, the U.S. shockingly accounts for 97% of these deaths, despite representing only 46% of the total population across these countries. The combined total of child and teen firearm deaths in eleven other wealthy nations is a mere 153, compared to the U.S.’s staggering 4,886.
Firearms contribute to 20% of all child and teen deaths in the U.S., a stark contrast to the average of less than 2% in other comparable wealthy nations. The U.S. not only has the highest overall rate of child and teen firearm deaths but also the highest rates across all categories: suicides, assaults, and unintentional or undetermined intent deaths.
Assaults and Suicides: The Devastating Details
In 2021, the firearm assault rate among U.S. children and teens was 3.9 per 100,000. The suicide rate was 3.8 per 100,000, with 1.8 of those suicides involving firearms. In contrast, comparable countries average an overall suicide rate of 2.8 per 100,000 children and teens, with only 0.2 per 100,000 firearm suicides.
If the U.S. could reduce its child and teen firearm suicide rate to Canada’s level, the peer country with the next highest rate, over 1,000 fewer young lives would have been lost in 2021 alone. The spike in child and teen firearm deaths in 2020 and 2021 was largely driven by a surge in violent assault deaths, reaching a high of 3.9 per 100,000 in 2021, a 50% increase from 2019. Firearm suicides among this age group also increased by 21% during the same period.
The Broader Impact: Mental Health and Beyond
Beyond mortality, exposure to and use of firearms have significant implications for children’s mental health. Research indicates that young people exposed to gun violence may develop symptoms of PTSD and anxiety. Survivors of firearm-related injuries, including young individuals, are at a heightened risk of mental health conditions and substance use disorders. Furthermore, gun violence disproportionately impacts children of color, particularly Black children, and those living in impoverished areas.
Methods
Data from CDC Wonder and the IHME Global Burden of Disease study were utilized for this analysis. Data categorization differences between these sources were addressed to ensure comparability. Mortality rates for peer countries were calculated using UN population estimates.
Conclusion
The data is undeniable: the United States is an extreme outlier in child and teen firearm mortality among wealthy nations. This is not simply a matter of statistics; it represents thousands of young lives tragically cut short and countless others affected by gun violence. Understanding the depth of this crisis – the “one percent” we never wanted to be – is the first step towards meaningful change and ensuring the safety and well-being of all children. The question remains: why not take decisive action to address this uniquely American tragedy?
