Guest blog by AZPHA Member Allan Williams, PhD
In 2018, a paper by Cunningham et al in the New England Journal of Medicine reported that between 1999 and 2016, firearm injuries were the second leading cause of death among children and adolescents (ages 1-19) in the US, trailing only motor vehicle crashes.
A subsequent analysis by Goldstick et al in the same journal using data thru 2020 found that by 2020, firearm deaths became the leading cause of death in that age group, exceeding for the first time motor vehicle deaths. An additional finding was that drug overdose and poisoning deaths surpassed cancer deaths as the third leading cause.
Using the same definitions and methods as those previous reports, the situation in Arizona differed from the US in that three different causes have competed for the leading cause of death since 2020.
As shown in the figure below, drug overdoses and poisoning were the leading cause in 2020, while motor vehicle crashes were again the leading cause in 2021 and 2022.
Then, in 2023 firearm deaths became the leading cause of death.
Firearm injuries have remained the leading cause of death among children and adolescents in the US during 2022-2023. As shown below, among the states with adequate data during that period, firearm injuries were the leading cause of death in 23 states and tied with motor vehicle crash deaths as the leading cause in two states (AZ & KY).
In Arizona, 31% of the firearm deaths among youth were classified as unintentional or suicides while 63% were classified as homicides, all outcomes that could be reduced with secure gun storage legislation and public awareness by households with guns. A 500-page critical systematic review of research by the RAND Corporation (Smart et al, 2024) concluded that:
“We find supportive evidence, our highest evidence rating, that CAP laws, or safe-storage laws, reduce self-inflicted fatal or nonfatal firearm injuries, unintentional firearm injuries and deaths, and firearm homicides among youth.
There is also moderate evidence that CAP laws reduce firearm suicides among young people, and limited evidence that such laws reduce unintentional firearm injuries among adults. The evidence is stronger for negligent-storage laws than for reckless endangerment laws; reckless endangerment laws are sometimes considered a weaker form of CAP law.”
“States without negligent-storage CAP laws should consider adopting them or other safe-storage laws as a strategy to reduce total and firearm suicides, unintentional firearm injuries and deaths, and firearm homicides among youth.”
Several cities and 26 states have such laws. However, as noted in the 2023 AZPHA comprehensive report Gun Violence in Arizona: Data to Inform Prevention Policies, Arizona lacks these and most other gun violence prevention laws and ranks 43rd in the country in 2025 for the overall strength of its gun laws by Everytown Research.
