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Pediatric Mortality Decreases in U.S., but Rates Still Higher than Canada and U.K.

, by DCEG Staff

All-cause mortality rates in the U.S. have decreased for most ages and racial/ethnic groups but remain higher and are improving more slowly compared to Canada and the United Kingdom. However, cause-specific mortality increased for infants by accidental suffocation and strangulation in bed, and for young adults by suicide and drug poisoning. The findings were published online October 1, 2018, in the journal JAMA Pediatrics.

DCEG investigators and collaborators examined death certificate data from the U.S. National Center of Health Statistics, Statistics Canada, and the U.K. Office of National Statistics, focusing particularly on all deaths that occurred between 1999 and 2015 among children and young-adults aged 25 or younger in the United States, Canada, and England/Wales. In addition to stratifying the data by 4-year age brackets, the U.S. data was further stratified by race/ethnicity.

In 2015, declines in mortality rates resulted in approximately 12,000 fewer deaths compared to what was expected based on 1999-2002 rates. Increases in infant mortality rates due to accidental suffocation and strangulation in bed resulted in 560 additional deaths; increases in suicide and drug poisoning rates in youth, resulted in an additional 1,700 and 2,100 deaths, respectively. The authors noted striking racial disparities in the U.S. Even though the infant mortality rate declined by 20% between 1999 and 2015, achieving the Healthy People 2020 goal of <6 deaths/1,000 infants, infant mortality rates in 2015 remained exceptionally high for blacks (11 deaths/1,000 infants) and American Indians and Alaska Natives (9.7 deaths/1,000 infants).

The authors note: the findings of this study support the urgent need for policies and interventions that aim to prevent drug poisoning and suicide, such as improved diagnosis and treatment of depression in youth. Additionally, efforts to improve maternal health and access to quality healthcare and to educate parents about healthy sleeping habits for infants should remain a priority.

Reference: Sahar Q Khan, et al. U.S. Infant and Youth Mortality Trends by Race/Ethnicity and Cause of Death in the United States. JAMA Pediatr, October 1, 2018. DOI:10.1001/jamapediatrics.2018.3317

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