“More than 1,400 North Carolina children died in 2023, the most recent data available from the state, including 102 who died from gunshot wounds. That’s less than the number of infants who died from childbirth complications, which was 448. But among children 1-17, no other cause claimed more than 100 lives.”
Children ages 1 through 17
Stein’s communications team cited a February 2025 report by the North Carolina Child Fatality Task Force, which cataloged data from 2023.
The task force, created in 1991, examines information surrounding the deaths of children up to age 17. The group includes members appointed by the Democratic governor and Republican legislative leaders. Many of its members work in fields related to health care, law enforcement or social services. We also examined data from the U.S. Centers for Disease Control, which researches causes of death.
For North Carolina children ages 1 through 17, CDC data for 2023 show that firearm-related injuries were the leading cause of death. In North Carolina, the CDC logged 100 deaths related to firearms — just ahead of motor vehicle accidents, which caused 96 deaths. Firearm-related deaths were also the leading cause of fatalities for the 1-though-17 age group in 2022, according to an analysis of CDC data by researchers at Johns Hopkins University.
The state task force’s report lays out a couple of ways of measuring death data.
In its executive summary, the task force lists “injuries” as the top cause of death for children ages 1 through 17. Under the injury category, motor accidents killed the most people: 99. Homicide caused 78 deaths and suicide was the cause of 59.
The report goes on to say, though, that the number of deaths caused by guns — either by homicide or suicide — surpasses the number of deaths caused by motor vehicle accidents.
Of the combined 137 homicides and suicides in 2023, 102 were committed with a firearm. That number is down from 2022, when there were 108 gun-related child fatalities, but up from totals reported from 2014 to 2019, according to the task force report.
In the six years prior to the COVID-19 pandemic, gun-related child fatalities ranged from 38 to 62 per year. Gun-related child fatalities then surged to 109 in 2020 and to 121 in 2021. That’s why Stein’s proposed state budget, released in March, requested more than $2.3 million to promote safe gun storage, his office said.
The GOP-controlled General Assembly hasn’t taken up Stein’s proposed budget and is unlikely to do so.
Analyzing child deaths
When infants are included in the data, the top cause of death changes.
For all children — from birth through age 17 — the top cause of death in North Carolina was perinatal conditions, according to both state and federal data. The state’s task force documented 448 deaths related to childbirth — conditions such as low birthweight and birth defects. The CDC reported 446 deaths related to childbirth in North Carolina in 2023, a higher toll than any other cause of death.
However, researchers have told PolitiFact that they often exclude infants when analyzing “child” fatalities because infants can suffer from conditions that are unique to children who are younger than 12 months.
“Infant mortality has distinct leading causes, such as congenital conditions and perinatal complications, which differ significantly from the causes of death among older children and adolescents, including firearm injuries, motor vehicle crashes, and cancer,” Cassandra Crifasi, co-director of the Johns Hopkins Center for Gun Violence Solutions, told PolitiFact in an email.
“By excluding infants and focusing on children ages 1–17, researchers can better identify and compare the leading external causes of death relevant to injury prevention and public health strategies for this age group,” Crifasi said.
In a news release issued the same day of Stein’s social media post, the governor differentiated gun deaths from fatalities suffered by infants. He said firearms are the leading cause of “injury-related death” for children in the state.
Our ruling
Stein said “guns are the leading cause of death for children in North Carolina.”
State and CDC data support Stein’s claim for children ages 1 through 17. When infants are considered, perinatal conditions become the top cause of death for all children under 18 years old. But researchers often exclude infants from datasets on child fatalities because infants suffer from conditions that other children don’t.
The statement is accurate but needs clarification and additional information. That’s our definition of Mostly True.