Richmond Leader

Child and teen mortality in the U.S. experiences largest increase in decades

Child and adolescent mortality rates in the United States rose by 20% between 2019 and 2021, the largest increase in at least 50 years, according to an editorial published Monday in the Journal of the American Medical Association. These increases follow decades of progress in lowering the rate of death from childhood diseases. 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 new research is based on a detailed examination of death certificate data from the Centers for Disease Control and Prevention. The analysis revealed that the mortality rate of Americans ages 1 to 19 rose by 11% between 2019 and 2020 and an additional 8% between 2020 and 2021.

“I have not seen this in my career,” said lead author Steven Woolf, M.D., director emeritus of the Center on Society and Health at Virginia Commonwealth University. “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 well 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.

“We've now reached a tipping point where the number of injury-related deaths is so high that it is offsetting many of the gains we’ve made in treating other diseases,” said Elizabeth Wolf, M.D., an assistant professor in the Department of Pediatrics at the VCU School of Medicine and pediatrician at the Children's Hospital of Richmond at VCU. In addition to Woolf and Wolf, the study was co-authored by Frederick Rivara, M.D., a professor of pediatrics at the University of Washington and Seattle Children’s Research Institute and acclaimed expert on pediatric injury prevention.

While deaths from COVID-19 contributed to the recent increase in child mortality, its impact was overshadowed by the increase in deaths from injuries, according to the data. In 2020, the mortality rate from COVID-19 among children and adolescents was 0.24 deaths per 100,000, whereas the increase in injury-related deaths alone was nearly 12 times higher.

“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,” said Woolf, a professor in the Department of Family Medicine and Population Health at the VCU School of Medicine. “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,” she said. “It’s estimated that only half of children with a treatable mental health condition have access to a mental health professional.”

Original source can be found here