Every death of a child is a tragedy. According to a recent study in the New England Journal of Medicine (NEJM), these tragedies are all too common in the United States, with children here being 57% more likely than children in other wealthy countries to die by the age of 19. Deaths of children and teenagers from age one to nineteen in the U.S. are also now more likely to be due to injuries (61%) rather than illnesses (39%).
This is in part because over the years, advances in sanitation, vaccination, diagnosis, and treatment have reduced the chance of dying from infectious diseases. In 1900, pneumonia, tuberculosis, and diarrhea and enteritis were the most common causes of death for the entire U.S. population, with 40% of these deaths being those of children. By 2016, the most recent data available, none of these diseases were among the ten leading causes of death for children.
Among injury deaths, most (57%) were unintentional, with suicides (21%) slightly more common than homicides (20%).
Cars, or motor vehicle collisions, comprised the largest single cause of death, killing 4,074 young people in the United States in 2016, or 20% of child deaths overall. At 15%, firearms are the second largest cause, with 59% of these deaths classified as homicides, 35% as suicides, and 4% as unintentional. Although drowning is a relatively less common cause of death, it was the most common cause of death among the youngest children, age one to four.
Child deaths from car crashes have decreased significantly since the early 2000s, which the authors attribute to seat belt and child car seat use, more stringent safety standards and features in cars and roads, graduated driver-licensing programs, and campaigns to reduce teen drinking and driving. But more recently, from 2013 to 2016, the rate of car crash deaths has increased. According to the authors, the causes for this reversal are not yet fully known, but likely include an increase in distracted driving due to peer passengers and the use of cell phones. Of course, this time period coincides with increased ownership of smartphones among teenagers, with smartphone ownership among all Americans increasing from 35% to 70% between 2011 and 2016.
As the rate of unintentional gun-related deaths has remained relatively stable, the increase in gun deaths from 2013 to 2016 reflects rising rates of firearm homicide (increased by 32%) and suicide (by 26%). In 2016, there were 126 unintentional child firearm deaths (and 50 more with an undetermined intention), which could have been made less likely through safer gun practices. This leaves almost 3,000 gun-related deaths of children through homicide and suicide.
Instead of seeing child injury deaths simply as “accidents,” the study’s authors pointed out that these are “social ecologic phenomena that are amenable to prevention.” Public health initiatives have made progress in reducing the number of children who die from car crashes, drowning, and residential fires, but in comparison with other countries, the United States has a long way to go. For cars and even more so for guns, the United States has the highest rates of child death as compared with other wealthy countries. Maybe this isn’t so surprising, given that the United States is the only country in the world with more guns than people.
If you’re wondering what you can do to protect the children and teens in your life, you can check out the CDC’s child injury prevention tips. For motor vehicle collisions, these tips include things like using seat belts and child car seats correctly and consistently. The CDC child injury page does not mention guns.
The study, published in the New England Journal of Medicine, analyzed data from the Wide-ranging Online Data for Epidemiologic Research (WONDER) system of the Centers for Disease Control and Prevention (CDC), which collects information from U.S. death certificates. Check it out here for more details.
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