Defining the Full Spectrum of Pediatric Firearm Injury and Death in the United States: It is Even Worse Than We Think

To characterize the full spectrum of pediatric firearm injury in the United States by describing fatal and nonfatal injury data epidemiology, vulnerable populations, and temporal trends. Firearm injury is the leading cause of death in children and adolescents in the United States. Nonfatal injury is critical to fully define the problem, yet accurate data at the national level are lacking. A cross-sectional study combining national firearm injury data from the Centers for Disease Control (fatal) and the National Trauma Data Bank (nonfatal) between 2008 and 2019 for ages 0 to 17 years. Data were analyzed using descriptive and χ 2 comparisons and linear regression. Approximately 5000 children and adolescents are injured or killed by firearms each year. Nonfatal injuries are twice as common as fatal injuries. Assault accounts for the majority of injuries and deaths (67%), unintentional 15%, and self-harm 14%. Black youth suffer disproportionally higher injuries overall (crude rate: 49.43/million vs White, non-Hispanic: 15.76/million), but self-harm is highest in White youth. Children