Childhood Mortality Trends, 1999-2021 (provisional), Ages 1-17

Good News for Young Kids, Not for Teens

There was the monthly update of the provisional deaths data at CDC WONDER last week, and I’ve been pulling data.

There is still bad news in there for 2021, and I’m reading the tea leaves for 2022 (still bad signs on homicides, drug ODs, etc.) so I thought I’d go seeking some good (and not-so-good) news in the childhood mortality stats.

I will not be using standard age groups, which CDC WONDER generally spits out at 1-4, 5-9, 10-14, 15-19, etc. That does not accord with what we think of as childhood, and aren’t useful groupings for the discussions I want to have. I know what the general pre-pandemic patterns looked like, and rather than get too complicated, I am enforcing three childhood age groups:

Age 1-4 (Preschoolers)
Age 5-12 (Schoolkids)
Age 13-17 (Teens)

These are meaningful in terms of the types of mortality risks they face, and do not blur the distinction between legal adults and minors (which do have repercussions for things such as, oh, homicide). I am excluding under age 1, i.e. infants, which have a much higher mortality risk than even teens.

These ages see the lowest mortality rates in life in general, and that’s still been true during the pandemic.

I do have some good news, at least when it comes to little kids and schoolkids. The teens, alas, I’ve got some bad news there, though not as bad as the experience as young adults.

The good news — mortality continues to improve for little children

Let me lead with the good news:

For both preschoolers and schoolchildren, from 1999-2021 — yes, even including the pandemic years — the total mortality rate for these groups decreased almost 30%.

For the age 1-4 group, the rate went from 34.2 per 100,000 per year in 1999 to 24.4 per 100K in 2021 (provisionally).

For the age 5-12 group, the rate went from 17.0 per 100K in 1999 to 12.3 in 2021.

Remember these rates are per 100,000 people. If I wrote this as a percentage, that would be 0.0123% as a mortality rate. These are the ages with the lowest mortality from anything.

That’s why it’s so shocking when a child in this age category dies from anything.

The primary cause of death for children are accidental causes, especially motor vehicle accidents, and these have progressively gotten better. But it’s not just accidental causes of death where things have improved for small children. Things have slowly but surely improved for pediatric cancer and other physiological causes.

So yay!

The bad news: teen mortality worsened 30% during the pandemic

The rest of the post is going to be the not-fun stuff.

I’ve got worse news in the coming weeks — this isn’t even the worst mortality increase among age groups. It’s much worse for the Millennials (the Millennials are in early middle age now. You know that, right?)

That’s mainly because COVID has barely touched the teens. But a lot of the nasty hitting the young adults have also affected the teens, just not as bad: homicide, drug ODs, and motor vehicle accidents.

Breaking out the top causes of death for teens (plus COVID)

The top three causes of death for teens are accidents, suicide, and homicide, and has been for a long time. I’ve also thrown in cancer as the top physiological cause of death for teens for comparison, alongside COVID, which doesn’t rank all that high. You kind of have to squint to see it on the graph.

With the stacked column, you can see how much accidents have shrunk, but it remains the top cause of death for teens.

Cause of death trends for teens – pre- and post-pandemic changes

It’s hard to see the trend cause-by-cause in this format, though, so let me switch to a line graph:

There was the good news from before the pandemic: the accidental death rate had come way, way down. That was mostly due to improved traffic safety. (Not reduced drug ODs, alas)

In the pandemic, both increased motor vehicle deaths and drug overdoses has pushed up the accidental death rate for teens to increase to levels seen a decade ago.

But there was a bad pre-pandemic trend: suicide rates had increased from 2007 to 2018 — increasing a total of 120% over that period. That was hideous.

It seemed to have reversed in 2019, and come down during the pandemic. The suicide trends in the pandemic really made no sense to anybody, but perhaps the increased drug ODs were actually suicides.

Homicides didn’t have a steady trend before the pandemic, but has definitely had a bad trend during the pandemic. Homicide death rates for teens increased over 50% from 2019 to 2021.

One observation: suicide and homicide death rates used to be about the same for teens in the early 2000s, and then with the bad suicide trend, suicide ranked higher. Even with the increase in homicide rates, suicide still ranks higher.

As a reminder with these types of causes of deaths: with the most recent data update, I am still missing December 2021 data for suicides, homicides, and accidents because of the 6-month delay on that sort of data. I am pretty satisfied that we are very close for the full-year death rate, but these rates for these top causes of deaths for teens in particular will likely go higher — those “other causes” will likely get distributed among suicide, homicide, and accidents.

Get ready for some uglier stuff

Because y’all — yes, this is bad for teens.

But these rates – homicide, suicide, and accidental rates of death – are lower than the ones we’re going to see for young adults and middle-aged adults.

And as age gets old, the older groups will see physiological causes killing them off at higher rates, especially COVID.

The children have almost no bad physiological causes of death trends one has to watch out for. The physiological causes of death that affect kids have generally had good trends as medical treatments improve. The only causes that have bad trends have been “external” causes — homicide, suicide, and accidents.

As bad as the trend is for teens, it’s even worse for young adults. So get ready for that one next.

Methodology

Data Sources: Centers for Disease Control and Prevention, National Center for Health Statistics. National Vital Statistics System.

Finalized data: Mortality 1999-2020 on CDC WONDER Online Database, released in 2021. Data are from the Multiple Cause of Death Files,1999-2020, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/ucd-icd10.html on Jun 14, 2022

Provisional data: Provisional Mortality on CDC WONDER Online Database. Data are from the final Multiple Cause of Death Files, 2018-2020, and from provisional data for years 2021-2022, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10-provisional.html on Jun 14, 2022

Death rates were calculated using death counts and estimated population sizes, using age groups aggregated as follows:

Age 1-4
Age 5-12
Age 13-17

Cause of death data used the 113 Rankable Cause of Death categorization ofICD-10 codes:

• Accidents — Accidents (unintentional injuries) V01-X59, Y85-Y86

• Suicide — Intentional self-harm (suicide) U03,X60-X84,Y87.0

• Homicide — Assault (homicide) U01-U02,X85-Y09,Y87.1

• Cancer — Malignant neoplasms C00-C97

• COVID — COVID-19 U07.1

Spreadsheet:

Childhood Mortality Age 1 17 1999 2021 Provisional As Of 2022 June 14

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