Racial and ethnic disparities in pediatric firearm deaths persist in 2022 and 2023

Firearms became the leading cause of death in the United States pediatric population in 2019 and have persisted as the leading cause through 2021, with widening racial and ethnic disparities. We aimed to examine recent trends in U.S pediatric firearm mortality, how they differ by intent, and identify which ages, and racial and ethnic groups have been most impacted over time.

The Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database was queried for mortalities in children aged 0-19 years from 2014-2023, and crude death rate was reported as number of deaths per 100,000 persons per year.

Firearms continued to be the leading cause of death in patients aged 0-19 years from 2021 to 2023, firearm crude death rate decreased from 5.8 to 5.5. In patients aged 14-19, firearms became the leading cause of death in 2016. In patients aged 0-13 years, firearms continue to be the fourth leading cause of death. Firearm death rates for Black children decreased from 18.6 in 2022 to 17.6 in 2023 yet remained far higher than other races, and highest in all census regions. Crude firearm death rates for American Indian and Alaskan Native (AIAN) children remained the second highest. The firearm suicide rate in Black children (1.8) surpassed that of White children (1.6) in 2022 and was the highest of any ethnicity in 2023. NonCore (rural) regions had the highest firearm crude death rates in 2018-19, and AIAN children were disproportionately affected in these areas, while Large Central Metro areas surpassed this in 2020-2021.

Firearms remain the leading cause of death among children aged 14-19, and the fourth leading cause of death among children 13 and younger. Racial and ethnic disparities remain prominent, as Black and American Indian and Alaskan Native children continue to be disproportionately affected, particularly by firearm suicide. Prevention strategies should target these vulnerable populations and children at highest risk to prevent future firearm deaths.