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.