Firearms Now the Leading Cause of Death for US Children – New Study Reveals How State Policies Can Save Lives

A new wave of research has confirmed a grim milestone: more American children and teenagers now die from firearm-related injuries than from any other cause.

The latest study, published in JAMA Pediatrics (June 2025), finds not only an alarming national trend but also sharp differences among states—differences directly tied to gun policy.

According to the researchers, the strictness or leniency of state firearm laws determines not only the overall child gun death rate, but also the size of racial disparities and the prospects for prevention.

Pediatric Firearm Deaths in the US – Key Figures (2011–2023)

Category	Expected Deaths (Post-McDonald)	Actual Deaths (Post-McDonald)	Excess Deaths
All States (Total)	17,000	23,000	6,000
Most Permissive States	—	—	6,029
Middle Permissiveness	—	—	1,424

What the Study Found: Policy Drives Death Rates

Researchers split states into three groups: “most permissive,” “permissive,” and “strict,” based on state firearm policies, which include safe storage laws, background checks, and Stand Your Ground laws.

• Permissive states saw the largest number of “excess” child and teen firearm deaths—over 6,000 more than expected based on prior trends.
• Strict states (California, Maryland, New York, Rhode Island, Massachusetts, New Jersey, Connecticut, Illinois) had a mix of results: four saw significant decreases, while two (Illinois, Connecticut) saw increases; two others saw no statistically significant change.

“We found 6,029 excess deaths in the most permissive states, compared with the number expected if states had kept pre-2010 policies,” said Dr. Jeremy Faust, lead study author and ER physician at Brigham and Women’s Hospital in Boston.

Changes in Child Firearm Death Rates by State Category

Black Children Hit Hardest: Widening Racial Gaps

One of the study’s most urgent findings: Black children and teens face the steepest increase in firearm deaths in states with loose gun laws. While all children are at greater risk in permissive states, the rate for non-Hispanic Black youths rose disproportionately, deepening America’s racial health gap.

“These are completely preventable deaths,” said Dr. Marie Crandall, a trauma surgeon in Cleveland who was not involved in the study but has spent decades treating young victims of gun violence. “We know as a society there are things we could do to de-escalate.”

The Role of Policy: What Works and What Doesn’t

The data points to specific laws that can make a measurable difference. States with safe storage laws, universal background checks, and stricter regulations consistently show lower rates of child firearm deaths. Where such laws are absent or recently repealed, rates climb.

State Law Examples and Pediatric Firearm Death Trends

Expert Voices: It’s a Public Health Problem, Not Just Politics

Experts interviewed for the study and subsequent reports stress that gun violence is a leading—and preventable—public health crisis. Yet, as Dr. Faust notes, official health reports have often sidestepped or omitted firearms as a child health threat.

“It’s hard to take them seriously if they’re omitting the leading cause of death,” Faust told [source].

Dr. Chethan Sathya, a pediatric trauma surgeon and head of Northwell Health’s Center for Gun Violence Prevention, argues that US society has reduced childhood deaths in the past—think car seat laws, tobacco education, or pool fencing—through data-driven, nonpartisan action. He urges a similar public health approach for gun deaths.

The Debate in State Capitols: Safe Storage Laws and Cultural Barriers

Why are secure storage laws so important?

In the United States, gun death rates among children 1-17 have increased by 106% since 2013 and gun violence has been the leading cause of death among this group since 2020.https://t.co/NaOazzDXrp

— John Feinblatt (@JohnFeinblatt) September 17, 2024

The report highlights how legislation around gun storage and access often meets fierce resistance. In Louisiana, recent attempts to mandate safe storage failed, even as the state led the nation in child firearm deaths and unintentional shootings by children.

Supporters point to the need to protect children, while opponents cite gun rights and the need for quick self-defense access.

“If it’s behind a locked drawer, how in the world are you going to protect your family if somebody intrudes?” asked Rep. Troy Romero, reflecting a common concern.

Advocates like Michelle Bell, who lost her son to gun violence in Cleveland and founded the support group M-PAC Cleveland, argue for a broader community and cultural shift. “It’s just so tragic that the No. 1 cause of death for children 18 and under is gun violence,” Bell says.

Community and Hospital-Based Prevention Efforts

What’s Next: A Public Health Approach to Saving Young Lives

The consensus among researchers and medical professionals is clear: data-driven, enforceable policy saves lives. That means strengthening child access prevention, background checks, and safe storage laws, paired with education and community programs.

But as recent legislative battles show, policy alone isn’t enough. Experts call for a shift in American culture around gun ownership, safety, and what it means to protect children at home and in their communities.

“We have to apply a public health framework to this issue, not a political one,” said Dr. Sathya. “There’s no question that this is a public health issue.”