According to the Journal of the American Medical Association, child and adolescent mortality rates in the United States have increased by 20%, the largest increase in at least 50 years. The alarming spike in pediatric mortality is primarily due to deaths from homicide, accidental drug overdoses, motor vehicle accidents, and suicide among those ages 10 to 19. The recent increase in mortality rates follows decades of progress in lowering the death rate from childhood diseases.
Lead author Steven Woolf, M.D., said,
“I have not seen this in my career. For decades, the overall death rate among U.S. children has fallen steadily, thanks to breakthroughs in prevention and treatment of diseases like premature births, pediatric cancer and birth defects. We now see a dramatic reversal of this trajectory, meaning that our children are now less likely to reach adulthood. This is a red flashing light. We need to understand the causes and address them immediately to protect our children.”
The recent increase in “all-cause mortality,” a measure of all deaths in children and teens, is largely driven by increases in certain injury-related deaths, which began before the COVID-19 pandemic. For example, the researchers found that suicide rates at ages 10-19 began increasing in 2007 and climbed by 70% by 2019. Homicide rates began increasing in 2013, rising by 33% by 2019. The number of overdose deaths began to rise in 2019, and deaths from car accidents dramatically jumped in frequency in 2020 and 2021.
“A large proportion of these deaths involve firearms, the method most commonly used by teens to die by suicide or commit homicides. Firearm ownership has increased, guns are more available to young people, and the weapons are more lethal. Mass shootings at schools receive a lot of national attention, but what adds up to a much larger death toll are the shootings of children, one by one, that we hear about on our local nightly news.”
Another major driver for these trends is the worsening mental health crisis affecting young people, Wolf said.
“There is a severe shortage of mental health providers who care for children and adolescents, especially in rural areas. It’s estimated that only half of children with a treatable mental health condition have access to a mental health professional.”
Although the pandemic did not initiate these trends, it may have poured fuel on the fire, the researchers said.
“Children and teens were impacted by the pandemic in so many indirect ways, whether from the death of a caregiver or extended school closings. The pandemic also upended health care delivery, making it harder for children to attend routine checkups and receive important vaccinations.”
The risk of injury-related death also varied significantly by race and ethnicity. In 2021, Black youths ages 10-19 were 20 times more likely to die by homicide than white and Asian American/Pacific Islander youths and six times more likely than Hispanic youths. Death by suicide was more than twice as likely among Black and American Indian/Alaska Native kids than white youths. American Indian/Alaska Native youths faced the most significant risk of dying in a motor vehicle accident.
Without bold research and policy actions to reverse the trend, children’s risk of not reaching adulthood may continue to increase, according to the researchers.
“The need to address policies on firearms and mental health is obvious, but we must also address the root causes of these deaths by expanding opportunities for education, well-paying jobs, good housing, and other living conditions. More research is also needed to better understand and address the increase in injury deaths. Modern medicine has fought the battle against pediatric diseases, but the threats to our children are now manmade. Without action, bullets, drugs and automobiles will continue to claim the lives of our most cherished population.”
