(NEW YORK) — Firearm deaths and drug poisoning deaths in children have spiked in the last decade, according to a new study in the United States. The study found an increase in firearm deaths by 87% and drug poisoning deaths by 133%.

Researchers looked at data from the Centers of Disease Control and Prevention’s injury reporting system. They analyzed injuries leading to death from 2011-2021 and nonfatal injuries from 2011-2020.

Overall, they found that fatal injury rates increased from about 14 deaths per 100,000 children in 2011 to over 17 deaths per 100,000 children in 2021. Firearm injuries made up the biggest portion of those fatal injuries.

Both the increase in firearm and drug overdoses may be because children can get a hold of these dangerous items easily, says Dr. Rebecca Mannix, an author on the study and a pediatric emergency medicine physician at Boston Children’s Hospital.

“The access issues of firearms and prescription and illicit drugs have also been a huge problem in the pediatric population,” she says. “There’s a reservoir of both prescribed and illicit drugs that kids have access to that can become quite deadly.”

The study found that pediatric injury fatalities sharply increased in the pandemic years of 2020 to 2021.

“The increase in pediatric injury-related deaths preceded the COVID-19 pandemic, though the pandemic exacerbated numerous factors underlying this disturbing trend, including access to lethal means, such as firearms and opioids, the mental health crisis and structural racism,” said Mannix in an email to ABC News. “In this way, the increase in deaths in 2020 to 2021 is an amplified trend that has been creeping up on us for the last decade.”

It remains unclear whether these trends will continue. The study also looked at the trends of injuries that did not lead to death in children.

Nonfatal injuries decreased by more than half between 2011 and 2020. Motor vehicle injuries saw a decrease by 47%.

While it is hard to determine why there was a decrease, Mannix and her team point to public health initiatives, such as booster seats for children, as a possible cause.

“This is largely due to public health interventions I think, in the last few decades, improving motor vehicle safety, improving helmet technology, [and] childproofing,” says Mannix.

Technological advancements and legislative requirements may also have contributed, experts say.

Public safety initiatives are key to keeping children safe, says Dr. Wee Chua, a pediatric emergency medicine physician at Massachusetts General Hospital and Harvard University. That includes “car seats, bike helmets, and the safe storage of firearms,” Chua says.

Despite overall decreases in nonfatal injuries, the rates of self-harm increased by 57%. Self-harm is the act of purposefully hurting oneself, and it’s associated with mental illnesses like depression and anxiety.

“I spend my clinical time in the ER,” says Mannix, “and I can tell you, there’s a behavioral health [and] mental health crisis in kids.”

Parents can prevent firearm injuries and drug poisonings by removing guns from homes, locking prescription drugs, monitoring for illicit and prescription drug use and seeing a doctor if your child is exhibiting self-harm behavior.

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