The mass shooting at an elementary school in Uvalde, Texas, Tuesday has put the spotlight back on recent data showing that firearm injuries are the No. 1 cause of death among children and adolescents in the United States.
A total of 19 children, mainly third and fourth graders -- as well as two teachers -- were killed at Robb Elementary, in what President Joe Biden referred to as an act of "carnage."
It's an all-too-familiar story in which communities are left wondering in the aftermath how to best keep children safe.
"It's a senseless act of violence," Dr. Jason Goldstick, an associate professor of emergency medicine at the University of Michigan, told ABC News. "You shouldn't be expected to be exposed to violence when going to school like that."
And it comes just a month after the Centers for Disease Control and Prevention released data showing guns were the No. 1 killer of children and adolescents in 2020.
The agency found that 4,368 Americans under the age of 19 died from gun violence in 2020, a 29.5% jump from 2019.
That's equivalent to 5.4 out of every 100,000 kids and teens in the U.S. dying from a firearm injury and a 63% jump from the 3.3 per 100,000 recorded one decade ago.
It's unclear what's behind the spike, but the data is consistent with other recent studies showing the increase in firearm-related injuries at the beginning of the COVID-19 pandemic.
"If you look at the trajectory over the last several years, that should raise alarm," said Goldstick, who is also a member of the university's Institute for Firearm Injury Prevention. "The fact that this is the leading cause of death among kids is obscene."
It also marks the first time since the CDC started recording leading causes of death among children that firearm-related injuries overtook motor vehicle crashes as the No. 1 cause.
For the last 21 years, gun deaths were second to motor vehicle crashes as the leading cause of death among children and adolescents; however, the gap between the two categories has been narrowing since 2016, the CDC said.
By comparison, motor vehicle accidents killed about five per 100,000 Americans aged 19 and younger in 2020.
That is a more than 50% decline in the rate of children and adolescents being killed by cars since 1999.
There has been significant progress in reducing the fatality rate of motor vehicle crashes, including increased use of seat belts and safety technology, including automatic emergency braking systems and airbags.
"A lot of the political rhetoric around reducing firearm-related deaths center around gun control and the Second Amendment," Goldstick said. "But we were able to accomplish huge reductions in motor vehicle crash injuries without banning cars ever. There's no reason an analogous approach can't work for firearms."
He added there are several evidence-based approaches that can help drive down firearm fatality rates including investments in organizations and programs aimed at curbing community violence, safe storage campaigns and firearm training courses.
"Tracking these kinds of trends is really sort of step zero," Goldstick said. "It's not a solution ... It tells you it's a worsening problem and points us in a direction to focus on to reduce mortality among children and teens."
ABC News' Ivan Pereira contributed to this report.