Children in America are facing one of the greatest public health crises of our time, and far from being a problem with medical care, the issue is mostly preventable.
A special report has now revealed that firearms are the second-leading cause of child fatality in the US, causing a quarter of all injury-related deaths in 2016 - a number that far exceeds the loss of life from cancer.
It's a deadly threat that is virtually unparalleled around the world. During 2016, the researchers found that children and adolescents under 19 in the US were more than 36.5 times as likely to be killed by gunshots than their counterparts in other high-income countries.
Even compared to many low and middle income countries the statistics are exceptional.
"I don't think it's acceptable for firearms to be a preventable cause of death and remain the second cause of death of children and teens," lead author Rebecca Cunningham, an emergency medicine professor at the University of Michigan, told NPR.
"We're not doing enough to keep kids safe."
Based on 2016 data from the Centers for Disease Control and Prevention (CDC), Cunningham and her team examined the causes of 20,360 childhood deaths between the ages of one and 19-years-old.
Thanks to vaccinations, antibiotics, and improved medical care, the results show that the number of childhood deaths from infectious diseases or cancer has plummeted since the turn of the century.
At the same time, however, this improvement has merely given way to even more injury-related deaths, which now make up the majority of all childhood deaths.
Most of these accidents come from motor vehicle crashes, but gun wounds are a close second. There is ample evidence to suggest that both of these issues are entirely preventable with the right evidence-based approaches.
"The biggest barrier to preventing the many deaths from injury is the sense of helpless inevitability conveyed by the word 'accident'," writes Edward Campion, the executive editor of the New England Journal of Medicine, in an accompanying editorial.
"Car crashes and lethal gunshots are not random results of fate. Both individuals and the larger society need to understand that there is much that can be done to reduce the rate of fatal trauma."
The statistics are grim. Among all the firearm deaths, around 60 percent were homicides and roughly 30 percent were suicides.
Plus, while only around 5 percent of firearm deaths in youths were unintentional injuries, these sorts of fatal accidents occur far more among children than adults.
This is probably because one in three US homes with kids under 18 years of age report having a firearm, and 43 percent of those said they don't keep their firearms safely locked and unloaded.
To be fair, things have gotten better. But even though firearm deaths were lower in 2016 than they were in 1993, progress has recently begun to stagnate. Between 2007 and 2016, the rates of childhood firearm deaths plateaued, and between 2013 and 2016, they even began to climb, rising by 28 percent.
What's more, some children in the US are more at risk from gun wounds than others. Among black youth, gun violence is the leading cause of death, occurring at a rate that is 3.7 times higher than among white youths. American Indian and Alaska Native youth were also found to be more at risk.
The results are enough to make your blood boil, and in his accompanying editorial, Campion left nothing back, calling the results "shameful" and "a crime against nature".
"The devastated families take no comfort from the fact that childhood deaths are now far less common than they were in centuries past," he writes.
"In recent decades, there has been progress, but the United States is clearly not effectively protecting its children."
This study has been published in the New England Journal of Medicine.