Gun-related deaths among children in the U.S. reached a distressing peak in 2021, claiming 4,752 young lives and surpassing the record total seen during the first year of the pandemic, a new analysis of Centers for Disease Control and Prevention data found. 

The alarming statistic clearly indicated that America’s gun violence epidemic has gotten worse, experts say. 

More than 80% of the gun deaths were among males 19 and younger. Black male children were more likely to die from homicide. White males 19 and younger were more likely to kill themselves with guns.

“This is undoubtedly one of our chief public health crises in this country,” said Dr. Chethan Sathya, a pediatric trauma surgeon at Northwell Health in New York and the lead author of the study, which was published Monday in the journal Pediatrics. “The most likely reason that your child will die in this country is at the hands of a firearm. That’s not acceptable.”

This grim reality marks the second consecutive year in which gun-related injuries have solidified their position as the leading cause of death among children and adolescents, surpassing motor vehicles, drug overdoses and cancer. 

There are no signs of this trend slowing, Sathya said.

Nearly two-thirds of the deaths in 2021 were homicides, although unintentional shootings have killed many children. No matter how young the victims, pediatric gun-related deaths have left their mark on nearly every corner of the U.S. 

In recent months, a 3-year-old in Florida died after shooting himself with a handgun. In California, a 3-year-old killed his 1-year-old sister with a handgun. A 2-year-old in Michigan died after finding an “unsecured firearm.” Just last week, a 6-year-old in Florida was fatally shot by a 9-year-old. 

Black children continue to be disproportionately affected.

From 2018 to 2021, there was a nearly 42% increase in the rate of children killed by guns, according to the analysis. The fatalities continued to increase in 2021, with more than 4,700 reported gun-related child deaths, an almost 9% increase in the rate compared with 2020.

Researchers had expected to see a decrease in gun-related deaths among children in 2021, following their sharp increase in 2020, which had been believed to be driven by pandemic-induced lockdowns and children being confined at home. 

Those projections, however, were not realized.

“This was surprising to many of us,” Sathya said, adding that the country has potentially entered an “alarming new baseline” in which it will continue to see more gun deaths in children.

Out of those 2021 fatalities, 64.3% were homicides, 29.9% were suicides and 3.5% resulted from unintentional injury, according to the analysis. 

The burden of gun homicides among children has disproportionately affected communities of color. 

Black children accounted for 67.3% of gun-related homicides, with a nearly twofold death rate increase from 2020. White children accounted for 78.4% of gun-related suicides. 

Overall, Black children represented half of all gun-related deaths.

The disparities between Black and white children match what has been found in earlier research, according to Nirmita Panchal, a senior policy analyst at KFF, formerly known as the Kaiser Family Foundation. 

“Communities of color have seen a stark increase in these deaths compared to their white peers,” she said. Furthermore, young survivors of gun-related injuries may face additional challenges that extend beyond their physical trauma, she added. They are also more susceptible to developing mental health problems and substance use disorders.

When examining gun-related deaths among children geographically, southern states — such as Louisiana, Mississippi, Alabama and South Carolina — and Montana bore a greater burden of fatalities, although researchers are beginning to see increasing rates in the Midwest, according to the analysis.

Older adolescents, ages 15 to 19, accounted for 82.6% of gun-related deaths in 2021. Across the U.S., higher poverty levels correlated with higher death rates from guns.

“Structural inequity, structural racism, social determinants of health, food insecurity are all root drivers of violence,” including gun violence, Sathya said.

Dr. Emily Lieberman, a pediatrician with Lurie Children’s Hospital, survived the Highland Park Shooting in Chicago last year, along with her husband and two children.

“I was not a hero that day. I saved no one, I helped no one but my family, and when I did leave that day alive, I knew that I was changed forever,” she said.

Lieberman said she wished she had been surprised by the latest statistics on pediatric gun deaths. But because of a lack of legislation from lawmakers targeting guns, she believes the death toll will only be higher next year.

“We are seeing every day countless children dying, perishing from gun violence,” she said. “It is affecting everyone, everywhere and only getting worse.”

Panchal noted members of Congress have focused on youth mental health, including expanding school-based mental health services and providing trauma care.

Sathya said he has advocated for better background checks and safer storage of weapons. He also said there needed to be more research into the root causes of gun violence.

“Although we can say this is an issue that might not affect everybody, it really does,” he said. “If you look at the spikes in gun injuries, it’s hitting all communities. It doesn’t matter where you live.”


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