Children living in high-risk neighborhoods are disproportionately affected by gun violence, even in states with relatively strict firearm regulations, according to a U.S. study.

Death rates from gunshots among young Americans were 11 times higher in ¡°socially vulnerable¡± communities compared to those in low-risk areas, according to research published Wednesday in the Journal of the American Medical Association. The authors used data tracking U.S. communities¡¯ vulnerability to public-health emergencies to determine which were at risk.

Guns are the leading cause of death for U.S. children, accounting for one in five child and teen fatalities, with most classified as violent assaults. Accidents account for about a third of gun deaths among small children.

The results suggest some communities need additional solutions, beyond strict gun laws, to reduce firearm-related risk, the study authors from Seattle Children¡¯s Hospital, the University of Washington and Harborview Medical Center in Seattle said.

¡°Legislation alone, although important, will not address the problem of gun violence in the U.S.,¡± the researchers wrote. It ¡°needs to be accompanied by genuine, deep, and long-term investment in historically marginalized communities to reduce inequities.¡±

After years of high-profile mass shootings, the U.S. has been locked in a fierce, long-running debate over gun control. Safety advocates have called for measures including a ban on assault weapons to lower the risk of violence and death. Opponents of increased gun regulation have cited the need for better enforcement of existing laws and improved protection of schools and institutions that have been targeted by gun violence.

While often in the news, mass shootings account for less than 2% of annual U.S. firearm-related fatalities. Policymakers should tailor solutions to more types of gun violence, experts say. Unintentional firearm deaths among children, for example, ¡°highlight the importance of safe storage practices and education about safe handling of firearms,¡± according to the Centers for Disease Control and Prevention.

By focusing attention on mass shootings, ¡°we are really missing the full scope of the problem,¡± said Chana Sacks, a physician and the co-director of the Center for Gun Violence Prevention at Massachusetts General Hospital in Boston, in an interview.

The between 2020 and 2022. The study didn¡¯t look at suicides, which represent more than a third of all firearm-related deaths in children and teens, according to the CDC.

The researchers compared the strength among state laws based on ratings from Giffords, an advocacy group led former U.S. Rep. Gabrielle Giffords of Arizona, who was attacked by a gunman in 2011. Firearm death rates were higher overall among young people living in states with loose gun laws. But gun deaths were...