Are guns the biggest killer of ‘children and teens'?

Washington Post

18-06-2025

'I recently learned an alarming statistic — gun injuries are the No. 1 killer of children and teens in this country.'
— actor Harry Hamlin, in an ad sponsored by the Ad Council, June 2025
The Ad Council, which distributes public service announcements, last year launched a $10 million campaign to inform Americans of the statistic cited by Hamlin in one of the recent ads. In announcing the campaign, the Ad Council noted that a poll has found that just 26 percent of Americans surveyed 'selected gun injuries as the leading cause of death among children, demonstrating a need for further education.'
Besides the Hamlin ad, the spots feature young teens debating gun violence, parents talking about guns and a pediatrician with a young child. They all highlight the same point — 'Firearm injuries are the leading cause of death for children and teens,' sourced to the Johns Hopkins Center for Gun Violence Solutions.
The ad campaign is designed to address this problem. But what happens if the statistic, as framed, is misleading?
Note that Hamlin, in the ad, referred to 'children and teens' and the Ad Council, in its poll, asked about just 'children.' Therein lies a tale.
We'd previously looked into this issue when then-Vice President Kamala Harris made a similar claim: 'Gun violence is the leading cause of death of the children of America — leading cause of death — not car accidents, not some form of cancer — gun violence.'
So much depends on the definition of child and teenager. Is a child under the age of 18? Or younger? And if one refers to teens, does that include 18- and 19-year-olds?
For instance, the National Institutes of Health, for grant applications, defines a child as 'an individual under the age of 18 years.' The European Union has a similar definition. The United Nations, in the 1989 Convention on the Rights of the Child, says 'a child means every human being below the age of eighteen years.'
The fact that in more than half the states people as young as 18 can purchase firearms is significant, because access to firearms increases the risk of violence. In 2018, 19-year-old Nikolas Cruz opened fire on students and staff at a high school in Parkland, Florida, killing 17 people. He legally bought a Smith & Wesson M&P 15 semiautomatic rifle from a licensed dealer a few miles from the school.
Two years ago, the source for this statistic, the Johns Hopkins Center, defended the inclusion of teens 18 and 19 years old to The Fact Checker in its reports released in 2022 and 2023.
Yet, in its 2024 report, issued after our previous fact check, Johns Hopkins narrowed the focus and created new categories: children (ages 1-9) and teens (10-17). Among teens, Johns Hopkins added two other categories: older teens (15-17) and emerging adults (18-19).
Asked why the change was made, Cassandra Crifasi, co-director of the Johns Hopkins Bloomberg School of Public Heath's Center for Gun Violence Solutions, told The Fact Checker in an email: 'Based on potentially different policy implications related to firearm purchasing for those 18-19, our team of researchers decided that to more clearly show the impact on youth, we would delineate between children 1-17 and emerging adults as 18-19.'
That's exactly the point we made in 2024. Still, the headline statistic remained the same: Gun violence was the leading cause of death among young people in 2022, even when defined as ages 1-17. But as we noted, removing 18- and 19-year-olds significantly narrows the gap between gun violence and the next highest cause of death — vehicle crashes.
In its 2022 report on 2020 data (ages 1-19), the Johns Hopkins Center for Gun Violence Solutions listed 4,357 deaths from firearms and 3,639 deaths from vehicle crashes. In the latest study (ages 1-17), the report showed 2,526 deaths from firearms and 2,240 deaths from vehicle crashes in 2022. That's a smaller difference.
(Johns Hopkins does not include children under 1 because they have perinatal deaths and congenital anomalies — unique, age-specific death risks. This decision marginally reduces the number of children killed by firearms. But it also greatly reduces the number of motor vehicle deaths. The results also change depending on whether only traffic-related crashes are counted instead of an overall motor vehicle category.)
But when older teens (15-17, as defined by Johns Hopkins) are removed from the calculations using the Center for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System (WISQARS), the numbers change dramatically, with almost 50 percent more deaths from vehicle crashes than firearms. Vehicle crashes exceed firearms deaths also for ages 1-15.
