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Gun-related deaths increased significantly among children and adolescents in 2020, becoming the leading cause of mortality among youth, researchers said.

The crude rate of firearm-related deaths among individuals ages 1 to 19 years increased by 13.5% from 2019 to 2020, reported Jason Goldstick, PhD, of the University of Michigan in Ann Arbor, and colleagues.

This was largely driven by a 33.4% increase in the crude rate of firearm-related homicides during this time period, they noted in a research letter in the . Firearm-related suicides only rose by 1.1%.

Drug overdoses and poisonings increased by 83.6% among children and adolescents, making it the third leading cause of death for this group.

The rates for other leading causes of death have remained stable since previous analyses, "which suggests that changes in mortality trends among children and adolescents during the early COVID-19 pandemic were specific to firearm-related injuries and drug poisoning," Goldstick and colleagues wrote.

While these data are consistent with other evidence showing that firearm violence increased during the COVID-19 pandemic, the reasons for this increase are unclear, and "it cannot be assumed that firearm-related mortality will later revert to prepandemic levels," the group added. "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."

Recent CDC mortality data showed that there were 45,222 firearm-related deaths in 2020 -- a new peak, the study authors noted. Compared with the more stable increases in gun deaths from 1999 to 2014, the 2020 surge in fatalities was sharp, they pointed out.

From 2019 to 2020, the relative increase in all types of firearm-related deaths (including suicide, homicide, unintentional, and undetermined) among kids was 29.5% -- more than double the relative increase in the general population. The increase was seen across most demographic groups and types of firearm-related deaths, Goldstick and team said.

This study adds to existing evidence showing a trend in gun violence among kids and adolescents in recent years. Earlier this week, a showed that firearm-related deaths became the number one cause of mortality among individuals ages 1 to 24 years in 2017.

"The crossing of these trend lines demonstrates how a concerted approach to injury prevention can reduce injuries and deaths -- and, conversely, how a public health problem can be exacerbated in the absence of such attention," the perspective authors wrote.

Goldstick and colleagues said that more investments have been made to prevent firearm violence, including funding opportunities from the CDC and NIH, as well as proposals for community violence prevention funding in federal legislation. "This funding momentum must be maintained," they urged.

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