Child and adolescent mortality is rising and it’s not all about COVID

by Jacob Fuller

Lauren Dempsey, MS in Biomedicine and Law, RN, FISM News 

Pediatric mortality rates increased by 20% between 2019 to 2021, the largest increase in 50 years, according to a new study published in the Journal of the American Medical Association (JAMA) last week.

Researchers say that these findings indicate that American children are less likely to reach adulthood, calling the results “tragic.”

The death rate among American children aged 19 and younger had been consistently trending down due to better access and higher quality prevention and treatment for health conditions like premature deaths, cancer, and birth defects, according to lead study author Dr. Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University.

When researchers analyzed data from death certificates from the Centers for Disease Control and Prevention (CDC), they found that the increase in pediatric mortality was largely due to injury-related deaths. This recent increase in all-cause mortality is predominantly caused by injuries, including those caused by violence, self-harm, and drug abuse. Woolf said that the progress that had resulted from decades of research is now being reversed in a trend that is “really troubling.”

According to the data, the majority of deaths occurred in children aged 10 to 19 years old with injury mortality growing by 22.6% between 2019 and 2020. In this age group, homicide deaths increased by 39.1%, drug overdoses increased by 113.5%, and car accident deaths increased by 15.6% in 2020 as compared to 2019.

Through the first two years of the pandemic, the nation saw a very similar uptick in the number of youth deaths by homicide and poisoning, of which 90% were accidental drug overdoses.

After a remarkable improvement in deaths related to transportation accidents over the last two decades, the COVID lockdowns ushered in a sharp increase in such deaths, as well. The team of researchers suggests that while the pandemic was not the cause for the increase in all-cause pediatric mortality rates, it “may have poured fuel on the fire.”


Children aged 1 to 9 years old saw an overall increase in deaths of 8.4% in 2021 and saw an increase in deaths involving fires or burns of 45.9%. The only age range that did not have a significant increase in deaths was infants.

Children of color were also more likely to experience injury-related deaths. Data showed that in 2021 black children between 10 and 19 years old were 20 times more likely to die by homicide when compared to white and Asian American/Pacific Islander children, and 6 times more likely than Hispanic children.

Suicide was also more likely to occur for black and American Indian/Alaska Native youths than white youths and American Indian/Alaska Native youths had the greatest risk of dying in a car accident.

However, this research confirms other studies that have shown the United States has had poor child health outcomes across every area when compared to other wealthy nations since the 1980s, even with greater per capita spending. A UNICEF report from 2013 ranked the U.S. twenty-fifth out of twenty-nine developed countries for overall child health and safety and also found that the U.S. had higher infant mortality rates and lower rates of life expectancy at birth.

The authors of this most recent study suggest that the United States is facing “a crisis like no other” and recommend additional research and policy changes to address these “urgently needed” changes. They also recommend that the health care system needs to be redesigned which would improve access to mental health services for children and adolescents and address “social inequities” and “systemic racism” in black communities.

Woolf said “Modern medicine has fought the battle against pediatric diseases, but the threats to our children are now manmade. Without action, bullets, drugs, and automobiles will continue to claim the lives of our most cherished population.”


While other causes of death were either decreasing or staying relatively level, suicides among youth were steadily increasing between 2007 and 2018, prior to the existence of COVID-19. Over that span, suicide rates among children and youth nearly doubled before slightly decreasing in 2019. In fact, 2019 marked the only year in which the suicide rate dropped since 2007.

There are certainly many layers to uncover to find all the causes of increased youth suicides. However, there is one major change in our society that directly coincides with the increase: the rise of social media.

Notably, it was in September 2006 that Facebook expanded from college and high school campuses to allow anyone 13 or older with a valid email address. That same fall, Condé Nast Publications purchased Reddit and Google purchased Youtube. The next year, in 2007, Twitter exploded onto the scene and Apple announced the iPhone.

That was the year youth suicide began its steady rise.