U.S. Mortality Rate Before Age 20 Worst Among Rich Nations

U.S. Mortality Rate Before Age 20 Worst Among Rich Nations

Children in the United States are 70 percent more likely to die before reaching adulthood than their peers in other wealthy nations, a study published in Health Affairs finds.

The study, Child Mortality in the US and 19 OECD Comparator Nations: A 50-Year Time-Trend Analysis, compared mortality trends for children from birth through age 19 in twenty member states of the Organization for Economic Cooperation and Development (OECD) between 1961 and 2010 and found that while child mortality rates have fallen steadily in all twenty countries, the U.S. has lagged far behind its peers since the 1980s. Conducted by researchers affiliated with the Johns Hopkins Hospital and Health System, Drexel University College of Medicine, and Children's Hospital of Philadelphia, the study also found that between 2001 and 2010 infants in the U.S. had a 76 percent higher risk of death than infants in other OECD nations, while the infant death rate from extreme prematurity was three times that of U.S. peer countries. The report also found that American teenagers were twice as likely to die in car crashes, and that youth between the ages of 15 and 19 were eighty-two times more likely to die as a result of gun homicide.

"Policy interventions should focus on infants and on children ages 15–19, the two age groups with the greatest disparities, by addressing perinatal causes of death, automobile accidents, and assaults by firearm," the report states.

"In all the wealthy democratic countries we studied, children are dying less often than they were fifty years ago," Ashish Thakrar, an internal medicine intern at Johns Hopkins and the study's lead author, told Vox. "But we found that children are dying more often in the United States than in any similar country."

In addition to the wide availability of firearms in the U.S. — where 4.4 percent of the global population owns half of the civilian-owned guns in the world — social factors such as poverty and access to health care play a role. Thakrar noted that the U.S. child poverty rate rose in the 1980s at the same time the country began falling behind other OECD countries in health outcomes. The fragmented healthcare system in which a low-income mother does not qualify for Medicaid until after she becomes pregnant may lead to existing untreated health issues affecting the child, whose health is further put at risk by the instability of federal funding for the Children's Health Insurance Program (CHIP) and Maternal, Infant, and Early Childhood Home Visiting. The budgets for the two programs expired in October, and the temporary funding Congress recently approved for the program could run out as early as January 19.

"We're seeing the effects of instability right now," Thakrar told Vox. "All across the country, families are waiting to hear if CHIP will be reinstated [and] whether they'll continue to have health insurance; their household visitations are at risk. Programs that have proven their benefit in the country still face constant instability."