Cherry-picking Who Is A Child

by Cory Franklin

April 19, 2023

America has an undeniable, serious problem with gun violence and firearm deaths. The debate about how to solve it revolves around whether guns are the cause or a symptom of deeper societal issues. In truth, whether cause or symptom, gun violence in the young does not lend itself to a single solution. It is a multifactorial problem that is obscured by a recent alarming statistic, currently being disseminated in the media and scientific literature.  Rather than an argument for a ban on AR-15s or a defense of the Second Amendment, this piece is meant to clarify that misleading statistic.                                             

According to data from the Centers for Disease Control and Prevention (CDC) and the New England Journal of Medicine (NEJM), in 2020 firearms became the number one cause of death in children and teens ages 1-19 in the United States. Firearm deaths – accidents, suicides, and homicides – have replaced auto accidents (fatalities from which have been declining for years) as the leading cause, costing the lives of roughly 4,500 children and teens annually.

There is no way to sugarcoat this statistic. In no other comparable country, except for Canada, were firearms among the top five leading causes of childhood and teenage deaths, and even Canadian deaths were far below those in the US.  In the 1-19 population, compared with other countries, the US accounts for greater than 95% of the firearm deaths – far more than Japan and countries of Western Europe combined. This is shocking, and can’t be explained away. But it is also a fundamentally disingenuous statistic that, rather than illuminating, obscures the problem of firearm deaths in those under 20.          

Put simply, virtually no study on any scientific issue considers the broad grouping of ages 1-19 a single cohort. This grouping encompasses toddlers, preschoolers, elementary school children, adolescents and young adults. Is there any logic in combining those too young to walk with those learning to ride a bicycle with those who are driving cars? Unfortunately, this is how the CDC has defined children, thereby conflating vastly different circumstances.   The CDC cherry-picking of who is considered a child extends even further because infants under one year of age have been excluded.  The causes of death in the “under 1 age group” have little to do with firearms and their inclusion would disrupt the narrative.   

The differences matter.  Combining such different age groups makes for a heart wrenching headline but is not especially good science. True, every death has guns in common, but the circumstances in the various age groups are vastly different (as are the guns involved in these deaths.)  

In the younger groups, with the exception of a relatively small (but still terrible) number of accidental deaths, firearms are not a particularly significant factor. Once children become pre-teens, suicide by gun begins to show up as a more important cause of death, but there are still considerably fewer deaths than caused by accidents and motor vehicles. It is teenage homicides that comprise 60% of all the firearm deaths, and this accounts for the “leading cause in ages 1-19” statistic. Moreover, if the disproportionately high number of gun deaths in 18 and 19-year-olds is considered separately, the meme that “guns are the leading cause of death in our children” is no longer true.   

Why the manipulation of the stats? Are journalists and researchers simply trying to rationalize stronger gun control legislation? Is this an effort to tug on heartstrings by talking about “children” when the overwhelming problem statistically is intramural urban violence among teenagers?

You won’t solve the problem of the 5-year-old killed accidentally handling a gun in the home with the same measures as preventing the 12 year-old who attempts to commit suicide with a gun. The 16-year-old school shooter (despite the disproportionate press coverage they receive, school shootings represent a tiny fraction of gun deaths) is a completely different issue from the 19-year-old killed in an inner-city drive-by shooting. By themselves, gun control measures, whatever that constitutes,  can only address each of these challenges at the margins.                                                                                                      

In a memorable 1985 lecture at Harvard on societal problems later published in a book titled Family and Nation, the brilliant stateman and social critic Daniel Patrick Moynihan quoted the French author Georges Bernanos, “The worst, the most corrupting lies are problems poorly stated.” Moynihan emphasized that before we posit solutions to complicated problems – in this case gun violence – we must strive to understand the true nature of exactly what we are trying to solve. When considering gun deaths, lumping together everyone below the age of 20 (except for babies)- as the CDC, NEJM, and the press are doing –  is an impediment to that understanding. It is shoddy science, intellectually dishonest, and a profound disservice to the victims and the complex, tragic nature of firearm deaths.


About the author:

Dr. Cory Franklin

Cory Franklin, physician and writer is a frequent contributor to

He was director of medical intensive care at Cook County Hospital in Chicago for more than 25 years. An editorial ng the pathologists who studied it intently but had no idea what body part it could be. This was before it was known as trolling.)

There is a lesson here. The next time someone tells you, with unmistakable conviction, that he believes in “the science,” gladly offer to discuss science with him over a sandwich. Give him a choice, chorizo or perhaps kosher salami. board contributor to the Chicago Tribune op-ed page, he writes freelance medical and non-medical articles. His work has also appeared in the New York Times, Jerusalem Post, Chicago Sun-Times, New York Post, Guardian, Washington Post and has been excerpted in the New York Review of Books. Cory was also Harrison Ford’s technical adviser and one of the role models for the character Ford played in the 1993 movie, “The Fugitive.” His YouTube podcast “Rememberingthepassed” has received 900,000 hits to date. He published “Chicago Flashbulbs” in 2013, “Cook County ICU: 30 Years of Unforgettable Patients and Odd Cases” in 2015, and most recently coauthored, A Guide to Writing College Admission Essays: Practical Advice for Students and Parents in 2021.