Firearms are the leading cause of death for children and adolescents ages 1 to 19 in the United States, a ranking they’ve held since 2020. For the general population across all ages, gun violence does not rank as the top cause of death. Heart disease and cancer have held those positions for decades. The answer depends entirely on which age group you’re looking at.
Why the Age Range Matters
The statistic that gets the most attention, and likely the one behind your search, applies specifically to Americans between the ages of 1 and 19. In 2020, firearms surpassed motor vehicle accidents to become the single largest killer in that age group. That shift was driven by two simultaneous trends: a sharp rise in gun deaths and a long decline in traffic fatalities among young people, thanks to improvements in car safety, seat belt use, and graduated licensing laws.
The starting age of 1 is significant. Infants under 1 year old die overwhelmingly from congenital conditions, premature birth complications, and other medical causes that have nothing to do with injury. Including them in the count would dilute the data in a way that obscures what’s actually killing older children and teenagers. That’s why most researchers and the CDC use 1 as the starting point for injury-related mortality rankings.
For the youngest children, ages 0 to 9, motor vehicle crashes remain the leading cause of injury death. Firearms dominate the statistics primarily because of what happens to teenagers. The 15 to 19 age group accounts for the vast majority of firearm deaths among minors.
What the Numbers Look Like
In 2023, 46,728 people of all ages died from firearms in the United States, the third-highest total ever recorded. To put that in perspective, roughly 128 people died from guns every day that year.
The breakdown by intent often surprises people. Nearly 6 out of every 10 gun deaths are suicides, not homicides. In 2023, 27,300 people died by gun suicide, the highest number on record. Homicides make up most of the remainder, with smaller numbers from accidental shootings, legal intervention, and undetermined causes. More than 500 people are killed by unintentional gunfire each year, and thousands more are injured.
Among children and adolescents specifically, the picture shifts. Firearm homicides in the 0 to 19 age group increased 87% between 2011 and 2021, rising from about 2 per 100,000 to 3.72 per 100,000. Firearm suicides among young people rose 68% over that same decade. These aren’t small statistical fluctuations. They represent a fundamental change in what kills young Americans.
How Firearms Compare for the General Population
For all Americans regardless of age, firearms are not close to the top of the list. Heart disease kills roughly 700,000 people per year. Cancer kills around 600,000. The leading causes of death for the full population are dominated by chronic diseases that primarily affect older adults, which is why the overall rankings look so different from the rankings for children and teens.
The CDC groups certain causes under broader categories for its official rankings. Motor vehicle deaths, for example, fall under “unintentional injuries” rather than being listed on their own. Firearm deaths similarly span multiple categories: they appear under homicide, suicide, and unintentional injury depending on the circumstances. This classification system means you won’t find “gun violence” as a single line item on the CDC’s standard leading causes of death table for the general population, even though the combined toll is substantial.
Disparities Within the Data
The risk of dying from a firearm is not evenly distributed. Race, sex, and geography all play major roles. Among 15 to 19 year olds, American Indian and Alaska Native males had the highest firearm suicide rate in 2020, at roughly 24 per 100,000. Black adolescents face disproportionately high rates of firearm homicide. Rural and urban communities experience different patterns of gun death, with rural areas seeing higher rates of suicide and urban areas seeing higher rates of homicide.
These disparities mean that national averages can obscure what’s happening in specific communities. For some demographic groups, the firearm death rate is several times higher than the national figure, while for others it’s well below average.
What Changed in 2020
The crossover year, when firearms overtook motor vehicles as the leading killer of young people, wasn’t a coincidence. Motor vehicle fatality rates among children had been falling steadily from 2011 to 2019. Then, while traffic deaths ticked back up slightly during 2020 and 2021, firearm deaths surged past them. The gap between the two has persisted since.
Several factors contributed to the spike in gun deaths starting in 2020, including record firearm sales, disruptions to community violence intervention programs, economic stress, and reduced access to mental health services during the pandemic. Whether the elevated rates will remain at this level or return closer to pre-2020 numbers is still playing out in the data.