Offsetting decades of progress

Child mortality rises sharply in the United States

Little expresses more clearly the immense social crisis in the United States than the fact that child mortality is rising. 

Between 2019 and 2021, all-cause mortality rates among ages 1-19 rose by nearly 20 percent. These deaths are overwhelmingly driven by preventable injuries that have socially-conditioned causes, including homicides, overdoses and automobile accidents. COVID-19 also contributed. Only infants younger than one year did not experience increasing mortality rates during this time. 

Steven Woolf of the Virginia Commonwealth University, author of a recent opinion article in the Journal of the American Medical Association documenting this trend, observed to The Hill that “an increase of this magnitude has not occurred in half a century ... and perhaps has not occurred since the influenza pandemic [of 1919].” 

Woolf and his co-authors reviewed mortality data from the Centers for Disease Control and Prevention  (CDC) between 1999 and 2021 and found that pediatric injury deaths began rising over a decade ago. Suicides among ages 10-19 started to climb in 2007, increasing by 69.5 percent by 2019. Homicides in this group increased 32.7 percent between 2013 and 2019. 

Since then, over the first two years of the COVID pandemic, injury deaths continued to shoot up. Between 2019 and 2020, homicides in ages 10-19 increased by 39.1 percent, overdose deaths increased 113.5 percent, and transport-related deaths jumped 15.6 percent after having declined for decades. Even in children ages 1-9, injuries accounted for two-thirds of the increase in all-cause mortality.

The authors note that for decades, advances in public health and safety related both to injury prevention (e.g., seat belts and smoke detectors) and disease prevention in children and infants led to a decline in pediatric mortality, but this progress was now being “entirely offset by injuries, primarily those involving violence, self-harm, and drug misuse.” The greatest contributor to the increasing mortality rates was gun-related deaths, which accounted for 47.8 percent of the increase in 2020. 

For the first time in US history, firearm-related injuries became the leading cause of death among children in 2020, surpassing automobile accidents. Firearm-related deaths have been increasing in children since 2013 but rose markedly after 2019. The Pew Research Center reported a 50 percent increase in total firearm-related deaths in children under the age of 18 between 2019 and 2021. The majority of these (60 percent) were homicides, followed by suicides (32 percent) and accidents (5 percent). In contrast, among adult victims of firearm-related deaths in 2021, the majority (55 percent) were suicides. 

The United States stands alone among its peers in regard to firearm deaths in children. An analysis by the Kaiser Family Foundation comparing firearm-involved death rates in children in the US to those in peer countries found that the US had 7 times the rate of Canada, the second-highest country. Moreover, the US is the only country among comparable nations where youth firearm deaths have increased since 2000. 

A memorial at Robb Elementary School in Uvalde, Texas Monday, May 30, 2022, to honor the victims of the school shooting. Photographs of the victims, from left, show Layla Salazar, McKenna Lee Elrod, Jayce Carmelo Luevanos and Nevaeh Alyssa Bravo. (AP Photo/Jae C. Hong)

Already in 2023, there have been 227 mass shootings and 674 firearm deaths in children ages 0-17, according to the Gun Violence Archive. The K-12 Shooting Database has recorded 121 school shooting incidents this year, and 2023 is projected to have the highest number of school shootings on record.

It is no accident that rising mortality rates among children and youth are led by deaths of an antisocial and violent character and by deaths of despair. These deaths are a reflection of the rotten environment that exists in the center of world capitalism, which offers young people no future. 

For the last thirty years, the US has been waging unending wars abroad that have killed 4.5 million people just since 2001. Now the US is escalating the NATO war against Russia in Ukraine with open discussions among state and military officials of the possibility of a nuclear World War Three. 

War abroad has been accompanied by decades of social counter-revolution at home, during which inequality has soared, social assistance has been gutted, and the economic and democratic gains won by the working class over a century of struggle have been systematically rolled back. Among the latter is the recent push by lawmakers across the US to dismantle restrictions on child labor

Moreover, young people are aware that the entire world faces multiple existential threats in the forms of war, climate change, dictatorship and, not least of all, the ongoing COVID pandemic, which has  violently shaken their lives. 

While the bourgeois press has cynically sought to blame school closures, a vital public health measure against the pandemic, for the mental health and mortality crisis among the youth, they seek to minimize the traumatizing impact of mass death and disease on American children. 

According to the research by Woolf et al., COVID-19 accounted for a full 20 percent of the increase in child mortality rates in 2021. Other research found that it became the 8th-leading cause of death in US children following the Delta and Omicron waves. 

The direct effects of the pandemic on children have been staggering. CDC data shows that more than 2,200 children have died from COVID, more than 190,000 have been hospitalized, and virtually every child (96.3 percent as of last December) has been infected at least once. Millions of children are suffering from long COVID complications which can be both dangerous and severely debilitating. Add to this the devastating grief of more than 267,000 children who have lost one or both parents to COVID, and others who have lost grandparents and other non-parental caregivers. 

It is no wonder that the youth mental health crisis, which has been documented for over a decade, would be exacerbated by these experiences. 

Just as the capitalist politicians of both parties deliberately chose to let the pandemic rip through the population, sacrificing the lives of thousands of children in the process, they will do nothing to provide the necessary resources to address the child mortality or child mental health crises.  

Health professionals have warned that in many cases there is no help available for young people. A 2019 study found that nearly half (49.4 percent) of children in need of mental health treatment did not receive it.  

Dr. Jennifer Downs of Connecticut's Children's Hospital told the New York Times that it took an average of one week, and sometimes as long as one month, for children who go to the emergency room for psychiatric care to secure an inpatient bed.  The vast majority of states are classified as having a “severe shortage” of child and adolescent psychiatrists, according according to the American Academy of Child and Adolescent Psychology. 

Despite this, the Biden administration pledged only a pittance ($300 million) to youth mental health programs in 2022, a fraction of the tens of billions given to Ukraine since the start of the NATO war against Russia last year.

In the face of immense challenges, students and young workers across the US are being radicalized by their experiences. During the Omicron wave of the pandemic, thousands of students in cities across the country walked out of school as part of a global struggle to temporarily close schools and stop the pandemic. Only a few months later, following the massacre in Uvalde, Texas, students again protested nationwide against the school shooting epidemic

What is most critical, young people are increasingly attuned to the struggles of educators and the broader working class. From the strike by 35,000 teachers in Los Angeles to the strike by academic workers at Temple University, students have voiced their support and are beginning to see their struggles for a better life as a component part of the movement of the international working class. 

The source of the profound social retrogression occurring in the US, evident in rising youth mortality, falling life expectancy and daily mass shootings, is capitalism. The International Youth and Students for Social Equality, the youth movement of the Socialist Equality Party, believes there is a bright future to be won, but it must be fought for. We encourage young people to take up the fight for socialism today.