Health and Safety - Mortality Among Children

In the second half of the twentieth century, childhood death rates declined dramatically. The majority of childhood deaths are from injuries and violence. While death rates for all ages decreased, the largest declines were among children.

In 2001 three of the leading causes of childhood death were unintentional injuries, congenital anomalies (birth defects), and malignant neoplasms (cancers). (See Table 5.5.) The remaining deaths were spread across a variety of diseases, including heart disease, pneumonia, influenza, HIV/AIDS, homicide, and suicide.

Motor Vehicle Injuries

Although motor vehicle fatalities decreased by 25% between 1982 and 2000 for fifteen- to twenty-year-olds,

FIGURE 5.1

traffic accidents were still the leading cause of death for that age group in 2002. That year, 3,827 young people were killed in traffic accidents. Many of those killed had been drinking alcohol and were not wearing their seat belts.

Suicide

In 2001 suicide was the fifth leading cause of death among people five to fourteen years old and the third leading cause of death in fifteen- to twenty-four-year-olds. (See Table 5.5.) In 2001 white males ages fifteen to nineteen had twice the suicide rate (fourteen per one hundred thousand) of African-American males (7.3 per one hundred thousand) or Hispanic male youth (7.8 per one hundred thousand). Among females ages fifteen to nineteen, the rate for whites (2.9 per one hundred thousand) was considerably higher than that for Hispanics (2.5 per one hundred thousand) or African-Americans (1.3 per one hundred thousand) (National Vital Statistics Reports, vol. 52, no. 9, November 7, 2003).

The 2003 Youth Risk Behavior Survey questioned high school students regarding their thoughts about suicide. Almost one in six students surveyed (16.9%)

TABLE 5.3

Ten leading causes of infant mortality by race and Hispanic origin, 2002
	Rate per 100,000 live births
SOURCE: Adapted from "Table 8. Infant Deaths and Infant Mortality Rates for the 10 Leading Causes of Infant Death, by Race and Hispanic Origin: United States, Preliminary 2002," in "Deaths: Preliminary Data for 2002," National Vital Statistics Report, vol. 52, no. 13, February 11, 2004, http://www.cdc.gov/nchs/data/nvsr/nvsr52/nvsr52_13.pdf (accessed September 3, 2004)
Birth defects	140.7
Preterm/low birth weight	114.4
SIDS	50.6
Maternal pregnancy complications	42.9
Placenta, cord complications	25.3
Respiratory distress	23.8
Accidents	22.2
Bacterial sepsis	18.3
Circulatory system diseases	16.1
Intrauterine hypoxia/birth asphyxia	14.4

claimed that they had thought about attempting suicide in the previous twelve months. (See Table 5.6.) Although the suicide death rate was much higher among males than females, females (21.3%) were more likely to have considered suicide than males (12.8%). Of all students, 16.5% (18.9% of females and 14.1% of males) had made a specific plan to attempt suicide, 8.5% of students (11.5% of females and 5.4% of males) claimed they had attempted suicide in the previous year, and 2.9% of high school students (3.2% of females and 2.4% of males) said they had suffered injuries from the attempt that required medical attention. These numbers reflect the fact that females of all ages tend to choose less fatal methods of attempting suicide, such as overdosing and cutting veins, than males, who tend to choose more deadly methods, such as shooting or hanging.

The likelihood that a child will commit suicide increases with the presence of certain factors in his or her profile. Among the factors whose presence may indicate heightened risk are depression, substance abuse, behavioral disorders, accessibility of handguns, and a tendency toward perfectionism. The suicide rate among male homosexual teens is believed to be extremely high. A 2002 study corroborated previous estimates that 20% to 42% of teens and young men who have sex with other males attempt suicide (Gary Remafedi, "Suicidality in a Venue-Based Sample of Young Men Who Have Sex with Men," Journal of Adolescent Health, vol. 31, October 2002).