(Reuters Health) – Firearms kill almost 1,300 American youngsters each year, and boys and black children are most often the victims, a U.S. study finds.

During the 13-year study, more than half of the gun-related deaths were homicides, while 38 percent were suicides and 6 percent were fatalities from accidental gun injuries, researchers report in Pediatrics.

Each year, guns seriously wounded about 5,800 additional kids under 18.

“Firearm injuries are a leading cause of death among U.S. children aged 1 to 17 years and contribute substantially each year to premature death, illness and disability of children,” said lead study author Katherine Fowler of the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta.

“About 19 children a day die or are medically treated in an emergency department for a gunshot wound in the U.S.,” Fowler said by email.

Although accidental firearm deaths among children declined from 2002 to 2014 and gun-related homicides decreased from 2007 to 2014, suicides surged 60 percent from 2007 to 2014, the analysis of national injury records found.

Boys account for 82 percent of all child firearm deaths, and black children have the highest rates of firearm mortality overall due to much higher firearm homicide rates. About four black children out of every 100,000 die from gunshot homicides, ten times higher than the rate for white, Asian or Pacific Islander kids, the study found.

“It is important to note that firearm injuries and especially deaths are typically not isolated events,” said Alex Piquero, a criminology researcher at the University of Texas at Dallas who wasn’t involved in the study.

“They often tend to co-occur with other crimes, whether gang-related, drug involved or other serious criminal activities, and for many of these crimes boys tend to be overrepresented compared to girls,” Piquero said by email. “Crime – especially violence, poverty and related adverse contextual circumstances – are unfortunate characteristics that are common to inner city areas that are overrepresented by minority residents.”

For younger children, homicides often occurred in the context of domestic violence, a conflict between intimate partners or other family members. Among older kids, homicides typically happened during disputes with their peers, the study also found.

Suicides often occurred in the context of stressful circumstances or relationship problems with a boyfriend, girlfriend or family member. White children, American Indian and Native Alaskan children were four to five times more likely to die by suicide than other kids.

If kids didn’t have guns, the impulse to kill themselves might pass before they acted on it, said Dr. Eliot Nelson, author of an accompanying editorial and a researcher at the University of Vermont Children’s Hospital in Burlington.

“Too many people assume that if (youngsters) didn’t have a gun they’d use something else, but the quick lethality of guns makes them especially dangerous for an impulsive teen whose moment of crisis might pass with a little time,” Nelson said by email.

“Other methods are harder to use or more likely to be survivable, such as an overdose,” Nelson added.

Accidental gun deaths, meanwhile, almost always happened in the context of children playing with firearms.

All gun deaths and injuries are preventable, experts say.

“Children are curious, and research tells us that they know more about the location of guns in the home than parents might assume,” said Dr. Ruth Abaya of the Children’s Hospital of Philadelphia.

“Simply instructing kids about safe handling is not sufficiently protective,” Abaya, who wasn’t involved in the study, said by email. Guns ideally should be stored outside the home, she said, but if they are in the home they should be unloaded, locked, and in a gun safe.

Parents also shouldn’t underestimate how witnessing gun violence influences kids, said Joan Reid, a researcher at the University of South Florida in St. Petersburg who wasn’t involved in the study.

“Living in communities marred by violence that seems to be inevitable and unavoidable, some come to view gun carrying as a defensive strategy, adopting the belief that gun carrying can keep them safer,” Reid said by email. “However, we know that carrying a gun increases the likelihood of youth being injured or dying by gun violence.”