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RALEIGH, N.C. (AP) — The number of North Carolina children who died by either homicide or suicide has more than doubled over the past decade, and a report released this week shows homicide was the leading cause of death among children from age 1 to 17 in 2020.

The state Child Fatality Task Force’s report said that in 2020, 92 children died as a result of homicide, making it the leading cause of death for that age group. It was the second-leading cause of death among children aged 1 to 4, news outlets reported.

Of the total number of homicides, 13 children under the age of 1 died from homicide in 2020, according to the report. One of the 13 deaths involved a firearm.

The report defines a child as anyone under 18.

Also in 2020, suicide was the fourth leading cause of death for children with 56 deaths. Among children aged 10 to 14, it was the leading cause of death. Self-inflicted injuries resulted in almost 550 hospitalizations and more than 2,700 emergency department visits in the state in 2020, the report said.

The report also noted that suicidal behavior by high school students has been trending upward and is most pronounced among youth who identify as gay, lesbian or bisexual.

Statewide, there were 152 deaths due to prematurity and low birth weight, while 146 were the result of congenital malformations, deformations and chromosomal abnormalities, the report said. According to the report, the infant mortality rate in North Carolina was 6.9 per 1,000 births, the eighth highest rate in the U.S.

According to the report, most causes of death among children in the state held relatively steady from 2011 through 2020, the most recent year for which figures are available.

In the report, the task force renews a call for North Carolina to increase funding for programs targeted at reducing child fatalities, including educating people about infant sleep safety, firearm safety and improving maternal and infant health, especially among minorities.