Although childhood mortality declined across wealthy countries during a 50-year period, mortality rates in the United States have been higher than 19 other nations in recent decades, according to published study results.
“Across almost every domain, the United States has poorer child health outcomes than other wealthy nations,” Ashish P. Thakrar, MD, an internal medicine intern at the Johns Hopkins Hospital and Health System, Baltimore, and colleagues wrote. “A UNICEF report from 2013 summarized these findings by ranking the U.S. 25th of 29 developed countries with respect to overall child health and safety. Compared to other high-income nations, mortality rates for U.S. infants are higher and life expectance at birth is lower.”
Thakrar and colleagues assessed mortality trends for the U.S. and 19 comparator wealthy nations in the Organization for Economic Cooperation and Development (OECD19) for children aged 0 to 19 years between 1961 to 2010. Data from the Human Mortality Database and the WHO Mortality Database for each of the countries were used.
ICD-7, ICD-8, ICD-9 and ICD-10 codes were used to record cause of death during the study period.
There was a decline in childhood mortality rates from 1961 to 2010 for the U.S. and the OECD19. However, the U.S. childhood mortality rate fell at a slower pace than the OECD rate during that time, with the U.S. rate beginning to exceed the OECD rate in the late 1960s.
“By the 1990s and into the 2000s, the U.S. ranked lowest of all 20 nations in terms of child mortality rates,” the authors wrote.
There was a 76% greater risk of death for infants and a 57% greater risk of death for children aged 1 to 19 years between 2001 and 2010 in the U.S. compared with the OECD19.
“If the U.S. had achieved just the average childhood mortality rate of the OECD19 over the 50-year study period, over 600,000 deaths could have been avoided — a rate of about 20,000 excess deaths per year by the turn of the century,” the authors wrote.
“Persistently high poverty rates, poor educational outcomes and a relatively weak social safety net have made the U.S. the most danger of wealthy nations for a child to be born into,” the authors concluded. “All U.S. policymakers, pediatric health professionals, child health advocates and families should be troubled by these findings. The findings should motivate Americans to do everything possible to improve the medical and social conditions of children that are responsible for these preventable deaths.” – Bruce Thiel
Disclosures: The study was supported by institutional development funds from the Children’s Hospital of Philadelphia (CHOP) to the Applied Clinical Research Center at CHOP. Infectious Diseases in Children was unable to determine the authors’ relevant financial disclosures at time of publication.