Firearms are now the top cause of death among U.S. youth

“We continue to fail to protect our youngest”

Firearms have surpassed motor vehicles as the leading cause of death among children and adolescents in the United States, according to new federal data analyzed by researchers at the University of Michigan.

U-M researchers Jason Goldstick, Rebecca Cunningham, and Patrick Carter co-authored an article published in The New England Journal of Medicine that quantifies the leading causes of death nationwide for individuals ages 1 to 19. Based on their analysis of data from the Centers for Disease Control and Prevention, firearm-related deaths among children and adolescents increased by 29 percent from 2019-20.

“The increasing rates of firearm mortality are a longer-term trend and demonstrate that we continue to fail to protect our youngest population from a preventable cause of death,” says Goldstick, research associate professor of emergency medicine at Michigan Medicine and of health behavior and health education at the U-M School of Public Health.

“Recent investments in firearm injury prevention research by the CDC and National Institutes of Health, in addition to community violence prevention funding in the federal budget, are a step in the right direction, but this momentum must continue if we truly want to break this alarming trend.”

Injury prevention science

Goldstick and colleagues at the U-M Institute for Firearm Injury Prevention are working to maintain momentum in this space through its new Data and Methods Core, where researchers analyze national datasets to identify key trends in firearm violence. The institute launched last year as part of a $10-million university commitment to generate new knowledge and advance innovative solutions to reduce firearm injuries and deaths, while respecting the rights of law-abiding citizens to legally own firearms.

U-M researchers’ latest analysis on major causes of death in children and adolescents signals an upward trend in firearm violence nationwide, and can help policymakers and community groups identify potential solutions to address this national crisis.

More than 4,300 individuals ages 1-19 across the U.S. died as the result of firearms in 2020, which includes suicides, homicides, and unintentional deaths. Motor vehicles caused about 3,900 fatalities among children and adolescents in 2020, while drug poisoning deaths increased by more than 83 percent — to more than 1,700 total deaths — to become the third-leading cause of death in this group.

chart re: teens and firearm deaths

“Motor vehicle crashes were consistently the leading cause of death for children and adolescents by a fairly wide margin, but by making vehicles and their drivers safer, these types of fatalities have drastically decreased over the past 20 years,” says Carter, co-director of the institute and associate professor of emergency medicine and of health behavior and health education.

“Injury prevention science played a crucial role in reducing automobile deaths without taking cars off the road, and we have a real opportunity here to generate a similar impact for reducing firearm deaths through the application of rigorous injury prevention science.”

More and more intense

More than 45,000 people across the U.S. died as the result of firearms in 2020, regardless of age — a more than 13 percent increase when compared to 2019. The national increase was driven largely by firearm homicide, which jumped more than 33 percent from 2019 to 2020. Firearm suicides increased by about 1 percent, according to data analyzed by U-M researchers.

“Firearm violence is one of the most critical challenges facing our society, and based on the latest federal data, this crisis is growing more and more intense,” says Cunningham, U-M vice president for research and the William G. Barsan Collegiate Professor of Emergency Medicine.

“As a nation, we turn to scientific evidence to prevent injuries and deaths, and firearms should be no different. Michigan has incredible expertise in this space, and we will continue to use our collective knowledge to create safer and more vibrant communities nationwide.”


  1. Eileen Feldman - 1966

    The national/state age of permission to buy, own, carry any size gun should be raised to 21 — the same as for alcohol. The teen brain is not mature enough to be entrusted with considered decisions with lethal weapons before that age.


    • Mike Lazarus

      I’m sorry Eileen, but our government would have to disagree with you on that one.

      “Federal Law requires nearly all-male US citizens and male immigrants, 18 through 25, register with Selective Service.”


  2. George Saunders - 1966

    Your “research” lacks insights and sophistication. Stop embarrassing the UofM with this amateur coverage of the epidemiology.


    • Joel Gruber - 1983

      Well said, the article lacks any meaningful breakout across the three given categories: suicides, homicides, and unintentional deaths.

      Is this primarily due to the much discussed increase in suicide? If so, which sub groups are experiencing this increase?

      Is this due in part to homicides, perhaps driven by increased lawlessness in our long suffering inner cities?

      I am left with little to show for my time invested in the article. Where was the editor?


  3. Stphen Kale - 1958

    New laws are not the answer. I was taught firearms safety at Boy Scout camp when I was 12 or 13 years old. As allowed by law I have owned and used firearms ever since. During my last 2 years at Michigan I kept my shotgun in my residence and hunted with friends up in the thumb. Today I observe the awful number of shootings in my home town of San Antonio. I believe they are due to 1) careless parents breaking the law by not securing firearms from their children, and 2) teenage and young men who have never learned that life is sacred and don’t care. They think that violence is the only way to better themselves and settle arguments. New laws are not going to correct their attitudes.


  4. Patrick McNally - 1980, 1981

    If a minor change in the range of deaths is extended to pre-born lives, the total amount of firearm deaths under 19 years is minor compared to the amount of abortion deaths. In 2020 in Michigan alone, the state of Michigan statistics show 29,669 reported abortion deaths, compared to 4300 firearm deaths nationwide in this study.


