'A red flashing light': Kids and teens dying at the highest rate in decades — and the COVID-19 virus isn't directly driving the trend

What does the study say?

TheBlaze reported in August that there had been a precipitous drop in the average life expectancy in America for a second year in a row.

Data collected by the National Center for Health Statistics revealed that in 2019, the average American was expected at birth to live to 78 years and 10 months. That figure dropped to 77 years in 2020. In 2022, the life expectancy for the U.S. population stood at 76 years and one month — the lowest it had been since 1996.

Not only are American geriatrics dying younger on average, but the nation's youth are dying with greater frequency, bucking a trend that saw life expectancy lengthen over the course of the 20th century.

Between 2019 and 2021, the mortality rate for youths ages 1 through 19 increased by 10.7%. For the same demographic, the mortality rate jumped an additional 8.3% between 2020 and 2021.

Researchers at Virginia Commonwealth University School of Medicine and the University of Washington's department of epidemiology noted that while persons ages 10-19 were driving the spike in the pediatric mortality rate, all-cause mortality also jumped by 8.4% in children ages 1-9 in 2021.

Infants (i.e., under one year old) were standouts, however, having not suffered an increase in mortality.

While the timeline might leave some to suspect that the Wuhan coronavirus played a role, the researchers noted that "this reversal in the pediatric mortality trajectory was caused not by COVID-19, but by injuries."

Lethal injuries

Injuries are defined in the paper as "all external causes of morbidity and mortality," which "involve multiple mechanisms including transportation, firearms, and poisoning."

Unintentional drug overdoses constitute a form of poisoning under this definition and since 2016, accounted for over 90% of poisoning deaths at ages 10 to 19.

A study published March 8 in the journal Pediatrics found that opioids were the leading cause of fatal poisonings among children five years old and younger from 2005 to 2018.

The leading causes of death in recent years for persons aged 1 to 19, in order, are: transport, homicide, suicide, and poisoning.

"In 2020, the COVID-19 mortality rate at ages 1 to 19 years was 0.24 deaths per 100 000, but the absolute increase in injury deaths alone was nearly 12 times higher (2.80 deaths per 100 000)," wrote the researchers. "COVID-19 mortality rates at ages 1 to 19 years nearly doubled in 2021 but explained only 20.5% of that year’s increase in all-cause mortality."

The researchers noted that the increase in pediatric injury deaths predates the pandemic — that suicide, homicide, and poisoning deaths have long been on the rise.

Suicides amongst adolescents and teens began to spike in 2007. Murders for this demographic began increasing in 2013.

"Between these nadirs and 2019, the eve of the COVID-19 pandemic, mortality rates for suicide increased by 69.5% and homicide rates increased by 32.7%," says the report. "Likely contributors to both trends include increased access to firearms and a deepening mental health crisis among children and adolescents. Access to opioids (eg, fentanyl) also increased, and overdose death rates for individuals aged 10 to 19 years began increasing shortly before the COVID-19 pandemic."

Elizabeth Wolf, co-author on the paper and an assistant professor in the Department of Pediatrics at the VCU School of Medicine, said, "We've now reached a tipping point where the number of injury-related deaths is so high that it is offsetting many of the gains we’ve made in treating other diseases."

While the researchers indicated many suicides are committed using firearms, that does not account for the underlying cause.

"There is a severe shortage of mental health providers who care for children and adolescents, especially in rural areas," said Wolf. "It’s estimated that only half of children with a treatable mental health condition have access to a mental health professional."

Gender inequality

According to the researchers, the increase in injury deaths that took place in 2020 primarily involved males.

Whereas the age-specific all-cause mortality rate per 100,000 people was nearly 40 for males in 2021, the rate was just over 20 for females. In the same year, the injury mortality rate for males was over 25, it was around 11 for females.

Risk also differed greatly by race.

Black youths accounted for 62.9% of homicide victims aged 10 to 19. Black youths in this age range had a homicide rate 20 times higher than Asian, Pacific Islander, or white youths and six times higher than their Hispanic peers.

'Fuel on the fire'

The pandemic did not start these trends, but it likely exacerbated them.

The Centers for Disease Control and Prevention reported in June 2021 that by May 2020, "during the COVID-19 pandemic, [emergency department] visits for suspected suicide attempts began to increase among adolescents aged 12–17 years, especially girls. During February 21–March 20, 2021, suspected suicide attempt ED visits were 50.6% higher among girls aged 12–17 years than during the same period in 2019; among boys aged 12–17 years, suspected suicide attempt ED visits increased 3.7%."

Former CDC director Robert Redfield suggested that COVID-19 health protocols and school measures may have adversely impacted America's youth, noting in July 2020, "There has been another cost that we’ve seen, particularly in high schools. We’re seeing, sadly, far greater suicides now than we are deaths from COVID. We’re seeing far greater deaths from drug overdose that are above excess that we had as background than we are seeing the deaths from COVID."

The researchers suggested the pandemic "may have poured fuel on the fire," citing a 22.6% spike in injury mortality at ages 10 to 19 between 2019 and 2020. Much of this surge involved homicides (up 39.1%) and overdose deaths (up 113.5%).

Wolf said the extended school closures supported across the U.S. by various teachers' unions impacted kids in "indirect ways."

"Among children aged 1 to 9, injuries explained two-thirds (63.7%) of the increase in all-cause mortality in 2021, including a 45.9% increase in deaths involving fires or burns," added the researchers.

Concerning the upward trend of pediatric mortality rates, Steven Woolf, lead author on the paper and director emeritus of the Center on Society and Health at Virginia Commonwealth University, told VCU News, "I have not seen this in my career."

"For decades, the overall death rate among U.S. children has fallen steadily, thanks to breakthroughs in prevention and treatment of diseases like premature births, pediatric cancer and birth defects. We now see a dramatic reversal of this trajectory, meaning that our children are now less likely to reach adulthood," said Woolf. "This is a red flashing light. We need to understand the causes and address them immediately to protect our children."

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