A child born in the United States has a 76 percent greater risk of dying before their first birthday than one born in other wealthy, democratic countries, according to a study published online Monday in the journal Health Affairs.
As for older children in the United States — those aged 1 to 19 — their risk of dying before adulthood is 57 percent greater than in other wealthy countries.
That’s not to say that the risk of an early death has not decreased for American children over the past 50 years. It has. But the United States has been less successful in reducing that risk than their peers in the developed world.
“If the US had achieved just the average childhood mortality rate of [the other developed countries] over the fifty-year study period, over 600,000 deaths could have been avoided — a rate of about 20,000 excess deaths per year by the turn of the century,” the study says.
“Overall child mortality in wealthy countries, including the U.S., is improving, but the progress our country has made is considerably slower than progress elsewhere,” said Dr. Ashish Thakrar, the study’s lead author and an internal medicine resident at Johns Hopkins Hospital, in a released statement.
“Now is not the time to defund the programs that support our children’s health,” he added.
More money, poorer results
As Thakrar and his colleagues note in their study, the United States spends more money per child on health care than any other country in the world. Yet its children have poorer health outcomes than those living in most other wealthy countries.
And the situation in the U.S. may soon worsen. The Trump administration has proposed substantial cuts to health programs that help children, most notably the Children’s Health Insurance Program (CHIP), which serves 9 million children. Late last month, Congress passed emergency legislation to continue funding CHIP through May, but many states are expected to run out of money for the program before then.
For the study, Thakrar and his colleagues compared 1961-2010 child mortality rates in the U.S. with 19 other countries in the Organization for Economic Cooperation and Development (OECD), including Great Britain, Canada, Australia, France, Switzerland, Germany and Sweden.
The data revealed that during the 1960s, the death rate for U.S. infants (children under the age of 1) was 240.7 per 10,000 infants, somewhat better than the average rate of 250.3 per 10,000 in the other 19 countries. For older children, the U.S. death rate during that decade was essentially the same as the average rate in the other countries: 6.7 per 10,000.
Beginning in 1970s, however, the U.S. death rate for the older age group became higher than the average rate for the other OECD countries, and in the 1980s it became significantly higher for infants as well.
In the decade ending in 2010, the U.S. infant death rate was 68.8 per 10,000, compared to an average of 39 per 10,000 in the other 19 countries. For older children, the death rate in the U.S. was 3.1 per 10,000, compared to an average of 2.0 per 10,000 in the other OECD countries.
Leading causes of deaths
About 90 percent of child deaths in all of the countries in the study occurred among infants and adolescents aged 15 to 19.
In the United States, the current leading causes of death among infants are premature deaths and sudden infant death syndrome (SIDS), the study found. Infants in the U.S. are three times more likely to die from complications associated with a premature birth and twice as likely to die from SIDS as infants in the other countries in the study.
The two leading causes of death among adolescents aged 15 to 19 are motor vehicle crashes and gun violence. American teens are twice as likely to die from motor vehicle-related injuries and a stunning 82 times more likely to die from gun-related injuries than teens in the other countries.
Everybody ‘should be troubled’
The study concludes with a strongly worded call to action:
There has never been a better time to be born in any of these 20 countries. Despite this generalized trend, children are less likely to survive and transition into adulthood in the US than in other OECD countries. Persistently high poverty rates, poor educational outcomes, and a relatively weak social safety net have made the US the most dangerous of wealthy nations for a child to be born into.
All US policy makers, pediatric health professionals, child health advocates, and families should be troubled by these findings. The findings should motivate Americans to do everything possible to improve the medical and social conditions of children that are responsible for these preventable deaths.
FMI: An abstract of the study is available on the Health Affairs website, but the full study is behind a paywall.