Firearms deaths among U.S. children continue to spike, Northwell Health study shows over 40 percent increase

Published in the journal Pediatrics, research led by Dr. Chethan Sathya found a 41.6 percent increase in the firearm death rate among children between 2018-2021.

Dr. Chethan Sathya is the director of Northwell Health’s Center for Gun Violence Prevention. (Credit: Northwell Health)

NEW HYDE PARK, N.Y.--()--In 2020, firearm injuries overtook traffic accidents as the leading cause of death among children and adolescents in the United States. New research, led by Northwell Health and the Feinstein Institutes for Medical Research, found a 41.6 percent increase in the firearm death rate among children and adolescents between 2018-2021. The research, published in the journal Pediatrics, broke down the demographics, geography and poverty levels of gun deaths. The drastic spike solidifies the need to implement prevention strategies and policies among high-risk communities.

The research, led by Chethan Sathya, MD, director of Northwell Health’s Center for Gun Violence Prevention, and Bailey Roberts, MD, resident general surgery at Northwell’s Long Island Jewish Medical Center and Elmezzi Graduate School of Molecular Medicine scholar, evaluated new 2021 data on U.S. pediatric firearm deaths and disparities to understand trends compared to prior years. Dr. Sathya and his team analyzed the information using the Centers for Disease Control and Prevention (CDC) online WONDER public health database.

The paper, titled “Trends and Disparities in Firearm Deaths among Children,” showed: From 2018-2021, there was a 41.6 percent increase in the firearm death rate. The 4,752 pediatric firearm deaths in 2021 translated to a rate of 5.8 per 100,000 persons, representing an 8.8 percent increase in the 2020 rate. In 2021, among children who died by firearms, 84.8 percent were male, 49.9 percent were Black, 82.6 percent were aged 15-19 years old, and 64.3 percent died by homicide. Black children accounted for 67.3 percent of pediatric firearm homicides, with a death rate increase of 1.8X from 2020-2021. White children accounted for 78.4 percent of firearm suicides.

“In the operating room and across our communities, we continue to see an increase in gun violence among children, a crisis that continues to skyrocket upwards,” said Dr. Sathya, trauma surgeon at Cohen Children’s Medical Center in New Hyde Park. “Our research reiterates the need for action now to bend this horrific curb.”

The findings pinpoint the growing racial, economic and geographical divides that put children at higher risk. Researchers found that geographically, there were worsening clusters of firearm death rates in Southern states and increasing rates in Midwestern states from 2018-2021. Across the U.S., higher poverty levels correlate with higher firearm death rates.

“Gun violence is a public health crisis and as Dr. Sathya’s research shows, children in communities of color and lower income are more at risk to die at the hands of a firearm. Enough is enough,” said Michael Dowling, president and CEO of Northwell Health. “Through community partners, fellow health system leaders, policymakers and politicians, we can move to reverse this ugly trend of child deaths. The time to act is long overdue.”

Since 2019, Northwell Health has been leading the charge to address gun violence as a public health crisis. Through Northwell’s Center for Gun Violence Prevention, the health system continues to invest in gun violence research, including screening emergency room patients about their risk of gun violence and whether they have a weapon in their home and if it is stored safely.

Every year, Northwell hosts its Gun Violence Prevention Forum that brings together leaders, advocates and community members to have an open dialogue on the state of the gun violence epidemic while offering strategies to implement change. The center also spearheaded the Gun Violence Prevention Learning Collaborative for Hospitals, in which over 600 hospitals from 38 states have come together to advance best practices.

In 2022, Northwell launched a multimedia, national awareness campaign focused on public awareness, which has been supported by more than 1,000 hospitals, health systems and associations nationwide. And through the Northwell-initiated National Health Care CEO Council on Gun Violence Prevention & Safety, more than 50 leading healthcare CEOs have pledged to leverage their collective influence and resources to curb the historic spike in gun-related deaths and injuries.

For more information about Northwell Health’s gun violence prevention efforts, please click here.

About Northwell Health

Northwell Health is New York State’s largest health care provider and private employer, with 21 hospitals, about 900 outpatient facilities and more than 12,000 affiliated physicians. We care for over two million people annually in the New York metro area and beyond, thanks to philanthropic support from our communities. Our 85,000 employees – 18,900 nurses and 4,900 employed doctors, including members of Northwell Health Physician Partners – are working to change health care for the better. We’re making breakthroughs in medicine at the Feinstein Institutes for Medical Research. We're training the next generation of medical professionals at the visionary Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and the Hofstra Northwell School of Nursing and Physician Assistant Studies. For information on our more than 100 medical specialties, visit and follow us @NorthwellHealth on Facebook, Twitter, Instagram and LinkedIn.

About the Feinstein Institutes

The Feinstein Institutes for Medical Research is the home of the research institutes of Northwell Health, the largest health care provider and private employer in New York State. Encompassing 50 research labs, 3,000 clinical research studies and 5,000 researchers and staff, the Feinstein Institutes raises the standard of medical innovation through its five institutes of behavioral science, bioelectronic medicine, cancer, health system science, and molecular medicine. We make breakthroughs in genetics, oncology, brain research, mental health, autoimmunity, and are the global scientific leader in bioelectronic medicine – a new field of science that has the potential to revolutionize medicine. For more information about how we produce knowledge to cure disease, visit and follow us on LinkedIn.


Matthew Libassi


Matthew Libassi