Gun deaths rising among children, Mass. researchers find

Sharp increase from 2011-2021, analysis shows

Julvonnia McDowell was making dinner one evening when she got a call saying that her 14-year-old son, JaJuan — a gentle boy who loved animals, who was so generous that he gave a pair of shoes to a classmate who was being teased — had been shot.

He was visiting a relative’s home when another teenager pulled a gun out from a drawer, where the firearm had been stashed under a T-shirt.

“JaJuan told him to put it away, but the other teenager said that it wasn’t loaded, not realizing it was loaded,” said McDowell, who lives in Atlanta and has become an advocate for gun safety with the local chapter of Moms Demand Action. “He pulled the trigger, and it hit JaJuan in the chest. JaJuan died 17 minutes later.”

Children are generally medically healthy, which is why accidental injuries pose the greatest threat to their lives. Car accidents have long accounted for the bulk of injury-related fatalities among children.

But according to an analysis published Thursday, the rate of firearm fatalities among children younger than 18 increased by 87 percent from 2011 to 2021 in the United States. The death rate attributable to car accidents fell by almost half, leaving firearm injuries the top cause of accidental death in children.

The finding underscores additional data showing that firearm injuries are now the leading cause of death among Americans under 20, excluding deaths of infants born prematurely or with congenital abnormalities.

Some 2,590 children and teenagers under the age of 18 died of firearm injuries in 2021, up from 1,311 in 2011, according to the study, which was published in the journal Pediatrics. In other industrialized countries, guns are not even among the top three causes of death for children.

Drug poisonings among children younger than 18 more than doubled, and suffocations increased by 12.5 percent, the researchers also found.

Great strides have been made toward protecting children from car accidents and deaths, including mandatory seat belts, booster seats, and air bags, said Dr. Rebekah Mannix, the paper’s lead author and a pediatric emergency medicine physician at Boston Children’s Hospital.

“The opposite is happening with firearms,” she added. “It’s just getting worse, and kids are dying at higher rates from firearms.”

Mannix’s daughter, Cordelia Mannix, a high school senior, helped with the study, and she is an author of the new paper.

Overall, the rate of nonfatal injuries dropped by more than half among children during the decade studied, from 11,592 per 100,000 to 5,359 per 100,000, while the rate of fatal injuries increased, from 14.07 per 100,000 children to 17.3 per 100,000, the study found.

“Firearms and drug poisonings are both exceptions to this, in that both the nonfatal injuries and the fatal injuries increased,” Mannix, a student at Middlesex School in Concord, Mass., said.

For both firearm injuries and opioid poisonings, “minutes count, and that’s why the fatality rate is high,” said Dr. Toni Gross, medical director of the emergency department at Children’s Hospital New Orleans. A child injured by gunfire — in a drive-by shooting, for example, or by shots that pierce walls of homes — is brought in to the hospital at least once a week, she said.

Firearms can be modified to include safety features like trigger locks that require fingerprint identification, but the firearm industry “has not signed on to making safety modifications,” Gross said.

And while many gun owners purchase firearms to protect themselves and their families, research has consistently shown that having a firearm dramatically raises the risk of gun death in the home, both homicides and suicides.

Mark Oliva, a spokesperson for the National Shooting Sports Foundation, which represents the firearm industry, said that it encouraged the safe storage of guns and had partnered with suicide-prevention groups to educate owners about the risk of self-harm.

The firearms industry does not oppose design features that would make guns childproof but does oppose mandates to introduce such features, he said. The group is not currently doing research on making firearms safer.

State laws can help reduce suicides, according to another recent study carried out by a gun violence prevention group. A report by Everytown for Gun Safety found that states that are considered leaders in firearm safety have seen a slight drop in the rates of suicides involving guns over the past 20 years. By contrast, states with lax or fewer gun safety laws experienced a 40 percent increase in gun suicide rates between 1999 and 2022.