About 1,300 US children under the age of 17 die from gun-related injuries per year, a government study has found.
Researchers at the US Centers for Disease Control and Prevention (CDC) also found that guns seriously wounded about 5,800 children each year.
Boys accounted for 82% of all child firearm deaths while black children were 10 times more likely to be killed by a gun, according to the study.
More than half of these deaths were homicides while 38% were ruled suicide.
The study, published in Pediatrics on Monday, also found 6% of firearm-related deaths were fatalities from accidental gun injuries.
“Firearm injuries are a leading cause of death among US children aged one to 17 years and contribute substantially each year to premature death, illness and disability of children,” said CDC’s Katherine Fowler, who led the study.
“About 19 children a day die or are medically treated in an emergency department for a gunshot wound in the US,” she told Reuters.
CDC researchers examined national data in what they describe as “the most comprehensive examination of current firearm-related deaths and injuries among children in the United States to date”.
The study found a 60% increase in gun suicides from 2007-15, according an analysis of national injury records.
Suicide was most likely to occur when children were dealing with stressful circumstances or relationship problems with a boyfriend, girlfriend or family member, the study revealed.
White children and Native American children were four to five times more likely to die by firearm suicide.
Accidental gun deaths appeared to happen most frequently among children playing with firearms.
The study comes as a four-year-old Pennsylvania boy shot himself in the face and died on Sunday.
Police in Monroe County have not charged anyone in the boy’s death.
Lexie Antonini, the boy’s 21-year-old mother and volunteer firefighter, said she didn’t “know how to feel”.
“I never thought I would see the day i would get the news my only son has passed away…my poor baby,” she wrote in a Facebook post.
“I don’t know how to feel. I don’t know what to do. I lost my everything,”
The CDC analysis also looked at deaths on a state level and found District of Columbia and Louisiana to have the highest rates of child firearm deaths.
Delaware, Hawaii, Maine and New Hampshire had 20 or fewer child gun-related deaths, according to the study.
Researchers also pointed out that children were rarely injured or killed by guns in other developed countries.
In fact, more than 90% of all children ages 14 and up who were killed by guns in high-income countries resided in the US.