As for children, ages 1-9 as defined by Johns Hopkins, firearms deaths are so much lower that they don't even make second place. Usually, most children die from vehicle crashes, but in 2023 drownings topped the list. There were 630 children who died by drowning, 578 in vehicle crashes and 234 by firearms.
The Johns Hopkins report has a chart that highlights the disparities among age groups. 'While teens account for most gun deaths in youth ages 1-17, younger children are not immune. A total of 140 children ages 1-4 and 117 children ages 5-9 died by a gun in 2022,' the report says.
Crifasi, in her mail, said: 'We recognize that gun violence is the leading cause of death for some age groups within the 1-17 range, while for others, it is among the leading causes but not the top cause.'
The Ad Council defended references to children in the ads.
'Even one death of a child from firearm injury is too many, and we hope this effort can help us find common ground and work to reduce the impact of gun violence on both children and teens,' said Ad Council spokesman Ben Dorf, who noted that the ads also featured teenagers and adults. 'We also have more work in the pipeline as part of this campaign that centers on teens, who we agree are immensely impacted by this issue,' he added.
Crifasi said the Johns Hopkins gun violence center 'was not consulted by the Ad Council on their campaign.' She added that 'whether the victim is a child in elementary school or a teenager on the cusp of adulthood, each life lost to gun violence is a preventable tragedy.'
The racial disparity in firearm deaths — and how it keeps growing — is striking, when you drill down on the CDC data. In 2018, vehicle deaths for Blacks ages 1-15 were higher than firearm deaths (274 vs. 247). But in 2023, 550 Blacks between the ages 1 and 15 were killed by a firearm, compared with 309 for vehicle crashes.
Meanwhile, among Whites, deaths from vehicle crashes for ages 1-15 (877 in 2023) remained much higher than firearms (572) — and drowning (469) or suffocation (419) are not far behind. The racial disparity is even greater among teens. Yet people who self-identify as Black make up less than 15 percent of the U.S. population, according to the Pew Research Center.
'We have noted the increase in gun suicides among Black youth,' Crifasi said. 'This is a troubling trend that we believe merits further attention and research. Our team has been focusing on these rising gun suicide trends and will be analyzing the latest data in a forthcoming report.'
In fact, much of the rise in firearm deaths in the 1-17 age range since 2018 can be attributed to the rise in deaths among Blacks, not Whites.
No matter how you slice the data, the United States stands unique among similar large and wealthy nations with so many firearms deaths of people under age 18. None has firearms deaths among the top four causes of death for children, according to a 2023 study by KFF, a health policy organization. The U.S. mortality rate is nearly 10 times that of Canada, which among U.S. peers has the second-highest child and teen firearm death rate. There are so few firearm deaths of children in other countries that it ranks 15th as a cause of death in Japan and Britain, and 13th in Germany and the Netherlands, KFF said.
A study published recently in JAMA Pediatrics traces the rise in gun deaths among Americans 17 and under to the 2010 Supreme Court decision, McDonald v. Chicago, that said states could not infringe on the Second Amendment right to possess firearms. The study found a clear distinction in the rise of deaths in states that enacted weaker gun laws. 'States with permissive firearm laws experienced thousands more pediatric deaths than would have occurred had their post-McDonald v. Chicago firearm mortality trends matched those in states with restrictive firearm laws, indicating that these deaths are not inevitable,' the study said.
The surge of gun violence in the United States is horrific, and we can understand the desire of advocates to highlight the risk to children. Johns Hopkins appropriately chose a more appropriate metric for its latest report, but its subcategories (such as children) highlight how wrong it would be to only reference children (as Harris did in 2024).
Firearms are the leading cause of deaths among teens, especially older teens. That's very clear, especially among Black teens. A more precise statement — highlighting the risk faced by teens — might help focus attention on who the horrible toll of gun violence harms most.
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