Causes of Death Among U.S. Children

Overall leading causes
Advances in the science of medicine and implementation of preventive measures including vaccination against childhood diseases such as measles and polio brought about a long-term trend decline in the death rates of U.S. children and adolescents. But recently there has been an increase in death rates due to failure to adequately address preventable causes of death. Over the past five years death rate increases from motor vehicle crashes, drug overdoses and gun violence have reversed the downward trend in child death rates. Death from firearm injuries (homicide, suicide, and unintentional) is now the leading cause of death and now accounts for about one fifth of all child and teen deaths.​ Other major causes include unintentional injuries such as drowning and falls, cancer, and congenital (birth) conditions, with the exact ranking varying by age group.​ Black children and teens experience disproportionately high firearm mortality, along with elevated rates for certain other injuries and chronic diseases.

Causes by broad age group

• Infants (under 1 year): Leading causes are conditions related to prematurity and low birth weight, congenital malformations, and pregnancy or birth complications.​
• Ages 1–4 years: Unintentional injuries (especially accidents), congenital malformations, and homicide are the top listed causes.​
• Ages 5–14 years: Unintentional injuries are the leading cause, followed by cancer and congenital malformations.​
• Teens (15–19 years): Injuries dominate, especially firearms (homicide and suicide), motor vehicle crashes, and drug overdoses/poisonings.​

Top Causes by Age Group

Suicide and overdose deaths among children and youth surged during the COVID-19 pandemic but have shown signs of slowing or declining in recent years. Overdose rates, driven largely by fentanyl, more than doubled from pre-pandemic levels, while suicide rates had been rising steadily beforehand, with firearms playing a key role in many cases.​

Overdose Trends
Drug overdose death rates among adolescents aged 12-19 jumped sharply starting in 2019, from 1.1 per 100,000 in 2019 to 2.8 in 2022, before easing to 1.7 in 2024. Fentanyl involvement rose dramatically, accounting for 65% of adolescent overdoses by 2020, with faster increases among Black and Hispanic youth compared to White youth, though White adolescents still represent the largest share. Total adolescent overdose deaths peaked at 721 in 2022 and fell to 441 by 2024, amid broader U.S. declines into 2025.​

Suicide Trends
Suicide rates among youth aged 10-19 increased by 70% from 2007 to 2019, contributing to child mortality rises, with firearms linked to nearly half of the 2020-2021 uptick in deaths. Overall child mortality for ages 1-19 rose 11% in 2020 and 8% in 2021, driven by suicides, homicides, and overdoses. Racial disparities persist, with notable increases across groups, though specific 2024-2026 data shows stabilization tied to broader mental health interventions.​

Reducing Child and Adolescent Deaths
Mortality data from other wealthy nations shows that US death rates for children and teens are substantially higher, so clearly much improvement is possible. Some specific risks and actions that can be taken to reduce risk of them are as follows:

• Firearm safety–keeping guns away from children and anyone with suicidal ideation or other mental problems, gun safety education, enforcing permit regulations, and limiting access to military type weapons are common sense options. (See Timely Topic, Gun Safety)
• Motor vehicle safety–enhanced driver education and license testing, enforcing traffic laws, elimination of the underuse of seatbelts, use of infant and child restraints, and addressing drunk or stoned driving are approaches to reducing this leading cause of death. The recent increase in motorized bikes is a new challenge that is similar to that posed by traditional motorcycles with underuse of head protection with helmets a leading contributor to serious injury and death. (See Timely Topics, E-Bikes, Teens and Distracted Driving and Safe Driving for Teens)
• Drug overdoses– Preventing teen drug overdoses works best when adults combine honest education, strong relationships, mental health support, and practical safety steps like securing medications and having naloxone available in high‑risk situations. No single approach is enough; layering strategies at home, school, and in the community offers the greatest protection.​ Open communication focusing on safety and health rather than scare tactics works best. Explain that many counterfeit pills and powders may contain fentanyl, so “trying something once” can be lethal, even for non‑regular users.​ Explain that cannabis is not benign and edible cannabis has let to many hospitalizations and deaths. Lock up prescription medications, count pills, and promptly dispose of unused opioids or sedatives through take‑back programs or pharmacy drop boxes. (See Timely Topic, Medicines Safety)​ Encourage involvement in sports, clubs, arts, or jobs that build skills, self‑esteem, and healthy peer groups, which all reduce substance risk.​ Watch for signs of depression, anxiety, trauma, bullying, or big life changes (moves, divorce, losses), which increase odds of substance misuse.​ Seek timely counseling, therapy, or psychiatric care when needed. SAMHSA’s National Helpline (1‑800‑662‑HELP) offers free, confidential treatment referrals 24/7.​ (See Timely Topic, Substance Abuse in Adolescents)
• Injuries–the top cause of injuries to children age 1 to 7 is playground accidents, among those age 8 to 11, bike accidents, and among those age 12 to 18 from football and basketball. High risk sports include skateboarding, snowboarding, skiing, motocross, mountain biking, and among girls cheerleading stunts. Underuse of head protection with helmets in sports is a leading contributor to serious injury and death. (See Timely Topics, Bike Safety for Kids, Head and Brain Injuries in Children)
• Infectious diseases–See Timely Topic, Vaccination.
• Cancer–See Timely Topic Cancer in Children.
• Suicide–See Timely Topics, Suicide, and Mental Illness.
• Choking–Asphyxiation from inhaled objects is the fourth leading cause of death among children age 4 and younger with 60% of the deaths due to choking on food. Hard candy, grapes, non-hot dog meat, and hot dogs are common causes of choking. Ensuring all food is in served in small portions and avoiding eating when in a car or running can help prevent accidental choking. Avoid feeding pureed food to babies age 4 months or younger. Parents should learn how to administer CPR for choking.
• Poisoning–Keep medications and household chemicals like shampoo and alcohol out of sight, out of reach and medications in containers with child resistant closures. Remember that safety caps are child resistant not child proof. (See Timely Topic, Medications Safety) Hazardous chemicals including pesticides, drain and other household cleaners, and soap pods should also be stored out of sight and out of reach. See Timely Topic: Protecting Children form Toxic Chemicals.
• Abductions–The U.S. Department of Education has an online guide to preventing the kidnapping of children at: https://www.ed.gov/sites/ed/files/parents/academic/involve/safety/personal_safety.pdf
• Tobacco– See Timely Topic: Tobacco Use Prevention.

Summing up
The U.S. consistently has higher child (especially infant) mortality rates than the average for other OECD countries, ranking near the bottom among wealthy nations, with recent data showing rates roughly double the OECD average and significantly worse than peer nations like Japan, Sweden, or Australia, driven partly by firearm deaths and socioeconomic disparities, with Black infants facing much higher risks. 
It would seem that other countries are trying harder to keep their children alive. Their success demonstrates that U.S. parents and institutions can do better with a healthier environment, health education, and healthy behaviors being the keys to improved health and lower death rates for U.S. Children.

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