Lee Lois K, Tang Suk-Fong S, Cull William L, Fleegler Eric W, Olson Lynn M
Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts.
Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
JAMA Pediatr. 2025 Mar 1;179(3):310-320. doi: 10.1001/jamapediatrics.2024.5089.
Injuries from firearms and motor vehicle crashes (MVCs) are the leading causes of death among US children and youths aged 0 to 19 years. Examining the intersections of age group, sex, race, and ethnicity is essential to focus prevention efforts.
To examine firearm and motor vehicle fatality rates by population subgroups and analyze changes over time.
DESIGN, SETTING, PARTICIPANTS: This cross-sectional study of firearm and MVC fatalities among US children and youths aged 0 to 19 years from the Centers for Disease Control and Prevention Web-Based Injury Statistics and Query Reporting System from 2011 to 2021. Participants included American Indian and Alaska Native; Asian, Hawaiian Native, and Pacific Islander; Black; Hispanic; and White youths. Data analysis was conducted from July 2023 to May 2024.
Firearm or MVC fatality.
Firearm and MVC fatality rates by year and over time, as measured by the Joinpoint regression annual percent change (APC).
From 2011 to 2021 there were 35 684 firearm and 40 735 MVC fatalities among US youths aged 0 to 19 years. For firearm fatalities, there were 21 332 homicides (59.8%), 12 113 suicides (33.9%), 1359 unintentional shootings (3.8%), 277 by legal enforcement (0.8%), and 603 from unknown intents (1.6%). When considering the intersections of age group, sex, race, and ethnicity, for firearm homicides among youths aged 15 to 19 years, the APCs were similar for Black (21.8%) and Hispanic (22.2%) males from 2018 to 2021, although with different peak rates (104.22 per 100 000 individuals and 17.80 per 100 000 individuals, respectively, in 2021). Black females aged 15 to 19 years demonstrated a dramatic APC increase of 40.7% from 2019 to 2021 (peak rate, 14.07 per 100 000 individuals). For firearm suicide in youths aged 10 to 19 years by sex, Black females had the greatest APC increase of 22.0% from 2016 to 2021. For MVC fatalities, the highest APC increase of 24.9% occurred among American Indian and Alaska Native females aged 15 to 19 years from 2018 to 2021. The highest MVC fatality rates occurred in 2021 among American Indian and Alaska Native males (38.16 per 100 000 individuals) and females (29.31 per 100 000 individuals) aged 15 to 19 years.
In this cross-sectional study, US youths aged 0 to 19 years experienced important disparities in firearm and MVC fatality rates and increases over time when considering the intersectionality by age group, sex, race, and ethnicity. These findings suggest that a multipronged strategy focused on individual, community, and policy level approaches for specific high-risk groups for each injury mechanism is necessary to address these leading causes of death in US youths.
枪支伤害和机动车撞车事故（MVC）是美国0至19岁儿童和青少年死亡的主要原因。研究年龄组、性别、种族和族裔的交叉情况对于集中预防工作至关重要。
按人群亚组检查枪支和机动车死亡率，并分析随时间的变化。
设计、背景、参与者：这项横断面研究利用疾病控制和预防中心基于网络的伤害统计和查询报告系统，对2011年至2021年美国0至19岁儿童和青少年的枪支和MVC死亡情况进行研究。参与者包括美洲印第安人和阿拉斯加原住民；亚裔、夏威夷原住民和太平洋岛民；黑人；西班牙裔；以及白人青少年。数据分析于2023年7月至2024年5月进行。
枪支或MVC死亡。
按年份和随时间变化的枪支和MVC死亡率，通过Joinpoint回归年度百分比变化（APC）衡量。
2011年至2021年，美国0至19岁青少年中有35684例枪支死亡和40735例MVC死亡。在枪支死亡中，有21332例为凶杀案（59.8%），12113例为自杀（33.9%），1359例为意外枪击（3.8%），277例由执法人员造成（0.8%），603例意图不明（1.6%）。在考虑年龄组、性别、种族和族裔的交叉情况时，对于15至19岁青少年中的枪支凶杀案，2018年至2021年期间，黑人（21.8%）和西班牙裔（22.2%）男性的APC相似，尽管峰值率不同（2021年分别为每10万人104.22例和每10万人17.80例）。15至19岁的黑人女性在2019年至2021年期间APC急剧上升了40.7%（峰值率为每10万人14.07例）。对于10至19岁青少年按性别划分的枪支自杀情况，黑人女性在2016年至2021年期间APC上升幅度最大，为22.0%。对于MVC死亡，2018年至2021年期间，15至19岁的美洲印第安人和阿拉斯加原住民女性APC上升幅度最高，为24.9%。2021年，15至19岁的美洲印第安人和阿拉斯加原住民男性（每10万人38.16例）和女性（每10万人29.31例）的MVC死亡率最高。
在这项横断面研究中，美国0至19岁青少年在枪支和MVC死亡率方面存在重要差异，并且在考虑年龄组、性别、种族和族裔的交叉性时，随时间有所增加。这些发现表明，有必要采取多管齐下的策略，针对每种伤害机制的特定高风险群体，从个人、社区和政策层面入手，以解决美国青少年这些主要的死亡原因。
