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Fatal injury rates have spiked over the past decade for children and teens in the U.S., especially deaths involving guns and drugs, according to new research published in the journal Pediatrics Thursday.

Using injury data for children under age 18 from 2011 to 2021 from the Centers for Disease Control and Prevention, researchers found firearm fatalities increased by 87.1% during that time period. Drug poisoning fatalities increased by 133.3%, and suffocation-related fatalities increased by 12.5%.

“Recent trends in pediatric injury-related fatalities are alarming, with increases in homicides, suicides, and poisonings in the past decade,” the authors write.

Nonfatal firearm and poison-related injuries also increased — up 113.1% and 9.9%, respectively.

At the same time, the rates of nonfatal injuries within the same age group decreased in several other categories from 2011 to 2020, including a 52.8% decline in injuries from falls and a 47.3% decrease in motor vehicle occupant injuries. Injuries from drownings stayed the about same. 

“The divergent trends between fatal and nonfatal injuries highlight the need for a comprehensive approach to childhood injury prevention,” the study notes. 

The authors credit the decrease in nonfatal car injuries, for example, to public health interventions targeting pediatric safety, technological advancements and legislative requirements.

But the opposite is the case for firearms and drug poisonings.

“Despite the progress in reducing most nonfatal injuries, the trends in increasing nonfatal firearm and poisoning injuries defy the overall trend in nonfatal injuries, in part because public health legislative support has lagged in these critical injury mechanisms,” they write. “This is especially concerning given the high case fatality rate of these injury mechanisms in children.”

In addition to more research, the authors urged the need for stronger legislation, enhanced public awareness, and improved health care systems to address both fatal and nonfatal injuries among children.