Weybright Elizabeth H, Terral Heather F, Conrick Kelsey M, Carter Patrick M, Rowhani-Rahbar Ali
Department of Human Development, Washington State University, 512 Johnson Tower, Pullman, WA, 99164, 509-335-2130, USA.
Department of Community and Behavioral Health, Washington State University, Spokane, WA, USA.
Inj Epidemiol. 2025 Sep 1;12(1):53. doi: 10.1186/s40621-025-00613-w.
Youth are at high risk for firearm-related injury and death. However, research combining children and adolescents into one homogeneous group ignores distinct developmental stages and associated risks. Addressing firearm mortality as a public health crisis requires strategies tailored to developmental stage, injury intent, setting, and cultural context. Given this, the purpose of the current study was to identify changes over time in injury mortality and specifically firearm-related mortality, among middle (11-13 year olds) and high school-aged (14-18 year olds) adolescents in metro and non-metro areas of the United States.
Crude death rate data were pulled from the United States Centers for Disease Control and Prevention Web-based Injury Statistics Query and Reporting System Fatal Injury Data from 2001 to 2022. Across all fatal injury causes among 11-18 year olds, firearms surpassed motor vehicle collisions as the leading cause of death in 2017. When looking specifically at fatal firearm injuries, rates of homicide were consistently higher than those of suicide and unintentional death, with a 79.3% increase from 2018 to 2022. In non-metro areas, suicide was the leading cause of death for the 11-13 year olds. Among the 14-18 year old group suicide remained the leading cause of death despite a 362.9% increase in homicide. In metro areas, homicides among 14-18 year olds surged 127.3% from a 2013 low and remained higher than rates of suicide.
Findings suggest developmental differences influence risk and combining children and adolescents together obscures distinct trends within critical developmental stages. Prevention strategies should be informed by developmental stage and include violence and injury prevention efforts in all areas as well as developmentally and culturally appropriate suicide prevention approaches in rural areas.
青少年面临与枪支相关的伤害和死亡的高风险。然而，将儿童和青少年合并为一个同质群体的研究忽略了不同的发育阶段及相关风险。将枪支死亡率作为公共卫生危机来应对需要根据发育阶段、伤害意图、环境和文化背景量身定制策略。鉴于此，本研究的目的是确定美国大都市和非大都市地区中（11至13岁）和高中年龄段（14至18岁）青少年的伤害死亡率，特别是与枪支相关的死亡率随时间的变化。
粗死亡率数据取自美国疾病控制与预防中心基于网络的伤害统计查询与报告系统2001年至2022年的致命伤害数据。在11至18岁的所有致命伤害原因中，枪支在2017年超过机动车碰撞成为主要死因。具体查看致命枪支伤害时，杀人率一直高于自杀率和意外死亡率，从2018年到2022年增长了79.3%。在非大都市地区，自杀是11至13岁青少年的主要死因。在14至18岁年龄组中，尽管杀人率增长了362.9%，自杀仍是主要死因。在大都市地区，14至18岁青少年的杀人率从2013年的低点飙升了127.3%，且仍高于自杀率。
研究结果表明发育差异会影响风险，将儿童和青少年合并在一起会掩盖关键发育阶段内的不同趋势。预防策略应依据发育阶段制定，包括在所有领域开展预防暴力和伤害的工作，以及在农村地区采取适合发育阶段和文化背景的自杀预防方法。
