Young Americans are dying at alarming rates, reversing years of progress (WSJ analysis)

For decades, advances in health and safety have steadily led to declining death rates among American children. In an alarming reversal, the rates have now risen to their highest level in nearly 15 years, mainly due to homicides, drug overdoses, car accidents and suicides, The Wall Street Journal writes.

Growth among younger Americans accelerated in 2020. Although Covid-19 itself has not been a major cause of death among young people, researchers say the social disruption caused by the pandemic has exacerbated public health problems, including worsening anxiety and depression . Greater access to firearms, dangerous driving, and more lethal narcotics also contributed to higher death rates.

Between 2019 and 2020, the overall death rate for people ages 1 to 19 rose 10.7 percent, and the following year it rose another 8.3 percent, according to an analysis of federal mortality statistics led by by Steven Woolf, director emeritus of the Center for Society and Health at Virginia Commonwealth University, published in JAMA in March. That’s the biggest increase for two consecutive years in the half-century that the government has publicly tracked such figures, according to Woolf’s analysis.

Other developed countries, including the United Kingdom, Germany, Canada and Norway, also saw an increase in deaths among young people during this period, although the increases were often concentrated in narrow age groups, according to the global count of deaths provided by Christopher JL Murray, director of the Institute for Health Measurement and Evaluation at the University of Washington.

The US is the only place among nations in the same tier where firearms are the No. 1 cause. 1 death in young people.

Suicide among Americans ages 10 to 19 began rising in 2007, while homicide rates for this age group began climbing in 2013, according to research published in JAMA by Woolf and co-authors Elizabeth Wolf of Virginia Commonwealth and Frederick Rivara of the University of Washington.

Increases in youth suicides and homicides went largely unnoticed at first because overall child and adolescent death rates continued to decline in most years.

Penicillin and other antibiotics reduced deaths from bacterial infections in the years following World War II, and vaccines controlled deadly viruses such as polio. Safer automobiles, seat belts, and car seats have made driving less deadly. Bicycle helmets, smoke detectors and swimming lessons have reduced fatal accidents and drownings. Medical advances that save premature babies and treat leukemia and other cancers have helped more children survive once-deadly diagnoses.

“All these gains are now essentially offset by four causes of death,” Woolf said.

When the pandemic began, youth deaths from suicide and homicide soared. Deaths from drug overdoses and deaths from transportation – mainly motor vehicle accidents – also increased significantly.

Covid, which rose to No. 3 in America’s leading cause of death during the pandemic, accounted for just one-tenth of the increase in youth deaths in 2020 and one-fifth of that in 2021, according to research led by Woolf, which uses data from at the Centers for Disease Control and Prevention.

Older children and adolescents, ages 10 to 19, accounted for most of the increase in youth death rates. Boys, whose death rates are about twice as high as girls, saw a slight worsening of their death rate during the pandemic, Woolf found. The overall findings held when the researchers excluded 18- to 19-year-olds, who were included in the wider research because such government data is grouped into five-year age bands.

Doctors and public health researchers say school closings, cancellations of sports and youth activities and limitations on in-person socializing have exacerbated a burgeoning mental health epidemic among U.S. youth. According to them, social media has helped fuel it by replacing successful relationships with a desire for online social attention that leaves young people unfulfilled and exposes them to sites that glorify unhealthy behaviors.

Demand for psychiatric services, counseling and other types of behavioral health support has far outstripped supply, leaving young patients to turn to emergency departments that have been overwhelmed by Covid.

“We’re seeing younger and younger patients coming in with mental health crises and even 8- to 10-year-olds coming in with suicidal ideation,” said Lois Lee, a pediatric emergency physician at Boston Children’s Hospital, who chairs the American Academy of Pediatrics Council on Injury, Violence, and Poison Prevention.

To some extent, rising death rates among young people mirror trends among the adult population. Death rates began to rise for middle-aged white Americans beginning in 1999, largely due to suicide, alcohol abuse, drug overdoses, and chronic liver disease, although rates for black and Hispanic Americans declined over the same period .

In 2020, life expectancy fell by 1.8 years, the biggest decline since at least World War II, not just because of Covid, but also because of increased deaths from unintentional injuries, including drug overdoses. drugs as well as homicides.

Researchers note that gun ownership has increased during the pandemic and that high-profile acts of police violence, including the killing of George Floyd, have increased distrust of law enforcement. That has led some people to resort to deadly forms of “street justice” instead of calling the police, said Daniel Webster, a professor of public health at Johns Hopkins University who researches gun violence and its prevention.

The rise in traffic-related deaths comes despite people driving less when the pandemic began. Researchers say the absence of other cars on the road has led some people to drive more recklessly, and that the distraction of mobile phones has made driving more deadly in recent years. Alcohol consumption increased during the pandemic, which may have led to an increase in drink-driving deaths.

Many public health experts say they don’t think the end of the pandemic will reverse the rising death rate among young people. Rivara predicts that these issues will continue due to persistent issues with mental health and the accessibility of firearms.

Wolf said the demand for child and adolescent psychiatric services still outstrips the supply in her Richmond, Va., office. Patients are on waiting lists for months to see a psychiatrist who accepts insurance.

Early in his career, he spent two years practicing pediatric medicine in sub-Saharan Africa. “There I saw children dying from malnutrition and infectious diseases,” she said. “Now that I’m back in the US, it’s incredibly difficult to see children dying from man-made causes like bullets and cars.”