If I drew you a graph that showed the death rate among American kids, you would see a backward check mark: Fewer kids died over the last several decades, thanks to everything from leukemia drugs to bicycle helmets. Then, suddenly, came a reversal. [New York Times]
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| The chart shows the mortality rate for children ages one through 19 | Source: Centers for Disease Control and Prevention WONDER database | By The New York Times |
I first noticed this in 2021 while poking around in mortality data from the virus-ridden year before. It looked bad. I knew that kids who contracted Covid tended to fare better than older people, but was the virus killing them, too?
Nope. It wasn’t the virus. It was injuries — mostly from guns and drugs. From 2019 to 2021, the child death rate rose more steeply than it had in at least half a century. It stayed high after that. Despite all of the medical advances and public health gains, there are enough injuries to have changed the direction of the chart.
Horrified, I started making phone calls. It turned out that I was not the only one who wanted to understand what was happening to America’s children. In today’s newsletter, I’ll explain what we now know.
Guns and drugs
When life expectancy in the United States plateaued around 2010, it was big news. Problems that grabbed people in midlife — chronic disease, depression, opioids and alcohol — were bringing down the average. Yet the survival rate for children kept improving, thanks to better neonatal care, vaccines and even swimming lessons.
The first real alarm bells coincided with the pandemic. That’s when the mortality rate among children and adolescents shot up by more than 10 percent in a single year. These children weren’t felled by some spreading contagion; their deaths were sudden and “almost always preventable,” as Dr. Coleen Cunningham, the pediatrician in chief at Children’s Hospital of Orange County, puts it. Deadly car accidents among tweens and teens climbed nearly 16 percent. Murders went up 39 percent. Fatal overdoses more than doubled.
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| In Brooklyn, New York. Victor J. Blue for The New York Times |
New patterns emerged with race and gender, too. Black and Native American children were dying at much higher rates than white children. And the disparities — which had been narrowing — were now widening again. Black kids were mostly shot by other people. Native American kids mostly shot themselves.
There were harbingers before 2020. Suicides started to increase in 10- to 19-year-olds after the 2007 recession alongside the rise of social media and cyberbullying. Homicides climbed as access to firearms rose. Overdose deaths spiked shortly before the pandemic began as cartels laced their drugs with fentanyl.
But guns were at the center of it all, replacing car crashes as the leading killer of kids. Gun deaths alone accounted for almost half of the increase in young people. They are now equivalent to 52 school buses of children crashing each year.
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| The chart shows mortality rates for children ages one through 19 | Source: Centers for Disease Control and Prevention WONDER database | By The New York Times |
Seeking answers
Of course, how children die is not the same as why, and answering the latter question could prove increasingly difficult in the years ahead.
That’s because of politics. Three decades ago, major health studies began to reveal the danger of guns. The National Rifle Association took notice. That’s when Congress barred the Centers for Disease Control and Prevention from spending money to “advocate or promote gun control.” Grants from the agency ended. Without the funding, the research stopped.
But a researcher helped persuade Congress to restore the money in 2019, just before the children’s mortality rate spiked. Gun-violence research is now going through a sort of renaissance. Epidemiologists are gathering better data on what’s behind the rise in gun deaths and what could help prevent them, from expanded background checks to gun safes.
But politics change, and that means funding could, too.
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