Suicide and homicide were the second and third leading causes of death, respectively, among teens ages 15 to 19, after unintentional injury, in 2014. Firearms were the instrument of death in 88 percent of teen homicides and 41 percent of teen suicides in 2014. While non-firearm injuries result in death in only one out of every 760 cases, almost one in four youth firearm injuries is fatal.
Although other teens are the perpetrators of many of the homicides of teens below age 18, two-thirds of the murderers are eighteen or older. Although school-related homicides receive substantial media attention, in the 2011-12 school year, they accounted for less than two percent of all child homicides.
Mood disorders, such as depression, dysthymia, and bipolar disease, are major risk factors for suicide among children and adolescents. One study found that more than 90 percent of children and adolescents who committed suicide had some type of mental disorder. Stressful life events and low levels of communication with parents may also be significant risk factors., Female teens are about twice as likely to attempt suicide; however, males are much more likely to actually commit suicide.,
Between the 1970’s the early 1990s, the homicide rate for teens ages 15 to 19 more than doubled, from 8 in 1970 to a peak of 20 per 100,000 population in 1993. The rate declined steeply during the late 1990s, then leveled out at around nine deaths per 100,000 between 2000 and 2004. Although the rate of homicides increased between 2004 and 2006, to 11 deaths per 100,000, it has since decreased. In 2014, the homicide rate was seven deaths per 100,000, the lowest rate on record. (Figure 1)
Trends in firearm-related deaths (homicides and suicides, as well as deaths from unintended injuries) have followed a similar pattern for teens ages 15 to 19, with rates declining dramatically during the late 1990s, from 28 per 100,000 in 1994, to 13 per 100,000 in 2000. As with the homicide rate, the firearm-related death rate fluctuated slightly between 2000 and 2006, before decreasing to 10 deaths per 100,000 in 2014. (Figure 1)
The teen suicide rate increased from 6 to 11 per 100,000 population between 1970 and 1988, remained steady until 1994, then declined to 7 per 100,000 in 2007. Since then, the rate has been increasing, and was at 9 per 100,000 in 2014. (Figure 1) Between 1994 and 2014, suffocation suicide rates have increased significantly, for both males and females, and all race/ethnicity groups, with overall rates doubling over that period.  Suffocation, as used in suicide attempts, has a high likelihood of resulting in death.
Males ages 15 to 19 are approximately three times more likely than females to die from suicide, (13 and 4 per 100,000, respectively, in 2014), and six times more likely to die from homicide (11 and 2 per 100,000, respectively, in 2014). Males of this age are also eight times more likely to die from firearm-related incidents of any kind: in 2014, 17 per 100,000 males died by firearms, compared with 2 per 100,000 females. (Figure 2)
The disparity between males and females in rates of homicide generally increased between 1970 and 2014, from a factor of four to a factor of six. The disparity between males and females in the suicide rate peaked in 1995, when it was approximately six times as high for males as for females. (Appendix 1)
In 2014, the homicide rate for black male teens was 46 per 100,000, more than 20 times higher than the rate for white male teens (2 per 100,000). Rates for other groups were 11 per 100,000 for Hispanic males, 7* per 100,000 for American Indian males, and 2* per 100,000 for Asian and Pacific Islander males. (Figure 3)
Among females, black and Hispanic teens had the highest homicide rates in 2014, at six and two per 100,000, respectively, followed by one per 100,000 for white and American Indian* females, and less than one* per 100,000 for Asian females. (Appendix 1)
Firearm deaths, which comprise a majority of teen homicides and suicides but also include accidental deaths, were highest in 2014 among black teens (47 per 100,000 males, and 5 per 100,000 females), and lowest among Asian teens (four per 100,000 males, and less than one per 100,000 females). American Indian and Hispanic teens had the second-highest rates (15 and 13 per 100,000 males, respectively, and one and two per 100,000 females, respectively). White teens had the second-lowest rate among males (11 per 100,000) and the second highest rate among females (two per 100,000). (Appendix 1, Figure 3)
In 2014, rates of suicide among male teens were highest among American Indians (20 per 100,000) and whites (17 per 100,000), followed by Hispanics at 9, blacks at 7, and Asian or Pacific Islanders at 6 per 100,000. Among females, American Indian teens had the highest rate at 12 per 100,000, followed by white teens at 5, Asian or Pacific Islander teens at 5, Hispanic teens at 3, and black teens at 2 per 100,000. (Figure 4)Among males, suicide rates have been increasing among white teens since 2007, but decreasing or remaining steady among other racial and ethnic groups. Among females, suicide rates have been rising among all groups since 2007. (Appendix 1)
*Note: These estimates should be treated with caution, as they are based on 20 or fewer deaths and may be unstable.
