In a recent post, I was critical of a publication in the New England Journal of Medicine called “Crossing Lines–A Change in the Leading Cause of Death among U.S. Children.” Despite the title focusing attention on “children,” the data cited in the article included deaths for individuals 1 to ***24*** years of age, which even in this coddled age stretches the definition of children too far.
I noted in that post, “it may be the case that the leading cause of death among U.S. children has changed. The data provided in this article don’t allow us to answer that question.”
Today I saw another piece in the NEJM that gets us closer to an answer, a letter entitled “Current Causes of Death in Children and Adolescents in the United States,” authored by scholars associated with the University of Michigan Institute for Firearm Injury Prevention.
In this correspondence, the authors discuss “children and adolescents,” defined as those from 1 to ***19*** years of age, which is better.
Some notable observations the authors make in their brief letter:
*There were 45,222 firearm-related deaths in the United States, including suicide, homicide, unintentional, and undetermined. They call it “a new peak,” but it is not clear if this means in terms of absolute numbers or per capita. I can believe the former; I’m not certain of the latter.
*The increase in the overall firearm death rate from 2019 to 2020 was driven by homicides (up 33.4%) rather than suicides (up 1.1%).
*”From 2019 to 2020, the relative increase in the rate of firearm-related deaths of all types (suicide, homicide, unintentional, and undetermined) among children and adolescents was 29.5% — more than twice as high as the relative increase in the general population.”
*Although suicides are typically 2/3s of all gun deaths in the overall population, looking at the Supplementary Index provided highlights that firearms deaths among children and adolescents are more commonly homicides.
*As with adult homicide, we see a concentration of child and adolescent homicide (and large increases from 2019 to 2020) among African American males.
I am still not convinced that comparing intentional deaths to accidental deaths makes sense practically, but certainly the gradually rising rate of death involving firearms among those 1-19 years of age from 2013 to 2020 merits attention.
Gun Curious 
I love these charts.
For example, the rate of firearms deaths has gone up about 1/100,000 deaths which is approximately 20+% an increase. Then it also appears that drugs and overdoses also claims about 1 additional per 100,000 which is approximately 60+% increase. Sure seems like THAT is more impactful.
Second, what do these graphs look like when we re-age the numbers to 0-17 years of age, instead of including 18 and 19 year olds?
Last, I am really impressed that (I am guessing) carseats have cut car crash deaths by 1/2 over 20years? That’s great! And they have saved more than guns have killed. (I survived growing up in the 70’s, riding in the front seat without seatbelts)
BTW, I wonder what the suicide gun deaths are in 1-17 and 18-19 year olds, knowing that over all gun deaths about 2/3 are historically suicide?
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I think there has been an increase in gang related activity among young black males but it appears that some of this activity has spilled over into the community and more “bystanders” are being shot at least that is what it appears from the news in NYC. This is similar to what happened in the 70s/80s in NYC with the Asian gangs. They went from keeping it confined to themselves to walking in and shooting up entire restaurants in China Town.
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Why do we need more research on gun violence when we already know the steps we can take to reduce it?
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I emailed the author and asked for a breakdown of traffic deaths, i.e., children inside cars vs. children hit by cars.
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What I find interesting is how the increase in ‘gun deaths’ exactly mirrors the increase in drug overdoses.
It is almost as though the lockdowns lead to an increase in drug use and and increase in drug (and and gang) related crime.
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