What are the most common causes of injury or death in children?

Most Common Causes of Injury or Death in Children

Injury is the number one killer of children ages 1 to 18 years in the United States, accounting for more deaths than all other causes combined. 1

Age-Specific Leading Causes

Infants (Under 1 Year)

• Sudden Infant Death Syndrome (SIDS) remains a significant contributor to infant mortality 1
• Suffocation deaths have increased by 20% from 2010-2011 to 2018-2019, driven in part by better death investigation that now classifies more sleep-related deaths as suffocation events 2, 3
• Head injuries from falls account for 92% of shopping cart-related injuries in this age group 4

Young Children (1-4 Years)

• Drowning is the leading cause of death, representing the single most common mechanism of fatal injury 4
• Unintentional injuries overall account for 12.6% of deaths in this age group 5
• Shopping cart-related injuries affect 85% of children under 5 years, with 79% involving head and neck injuries 4

School-Age Children (5-14 Years)

• Drowning is the second leading cause of death from unintentional injury 4
• Motor vehicle crashes become increasingly important as children age 1, 6
• Unintentional injuries are the clear leading cause of death 1

Adolescents (15-19 Years)

• Motor vehicle crashes are the single most common mechanism of death, causing approximately 2,500-fold more deaths than cardiovascular causes 4, 1
• Suicide is the second leading cause of death, with firearms accounting for a significant proportion 4, 1
• Homicide is the third leading cause, with 84.5% being firearm-related 1
• Proportionate mortality from injuries increases to 28.8% in this age group 5

Specific Injury Mechanisms by Frequency

Top Three Fatal Mechanisms (All Ages Combined)

1. Motor vehicle occupant injuries - most common overall cause of unintentional injury death 6, 7
2. Drowning - third leading cause of death from unintentional injury worldwide, accounting for 7% of all injury-related deaths 4
3. Pedestrian injuries - third most common mechanism after motor vehicle and drowning 7

Other Important Mechanisms

• Poisoning - increasing among children, particularly prescription opioid misuse and overdose 3
• Burns and fires - significant contributor, especially in low- and middle-income countries 6, 5
• Falls - common cause of non-fatal injury requiring emergency department visits 6

Critical Demographic Disparities

Sex Differences

• Male children have significantly higher injury death rates than females (11.3 vs. 6.6 per 100,000 population) 2
• The exception is burns, which occur more frequently among females in low- and middle-income countries 5

Racial and Ethnic Disparities

• American Indian/Alaska Native children have the highest death rates (19.4 per 100,000) 2
• Black children have elevated rates (12.4 per 100,000) and experienced a 9% increase in motor vehicle traffic deaths and 37% increase in poisoning deaths from 2010-2019 2
• Hispanic children experienced a 50% increase in poisoning deaths during the same period 2
• White children have lower rates (9.0 per 100,000) 2

Geographic Disparities

• Rural areas have 2.6 times higher death rates than urban areas (17.8 vs. 6.8 per 100,000 in most rural vs. most urban counties) 2
• Death rates increase progressively as rurality increases 2

Firearm-Related Deaths

Firearms are among the top 3 causes of death in American youth, with firearm-related deaths accounting for 28.7% of all injury deaths in 15-19 year-olds and 19.5% in those under 20 years 4

• The United States has firearm homicide rates 35.7 times higher than other high-income countries for youth 15-24 years 4
• Firearm suicide rates are 8 times higher in children 5-14 years compared to other high-income countries 4
• Black males 15-34 years are particularly affected, with firearms being the leading cause of death 4

Economic Impact

• Deaths from injuries account for more years of potential life lost under 18 years than SIDS, cancer, and infectious diseases combined 1
• The direct cost of childhood injury exceeds $50 billion annually in the United States 1

Common Pitfalls in Understanding Pediatric Injury Mortality

• Vital statistics alone underestimate the true burden - death certificate data provide limited information about circumstances compared to multidisciplinary child fatality review teams 4
• Aggregate trends mask important disparities - while overall injury death rates decreased 11% from 2010-2019, specific subgroups experienced increases 2, 3
• Age-specific patterns are critical - the leading cause varies dramatically by age, from SIDS in infants to drowning in toddlers to motor vehicle crashes in adolescents 4, 1, 2