The Major Causes of Death in Children

The authors and a colleague reply: In reply to Bleyer: in our article, we noted that in 2016, firearms were the second leading cause of death in children and adolescents between the ages of 1 and 19 years. Recent data from 2017 show that the trends we described are continuing, since the rate increased from 4.02 deaths per 100,000 children and adolescents in 2016 to 4.39 deaths per 100,000 in 2017 — a 9.1% increase.¹ Also, in reply to persons who say that young people who are 18 or 19 years of age should be categorized as adults rather than as adolescents, we point to data showing that in 2017, firearm-related injuries became the second leading cause of death among children and adolescents who were 1 to 17 years of age as well as among those who were 1 to 19 years of age.¹ It is not accurate to describe this as a problem of adults. Furthermore, the rate of deaths from these injuries among children and adolescents who were 1 to 17 years of age was 10.8% higher in 2017 than in 2016.¹

In reply to Bandara et al.: in the United States, children and adolescents in middle school and high school (those who are 14 to 17 years of age) are now more likely to die from firearm injuries than from any other cause, including motor vehicle crashes, and rates of death from firearm injuries among children and adolescents in this age group in 2017 were 8.67 per 100,000 — 22.8% higher than the corresponding mortality from traffic accidents involving motor vehicles, which was 7.06 per 100,000.¹ As a country, we are failing to keep our children safe, and with this failure more than 1800 children younger than 18 years of age (approximately 5 children each day) died from firearm injuries in the United States in 2017. The problem is indeed even worse than described.