In the Journals

Injuries top leading causes of pediatric, adolescent deaths

Rebecca Cunningham
Rebecca M. Cunningham

Although less than 2% of all deaths in the United States in 2016 were in children and adolescents, six of the 10 of the leading causes of death in this age group were caused by intentional and unintentional injuries, according to research published in The New England Journal of Medicine.

When Rebecca M. Cunningham, MD, director of the Injury Center at the University of Michigan, and colleagues examined which injuries contributed to the most deaths, they found that motor vehicle crashes accounted for 20%, followed closely by firearm-related injuries at 15.4%.

“Firearm-related injuries have been the second leading cause of death among children for the past 16 years,” she told Infectious Diseases in Children. “We have seen a 28% increase in the past 3 years. This needs to be a priority for medical professionals, families and public health at large.”

In 2016 — the most recent year in which national data were available, researchers said — 20,360 deaths occurred in U.S. children and adolescents aged between 1 and 19 years. Of these deaths, 60.6% were injury-related. The most commonly reported injury-related deaths other than motor vehicle crashes and firearm-related injuries included suffocations (7%), drownings (4.9%), drug overdoses or poisonings (4.8%) and fires or burns (1.7%).

Only four of the top 10 causes of death in children and adolescents were from medical conditions, including cancer (9.1%), congenital abnormalities (4.8%), heart disease (2.9%) and chronic lower respiratory disease (1.3%).

More than half of injury-related deaths were unintentional (57%). Intentional deaths in this age group were more likely to be related to suicide (21%) compared with homicide (20%).

Cunningham and colleagues observed different leading causes of death across the different age groups. For example, drowning was the most common cause of death among children aged 1 year to 4 years. The most common causes of death among those aged 5 to 9 years were cancer, motor vehicle crashes and congenital abnormalities. Injury-related deaths were most common among youth aged 10 to 19 years, including motor vehicle crashes, firearm-related injury and suffocation.

Cunningham praised pediatricians for their use of anticipatory guidance and screening related to injury prevention. However, she said that pediatricians tend not to screen and counsel as much for firearm ownership and safe storage.

“It has been a topic that has been uncomfortable for many physicians,” she said. “Physicians are uncomfortable asking the questions, are concerned that they may anger families that do not want to be asked or do not know what to do with the answers to these questions. This needs to be a part of routine screening. Once we find out that families have guns in the home, we need to really work with them to have the guns safely stored all the time in the same way that we have kids secured safely in cars when they are moving.”

Additionally, she added that safe firearm storage should be a priority for families with teens who have depression or any suicidal thoughts. – by Katherine Bortz

Disclosure: Cunningham reports no relevant financial disclosures.

Rebecca Cunningham
Rebecca M. Cunningham

Although less than 2% of all deaths in the United States in 2016 were in children and adolescents, six of the 10 of the leading causes of death in this age group were caused by intentional and unintentional injuries, according to research published in The New England Journal of Medicine.

When Rebecca M. Cunningham, MD, director of the Injury Center at the University of Michigan, and colleagues examined which injuries contributed to the most deaths, they found that motor vehicle crashes accounted for 20%, followed closely by firearm-related injuries at 15.4%.

“Firearm-related injuries have been the second leading cause of death among children for the past 16 years,” she told Infectious Diseases in Children. “We have seen a 28% increase in the past 3 years. This needs to be a priority for medical professionals, families and public health at large.”

In 2016 — the most recent year in which national data were available, researchers said — 20,360 deaths occurred in U.S. children and adolescents aged between 1 and 19 years. Of these deaths, 60.6% were injury-related. The most commonly reported injury-related deaths other than motor vehicle crashes and firearm-related injuries included suffocations (7%), drownings (4.9%), drug overdoses or poisonings (4.8%) and fires or burns (1.7%).

Only four of the top 10 causes of death in children and adolescents were from medical conditions, including cancer (9.1%), congenital abnormalities (4.8%), heart disease (2.9%) and chronic lower respiratory disease (1.3%).

More than half of injury-related deaths were unintentional (57%). Intentional deaths in this age group were more likely to be related to suicide (21%) compared with homicide (20%).

Cunningham and colleagues observed different leading causes of death across the different age groups. For example, drowning was the most common cause of death among children aged 1 year to 4 years. The most common causes of death among those aged 5 to 9 years were cancer, motor vehicle crashes and congenital abnormalities. Injury-related deaths were most common among youth aged 10 to 19 years, including motor vehicle crashes, firearm-related injury and suffocation.

Cunningham praised pediatricians for their use of anticipatory guidance and screening related to injury prevention. However, she said that pediatricians tend not to screen and counsel as much for firearm ownership and safe storage.

“It has been a topic that has been uncomfortable for many physicians,” she said. “Physicians are uncomfortable asking the questions, are concerned that they may anger families that do not want to be asked or do not know what to do with the answers to these questions. This needs to be a part of routine screening. Once we find out that families have guns in the home, we need to really work with them to have the guns safely stored all the time in the same way that we have kids secured safely in cars when they are moving.”

Additionally, she added that safe firearm storage should be a priority for families with teens who have depression or any suicidal thoughts. – by Katherine Bortz

Disclosure: Cunningham reports no relevant financial disclosures.