Over Half of Deaths Among Youths Preventable in US
December 20, 2018
Children and adolescents in the United States have a higher risk for death before age 19 than youths in other wealthy countries, such as Sweden, Australia, England, and Austria. More than half of the deaths are preventable, new research indicates.
Findings by Rebecca M. Cunningham, MD, an emergency medicine physician, who is director of the University of Michigan Injury Prevention Center in Ann Arbor, and colleagues were published online December 19 in a special report in the New England Journal of Medicine.
Vehicle crashes were the top cause of death for all US children and adolescents through age 19 (20.0% of all deaths), followed by firearm deaths (15.4% of all deaths), in 2016, the most recent year for which data were available.
The third most common cause of death among youths in the US was malignant neoplasms, the authors note, which accounted for 9.1%. Malignant neoplasms were the only non-injury-related cause of death in the top five leading causes. Deaths from malignant neoplasms decreased 32% from 1990 to 2016. The other two causes in the top five were suffocation (7.0%) and drowning (4.9%).
Overall, the US lost 20,360 children and adolescents in 2016, and 60.6% of the deaths were from preventable injuries, the authors report.
Edward W. Campion, MD, executive editor and online editor of the NEJM, said pointedly in an accompanying editorial, “In recent decades, there has been progress, but the United States is clearly not effectively protecting its children.”
Vehicle Crash Deaths Triple Those of Other Wealthy Countries
Cunningham and colleagues report that the rate for youths dying in vehicle crashes in the US was three times the overall rate for 12 other developed countries (5.21 per 100,000 [95% confidence interval (CI), 5.06 – 5.38] vs 1.63 per 100,000 [95% CI, 1.49 – 1.77]).
The rate of firearm deaths in this age group in the US was 36.5 times higher than that in the other 12 countries (4.02 per 100,000 [95% CI, 3.88 – 4.16] vs 0.11 per 100,000 [95% CI, 0.08 – 0.15]).
Among those firearm deaths in the US, 59% were homicides, 35% were suicides, and 4% were from unintentional injuries, such as accidental discharge.
Most of the data for this article were derived from death certificates in the Centers for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research (WONDER) system. Rates of death in countries other than the US are from the World Health Organization Mortality Database. The 12 wealthy countries included for comparison were England and Wales, Scotland, Sweden, the Netherlands, Lithuania, Iceland, Hungary, the Czech Republic, Cyprus, Croatia, Austria, and Australia.
The study is the first to calculate all causes of child and adolescent death by both mechanism and intent, the authors said in a press release.