ImportanceYouth (those aged <18 years) parental death has been associated with negative health outcomes. Understanding the burden of parental death due to drug poisoning (herein, drugs) and firearms is essential for informing interventions.ObjectiveTo estimate the incidence of youth parental death due to drugs, firearms, and all other causes.Design, Setting, and ParticipantsThis cross-sectional observational study was conducted using vital registration, including all US decedents, and census data from January 1990 through December 2020. Data were analyzed from May 30, 2023, to March 28, 2024.ExposuresParental death due to drug poisoning or firearms.Main Outcomes and MeasuresA demographic matrix projection model was used to estimate the number and incidence of youth experiencing parental death, defined as the death of 1 or more parents, per 1000 population aged less than 18 years. Analyses evaluated parental deaths by drugs, firearms, and all other causes from 1999 through 2020 by race and ethnicity.ResultsBetween 1999 and 2020, there were 931 785 drug poisoning deaths and 736 779 firearm-related deaths with a mean (SD) age of 42.6 (16.3) years. Most deaths occurred among males (73.8%) and White decedents (70.8%) followed by Black (17.5%) and Hispanic (9.5%) decedents. An estimated 759 000 (95% CI, 722 000-800 000) youth experienced parental death due to drugs and an estimated 434 000 (95% CI, 409 000-460 000) youth experienced parental death due to firearms, accounting for 17% of all parental deaths. From 1999 to 2020, the estimated number of youth who experienced parental death increased 345% (95% CI, 334%-361%) due to drugs and 39% (95% CI, 37%-41%) due to firearms compared with 24% (95% CI, 23%-25%) due to all other causes. Black youth experienced a disproportionate burden of parental deaths, based primarily on firearm deaths among fathers. In 2020, drugs and firearms accounted for 23% of all parental deaths, double the proportion in 1999 (12%).Conclusions and RelevanceResults of this modeling study suggest that US youth are at high and increasing risk of experiencing parental death by drugs or firearms. Efforts to stem this problem should prioritize averting drug overdoses and firearm violence, especially among structurally marginalized groups.

中文翻译：

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1999 年至 2020 年美国因药物中毒和枪支暴力而导致父母死亡的青少年

重要性青少年（年龄<18岁）父母的死亡与负面的健康结果有关。了解因药物中毒（此处为毒品）和枪支而导致父母死亡的负担对于为干预措施提供信息至关重要。目的估计因毒品、枪支和所有其他原因导致的青少年父母死亡的发生率。设计、设置和参与者此交叉研究使用人口动态登记（包括所有美国死者）和 1990 年 1 月至 2020 年 12 月的人口普查数据进行分段观察性研究。数据分析时间为 2023 年 5 月 30 日至 2024 年 3 月 28 日。暴露父母因药物中毒或枪支死亡。主要结果人口矩阵预测模型用于估计经历父母死亡（定义为每 1000 名 18 岁以下人口中有 1 位或更多父母死亡）的青少年人数和发生率。分析按种族和民族评估了 1999 年至 2020 年因毒品、枪支和所有其他原因造成的父母死亡。结果 1999 年至 2020 年期间，有 931 785 人因药物中毒死亡，736 779 人因枪支相关死亡，平均 (SD) 年龄为 42.6 岁（16.3）年。大多数死亡发生在男性（73.8%）和白人死者（70.8%）中，其次是黑人（17.5%）和西班牙裔（9.5%）死者。据估计，有 759 000 名（95% CI，722 000-800 000）青少年因毒品导致父母死亡，估计有 434 000 名（95% CI，409 000-460 000）青少年因枪支死亡，占 17%所有父母的死亡。从 1999 年到 2020 年，与因毒品导致父母死亡的青少年人数相比，估计增加了 345%（95% CI，334%-361%），因枪支导致父母死亡的青少年人数增加了 39%（95% CI，37%-41%）。 24% (95% CI, 23%-25%) 由于所有其他原因。黑人青年承受着不成比例的父母死亡负担，这主要是因为父亲因枪支死亡。 2020 年，毒品和枪支造成的父母死亡人数占 23%，是 1999 年 (12%) 的两倍。 结论和相关性 这项模型研究的结果表明，美国青少年因毒品或枪支导致父母死亡的风险很高，而且还在不断增加。解决这一问题的努力应优先考虑避免吸毒过量和枪支暴力，特别是在结构性边缘群体中。