Are Guns the Leading Cause of Death for Children in the US?

Motor vehicle-related crashes used to be the leading cause of death among children and teens.

Published March 29, 2023

Updated April 3, 2023
 (President of the United States Official Twitter Account/Wikimedia Commons)
Image courtesy of President of the United States Official Twitter Account/Wikimedia Commons

Key facts:

  • The latest available data pertinent to this claim covers 2020 and 2021. As of this writing, there is no data available for 2022 and 2023.
  • The claim that guns were the leading cause of death for U.S. children in 2020 and 2021 is true only if the selected age range is 1-19 years old. This range excludes infants under one year old, who have a unique risk of age-specific causes of death.
  • Similarly, capping the age range at 17, instead of 18 or 19, also alters the result, as children aged 17 and under have a greater risk of dying of vehicle-related injuries.

On March 27, 2023, a shooter entered The Covenant School, a private Christian school in Nashville, Tennessee, for preschool to sixth grade, and opened fire, killing six. In the wake of the shooting, former U.S. President Barack Obama tweeted, "We are failing our children. Guns are now the leading cause of death for children in the U.S."

In recent years, a number of our readers have asked us to confirm the veracity of the claim that gun-related incidents are the leading cause of death among children. While Obama's tweet was written in the present tense (claiming that guns "are" the leading cause of death in children), we're unable to discern whether that's true because the most recent available data is from 2021. The language of Obama's tweet also leaves the age range of the in-question demographic up for interpretation.

Considering those factors, we fact-checked whether gun-related incidents were the leading cause of death in recent years, by looking at recent research and mortality data compiled by the Centers for Disease Control and Prevention (CDC).

We found some elements of the assertion true, though some clarifications are needed. Within certain parameters — such as ages 1-18 and 1-19, in the years 2020 and 2021 — gun-related incidents were, in fact, the leading cause of death in children and teens. The most important caveat is that this conclusion derives from data that excludes infants below the age of 1, who are uniquely impacted by other causes of death. Adjusting the parameters in other ways also affects the result.

An analysis from the Kaiser Family Foundation, a research nonprofit, that relied on 2020 data compiled by the CDC found that firearms were the No. 1 cause of death for children and teens in the U.S. Those deaths included accidents, suicides, and homicides. The analysis found that in 2020 alone, gun-related violence killed 4,357 children (ages 1-19 years old) in the U.S. By comparison, motor-vehicle deaths accounted for 4,112 deaths in that age range.

However, the result is different if one removes 18- and 19-year-olds from the equation and only relies on data for 1- to 17-year olds from 2020. Nearly 2,400 children ages 1-17 died of vehicle-related injuries in 2020, compared with 2,270 firearm deaths, NBC News analysis of the CDC data showed.

We should also note that, in 2020, the leading causes of death among infants (children less than 1 year old) were birth defects or preterm-birth issues, according to the CDC. Johns Hopkins researchers did not include infants in their analysis of CDC's 2020 data because "infants (under age 1) are at a unique risk for age-specific causes of death, including perinatal period deaths and congenital anomalies. In 2020, 11 infants were killed by firearms."

So the CDC's 2020 data supports the claim that firearms were the leading cause of death among children that year, provided infants under the age of 1 are excluded, per the analyses of CDC data from Kaiser and Johns Hopkins researchers.

In a May 2022 article for the New England Journal of Medicine, experts from the University of Michigan Ann Arbor compared the 2020 data to previous years:

The previous analysis, which examined data through 2016, showed that firearm-related injuries were second only to motor vehicle crashes (both traffic-related and nontraffic-related) as the leading cause of death among children and adolescents, defined as persons 1 to 19 years of age. Since 2016, that gap has narrowed, and in 2020,  firearm-related injuries became the leading cause of death in that age group. From 2019 to 2020, the relative increase in the rate of firearm-related deaths of all types (suicide, homicide, unintentional, and undetermined) among children and adolescents was 29.5% — more than twice as high as the relative increase in the general population. The increase was seen across most demographic characteristics and types of firearm-related death.

For 2021, the data yielded the same results. A CNN analysis of CDC data determined that, in 2021, nearly 3,600 children and teens, ages 1-18, died in gun-related incidents, which was more than the number of motor-vehicle fatalities. CDC data from 2021 showed 4,733 children ages 1-19 died from gun-related incidents. In that same year, there were nearly 3,500 motor-vehicle-related deaths that include children 1-18, and that number increased significantly if one includes 19-year-olds, totaling almost 4,400.

(Note: When we calculated the above deaths from motor vehicle-related incidents in the CDC database, we also included the parameters for "Motor Vehicle Traffic," "Other Pedal cyclists," "Other Pedestrians," and "Other land transport.")

We should also note that if we were to calculate the number of motor vehicle deaths between the ages of 1-17 in 2021 using only "Motor Vehicle Accidents" as a category from CDC's "ICD-10 113 Cause List," the number of deaths would be 2,561, which would be slightly less than the number of deaths from guns, which totaled 2,565. If we were to make the same calculations within the same parameters from the ages of 1-18, it would be 3,588 number of deaths from firearms, and 3,397 deaths from motor vehicles.

Researchers have not determined exactly why children's deaths from gun violence in the U.S. had risen so considerably since 2020, but some emphasized that the increased availability of guns, especially handguns that tend to be used in homicides and suicides, likely played a role.

Looking at data from the CDC and the Gun Violence Archive, The New York Times found that, in 2021, Black children represented half of these gun deaths, and two-thirds of all gun-related homicides involving youths. In other words, Black children were overall six times as likely to die from gun violence compared to white children. Children in big cities were three times more likely to die from gun violence compared to children in small towns.


"A Steadily Growing Epidemic: Gun Violence in 2021." Giffords, 12 Jan. 2023, Accessed 28 Mar. 2023. 

"A Year in Review: 2020 Gun Deaths in the U.S." The Johns Hopkins Center for Gun Violence Solutions, 28 Apr. 2022, Accessed 29 Mar. 2023.

"Biden Claimed More Kids Are Dying of Guns than Cars. Here's What the Data Shows." NBC News, 3 June 2022, Accessed 29 Mar. 2023. 

"Fact-Check: Are Firearms the Leading Cause of Death in Children?" Austin American-Statesman, Accessed 29 Mar. 2023.

"Firearms Are the Leading Cause of Death for Children in the United States But Rank No Higher Than Fifth in Other Industrialized Nations." KFF, 8 July 2022, Accessed 28 Mar. 2023. 

Gebeloff, Robert, et al. "Childhood's Greatest Danger: The Data on Kids and Gun Violence." The New York Times, 14 Dec. 2022., Accessed 28 Mar. 2023. 

Goldstick, Jason E., et al. "Current Causes of Death in Children and Adolescents in the United States." New England Journal of Medicine, vol. 386, no. 20, May 2022, pp. 1955–56. (Crossref), Accessed 28 Mar. 2023. 

"Infant Mortality | Maternal and Infant Health | Reproductive Health." CDC. 8 Sept. 2022, Accessed 29 Mar. 2023. 

Panchal, Nirmita et al. "Child and Teen Firearm Mortality in the U.S. and Peer Countries." KFF, 8 July 2022, Accessed 28 Mar. 2023. 

"TJA Statement on the Covenant School Shooting." Trans Journalists Association, 27 Mar. 2023, Accessed 28 Mar. 2023. 


3 April 2023: We added more numbers by adjusting the parameters in the CDC database.

Nur Nasreen Ibrahim is a reporter with experience working in television, international news coverage, fact checking, and creative writing.