1990-2013 state rates for combined accident, homicide, and suicide are available from the KIDS COUNT Data Center.
Data for homicides by age group for all states and select counties are available from the Bureau of Justice Statistics.
Estimates of homicide rates among youth ages 10-29 for selected countries and global suicide rates for youth ages 15-24 are available from the 2002 World Report on Violence and Health. (Tables 2.1 and 7.2)
Estimates of death rates from self-harm and interpersonal violence for ages 15 to 29 in 2012 are available from the World Health Organization.
Through its Healthy People 2020 initiative, the federal government has set national goals to reduce suicide attempts by adolescents, from 1.9 per 100, in 2009, to 1.7 by 2020; to reduce homicides (among all age groups), from 6.1 per 100,000 population in 2007, to 5.5; and to reduce firearm-related deaths (among all age groups) from 10.2 per 100,000 population
in 2007, to 9.2.
Additional information is available for:
The National Registry of Evidence-Based Programs is a searchable database that includes the topics of violence prevention and suicide prevention.
An important component of reducing firearm-related injury is safe storage of household firearms, since firearms are presents in about one-third of American households with children and youth. Gun ownership has been found to be a risk factor for homicide in the home.
Homicide, suicide, and firearm-related deaths are determined by physicians, medical examiners, and coroners’ reports on death certificates. Deaths are classified using ICD 10 codes. More information on ICD 10 classification is available here.
Data for 1981-2014: Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System (WISQARS). National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. Available at: cdc.gov/injury/wisqars/index.html
Data for Total, Male and Female 1970 and 1980: National Center for Health Statistics. (2002). Health United States, 2002 with Chartbook on Trends in the Health of Americans. National Center for Health Statistics. 2002. Tables 46, 47, and 48.
Race data for 1970 and 1980: Trends in the well-being Of America’s children and youth 2001. U.S. Department of Health and Human Services. Office of the Assistant Secretary for Planning and Evaluation. Tables HC 3.4A and 3.5.
National Vital Statistics System
|Asian or Pacific Islander||–||–||14.8||23.7||20.5||7.5||6.6||8.2||6.6||6.8||7.1||10.2||4.8||4.7||1.9*||3.2*||3.0*||2.3*||2.8*||2.1*|
|Asian or Pacific Islander||–||–||2.6*||3.2*||2.3*||0.9*||1.1*||1.8*||1.9*||1.1*||1.2*||1.4*||0.9*||0.4*||0.5*||0.7*||0.4*||0.5*||0.5*||0.8*|
|Asian or Pacific Islander||–||–||12.0||10.2||9.4||8.1||6.9||5.5||6.4||8.0||4.4||7.6||7.7||4.7||6.4||6.3||7.5||6.3||8.7||6.3|
|Asian or Pacific Islander||–||–||4.0*||3.8*||3.8*||3.2*||2.7*||2.0*||2.4*||2.3*||2.8*||3.1*||1.7*||3.1*||3.6*||3.0*||2.8*||3.7||2.2*||4.7|
|Asian or Pacific Islander||–||–||22.2||29.0||26.9||8.8||7.1||9.5||7.0||8.2||8.7||11.5||6.3||5.2||2.5*||4.3||3.8||3.8||4.9||4.4|
|Asian or Pacific Islander||–||–||2.0*||3.8*||3.2*||2.1*||0.2*||0.7*||1.7*||1.3*||1.0*||1.4*||0.9*||0.4*||0.9*||0.4*||0.4*||0.7*||0.8*||0.8*|
|*These rates should be interpreted with caution because they are based on 20 or fewer deaths and may be unstable.Sources: Data for Total, Male and Female for 1970-1980: National Center for Health Statistics. (2002) Health United States, 2002 With Chartbook on Trends in the Health of Americans. National Center for Health Statistics. Tables 46, 47, and 48. Data for Race from 1970-1980: Trends in the Well-Being of America’s Children and Youth 2001. Tables HC 3.4A and 3.5. U.S. Department of Health and Human Services. Office of the Assistant Secretary for Planning and Evaluation; All data for 1995-2014: Centers for Disease Control and Prevention. (2015). Web-based Injury Statistics Query and Reporting System (WISQARS) [Online]. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (producer). Available at www.cdc.gov/injury/wisqars/fatal.html
Additional years of data are available in the excel spreadsheet.
