1. Stockwell, Serena


'Need to think beyond medical care to address social environment.'


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Compared with 19 other developed countries, the United States has the highest rate of childhood mortality even though we spend more per capita on health care for children than the other nations do.

Figure. Analysis of ... - Click to enlarge in new window Analysis of data from the Human Mortality Database (University of California, Berkeley, and Max Planck Institute for Demographic Research). Results for children in the 1-19 age group are age adjusted. Image (C) Health Affairs.

A 50-year analysis (1961-2010), the first of its kind, found that although overall childhood mortality has declined across all of the countries (members of the Organization for Economic Cooperation and Development), in the United States it is significantly higher-and has been since the 1980s. In the most recent decade analyzed (2001-2010), U.S. infants were 76% more likely to die before reaching adulthood than those in the other nations and children ages one to 19 were at 57% higher risk. During this same period, teens ages 15 to 19 were 82 times more likely to be killed by guns in the United States than in the comparison countries, mostly European and Scandinavian democracies.


Cumulatively, these findings translate to 622,700 more child deaths since 1961 in the United States than in the other 19 countries, according to the report. The main causes of the excess deaths were prematurity, sudden infant death syndrome, motor vehicle accidents, and gun violence.


"The key takeaway is that these are preventable deaths," said the study's lead author, Ashish Thakrar, an internal medicine resident at Johns Hopkins Hospital in Baltimore, Maryland. "But to turn that around, we need to think beyond medical care to address the social environment children are born into," Thakrar told AJN. "All health advocates, but especially those on the frontlines, like nurses, need to advocate for a sustained national focus on policies that support families and young children. We won't be able to reduce child mortality rates without also addressing child poverty-which remains higher here than in any other wealthy nation."-Serena Stockwell




Thakrar AP, et al Health Aff 2018 37 1 140-9