In a first, firearms were leading cause of death for U.S. children and teens in 2020

Gun deaths among children and teens rose by 29 percent in a single year, largely because of an increase in homicides.

Glock Inc. semi-automatic pistols for sale in El Cajon, Calif., on April 26, 2021.Bing Guan / Bloomberg via Getty Images file

Guns became the leading cause of death among children and teens in 2020, killing more people ages 1 to 19 in the U.S. than vehicle crashes, drugs overdoses or cancer.

More than 4,300 died of firearm-related injuries that year — a 29 percent increase from 2019 — according to a research letter published Wednesday in the New England Journal of Medicine. The letter analyzed decades of mortality data from the Centers for Disease Control and Prevention.

"In the last 40 years, and almost certainly before that, this is the first time that firearm injuries have surpassed motor vehicle crashes among kids," said a co-author of the letter, Jason Goldstick, a research associate professor at the University of Michigan.

Goldstick said homicides, rather than suicides, made up the majority of firearm deaths among children and teens in 2020. Gun killings, which disproportionately affect younger Americans, went up by 33 percent from 2019 to 2020.

The letter said, "We continue to fail to protect our youth from a preventable cause of death."

The number of car-related deaths — the former leading cause of death among children and teens — has dropped dramatically in the U.S. over the last 20 years, likely because of vehicle safety improvements. Around 3,900 people ages 1 to 19 died from vehicle crashes in 2020.

"You can reduce injury rates without banning guns, just like everyone reduced motor vehicle crash rates without banning cars," Goldstick said. The letter does not list specific policy solutions or funding priorities that could best solve the problem.

Most of the children killed by firearms in 2020 were 14 and older, Goldstick said, even though the legal age to purchase guns is 18.

"Kids don’t buy firearms, but that doesn’t mean that it’s not possible for kids to get access," he said.

A study published in February found that gun ownership increased during the coronavirus pandemic. As a result, more than 5 million children under 18 became newly exposed to guns in their households from January 2019 to April 2021.

A 2021 study, meanwhile, also reported a rise in firearm acquisitions after the pandemic started; that was correlated with higher rates of fatal and nonfatal gun injuries both suffered by young children and inflicted by them. The authors suggested that school closings and a resulting lack of adult supervision may have played a role in the trend.

Goldstick also emphasized that the CDC’s mortality data do not capture the full scale of gun violence among kids and teens.

"For every fatal firearm injury, there’s a bunch of nonfatal firearm injuries,” Goldstick said. “There’s not really great data on nonfatal shootings in the U.S."