Centers for Disease Control and Prevention. (2015). Web-based Injury Statistics Query and Reporting System (WISQARS) [Online]. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (producer). Available from: www.cdc.gov/injury/wisqars/fatal.html
Fingerhut, D. and Christoffel, K. (2002) Firearm-related death and Injury among children and adolescents. The Future
of Children, 12(2), 25-38. Available at: http://www.ncbi.nlm.nih.gov/pubmed/12194610
Finkerhor, D. and Ormrod, R. (2001). Homicides of children and youth. Office of Juvenile Justice and Delinquency Prevention, U.S. Department of Justice. pp. 4, 7. Available at: http://www.ncjrs.org/pdffiles1/ojjdp/187239.pdf
Robers, S., Kemp, J., Rathbun, A., Morgan, R. E., & Snyder, T. D. (2015). Indicators of school crime and safety: 2014 (NCES 2015-072/NCJ 248036). National Center for Education Statistics, U.S. Department of Education, and Bureau of Justice Statistics, Office of Justice Programs, U.S. Department of Justice. Washington, DC. Figure 1.2. http://nces.ed.gov/pubs2015/2015072.pdf
Office of the U.S. Surgeon General. (1999). Children and mental health. In Mental health: A report of the Surgeon General. Chapter 3. Washington, D.C.: U.S.GPO. http://www.surgeongeneral.gov/library/mentalhealth/
Shaffer, D., & Craft, L., (1999). Methods of adolescent suicide prevention. Journal of Clinical Psychiatry, 60 (Suppl. 2), 70–74. Available at: http://www.healthri.org/disease/violence/vppsuicide_shaffer.htm
Office of the U.S. Surgeon General. (1999) Children and mental health. In Mental health: A report of the Surgeon General. Chapter 3. Washington, D.C.: U.S.GPO. http://www.surgeongeneral.gov/library/mentalhealth/
Centers for Disease Control and Prevention . Injury Center: Violence Prevention: Suicide Prevention, Youth suicide. http://www.cdc.gov/ViolencePrevention/suicide/youth_suicide.html
Child Trends Databank. (2014). Suicidal teens. Available at: http://www.childtrends.org/?indicators=suicidal-teens
Centers for Disease Control and Prevention. (2015). Op cit.
Sullivan, E. M., Annest, J. L., Simon, T. R., Luo, F., & Dahlberg, L. L. (2015). Suicide trends among persons aged 10-24 years—United States, 1994-2012. MMWR, 64(8), 201-205.
Hispanics may be any race. Estimates for whites in this report do not include Hispanics.
Wintersteen, M. B. (2010). Standardized screening for
suicidal adolescents in primary care. Pediatrics, 125(5), 938-944.
Gardner, W., Klima, J., Chisolm, D., Feehan, H., Bridge, J., Campo, J., Cunningham, N., and Kelleher, K. (2010). Pediatrics, 125(5), 945-952.
Johnson, R. M., Miller, M., Vriniotis, M., Azrael, D., and Hemenway, D. (2006). Are household firearms stored less safely in homes with adolescents? Archives of Pediatric & Adolescent Medicine, 160, 788-792.
Kellerman, A. L., Rivara, F. P., Rushforth, N. B., Banton, J. G., Reay, D. T., Francisco, J. T., Locci, A. B., Pordzinski, J.,
Hackman, B. B., and Somes, G. (1993). Gun ownership as a risk factor for homicide in the home. New England Journal of Medicine, 329(15), 1084-1091.
Child Trends Databank. (2015). Teen homicide, suicide and firearm deaths. Available at: http://www.childtrends.org/?indicators=teen-homicide-suicide-and-firearm-deathsLast updated: December 2015