Mortality rates among American children and adolescents rose by almost 20 percent in just two years, with non-COVID injuries being a top reason for increased deaths.
Between 2019 and 2020, all-cause mortality rates for Americans in the age group of 1 to 19 years jumped by 10.7 percent, according to data collected and published by JAMA Network from the American Medical Association. This was followed by an 8.3 percent spike between 2020 and 2021. The total mortality rate in the two years between 2019 and 2021 was 19 percent—the biggest increase in at least 50 years. “These increases, the largest in decades, followed a period of great progress in reducing pediatric mortality rates,” the editorial stated.
“This reversal in the pediatric mortality trajectory was caused not by COVID-19, but by injuries,” the editorial stated. “In 2020, the COVID-19 mortality rate at ages 1 to 19 years was 0.24 deaths per 100 000, but the absolute increase in injury deaths alone was nearly 12 times higher (2.80 deaths per 100 000).”
Between 2019 and 2020, injury mortality rose by 22.6 percent among those between the ages of 10 and 19, with homicides rising by 39.1 percent and drug overdose deaths jumping by 113.5 percent. Among children aged 1 to 9 years, injuries accounted for 63.7 percent of the increase in all-cause mortality in 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, an author of the editorial and an assistant professor in the department of pediatrics at the Virginia Commonwealth University’s School of Medicine.
Non-COVID Death Causes
The editorial points out that the increase in injury deaths predates the pandemic. For instance, suicides among individuals between 10 and 19 years of age began to rise in 2007, with homicide rates starting to increase in 2013.
Between 2007 and 2019, mortality rates for suicide rose by 69.5 percent. Between 2013 and 2019, homicide rates increased by 32.7 percent. The editorial blamed the increase in suicide and homicide rates on a “deepening” mental health crisis and access to firearms.
Despite the fear created by the pandemic, the share of COVID-19 in deaths among children and young people (CYP) was lower when compared to other causes, according to a Jan. 30 study published in JAMA Network.
The study identified 821 deaths among CYP aged 0 to 19 years between August 1, 2021, and July 31, 2022, in the United States and compared it with other causes of death in 2019 prior to the pandemic. COVID-19 was ranked eighth among all causes of death within this demographic, accounting for 2 percent of all causes of death.
According to data from the National Center for Health Statistics, unintentional injuries were the leading cause of death among children in 2020, accounting for 12.5 percent of deaths below the age of 12 and 31.4 percent of deaths among adolescents aged 12-17.
COVID-19 accounted for 0.3 percent of deaths in children under the age of 12 and 0.8 percent of deaths among those aged 12-17.
Mental Stress Among Children
Mental health among children and adolescents worsened during the pandemic per a paper published in The Lancet Psychiatry that analyzed emergency department visits. The analysis found a 22 percent jump in youth visits for suicide attempts when comparing the period prior to the pandemic to the pandemic period until July 2021.
This surge in suicide visits happened even though there was a 32 percent reduction in pediatric emergency department visits for health-related reasons during the pandemic. In addition, there was also an 8 percent increase in visits for suicidal ideation—referring to individuals who entertain suicidal thoughts.
A study on the National Poison Data System found that suspected suicide attempts through self-poisoning among children rose by 26.7 percent between 2015 and 2020.
“We need to be vigilant for the warning signs associated with suicide risk in our children,” said Dr. Christopher Holstege, chief of the division of medical toxicology at the University of Virginia School of Medicine.
“Our study is one of a number that demonstrates that we are experiencing an unprecedented mental health crisis in younger age groups. As a society, we must commit more resources to the mental health needs of our children.”