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Trends from 2002 to 2014 were tested using joinpoint regression analyses.

Incident characteristics and circumstances were examined by using data from the National Violent Death Reporting System.

OBJECTIVES: Examine fatal and nonfatal firearm injuries among children aged 0 to 17 in the United States, including intent, demographic characteristics, trends, state-level patterns, and circumstances.

METHODS: Fatal injuries were examined by using data from the National Vital Statistics System and nonfatal injuries by using data from the National Electronic Injury Surveillance System.

States joined the NVDRS system in different years tests were used to test the statistical significance of differences in NVDRS circumstance counts between younger (aged 0–12 years) and older (aged 13–17 years) children for firearm homicide and unintentional firearm deaths.

This article provides the most comprehensive examination of current firearm-related deaths and injuries among children in the United States to date.

It examines overall patterns of firearm-related death and injury, patterns by type of firearm injury (interpersonal, self-directed, and unintentional), trends over time, state-level patterns, and circumstances surrounding these deaths.

Firearm-related deaths are the third leading cause of death overall among US children aged 1 to 17 years and the second leading cause of injury-related death.

Previous studies examined selected outcomes or certain types of firearm injuries.

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