Gun Violence & Kids: Impact, Trauma & Support

The United States experienced a sharp increase in firearm mortality among youth in recent years, with firearms becoming the leading cause of death for children and adolescents by 2020. beyond firearm deaths, there are manny more youth who survive gunshot wounds or are otherwise exposed to gun violence, which can lead to negative behavioral health outcomes. For example, increased youth suicide risk has been linked to communities exposed to school shootings. School shootings in the U.S. have increased in prevalence over time, as has exposure of school-aged children to these shootings, up from 19 per 100,000 school-aged children from 1999-2004 to 51 per 100,000 from 2020 to 2024.

The new Trump Management has revoked multiple gun safety initiatives in the interest of preserving Second Amendment rights. these initiatives include dismantling the School Safety Committeean Executive Order to review and revise firearm regulations by the Bureau of Alcohol, Tobacco, and Firearms that may infringe on Second Amendment rights, and the removal of the former Surgeon General’s advisory that identified gun violence as a public health crisis.

This brief explores the impacts of gun violence on children and adolescents (ages 17 and below) and current policies affecting gun accessibility and safety. Key findings include:

• Firearm death rates among children and adolescents increased 46% from 2019 to 2021,primarily driven by gun assaults. From 2021 to 2023, the firearm death rate has held steady at 3.5 per 100,000 children and adolescents. The increase in gun deaths during the pandemic is most pronounced among Black and Latino youth, among which gun assaults also account for the majority of firearm deaths.
• Nonfatal firearm injuries are two to four times more likely to occur than fatal ones, and Black youth are much more likely than their White peers to be injured by or exposed to a gun violence incident.
• Exposure to gun violence can have severe adverse effects on the mental health and well-being of children and adolescents, including increased likelihood of depression, PTSD, anxiety, and poor academic performance.
• The new Trump Administration has rolled back multiple Biden-era gun safety policies. Simultaneously, access to mental health and trauma support may be impacted by federal budget cuts and restructuring.

How have firearm deaths changed in recent years among children and adolescents?

Firearm-related deaths have increased among children and adolescents since the pandemic began, with seven children per day dying by firearm in 2023. From 2013 to 2023, nearly 21,000 children ages 17 and younger died by firearm. During this period, firearm death rates gradually rose until 2017, then slowed through 2019, before sharply rising with the onset of the pandemic and holding steady in 2023 (Figure 1). From 2019 to 2023, the firearm death rate among children and adolescents increased by 46% (from 2.4 to 3.5 per 100,000). This translates to seven children per day dying by firearm in 2023.

Recent increases in firearm deaths were driven by gun assaults, which accounted for nearly two out of three firearm deaths among children and adolescents in 2023. Gun assault deaths among children and adolescents have increased over the past decade,resulting in 1,622 deaths in 2023 (Figure 2). Leading up to the pandemic, gun assaults made up about half of all child and adolescent firearm deaths. However, from 2019 to 2023, the share of these firearm deaths attributed to gun assaults grew from 54% to 63%.

Among child and adolescent firearm deaths in 2023, 29% were suicides and 5% were accidental. Suicides by firearm have increased over the past decade among children and adolescents, peaking in 2021 with 827 deaths (Figure 3).Suicides by other means, however, have consistently declined since 2019. In 2023, firearms were involved in 47% of total suicide deaths among children and adolescents.

How do youth firearm deaths vary by demographic characteristics?

Firearm death rates have sharply increased among Black and Hispanic children and adolescents as the pandemic began. In 2023, the rate of firearm deaths among black youth was 11.7 per 100,000 – substantially higher than any other racial and ethnic group and over four times higher than White youth (Figure 4). Additionally, from 2018 to 2023, the rate of firearm deaths nearly doubled among black youth and increased by 73% among Hispanic youth. While firearm death rates for American Indian and Alaska Native (AIAN) youth fluctuated over the same period,they remained higher than the rates of their White,Hispanic,and Asian peers throughout the period. White youth experienced relatively stable and lower firearm mortality rates from 2018 to 2023, while Asian youth had the lowest firearm mortality rates across the period (Figure 4).

the recent increases in firearm deaths among Black and Hispanic children and adolescents were primarily driven by gun assaults. Since the onset of the pandemic, the gap in gun assault death rates between Black and White children and adolescents has significantly widened. The gun assault death rate among Black youth grew from 4.9 to 10.3 per 100,000 between 2018 and 2022, dropping slightly to 9.7 in 2023. Among White youth, it remained steady and below 1.0 per 100,000 (Figure 4). The gun assault death rate among Hispanic youth doubled 0.9 to 2.0 per 100,000 between 2018 and 2022 before dropping slightly to 1.8 per 100,000 in 2023.

In 2023, Black youth accounted for 46% of all youth firearm deaths even though they made up only 14% of the U.S. youth population (Figure 5). from 2018 to 2023, the share of firearm deaths attributed to Black children and adolescents grew from 35% to 46%; and the share attributed to Hispanic children and adolescents grew from 16% to 19%.

Firearm death rates for male children and adolescents are over four times higher than their female peers. From 2018 to 2023, the rate of deaths due to firearms increased by 53% among male children and adolescents but remained lower and stable among females (Figure 6).

Among firearm deaths,suicides by firearm are more common among adolescents compared to younger children,while accidental gun deaths are more common among younger children than adolescents (Figure 7). gun assaults accounted for roughly two-thirds of firearm deaths among both adolescents and younger children in 2023.The second most common type of firearm death among adolescents was firearm suicides (32%), and among younger children was accidental gun deaths (21%).

Firearm death rates among children and adolescents vary considerably by state; however, almost all states have seen growth in these death rates in pandemic years. From 2020 to 2023 the states with the highest firearm death rates among children and adolescents were the District of Columbia, Mississippi, and Louisiana (10.3, 9.0, and 8.8 per 100,000 respectively for combined years, 2020-2023.The District of Columbia was also among the states with the highest school shooting exposure rates among school-aged children and adolescents in the 2020-2024 period (356 per 100,000, respectively). The states with the lowest firearm death rates were Massachusetts, New Jersey, and New York (0.7, 0.9, and 1.1 per 100,000 respectively for combined years, 2020-2023). Almost all states experienced an increase in firearm death rates from pre-pandemic to pandemic years, with the largest changes seen in Nebraska, Connecticut, and North Carolina (125%, 100%, and 100% respectively) (Figure 8).

What do we certainly know about nonfatal firearm injury exposure among children and adolescents?

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