The massacre at Robb Elementary in Uvalde, Texas, revealed many disturbing facts about America’s exceptional propensity for gun violence. But perhaps one of the most disturbing is that firearms are now the leading cause of death among Americans aged 24 and under.
While guns have long been a regular part of American life, the emergence of firearms as the primary killer of young people is a relatively new phenomenon.
For years, cars had that distinction. But in the past two decades, motor vehicle deaths with: Americans ages 1 to 24 plummeted, dropping the percentage by nearly half. And sometime in the late 2010s, those two lines — car deaths and firearm deaths — crossed paths in the chart of the leading causes of death for young people.
In 2020, the most recent year for which data was available, 10,186 youths were killed by firearms, the highest number in two decades.
(It is worth noting that the number of deaths from motor vehicles increased in 2020, the first year of the pandemic. That said, firearms also saw a jump and continued to be the leading cause of death for young people.)
Based on a recent analysis of the data from the Centers for Disease Control and Prevention (CDC) published in the New England Journal of Medicine (NEJM), the one-level map tells a tragic story: lives taken too quickly. But it also shows how policy action can move the needle in saving lives — and how policy neglect can deepen an avoidable tragedy. The received item what first attention when first published in April, but the findings have resurfaced in several American media outlets after the massacre in Uvalde. It’s easy to see why the comparison strikes a chord: The youngest members of our society are dying from America’s most public health problems.
While the Uvalde massacre has sparked the latest round of national gun introspection, the US tragedy of gun violence goes far beyond such incidents. One of the the NEJM article co-authors, Lois Lee, a professor of pediatrics and emergency medicine at Harvard Medical School, told me that mass shootings with at least several deaths are unfortunately just the tip of the iceberg. “Mass shooting like [Uvalde] actually only responsible for less than 1 percent of pediatric firearms deaths. …Most gun deaths are not the result of mass shootings, but of homicides (62%) and suicides (33%),’ said Lee.
Even as the number of deaths from firearms among young people has risen, the number of deaths from motor vehicles has also increased decreased by about half since 2000. Although traffic violence still kills many children and significantly increased in the pandemic, the decades-long decline is nevertheless a hard-fought one public health milestone built on research, safety measures and regulations. This included adoption damage control principles in road safety policy: people will drive anyway, or so the thinking goes, so why not focus on making it as safe as possible?
The current number of young Americans being killed by firearms is not inevitable; it is a policy choice. in their analysis of this CDC data, Lee and her co-authors argue that the same approach to reducing motor vehicle deaths among young people can and should be applied to weapons.
How America Made Cars Safer, But Not Weapons?
The decline in motor vehicle deaths in America over the past two decades is part of a broader trend that started in the sixties. Ralph Nader’s groundbreaking 1965 reveal, Unsafe at any speedhas catalyzed an automotive safety movement that culminated in the creation of the National Highway Traffic Safety Administration (NHTSA), which set up the automotive safety infrastructure.
From the 70swould the NHTSA hold out database about motor vehicle-related deaths, invest in research and provide safety certifications for cars on the market, encouraging car companies to implement safety procedures. The work of the NHTSA and civil society organizations such as the Insurance Institute for Road Safety helped usher in a new era in which safety features such as seat belts and airbags were standardized. All of this, along with measures such as universal driver licensing and car registration, led to a decline in the number of youth and a decline in overall US motor vehicle deaths. The CDC would eventually call this up decline as one of the country’s greatest public health achievements of the 20th century.
And if Lee tells in the NEJM article, that progress has continued into the 21st century. in 1998, front airbags made mandatory in all cars and trucks sold in the US. Other improvements such as automatic emergency braking, blind spot detection, side airbags and rear-facing cameras have also contributed to an improved automotive safety landscape. “What we’ve seen is more than half a century of efforts to make the car safer,” said Mitchell Mossa professor of urban policy and planning and director of the Rudin Center for Transportation at New York University.
When cars went safely one way, the guns went the other way. Weapons are one of the few consumer goods whose safety is not regulated by any government agency† Weapon manufacturers are also very isolated from lawsuitsand may therefore have little incentive to design safer weapons, such as “smart weapons” which can only be used by the users they are registered for. As Moss said, “We really have a Wild West approach to gun production in this country.”
To top it off, federal investigations into guns, gun violence, and gun safety were also basically frozen for over 20 years until 2020 as a result of an NRA-backed measure known as the Dickey amendment† “We don’t even have a real, real-time national database to understand what’s going on with gun injuries and deaths,” Lee said. “We have a lack of infrastructure, a lack of researchers, and then a lack of knowledge to even know the things we can do to reduce or certainly reduce gun injuries and deaths.”
Compare that to cars. Looking at the public health results of reducing motor vehicle deaths, automotive safety improvements and the introduction of driver-specific regulations have paved the way, he says. Kerri Raissian, a professor of public policy at the University of Connecticut. “The federal government has encouraged the implementation of certain safety measures (for example, by tying interstate money to the legal driving age) and states enforce traffic regulations,” she wrote to me in an email. “It’s an achievement in terms of the result and the coordination it took to get us here.”
To be sure, the car death rate is still unacceptably high – a recent report of the International Transport Forum, which is affiliated with the Organization for Economic Co-operation and Development (OECD), found that in 2020 the US had more road deaths per 100,000 people than any other OECD country.
In fact, road deaths probably reached a highlight of 16 years last year, with pedestrian deaths notably, a 59 percent increase since 2009. This can be partly attributed to how cars have become safer for drivers and passengers, but not for anyone else† The automotive industry creates and promotes bigger and more dangerous SUVs those are much more likely to kill pedestrians in crashes. SUV sales have also surged over the past decade, which is good now half of all car sales in the U.S. Despite the increase in pedestrian fatalities, NHTSA has refused to adopt safety tests that other countries use to protect pedestrians.
That said, reducing overall deaths and injuries should be — and have been — the main policy goal, and it’s showing results, Lee says. “It’s unrealistic given the number of cars on the road and the number of vehicle kilometers driven or driven per person that we would ever get to zero,” she said. “And minimizing injuries or deaths is just the tip of the iceberg. There are much bigger injuries that require hospitalization.”
In front of legal† culturaland political reasons, gunsLike it cars, are inextricably linked to American life. But if that’s the case, that’s all the more reason that we should try to implement every possible strategy to reduce damage. Moss put it bluntly, “We’re not going to ban the car from American life,” and the same truth can be applied to guns. “I think what happened is that we normalized the death of children. We have become too accepting of this.”
As cafemadrid’s Marin Cogan wrote, “Doing nothing is endorsing an unacceptable status quo.” And even if federal action isn’t forthcoming soon, there’s still plenty that can and has been done at the state level to successfully reduce gun violence. Lee also pointed out a study she and her colleagues did, showing that enactment of laws requiring the safe storage of firearms away from children led to a reduction in infanticides, suicides and accidental deaths. Further, over there is solid research, both at home and abroad, shows that regulations such as licensing can curb the firearms killing of all people, not just young people.
“If a child is murdered, you lose the rest of their life as a member of society, as a member of their family, as a member of their community,” Lee said. “And the consequences of that will somehow never go away.”