A new study found that homicide is the leading cause of death for U.S. children.

According to research published in JAMA Pediatrics, the overall child homicide rate has increased an average of 4.3% annually since 2013.

The study, published Monday, was based on 38,362 homicide victims and found large disparities in childhood homicide rates across gender, race and age.

From 2019-2020, child homicide rates increased 27.7% from 2.2 per 100,000 to 2.8 per 100,000. The study found that homicides of children under 10 years old were most often due to parental abuse or neglect. Homicides among children 11-17 years old were mostly attributed to arguments and crimes committed by friends and acquaintances.

The study also found a 47.7% increase in firearm-related homicides from 2019-2020. The conclusion of the study recommended "more targeted strategies" to "urgently address firearm violence."

A University of Utah School of Medicine study published in JAMA Pediatrics on Monday also found an almost 50% increase in the number of children with firearm injuries from April 2020 to December 2021.

Boys saw a large increase in homicide rates, increasing 16.1% between 2018 and 2020. Out of the 38,362 victims studied using data from the Centers for Disease Control and Prevention's National Vital Statistics System, 69.4% were male. Specifically, black boys were killed more than any other group.

Homicide rates among girls decreased by 1.4% from 1999 to 2020. The study also found declines among children under 6, white children, Asian/Pacific Islander children and children in the northeast.

"I think, as a society, we have to take a hard look at the systems that we have in place to protect children and to try to come to an understanding of why they're not working better for these young children," Dr. Elinore Kaufman, a University of Pennsylvania trauma surgeon, wrote in an editorial to accompany the homicide study.