Firearm injuries and deaths in the United States have increased in recent years and adversely affect many children and adolescents. In 2020, firearms became the leading cause of death among children ages 19 and below and in the first six months of 2022, there were over 300 mass shootings across the U.S., including the shooting at Robb Elementary in Uvalde, Texas.
In addition to physical harm, direct and indirect exposure to gun violence can negatively affect the mental health and well-being of youth. This brief explores trends in firearm-related injury and mortality among children (ages 17 and below) and how they vary by race and sex. We analyze data from the Center for Disease Control and Prevention (CDC) Wonder injury and mortality database and define firearm-related deaths as gun assault deaths, suicide deaths by firearm, deaths due to accidental firearm discharge, legal intervention leading to firearm death, and firearm deaths from an undetermined cause. This brief also examines the negative mental health consequences stemming from exposure to gun violence and describes recent policy responses.
During the pandemic, firearm-related deaths increased among children, with seven children per day dying by firearm in 2021. From 2011 to 2021, nearly 18,500 children ages 17 and younger died by firearm. During this period, firearm death rates gradually rose until 2017, then slowed through 2019, before sharply rising in the first two years of the pandemic (Figure 1). From 2019 to 2021, the firearm death rate among children increased by 50% (from 2.4 to 3.6 per 100,000). This translates to seven children per day dying by firearm in 2021. Throughout the past decade, assaults have accounted for at least half of all youth firearm deaths while suicides by firearm have accounted for at least three in ten of these deaths. The spike in youth firearm deaths during the pandemic have primarily been driven by gun assaults. Firearm-related injuries among children have also increased in recent years – from 9.9 per 100,000 in 2010 to 15.5 per 100,000 in 2020 (the latest firearm injury data available).
By 2021, suicide deaths by firearm accounted for nearly half of all suicides among children and adolescents. Following a brief period of decline, suicide deaths by firearm increased by 26% among youth, from 657 deaths in 2019 to 857 deaths in 2021 (Figure 2). Meanwhile, suicide deaths by other means have declined among youth since 2018. As a result, suicide deaths by firearm accounted for 47% of all youth suicides in 2021.
Firearm death rates sharply increased among Black and Hispanic youth during the pandemic. In 2021, the rate of firearm-related deaths among Black youth was 12.0 per 100,000 – substantially higher than any other racial and ethnic group and six times higher than White youth (Figure 3). Although Black children made up 14% of the youth U.S. population in 2021, they accounted for 46% of youth firearm deaths. Additionally, from 2018 to 2021, the rate of firearm-related deaths doubled among Black youth and increased by 50% among Hispanic youth. While firearm death rates for American Indian and Alaska Native (AIAN) youth fluctuated over the same period, they remained higher than the rates of their White peers. White youth experienced relatively stable and lower firearm mortality rates from 2018 to 2021 (from 2.0 to 2.3 per 100,000), while Asian youth had the lowest firearm mortality rates across the period (Figure 3).
The recent increases in firearm deaths among Black and Hispanic youth were primarily driven by gun assaults and suicides by firearm. During the pandemic, the largest increases in gun assault deaths across racial and ethnic groups were among Black youth (80% increase from 556 deaths in 2019 to 1,000 deaths in 2021) and Hispanic youth (46% increase from 195 deaths in 2019 to 284 deaths in 2021) (Figure 4). Additionally, although suicide deaths by firearm are highest among White youth, the largest percent increases of these deaths were among Black youth (77% increase from 60 deaths in 2019 to 106 deaths in 2021) and Hispanic youth (48% increase from 79 deaths in 2019 to 117 deaths in 2021) (Figure 4). Data on firearm-related injury rates by race and ethnicity was not available. In general, children of color are more often exposed to gun violence than their White peers. A recent study found that this disparity in exposure to gun violence has been exacerbated during the pandemic, particularly for Black children. Further, a separate study found that children living in areas with a high concentration of poverty are more likely to experience firearm-related deaths and poverty disproportionately affects children of color.