  5. James Cowart - 1972

    The US ranks at the top in most gun related injuries and deaths of developed nations. Why is this the case? Unless one thinks that the US has more mental illness or more inept parents than any other developed country, one might think there is a causal connection between the proliferation of guns, including assault weapons, and the rate of gun injuries and deaths. The US has more guns per person than any other country. Only legislation could reduce the proliferation of guns in the US.


    • William White - 2006

      Mr. Cowart,

      What is an “assault weapon”? The government attempted to ban assault weapons back in the 1990’s, and resulted in some of the most ridiculous legal wrangling, and ineffectual legislation, ever attempted. The law resulted in banning weapons based upon mere cosmetic features, as opposed to attempting to address the actual sources of violent crime. The proper term you might be looking for is “modern rifles” and though it might pain you to acknowledge this, the Bill of Rights expressly forbids restrictions on our right to bear arms.

      In point of fact the US does not lead the world in firearms deaths/injuries… only certain cities and counties in America do so… cities led by democrats for generations I should add.

      I agree with the commenters above, this seems a specious and pointless article, and the headline merely click-bait. It is disappointing to see my alma mater associated with such leftist propaganda.

      Will White
      NERS PhD 2006


      • Theresa Driest - 1995

        Dear Mr. White,
        Are you for real? Pointless article? It is just like the right to pretend something is not happening at the cost of innocent people being killed but you right wing gun wackos. Let’s just pretend that guns in this country are not a problem because it’s your “right to bear arms” . Oh please ! Assault rifles are the problem duh……. do you not agree? DO SOMETHING ABOUT IT ! If you all can’t figure it out you don’t deserve to bear arms.


        • William White - 2006

          Dear Ms. Driest,

          Thank you for providing a shining example of leftist thought and rhetoric: “Assault rifles are the problem duh…” I stand in awe of your debate skills.

          A quick question, can you provide a definition of “Assault rifle”? You claim that they are “the problem”, and appear to insist that I agree with you (I do not). Do you actually know what you mean when you use this phrase?

          Let’s pretend that you can provide such a definition. How will you use that definition to ban such objects. Did you know that you can now 3D print almost all of the components of a modern rifle? If you don’t care about being able to run thousands of rounds through the device, you can actually 3D print the whole thing. It is certainly possible to create a modern rifle, capable of using commercial ammunition, that will operate for ~100 shots. More than sufficient for another school shooting. How are you going to “DO SOMETHING” about this? It is already illegal to bring firearms onto school grounds, a silly and pointless law in and of itself. These kinds of laws only serve to ensure that all of the good guys that could be on the school premises are completely unarmed. These laws don’t appear to do a good job of dissuading evil people from bringing guns into the school to slaughter children.

          You do a disservice to our children and our country by falling back on emotional reasoning and ignoring the facts. We would do better by observing what a country like Israel does to secure their schools than listen to fools who shriek that “guns are the problem”.

          Yours Truly,

          Will White
          NERS PhD 2006


  6. J. Raflowski

    Has anyone considered the mental illness impacts of the COVID-19 Pandemic? More depression and acts of hate, since many youth don’t identify with alternate outlets to defuse these adverse emotions..


  7. Patrick CARDIFF - 1990

    The authors report that firearms now rank as the #1 cause of teen deaths. They also state that “more than 45,000 people across the U.S. died as the result of firearms in 2020, regardless of age, an increase of 13% from 2019.” To me, these are “Wow, really?” statistics, eye-openers, and priors until contradicted by similar studies.

    Comments are for opinions, I get it. Opinions from non-experts, confirming beliefs, biased by politics. But veering from the facts does not make them go away. That’s what embarrasses me about Wolverine alums – not facing the facts.


  8. Norb Roobaert - 1963

    Guns are not the cause. Guns are the tools used by people who have mental problems. The title is completely misleading and if that was the result the study it was a waste of time and money. Until we tackle the real problem we will not make progress on this


  9. Gerald Weisberg - 1972

    “Don’t confuse me with the facts” is what some of the commentators seem to be saying. Like it or not, the facts are just that – facts.

    In 2020, the total number of homicides from firearms in Canada, the population of which is roughly one-tenth of the U.S., was 277. Canada has tough gun laws, one of which is the prohibition of the sale or possession of military-grade weapons. The AR-15 used to slaughter 19 children and two teachers in Uvalde, Texas, is a military-grade weapon.

    Supreme Court Justice Antonin Scalia, no bleeding-heart lefty pinko, wrote the following in his 2008 majority opinion in District of Columbia V. Heller – “Like most rights, the right secured by the Second Amendment is not unlimited. (It is) not a right to keep and carry any weapon in any manner whatsoever and for whatever purpose.”

    Is there the need to address mental health issues that eventuate in gun violence? Absolutely. Is there the need to examine so-called “red-flag” gun laws? Yes. But, NOT mutually exclusive to these needs is the need to put into place what are appropriately termed “common sense” gun laws, specifically universal background checks, which are supported by over 80% of the American people, and the prohibition of the sale or possession of military-grade weapons.

    Gerald Weisberg, M.D.


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