After declining for more than a decade, the death rate among America’s children and teens has taken a troubling and tragic turn upward in recent years, according to a report released last Friday by the Centers for Disease Control and Prevention (CDC).
For the report, CDC researchers analyzed death certificate data filed between 1999 and 2016 in all 50 states and the District of Columbia.
They found that the death rate for young people aged 10 to 19 years fell by 33 percent between 1999 and 2013, primarily because of a drop in deaths caused by infectious diseases. But then the death rate started to rise again — by a startling 12 percent within just four years, 2013 through 2016.
That increase was not triggered by a resurgence of illness-related deaths, however. The rate of such deaths among young people has remained fairly stable in recent years. Instead, the jump in the young people’s death rate was driven by injury-related deaths caused by accidents, suicides and homicides.
That finding was unexpected.
“When I first conceded to do this report two-and-a-half years ago, I thought that we would be documenting a decline,” Sally Curtin, one of the report’s authors and an epidemiologist at the CDC, told CNN. “We were surprised that there was such a broad increase across so many causes of death. There wasn’t just one that was contributing.”
What the study found
Here are some of the key findings from the report:
Accidental deaths: Motor vehicle crashes, poisonings and drownings were responsible for 85 percent of all accidental deaths of young people in 2016. Motor vehicle crashes were by far the leading cause, accounting for 62 percent of unintentional injury deaths that year, followed by poisonings (16 percent) and drownings (7 percent).
In 1999, drowning deaths were the second leading cause of accidental deaths for young people aged 10 to 19. That changed in 2002, however, when poisoning deaths overtook them.
Most poisoning deaths in recent years involve older teens (15 to 18 years old) and are the result of drug overdoses, primarily due to heroin and other opioids.
The report also notes that the motor vehicle death rate for young people in 2016 was half of what it was in 1999, but 12 percent higher than in 2013, its most recent low point. The CDC researchers suggest the increase may in part be because more teenagers are driving than they were in the immediate aftermath of the Great Recession (2007-2009).
Suicides: Suicides among 10- to 19-year-olds declined by 15 percent between 1999 and 2007, but then jumped a startling 56 percent between 2007 and 2016.
In 2011, suicide replaced homicide as the second-leading cause of injury death among young people.
About half of the suicides by young people in 2016 involved guns, while the other half were the result of suffocation, including hangings. That’s a change, say the CDC researchers, from 1999, “when the firearm-suicide death rate was nearly twice that of suffocation.”
Firearms are still the leading method of suicide for boys aged 15 to 19 years, however.
Homicides: The homicide rate for young people declined by 35 percent from 2007 through 2014, but then did an about-face and increased by 27 percent through 2016.
The murder rate for boys is about four to six times higher than it is for girls, the report also found.
Most murders of young people — nine in 10 such deaths — involve a gun, and the firearm-homicide rate for young people increased by about one-quarter between 2014 and 2016.
Needed: ‘A dedicated effort’
This CDC study comes with several caveats. The main one is that suicide tends to be underreported, particularly those involving drug overdoses. And different states have different ways of classifying deaths.
Still, the trends reported in the report are supported by other research, as explained in a paper published last week in the Journal of the American Medical Association (JAMA). That paper notes that there was a sharp jump in deaths from injuries among young people aged 15 to 34 years old between 2012 and 2016.
“The recent trends of increasing numbers of teenagers and young adults dying from potentially preventable causes, such as overdoses, motor vehicle crashes, and firearms, suggest a concerning trajectory for US health outcomes, which stands in contrast to trends in other high-income countries,” write the authors of the JAMA paper, Dr. Lois Lee and Dr. Rebekah Mannix, who are both emergency physicians at Boston Children’s Hospital.
“Reversing this course of increasing mortality among teenagers and young adults will require the enactment of effective policies to prevent and treat opioid addiction, build safer motor vehicles and roadways, and increase mental health services while restricting access to firearms for those who may harm themselves or others,” they add.
Dr. David Katz, the founding director of the Yale University Prevention Research Center, was more blunt in discussing the implications of the CDC report’s findings with HealthDay reporter Dennis Thompson.
“The only proper response to this report is a dedicated effort to remedy all components of the problem,” Katz told Thompson. “… We need better, early detection of depression and drug misuse in young people, and effective, compassionate treatment when we find it.”
“And we need to do far more to keep guns out of the hands of desperate people,” Katz added. “Guns tend to make suicide and homicide attempts more likely to succeed, and that variety of success is a public health failure of the first order.”
FMI: The CDC report was published June 1 in the CDC’s National Vital Statistics Reports, where it can be read in full.
Diseases of Disconnection and Despair
Susan Perry’s commentaries on drugs, alcohol, suicides, and homicides highlight the magnitude of what we are calling the Diseases of Disconnection and Despair.” Health is not just about individual actions and medical care, it’s mostly about being in supportive relationships with family, friends, church, workplace, and the community. When those relationships are strained, broken, or non-existent, people medicate themselves with drugs, alcohol, tobacco, food, sex, gambling, screens, and the adrenaline rush of violence leading to the dreadful consequences Ms. Perry chronicles.
We need to take a new approach to addressing this situation. Instead of just focusing on a specific outcome, we need to focus on addressing the root causes. We need to focus on building healthy relationships by supporting families, schools, civic organizations among others that help create and strengthen community resilience. Among other things, we need to:
* provide paid family and sick leave so parents can spend time with their children during the most important time of their development,
* provide high-quality and affordable childcare so children can be in a nurturing environment when their parents are working or going to school,
* increase wages of low income individuals so that the economic stresses of poverty don’t interfere with healthy family development,
* create safe, stable, and secure housing for everyone which reduces family stress and enhances neighborhood cohesion,
* reform school discipline policies and find ways to better address disruptive behaviors in schools so suspensions/expulsions are not needed, and
* restructure our criminal justice system so that the financial and emotional devastation of incarceration on individuals and families can be reduced.
Mother Teresa once said “The greatest epidemic today is not TB, HIV or leprosy, it is being unwanted. Being unwanted, unloved, uncared for, forgotten by everybody is a much greater hunger, a much greater poverty, than the person who has nothing to eat.” We need to build a society and a community where young people feel included and wanted. A place where they feel like they belong. Only then will we be able adequately address these Diseases of Disconnection and Despair.
Ed Ehlinger