Two recent reports point to a worrying trend: kids and adolescents have been dying at increasing rates in the U.S. over the last few years, and COVID has little to do with it.

Between 2019 and 2021, all-cause child mortality rose by 10.7% one year and 8.3% the following, the largest increase in decades. Among the main causes: suicide, homicide, drug overdoses and car accidents.

Guns are an important protagonist in a young person’s risk of dying. Gun deaths among U.S. children rose 50% in two years, and so far, this year, there have been 42 incidents of gunfire on school grounds, resulting in 17 deaths and 32 injuries nationwide. Accordingly, life expectancy in this country has taken a downturn.

(Above, l-r): Steven H. Woolf, MD, MPH, Professor of Family Medicine and Population Health at Virginia Commonwealth University School of Medicine; Kim Parker, Director of Social and Demographic Trends at Pew Research Center; Mayra Alvarez, President at The Children’s Partnership; and Kelly Sampson, Senior Counsel and Director of Racial Justice for Brady United. (EMS)

At an Ethnic Media Services briefing, April 21, speakers­ ­— Steven H. Woolf, MD, MPH, Professor of Family Medicine and Population Health at Virginia Commonwealth University School of Medicine; Kim Parker, Director of Social and Demographic Trends at Pew Research Center; Mayra Alvarez, President at The Children’s Partnership; and Kelly Sampson, Senior Counsel and Director of Racial Justice for Brady United ­– presented the latest research and discussed the main reasons for this increase as well as the potential policies that could help address it.

“This is very unusual. It’s not occurred very much at all in the last half-century there have been occasional one-year increases of a very small magnitude that we’re immediately followed by decreases. Two back-to-back years of increases is very unusual, and the increase that’s recently occurred in 2020 and 2020,” said Steven H. Woolf, MD, MPH, Professor of Family Medicine and Population Health at Virginia Commonwealth University School of Medicine.

“One is of a magnitude that we have not seen, probably, since the influenza pandemic of 1918.

We’ve experienced a 20% increase in all-cause mortality. That’s a massive increase, and one might be tempted to think that this had something to do with COVID-19.

“That’s obviously the time-period when this occurred. But our analysis found that COVID-19 explained relatively little of this increase, and most of it was being driven by injury, deaths and other external causes of death that have been responsible for this increased death rate primarily have been costs by trends that predate the pandemic, like mortality for homicide, suicide, drug overdoses and car accidents,” said Dr Woolf.

“Suicide rates began increasing in 2007 in this population. Homicide rates in this age group began increasing in 2013. The increase in drug overdose deaths began shortly before the COVID-19 pandemic, around 2018 or 2019, as more and more children and teenagers acquired access to and other synthetic opioids.

“The COVID-19 pandemic, therefore, didn’t cause this trend, but the rates increased very dramatically during this time period, between 2019 and 2021 deaths in those ages 10 to 19 increase by 30 percent. 9% for homicides, a 114% for drug overdose, and 16% for car accidents. Firearms played a dominant role in this increase,” said Dr Woolf.

“To talk a little bit about the racial and ethnic differences, young people were not equally affected by these trends. They were more severely impacted among some racial and ethnic groups.

“Black youth were at considerably greater risk of dying from homicides, accounting for about 63% of the homicide victims that occurred in 2020. The black homicide rate among young people was 6 times that of the Hispanic population, and 20 times that of the homicide rate.

In white and Asian and Pacific Islander descent youths, and across all racial ethnic groups, males are at higher risk of dying from these deaths than females.

“When we think about the intersection between race and gender, we discover even more dramatic differences. The homicide rate among black males was more than 60 times that of white females.

“The racial groups are at risk of other kinds of injury. Destiny for example, the risk of dying in car accidents was highest for American Indian and Alaska natives.

“White youth have typically been the racial group that has experienced the highest death rate.

“These four causes have offset all the live saved by advances in pediatric medicine, all the deaths that we’ve avoided through reductions in injury rates, all of those games, childhood, leukemia, addressing birth defects, reducing premature mortality, rates all of those are now being offset by these four man-made pathogens,” said Dr Woolf.

“In terms of policy priorities, one is the need to deal with firearms. Gun violence is reaching historic proportions where all cost mortality is increasing for the one-to-19 age group, which basically means the probability of young people reaching age 20 is now decreasing, and our children are less likely to become adults.

“But if we get to the point where our children are less likely to reach adulthood, then the need for sensible gun reform cannot be greater, because we’re now losing our most cherished population,” said Dr Woolf.

“Priority number one is guns, number two, the mental health crisis in young people. The fact that suicide rates were increasing as long ago as 2007 is a an indication along with other factors that we need to really address the kinds of depression, anxiety, and other mental stresses that our young people are facing these days, and they’re leading out only to fatal outcomes like suicide,” said Dr Woolf.

“The data that we looked at did show a sharp increase in both the number and the rate of gun deaths among children in teens under the age of 18, and we kind of zeroed in on that same timeframe of 2019 to 2021, with the pandemic obviously occurring in the middle of that, and the number of gun deaths to children in that age group increased by 50% over that period,” said Kim Parker, Director of Social and Demographic Trends at Pew Research Center, echoing much of the stats shared by Dr Woolf, earlier.

“According to a survey, the top concern for parents by far was mental health, and we found that about 76% of parents said they were at least somewhat concerned that their one of their children would struggle with anxiety or depression at some point and 40% of parents were extremely concerned about that.

“When we asked parents specifically how concerned they are that their children, a child of theirs, might be shot at some point.

“We found that almost half of chill, almost half of parents were at least somewhat concerned about that, and 22% of parents were extremely, are very concerned that a child of theirs might be shot, and we found why differences there by race as well, but the patterns are a little different from what we see in the CDC data.

“In our survey we found Hispanic parents were the most likely to express a high degree of concern about a child being a child of theirs being shot, 42% of Hispanic parents said they were extremely worried. About that about a third of black parents expressed that same level of concern, and the shares for white and Asian parents were lower, 23% and 12%.

“For Asian parents. We also found big differences by community type among parents. Parents living in urban areas were significantly more likely to express a high level of concern about their children or child being shot than parents in rural or suburban areas, and we also found a very wide income gap with as many as 40% of lower income parents saying that they were extremely worried about their child being shot, compared to much lower shares among middle and upper, only 10% of higher-income parents expressed a similar view,” said Parker.

Mayra Alvarez, president at The Children’s Partnership said, “Our children, when it comes to gun violence, have witnessed shooting after shooting. These tragedies are not only going to have long lasting detrimental impacts on the health of those that have been victims of gun violence, but on the mental health of the millions of children that are watching.

“A sense of safety is necessary for our kids to grow up healthy and thrive, and yet we’ve seen that parking lots and churches, stores, classrooms, no places safe.

“Our children are dependent on the adults in their lives to take care of them, and our elected officials. All of us have a moral duty to take care of our kids,” said Alvarez.

Kelly Sampson, Senior Counsel and Director of Racial Justice for Brady United, pointed that there’s been some research into the relationship between video games and aggression.

“And there’s not really a strong relationship that they’re at all,” said Sampson.

“We know that the video game industry is global. But the difference is that in the United States there’s this access to firearms.

“Many of the issues that we have in the United States, whether it be mental health or even racism, they are not exclusive to our country, but what is different about us is the U.S. lacks regulations, that we have around firearms and the ease with which someone who was going through a mental health crisis, or who might be racist, or who is just angry, can get access to a firearm and kill people.

“The access is really key, and it’s not inevitable. There are things that we can do about it,” said Sampson.