North Carolina child death rate rises, teen homicides drive increase

North Carolina’s child death rate climbed again in 2024, and the sharpest warning sign is among teenagers. State data show children ages 15 to 17 drove the biggest increase in homicides over the past decade, a trend that matters in Buncombe County, where local reviews have already flagged unsecured firearms and youth suicide as major concerns.

The state ranked 12th nationally for child mortality in 2024, down from 17th the year before. Excluding infants, North Carolina’s child death rate was 27.5 per 100,000 children, higher than the national rate of 21.8. In all, 1,386 North Carolina children ages 0 to 17 died in 2024, and 56% were infants who never reached their first birthday. For children ages 1 through 17, the leading causes of death were motor vehicle crashes, other unintentional injuries and homicides.

Homicides remain a central part of the problem. North Carolina’s child homicide rate fell from a peak of 4.4 per 100,000 in 2022, but it was still 3.5 per 100,000 in 2024, above the national rate of 2.7. Firearms were involved in 73% of the 460 child homicides recorded during the most recent five-year period, up from 54% of 264 child homicides in 2015-2019.

In Buncombe County, those numbers land in a community of 280,123 people centered on Asheville, where 95,376 residents live and Mission Hospitals serves as the closest trauma center. The Buncombe County Community Child Protection Team and Child Fatality Prevention Team reviewed the deaths of 24 county children in 2022, with five additional cases still pending review under state guidelines. The county’s 2023 annual report pointed to unsecured firearms, youth suicide and unsafe sleep as the main problem areas.

The local picture also shows that violence and injury prevention remain urgent. Buncombe County recorded 85 violent deaths in 2022, and the county’s violent crime rate fell 7% over the past year. But in 2024, 108 Buncombe County residents went to emergency departments for firearm injuries, a 15% increase from the year before.

The county report also found Black infants in Buncombe County were 2.36 times more likely to die before age 1 than white infants during the 2018-2022 period, underscoring how child safety here stretches beyond shootings alone. State law created North Carolina’s child fatality prevention system in 1991, and 2023 changes to that system took effect July 1, 2025. For schools, law enforcement and nonprofits in western North Carolina, the new numbers point to the same task: keep teens away from guns, identify youth in crisis sooner, and close the infant survival gaps that still weigh heavily on Buncombe County families.