Wednesday, January 10, 2018

U.S. child mortality highest among wealthy nations; most deaths among infants (especially rural) and late teens

Washington Post charts; click on the image to enlarge it.
"American babies are 76 percent more likely to die before they turn a year old than babies in other rich countries, and American children who survive infancy are 57 percent more likely to die before adulthood, according to a sobering new study published in the journal Health Affairs," Christopher Ingraham reports for The Washington Post.

Ashish Thakrar, an internal-medicine resident at The Johns Hopkins Hospital in Baltimore and lead author of the study, writes that "persistently high poverty rates, poor educational outcomes, and a relatively weak social safety net have made the U.S. the most dangerous of wealthy nations for a child to be born into." U.S. policy decisions could play a big role in those conditions. Policy decisions explain at least 47 percent of the differences in life expectancy between countries, according to a 2010 study. And a 2007 study found that about 20 percent of the difference in infant mortality rates can be explained by policy decisions.

Thakrar "notes that while the U.S. spends more per capita on health care for children than other wealthy nations, it has poorer outcomes than many. In 2013, the United Nations Children's Fund ranked the U.S. 25th in a list of 29 developed countries for overall child health and safety," Ingraham reports.

In the 1960s the U.S. had a much lower childhood mortality rate than the average of 19 other wealthy countries in the Organization for Economic Co-Operation and Development, but that began to change in the 1970s and the gap widened dramatically in the 1980s (coinciding with a rise in childhood poverty). The gap today translates to about 20,000 deaths a year. Since 1961, that means about 600,000 deaths. The U.S. has ranked last in the OECD for child mortality since the 1990s, Sarah Kliff reports for Vox.

Centers for Disease Control and Prevention chart
About 90 percent of the U.S. deaths were among infants from birth to age 1 and teens 15 to 19; comparatively few deaths occurred between ages 1 and 14. Among infants, the leading causes of death are premature births (which have risen dramatically in recent years) and Sudden Infant Death Syndrome. Infant mortality has decreased since the 1960s, but declined more in other OECD countries. In the U.S., the infant mortality rate in rural areas is 25 percent higher than in urban areas.

The two leading causes of death for 15-to-19- year-olds in the U.S. were motor vehicle accidents and assault by firearm. "Teenagers were twice as likely to die from motor vehicle accidents and 82 times more likely to die from gun homicide in the U.S. than in other wealthy nations," Thakrar writes. Though overall gun ownership is higher in rural areas of the U.S., urban teens are more likely to die from shootings. But rural drivers are far more likely to die in car wrecks than their suburban and urban counterparts.

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