Are gun still the leading cause for deaths in children?
Executive summary
Firearm-related injury has overtaken motor vehicle crashes and other causes to become the leading cause of death for children and adolescents in the United States in recent years, a shift documented by peer-reviewed and public‑health institutions [1] [2]. Globally and for the youngest children under five, the dominant causes remain infectious disease, preterm and birth complications, and congenital conditions, so the U.S. pattern does not reflect worldwide child mortality drivers [3] [4].
1. The headline: guns are now the top killer of U.S. children
Multiple recent analyses and public‑health summaries report that firearm-related injury is the leading cause of death among U.S. children and teenagers, with sustained increases in gun deaths since the 2010s and firearms surpassing motor vehicle crashes around 2020 [1] [2] [5]. Johns Hopkins’ Center for Gun Violence Solutions reported firearms killed more children ages 1–17 than any other cause for several consecutive years and documented a more than 100% rise in the rate since 2013 in that age group [2]. The New England Journal of Medicine summarized that firearm-related injury is now the leading cause of death among children and teens, framing it as a largely preventable public‑health failure [1].
2. How the rankings changed: from car crashes to guns
Historically motor vehicle crashes were the single largest cause of death for U.S. children and adolescents—accounting for roughly 20% of deaths in prior analyses—while firearms ranked second [6]. That ordering has changed in the last several years as firearm deaths rose and vehicle‑related fatalities declined or grew more slowly, producing the new ranking reflected in CDC and academic reporting [6] [7]. America’s Health Rankings and other analyses underline that injury as a category remains the dominant cause of pediatric mortality, with the leading mechanisms shifting toward firearms in recent periods [8].
3. Age, geography and intent matter—nuance in the data
The “children” cohort is defined differently across studies (e.g., ages 1–17, 1–19), and causes vary substantially by age: infant deaths are dominated by congenital problems, low birth weight and SIDS, not firearms [7]. Firearm deaths among youth include homicides, suicides and unintentional shootings—with homicide a large component for many adolescent firearm fatalities—so policy and prevention strategies must address multiple intents and demographic patterns [6] [8].
4. Global context: U.S. outlier, world sees different killers
Worldwide, the leading causes of death for children under five remain infectious diseases (pneumonia, diarrhea, malaria), preterm birth complications and intrapartum problems; the global burden picture is dominated by low‑ and middle‑income regions rather than high-income patterns like U.S. firearm mortality [3] [4]. International datasets and the Global Burden of Disease emphasize that the U.S. trend of firearms as the top cause among older children is not mirrored globally for under‑5 mortality [3] [9].
5. What experts say about prevention, research gaps and policy
Children’s hospitals, public‑health centers and academic groups are calling for focused prevention: secure‑storage laws, stronger child‑access prevention, and more funding for firearm‑injury research—areas long underfunded relative to the mortality burden—because evidence mobilized through hospitals and centers has been sparse compared with investment in motor vehicle safety or cancer research [10] [2]. Johns Hopkins and Children’s Hospital networks specifically recommend legal and clinical interventions to reduce access and accidental and intentional shootings among youth [2] [10].
6. Sources, disagreements and limitations
Authoritative U.S. sources (NEJM, CDC summaries, Johns Hopkins, America’s Health Rankings) align on the recent ranking shift to firearms for children and teens, but older reviews and some public education pages emphasize that “injury” broadly remains the leading category and that motor vehicle crashes were historically first [1] [6] [11]. Reporting variations reflect differences in age ranges, single‑year vs multi‑year averages, and final mortality data lag; the CDC’s official mortality briefs provide the formal ranked lists and year‑to‑year trends [7]. Where a claim is not explicitly detailed in the assembled reports—such as the precise count for 2024 by age group—this analysis does not assert those specifics beyond what the cited sources provide.