Children's Accidental Gun Deaths, 2003–2021: Most at Home, Many With Unlocked, Loaded Guns

In the United States, unintentional injury is the fourth leading cause of death for infants (under 1) and the top cause for children and adolescents aged 1–17, and firearms are a leading way those injuries happen. Unsecured guns — stored unlocked and loaded — are linked to both unintentional and intentional (suicide) firearm injuries and deaths of young people. Most unintentional shootings of children happen at home, usually with a gun from the child's own home; in 2021, about 30 million children lived in homes with firearms, including 4.6 million in homes that stored them loaded and unlocked.

This CDC report describes every unintentional firearm death of children aged 0–17 (called "children" here) recorded from 2003 to 2021.

How the deaths were found

• Source: CDC's National Violent Death Reporting System (NVDRS), which links death certificates, law enforcement reports and coroner or medical examiner records for each incident — here from 49 states, the District of Columbia and Puerto Rico. Florida's data were left out as not complete enough, and states joined in different years.
• Definition: a death from a gunshot by a powder-charged weapon when the evidence showed the shooting was not intentionally aimed at the victim. BB, pellet, air and gas guns were excluded.
• Review: two reviewers read the free-text narratives, each checking a 5% sample of the other's cases until they agreed completely.

Who died

NVDRS identified 1,262 deaths. 83.1% were boys.

Most victims were non-Hispanic White (42.2%), non-Hispanic Black or African American (39.9%) or Hispanic or Latino (10.7%).

How the 1,262 deaths were identified in NVDRS, 2003–2021. Figure from CDC's report.

Who fired

When someone else fired, and their sex and age were known:

• 93.9% of shooters were male, and 75.2% were aged 2–17;
• victims 6–17 were most often shot by someone aged 11–17 (63.4%); victims 0–5 most often by another child aged 2–5 (37.2%).

Where the relationship was known, the shooter was:

Where and how it happened

• 85.5% were shot in a house or apartment — 55.6% in their own home.
• In 34.1% of incidents, other children were present or saw it happen.

The most common circumstances (more than one could apply):

The guns

• 74.0% were handguns.
• 44.6% belonged to a parent of the shooter; 18.2% to the shooter; 12.2% had been reported stolen.
• Where storage was known, the gun had been kept loaded in 73.8% of incidents and unlocked in 76.2%. Of unlocked guns whose loaded status was known, 90.6% were loaded.
• Unlocked guns were most often taken from in or on a nightstand, under a mattress or pillow, or on a bed (30.0%), a shelf or closet (18.6%) or a vehicle (12.5%).

What the authors conclude

• Firearm owners who don't lock all their guns often say locks are unnecessary or would slow access in an emergency — almost half, in one study — which may explain why so many guns came from bedside.
• Parents often misjudge what their children know about where guns are kept and what they would do if they found one; many believe their child can tell a real gun from a toy, and would leave it alone and tell an adult. Here, about two thirds of shooters were playing with or showing the gun, and in 28.0% of deaths of children 0–5, the gun was mistaken for a toy — so relying on children is not enough.
• Children who are exposed to gun violence may suffer poor mental health, such as anxiety; those involved need support.
• Store guns locked, unloaded, and separate from ammunition; supervise children where there is a gun; and ask whether there are unsecured guns in homes your children visit.
• Some states have child access prevention (CAP) laws that hold owners liable when a child gets an unsecured gun. Some research suggests they may help; other research questions how well known they are and finds only modest effects on storage.
• Policymakers, health care professionals such as pediatricians, and others can work with parents, caregivers and gun owners to overcome the barriers to secure storage.

These deaths are preventable.

Limits

• Investigative reports may lack detail — storage and access information is often incomplete.
• States joined NVDRS in different years, so not every death in the period is captured, and Florida is missing.
• Deaths may be misclassified on death certificates, although NVDRS identifies them better than death certificates alone.

Sources

Based on Wilson RF, Mintz S, Blair JM, Betz CJ, Collier A, Fowler KA, "Unintentional Firearm Injury Deaths Among Children and Adolescents Aged 0–17 Years — National Violent Death Reporting System, United States, 2003–2021," MMWR Morbidity and Mortality Weekly Report, volume 72, Centers for Disease Control and Prevention; a work of the United States government in the public domain.