Children Present or Witnessing Violent Deaths and Suicides

Importance: Although children's exposure to violence and having a family member die by suicide have been previously documented, limited studies have quantified or characterized violent deaths and suicides where children were reported as present for or having witnessed the event. Objective: To present data on violent deaths and suicides where children were documented as present for or having witnessed the fatal events. Design, Setting, and Participants: The US Centers for Disease Control and Prevention's (CDC's) National Violent Death Reporting System (NVDRS) combines data from death certificates, coroner/medical examiner reports, and law enforcement reports to provide contextual information about violent deaths and suicides. Using NVDRS data from 2019 to 2023 (50 states, District of Columbia, and Puerto Rico), the frequency of violent deaths and suicides that children were reported present for and/or witness to by manner of death were examined, in addition to decedent and incident characteristics. Data analysis occurred between July and September 2025. Exposures: Child reported as present for and/or witness to the violent death or suicide. Main Outcomes and Measures: Number and percentage of violent deaths and suicides where a child was documented as present for or witness to the death by manner of death, decedent characteristics (sex, age, race and ethnicity, relationship to suspect/shooter), and characteristics (eg, method and location of injury, mental health problems, relationship problems). Results: Of 196 843 violent deaths and suicides from 2019 to 2023, a child was reported as present for or witness to 19 171 deaths (9.7%; 8205 homicides [16.4%], 8880 suicides [6.9%], 608 unintentional firearm injury deaths [38.0%], 266 legal intervention deaths [11.1%], and 1212 deaths of undetermined intent [8.5%]). Most decedents were male (13 554 of 19 169 [70.7%]), non-Hispanic White (8956 of 19 098 [46.9%]), and younger than 35 years (11 399 of 19 168 [59.5%]). Race and ethnicity of other decedents included the following: 393 Asian (2.1%), 5953 Black or African American (31.2%), 3014 Hispanic (15.8%), 367 multiracial (1.9%), 360 Native American or Alaska Native (1.9%), and 55 Native Hawaiian or Other Pacific Islander (0.3%). Most deaths involved a firearm (12 619 of 18 983 [66.5%]), occurred in homes (14 956 of 19 057 [78.5%]), and were preceded by intimate partner violence (IPV; 2173 of 7497 [29.0%] for homicides) or intimate partner problems (ie, breakup, argument; 3857 of 8570 [45.0%] for suicides). Other characteristics varied by manner of death. Conclusions and Relevance: In this cross-sectional study, children in the US were reported as present for or witness to almost 1 in 10 violent deaths or suicides, many of which took place in homes, involved a firearm, and were preceded by IPV or intimate partner problems. These findings underline opportunities for a comprehensive approach to preventing violent deaths and suicides, reducing children's exposure to these traumatic events, and ensuring postvention opportunities for young survivors.