The United States is facing a public health crisis that threatens the lives of its youngest citizens. According to a new study published in the Journal of the American Medical Association, the death rate of Americans ages 1 to 19 rose by 20% between 2019 and 2021, mainly due to injuries from homicide, overdose, car accidents and suicide.
This is the largest increase in pediatric mortality in at least 50 years, reversing decades of progress in reducing deaths from diseases like premature births, pediatric cancer and birth defects.
“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. 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 study 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.
The researchers found that 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, 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.
The study also revealed significant disparities in pediatric mortality by gender, race and ethnicity. Boys are dying at nearly twice the rate of girls. In both 2020 and 2021, Black, non-Hispanic children had higher death rates from COVID-19 than Hispanic and White, non-Hispanic children.
The researchers attributed the rise in pediatric mortality to a combination of social, economic and environmental factors that have eroded the health and well-being of American children.
“The pandemic has been hard on everyone but especially on our kids,” said 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. “They have been isolated from their friends at school and their extended families. They have been exposed to more violence at home and in their communities. They have had less access to health care services for mental health problems or substance use disorders.”
The researchers called for urgent action from policymakers, health care providers, educators and parents to address the root causes of pediatric mortality and prevent further loss of life.
“They assigned blame to “manmade pathogens,” particularly guns and drugs,” wrote The Hill. “Pediatric death rates are rising mostly because of injuries, as opposed to diseases such as cancer and COVID-19.”
The researchers urged for more investment in prevention programs that target the leading causes of injury deaths among U.S. children and teens: transportation, firearms, poisoning and suicide.
They also recommended for more support for families and communities that are struggling with poverty, food insecurity, stress and trauma.
They emphasized that saving children’s lives is not only a moral imperative but also an economic one.
“Children are our future,” Woolf said. “Their health affects our nation’s productivity, innovation and competitiveness. If we fail to protect them, we fail ourselves.”