Fact check: What were the top five causes of death among children under 18 in the USA in 2024?

1. Why the question can't be answered definitively from these analyses — data gaps and timing

None of the supplied analyses contains a contemporary, comprehensive ranking of the top five causes of death specifically for U.S. children under 18 in 2024; most discuss related age bands (0–19) or prior years and emphasize trends rather than a single-year ranked list. The sources note provisional mortality releases and trend studies that are useful for context but do not substitute for finalized 2024 cause-of-death tabulations, which public health agencies typically release after death certificate processing and validation ^{[1] [4]}. Because final national mortality statistics for a calendar year are often subject to revision, the absence of a finalized CDC/NCHS table for “ages <18, 2024” in the provided materials prevents a verified top-five list for that year ^[4].

2. What the sources do agree on — consistent leading contributors to child mortality

Across the analyses, several causes repeatedly emerge: homicide and firearm-related injuries, unintentional injuries including motor vehicle crashes, congenital anomalies and perinatal conditions, and drug overdoses/increasing violence-related causes among adolescents. Multiple pieces emphasize that homicide rose to be a leading cause among youth in recent years and that firearm deaths and drug overdose have increased, altering previous patterns where accidents and medical causes dominated ^{[5] [3]}. These recurring mentions suggest that while exact 2024 ranks aren’t given, the same handful of causes very likely occupy the top positions for children and adolescents.

3. Where COVID-19 fits — significant but not necessarily top five in supplied analyses

One analysis specifically places COVID-19 among leading causes for ages 0–19 but frames it as #9 overall and #1 among infectious/respiratory causes, also noting it ranks higher among disease-related causes ^[2]. That source was published September 7, 2025, indicating retrospective assessment rather than a contemporaneous 2024 ranking. The implication from this data is that COVID-19 contributed meaningfully to mortality in children and young people but, in the cited analysis, did not occupy a top-five overall rank for 0–19, suggesting it may or may not be in the top five for <18 without direct 2024 tables ^[2].

4. Infants vs. older children — different dominant causes and separate reporting

Several supplied analyses distinguish infant (<1 year) mortality patterns from those of older children, noting **congenital malformations, short gestation/low birth weight, sudden infant death syndrome, and perinatal/maternal complications** as leading infant causes ^{[3] [6]}. These infant-specific causes frequently top infant mortality lists and are often separated in public health reporting from causes among ages 1–17, which tend to include injuries, homicide, and suicide. The absence of an explicit aggregated “under 18” top-five in the provided materials means any single list would need careful stratification by age to avoid mixing fundamentally different cause profiles ^[3].

5. Conflicts and differing emphases among the sources — violence vs. medical causes

The analyses present two emphases: one set highlights increasing violence-related deaths (homicide, firearms, drug overdoses) as dominant trends among youth in recent years, while other works emphasize persistent medical and perinatal causes, particularly for infants. The research noting homicide as the leading cause for youths aged 1–19 since 2019 stresses a violent-cause shift ^[5], whereas trend analyses focused on mortality and chronic conditions underline continuing burdens from congenital and perinatal conditions for younger age groups ^[3]. This difference reflects age-specific realities and the need for age-stratified cause lists.

6. What to consult to get a definitive 2024 top-five list — recommended data sources and why they matter

To produce an authoritative top-five causes-of-death list for children under 18 in 2024, one must consult finalized national mortality tables that break down causes by single-year age groups or the “under 18” bracket from authoritative datasets such as CDC/NCHS final mortality files or peer-reviewed analyses that explicitly tabulate 2024 causes. The supplied materials include a provisional CDC portal reference ^[4] and multiple trend studies, but none provides the finalized 2024 ranking; obtaining the CDC/NCHS final cause-of-death table for 2024 would resolve the current uncertainty and confirm whether causes like homicide, unintentional injury, congenital disorders, suicide, and COVID-19 occupy the top five ^{[4] [1]}.

7. Bottom line and cautious interpretation — what we can say now

Using only the provided analyses, the most defensible statement is that the top causes for U.S. children in recent years have consistently included unintentional injuries, homicide/firearm injuries, congenital/perinatal conditions, and a rising share of drug-related and firearm deaths among adolescents, while COVID-19 is notable but not clearly in the top five for the age bands discussed. Final confirmation for 2024 requires direct examination of finalized CDC/NCHS cause-of-death tables; the current sources are valuable for trend context but insufficient to definitively list the top five causes for children under 18 in 2024 ^{[3] [2] [4]}.