Nearly 1,300 children are killed by guns every year in the United States and another 5,800 are wounded, making firearms the third-biggest killer of American kids, according to a new study published in the medical journal Pediatrics.

There are three main categories of death by firearms: homicide, suicide, and unintentional gun-related deaths. Just 6 percent of gun fatalities among children — meaning people up to 17 years old — are unintentional, according to the study. The rest are due mostly to homicides, followed closely by suicides.

The study, conducted by researchers at the University of Vermont, drew on databases including the National Violent Death Reporting System, which tracks trends in causes of violent deaths via police reports, hospital records, and medical examiner reports; demographic data; and figures from the Centers for Disease Control and Prevention.

About 19 children die or receive treatment in an emergency room for a gunshot wound every day in the U.S, and most of the victims are boys between the ages of 13 and 17. But suicide and homicide, whether among young people or adults, are two distinct problems, and that’s reflected in both the racial and geographic breakdown of the data.

More than half of youths killed in firearm homicides are black.

Each year from 2012 to 2014, there was an average of 693 firearm homicides involving kids, and black youth were killed in 56 percent of them. Black male teenagers are 10 times more likely to be shot dead in a homicide than their white counterparts and four times more likely than Hispanics.

Homicides among youth were concentrated in the South, the Midwest, two Western states, and three Northeastern states, including in cities like Baltimore, Chicago, and Compton, California, that have seen a dramatic uptick in gun violence and murders in recent years. Youth homicides, like homicides overall, dropped significantly between 2007 and 2014, but the study does not encompass the homicide spike criminologists observed beginning in 2015.

White and Native American teenagers are four times more likely to die by suicide using a firearm than black teenagers are.

There were an average of 500 youth suicides per year involving firearms between 2012 and 2014, and they were most prevalent in Idaho, Alaska, and Montana — states that have high overall suicide rates and rank in the top 10 for rates of gun ownership.

Researchers found that relationship problems — whether with a romantic partner, a friend, or a family member — triggered 71 percent of suicides by firearms. Forty-two percent of suicides were caused by a “crisis in the past or upcoming two weeks.”

Dr. Eliot Nelson, a pediatrician at the University of Vermont Medical Center, offered a critique of the study, also published in Pediatrics, that underscored the urgency for pediatricians and policymakers to recognize the creeping rates of youth suicides, particularly in rural states, and pointed to the suicide statistics as being especially troubling when viewed in the context of accessibility to firearms. “The current report’s analyses confirm that suicides often occur in response to short-term crises,” Nelson wrote. “The availability of a firearm may be especially critical for an impulsive teenager in such moments.”