In 2010, the U.S. Supreme Court extended the right to bear arms to every corner of the country. The landmark case effectively limited the ability of state and local entities to restrict gun ownership within their jurisdictions. What followed, a new study finds, was a surge of children’s deaths that might have been prevented.
Over a decade after the court’s McDonald v. Chicago ruling, children in the United States are dying from firearms at higher rates than ever before. And according to a new study published in JAMA Pediatrics, that surge didn’t happen everywhere equally. It happened overwhelmingly in states that chose to make gun ownership easier.
Guns kill children
If you’re like most people, you’re probably thinking, “No shit, Sherlock.” But there’s still a lot of people in the “guns don’t kill people” crowd. That’s why it’s important that science provides the cold, hard data. So, it has done just that, and the data looks horrifying.
“We saw over 7,400 more pediatric deaths due to firearms than would have been expected,” said first author Jeremy Faust, MD, an emergency physician at Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system. “And when checked against other causes of death, including homicides and suicides not involving firearms, there were not similar changes. This shows that differences in firearm laws matter.”
To understand what changed, the researchers grouped all 50 US states into three categories: strict, permissive, and most permissive. Then they looked at pediatric firearm deaths — homicides, suicides, and accidental shootings involving those under 18 — from 1999 to 2023, splitting the timeline around the pivotal Supreme Court ruling.
What they found was stark.
In the 13 years after McDonald v. Chicago, states with the most permissive gun laws experienced 6,029 more child deaths than demographic trends would have predicted. Permissive states saw 1,420 more. States with stricter gun laws, by contrast, either held steady or saw reductions.
Dr. Onyeka Otugo, an emergency physician and study co-author, emphasized what the numbers suggest, “Gun laws truly make a difference for the collective safety of children.”
The problem is growing
Firearms are now the leading cause of death among U.S. children and teens, and they’ve been like this since 2019. According to the CDC, no other high-income country sees gun violence rank nearly as high among youth mortality causes. School shootings remain tragically common, with 18 incidents recorded in just the first four months of 2025. While deaths from opioid poisonings have also surged — doubling over five years to make up 7.3% of youth deaths — no other cause has overtaken firearms in lethality for America’s youngest generation.
It’s not just children, either. A growing body of research reinforces the finding that more permissive gun laws lead to higher rates of firearm-related deaths among Americans. For instance, states that relaxed concealed‑carry rules experienced an increase in overall homicides and firearm homicides. Cross‑state analyses show that a 10% rise in gun ownership correlates with a 35% uptick in mass shootings while another BMJ study found that more permissive gun laws consistently produced higher mass shooting rates. Numerous studies, from Connecticut and Missouri, show that weaker background checks and licensing rules correlate with notable increases in both homicides and suicides
The study doesn’t name which policies are most responsible for the changes in death rates. But it does build on earlier research suggesting certain safeguards — like universal background checks, secure gun storage requirements, and child access prevention laws — can reduce firearm deaths among children.
Despite this growing toll, research into preventing gun deaths remains underfunded, and the current administration wants to cut even that. The new study was conducted without federal support, relying on public datasets from the Centers for Disease Control and Prevention (CDC), but even that is in jeopardy. Faust warned that recent cuts to the CDC’s Injury and Violence Prevention Center could undermine future tracking of this epidemic. “We do it because we care about it,” he said of the study. “But that’s not sustainable.”
The good news is that we see what works. Gun prevention can help save children’s lives. The bad news is that many states are moving in the opposite direction — loosening firearm regulations despite mounting evidence of their deadly consequences. Researchers, physicians, and public health advocates now face the daunting task of not only caring for the wounded but also fighting for policies that could prevent these tragedies in the first place.
As data continues to pile up, one message rings clear: the easier it is to get guns, the more children get killed. And the longer we wait to act, the worse it gets.
The study was published in JAMA Pediatrics.
