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Journalism of Courage
In the days immediately before and after the mass shooting in Texas on May 24, in which 19 schoolchildren were killed, medical specialists published two commentaries highlighting the toll gun violence has been taking on American children and adolescents.
Firearm violence is now the leading cause of death among people in the age group 0-19 in the United States, according to data recently released by the US Centers for Disease Control and Prevention (CDC) and referenced by both commentaries. In 2020, firearms overtook vehicle crashes as the leading cause of death in this age group.
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Trends in deaths
The graph, published in the New England Journal of Medicine on May 19 along with a letter to the editor from three faculty members of the University of Michigan’s emergency medicine department, shows deaths caused by firearms crossed 5.5 per lakh population in the 0-19 age group in 2020, higher than the deaths caused by vehicle crashes (about 5 per lakh). Overall, out of 45,222 deaths caused by firearms in 2020, 4,357 were of children, National Public Radio quoted Patrick Carter, one of the authors of the letter, as saying.
Both commentaries noted the contribution of murders to the rise in firearm deaths. “The increase in firearm deaths is largely due to increased firearm homicides, as nearly 60% of firearm deaths among young people since 2010 were homicides,” six paediatric emergency medicine specialists from various US institutions wrote in a comment in The Lancet Child and Adolescent Health on May 26.
Between 2019 and 2020, across age groups, the rate of all firearm deaths rose 13.5%, while firearm deaths due to murder rose 33.4%. In the 0-19 age group, “the relative increase in the rate of firearm-related deaths of all types (suicide, homicide, unintentional, and undetermined)… was 29.5% — more than twice as high as the relative increase in the general population”, the letter in NEJM said.
After gun violence and motor crashes, the third leading cause of death was drug overdose and poisoning, which increased by 83.6% from 2019 to 2020 in the 0-19 group.
Rise during pandemic
Going by the relative stability in other leading causes of death, the letter in NEJM suggested that changes in mortality trends among children and adolescents during the early pandemic were specific to firearm-related injuries and drug poisoning. Covid-19 itself resulted in 0.2 deaths per 100,000 children and adolescents in 2020.
The authors of the Lancet commentary also highlighted the absence of prevention efforts: “Although firearm fatality rates started to increase in 2014, the societal upheaval of the Covid-19 pandemic probably accelerated this increase with the escalation of mental health stressors and worsening of wellbeing. This shift in the daily lives of young populations during the pandemic occurred in the context of an absence of prevention efforts in the past decades to decrease firearm injuries and deaths.”
And the authors of the NEJM letter wrote: “Although the new data are consistent with other evidence that firearm violence has increased during the Covid-19 pandemic, the reasons for the increase are unclear, and it cannot be assumed that firearm-related mortality will later revert to prepandemic levels. Regardless, the increasing firearm-related mortality reflects a longer-term trend and shows that we continue to fail to protect our youth from a preventable cause of death.”
