Accidents, also classified as unintentional injuries, are the leading cause of death among teenagers in the United States. Homicide ranks second, followed by suicide. Together, these three causes account for the vast majority of teen deaths, far outpacing any medical condition. In 2023, 12,777 adolescents aged 15 to 19 died in the U.S., a rate of 57.9 deaths per 100,000.
How Teens Die in the U.S.
The top three causes of death for teens are all injury-related, not disease-related. Accidents make up roughly 48% of all teen deaths, with motor vehicle crashes being the single largest contributor within that category. Homicide accounts for about 13%, and suicide for about 11%. Cancer (6%) and heart disease (3%) are the most common natural causes, but they’re far less prevalent than the injury categories.
One major shift in recent years: firearms surpassed motor vehicle crashes as the leading cause of death among young people aged 11 to 18 in 2017. That includes firearm deaths across all categories, whether classified as homicide, suicide, or accidental. When you look at the broader age range of 1 to 19, firearm-related injuries became the overall leading cause of death in 2020.
Drug overdose and poisoning have also surged. From 2019 to 2020, drug overdose deaths among children and adolescents increased by 83.6%, driven largely by a 110.6% spike in unintentional poisonings. Overdose became the third leading cause of death for the 1-to-19 age group during that period.
Car Crashes and Risk Factors
Motor vehicle accidents remain the single largest type of accidental death for teens. The risk factors are well documented and, in many cases, preventable. Among teen drivers and passengers aged 16 to 19 who died in car crashes in 2020, 56% were not wearing a seat belt. In 2019, 39% of high school students who drove reported texting or emailing while behind the wheel at least once in the prior 30 days.
Graduated driver licensing (GDL) laws, which phase in driving privileges for new teen drivers through restrictions on nighttime driving and passengers, have made a measurable difference. States with these laws have seen a 15% to 40% reduction in crash rates for 16-year-olds. One national study estimated a 35% reduction in fatal crashes per year for 16-year-olds under GDL laws. About half that improvement came from teens simply driving fewer miles, and the other half from safer driving when they were on the road. The protective effect fades with age: 17-year-olds saw a 17% reduction, while 18-year-olds showed almost no benefit, likely because GDL restrictions no longer apply.
Suicide Trends in Young People
Suicide is the third leading cause of death for older teens (15 to 19) and ranks even higher among certain demographic groups. For non-Hispanic Asian American teens of both sexes aged 15 to 19, suicide has consistently been the top cause of death. For non-Hispanic White boys in the same age range, suicide and transportation accidents trade places at the top depending on how deaths are classified and which years are examined.
Among younger adolescents aged 10 to 14, suicide also ranks prominently. National Institutes of Health researchers found that suicide rates among preteens (ages 8 to 12) have been increasing by approximately 8% per year since 2008. That trend is particularly alarming because it extends into an age group where suicide was historically rare.
Racial and Ethnic Disparities
The leading cause of death varies significantly by race and ethnicity. For non-Hispanic Black boys aged 15 to 19, homicide has been the top cause of death before, during, and after the COVID-19 pandemic. For Hispanic boys in the same age group, homicide and transportation accidents have traded the top position over recent years. Non-Hispanic White boys are more likely to die from suicide or transportation accidents. These patterns held relatively stable from 2018 through 2023.
For girls aged 15 to 19, the disparities are similar. Non-Hispanic Black girls face homicide as their leading specific cause of death, while transportation accidents top the list for Hispanic and non-Hispanic White girls. Unintentional firearm injuries rank among the top ten causes of death for non-Hispanic Black and Hispanic boys aged 15 to 19, a distinction not seen in other groups.
Younger Teens vs. Older Teens
The risk profile shifts between early and late adolescence. For 10-to-14-year-olds, accidents still lead, but the gap between accidents, suicide, and homicide is narrower. Suicide is a more prominent relative threat in this younger group, particularly for White and Asian American boys. Among non-Hispanic Black boys aged 10 to 14, homicide rose to the top during the pandemic years of 2020 and 2021.
Older teens aged 15 to 19 face dramatically higher overall mortality. Their death rate of 57.9 per 100,000 reflects the combined effect of driving (often with limited experience), greater exposure to violence, and higher rates of substance use. The jump in risk from early to late adolescence is largely driven by the fact that 16-year-olds start driving and older teens are more likely to be in social environments where firearms and drugs are present.
What’s Changed Over Time
The rank order of accidents, homicide, and suicide as the top three causes of teen death has remained remarkably stable for decades. What has changed is the role of firearms and drugs within those categories. The crossover of firearms past motor vehicles as the leading injury cause in 2017 reflected both a rise in gun deaths and a long-term decline in traffic fatalities driven by safer vehicles and graduated licensing laws.
The drug overdose surge, largely tied to illicit fentanyl contaminating the drug supply, added a new dimension to accidental death starting around 2019 and 2020. For teens, who may be experimenting with substances for the first time, even a single exposure to a contaminated pill can be fatal. This has pushed unintentional poisoning into the top causes in a way that wasn’t true a decade ago.