After years of medical advances, American children are now less likely to grow up

Deaths among children and teenagers increased during the COVID-19 pandemic, driven by fatal injuries, in a dramatic shift after decades of progress from medical advances in pediatric diseases, according to an editorial published this week in the Journal of the American Medical Association.

Researchers analyzed death certificate data from the Centers for Disease Control and Prevention and found that pediatric mortality increased by 20% from 2019 to 2021 – the largest increase in 50 years.

For decades, the overall death rate among Americans 19 and younger has been steadily declining because of breakthroughs in the prevention and treatment of conditions such as premature births, pediatric cancers and birth defects, said lead author Dr. Steven Woolf, director emeritus of the Center for Society and Health at Virginia Commonwealth University.

But the new findings represent a reversal of this trend, “meaning our children are now less likely to grow up.”

“It’s very tragic,” he said. “The progress we’ve made in reducing child mortality is the product of decades of research … and to see all that progress reversed by a handful of factors is really troubling.”

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What the report found: Spike driven by injuries

Researchers found that this increase is largely driven by an increase in injury-related deaths, such as suicides, homicides, overdose deaths and car crashes, all of which began to rise before the COVID-19 pandemic.

  • Suicide rates began to rise in 2007 and increased by 70% in 2019.

  • The number of homicides began to rise in 2013 and increased by 33% in 2019.

  • Overdose deaths began to rise in 2019, shortly before the pandemic.

The study also found that most of the deaths were attributable to older children aged 10 to 19. But deaths among younger children – ages 1 to 9 – had also increased by 8.4% in 2021. The only age group that did not experience a significant increase increase was infants.

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The new analysis also highlighted significant differences:

  • In 2021, black youth ages 10 to 19 were 20 times more likely to die by homicide than white youth and six times more likely than Hispanic youth.

  • Death by suicide was also twice as likely among black and American Indian/Alaska Native youth compared to white youth.

  • American Indian/Alaska Native youth also faced the greatest risk of dying in a motor vehicle crash.

What is behind the increase in deaths?

Although COVID-19 did not start these trends, study authors said the pandemic may have “added fuel to the fire” as access to firearms and opioids increased, alongside a “deepening mental health crisis.”

The pandemic may also have further hampered trauma care and emergency services as the health care system was overwhelmed by COVID-19 patients, said Dr. Henry Xiang, professor of medicine and epidemiology and director of the Center for Pediatric Trauma Research at Nationwide Children’s Hospital, who is not affiliated with the study.

“This is not a surprise,” he said. “Based on my research in this area for over 20 years, I have noticed significant changes in pediatric mortality rates, particularly those caused by suicide, violence and opioid abuse, in the last five to 10 years.”

Previous research has documented the steady increase in injury-related deaths among younger Americans, Woolf said. But for the first time, the trend has offset reductions in deaths caused by childhood diseases and tipped the scale for all-cause mortality.

“When you look at all-cause mortality — or deaths from anything — you’re looking at a balance between progress in lowering mortality and conditions that increase mortality,” he said. “When we see the all-cause mortality rate going up … it just speaks to how massive the death toll is.”

How do we protect our children?

More research into injury-related deaths is needed to identify trends and inform policy, experts say.

Xiang co-authored a study published in August 2022 showing that injury-related deaths among people under the age of 70 declined between 1981 and 1993, but saw a significant increase from 1994 to 2019. Despite the worrying trend, the study found that The National Institutes of Health severely underfunded research into suicide, homicide, and accidental injury.

“We’re not doing enough research on this topic,” Woolf said. “We need to fund research in relation to the death toll.”

Meanwhile, experts say it’s important to address the growing mental health crisis and gun safety.

It’s important for parents and families to have conversations about mental health and substance use at home with their children, said Anthony Estreet, executive director of the National Association of Social Workers. But schools play a “critical role” in identifying students who may exhibit early warning signs, he said.

While gun policies don’t change overnight, experts say gun safety can be practiced at home. This includes keeping guns and ammunition separate from each other and locking firearms to prevent children from accessing them.

“It goes hand in hand with responsible gun ownership,” Estreet said. “The more we have these conversations and we push the legislation, we may see a reversal of that trend.”

You deeper

Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.

Healthcare and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

This article originally appeared on USA TODAY: Child deaths rise during COVID due to murder, suicide, overdose

After years of medical advances, American children are now less likely to grow up

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