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America's Children in Brief: Key National Indicators of Well-Being, 2020

Child and Adolescent Mortality

Medical and public health advances have contributed to reductions in the number of deaths among children and adolescents.39 Deaths from infectious disease and cancer have declined with the introduction of vaccination, antibiotics, and the improved detection and treatment of cancer.40 However, 19,660 deaths occurred among those ages 1–19 in 2018.41 Knowing the patterns of the leading causes of death for this age group may help target medical and public health interventions.39, 40

Figure 12: Death rates among children ages 1–4 by selected leading causes of death and metropolitan status, 2018
Death rates among children ages 1–4 by selected leading causes of death and metropolitan status, 2018

NOTE: Underlying causes of death are based on the International Classification of Diseases, 10th revision. Unintentional injuries is another term for accidents. Unintentional injury deaths are identified by codes V01–X59 and Y85–Y86. Cancer (malignant neoplasms) deaths are identified by codes C00–C97. Birth defect (congenital malformations, deformations, and chromosomal abnormalities) deaths are identified by codes Q00–Q99. Homicide deaths are identified by codes U01–U02, X85–Y09, and Y87.1. The U.S. Office of Management and Budget classifies counties as within a metropolitan or a micropolitan statistical area. The remaining counties are not classified and are considered rural in this report. Rural counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas.

SOURCE: National Center for Health Statistics, National Vital Statistics System.

  • In 2018, the all-cause death rate among children ages 1–4 was 24 deaths per 100,000 children. Children in rural counties had the highest death rate (36 per 100,000), followed by children in micropolitan counties (31 per 100,000) and metropolitan counties (23 per 100,000).
  • The death rate for unintentional injuries was 8 deaths per 100,000 children. Unintentional injury death rates were highest for children in rural counties (16 per 100,000), followed by micropolitan counties (12 per 100,000) and metropolitan counties (7 per 100,000).
  • In 2018, the death rates among children ages 1–4 was 2 per 100,000 each for cancer, birth defects, and homicide. There was no statistically significant difference by metropolitan status for these causes of death.

Figure 13: Death rates among children ages 5–14 by selected leading causes of death and metropolitan status, 2018
Death rates among children ages 5–14 by selected leading causes of death and metropolitan status, 2018

‡ Reporting standards not met; the number of deaths is too few to calculate a reliable rate.

NOTE: Underlying causes of death are based on the International Classification of Diseases, 10th revision. Unintentional injuries is another term for accidents. Unintentional injury deaths are identified by codes V01–X59 and Y85–Y86. Cancer (malignant neoplasms) deaths are identified by codes C00–C97. Suicide deaths are identified by codes U03, X60–X84, and Y87.0. Most suicides in the 5–14 age group are among those ages 10–14. Birth defect (congenital malformations, deformations, and chromosomal abnormalities) deaths are identified by codes Q00–Q99. Homicide deaths are identified by codes U01–U02, X85–Y09, and Y87.1. The U.S. Office of Management and Budget classifies counties as within a metropolitan or a micropolitan statistical area. The remaining counties are not classified and are considered rural in this report. Rural counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas.

SOURCE: National Center for Health Statistics, National Vital Statistics System.

  • In 2018, the all-cause death rate among children ages 5–14 was 13 deaths per 100,000 children. Children in rural counties had the highest death rate (18 per 100,000), followed by children in micropolitan counties (16 per 100,000) and metropolitan counties (13 per 100,000).
  • Unintentional injuries were the leading cause of death among children ages 5–14 in 2018 (3.5 per 100,000), followed by cancer (2.1 per 100,000), suicide (1.5 per 100,000), birth defects (0.9 per 100,000), and homicide (0.7 per 100,000).
  • Death rates for unintentional injuries was highest for children in rural counties (7 per 100,000), followed by micropolitan counties (5 per 100,000) and metropolitan counties (3 per 100,000).
  • Death rates from suicide were higher for children in rural (2 per 100,000) and micropolitan (3 per 100,000) counties than in metropolitan counties (1 per 100,000).
  • In 2018, there was no statistically significant difference by metropolitan status for death rates from cancer, birth defects, and homicide among children ages 5–14.

Figure 14: Death rates among adolescents ages 15–19 by selected leading causes of death and metropolitan status, 2018
Death rates among adolescents ages 15–19 by selected leading causes of death and metropolitan status, 2018

NOTE: Underlying causes of death are based on the International Classification of Diseases, 10th revision. Unintentional injuries is another term for accidents. Unintentional injury deaths are identified by codes V01–X59 and Y85–Y86. Suicide deaths are identified by codes U03, X60–X84, and Y87.0. Homicide deaths are identified by codes U01–U02, X85–Y09, and Y87.1. Cancer (malignant neoplasms) deaths are identified by codes C00–C97. Heart disease deaths are identified by codes I00–I09, I11, I13, and I20–I51. The U.S. Office of Management and Budget classifies counties as within a metropolitan or a micropolitan statistical area. The remaining counties are not classified and are considered rural in this report. Rural counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas.

SOURCE: National Center for Health Statistics, National Vital Statistics System.

  • In 2018, the all-cause death rate among adolescents ages 15–19 was 49 deaths per 100,000 adolescents. Adolescents in rural counties had the highest death rate (69 per 100,000), followed by adolescents in micropolitan counties (59 per 100,000) and metropolitan counties (47 per 100,000).
  • Unintentional injuries were the leading cause of death among adolescents ages 15–19 in 2018 (17 per 100,000), followed by suicide (11 per 100,000), homicide (8 per 100,000), cancer (3 per 100,000), and heart disease (1 per 100,000).
  • Death rates for unintentional injuries were highest for adolescents in rural counties (32 per 100,000), followed by micropolitan counties (25 per 100,000) and metropolitan counties (15 per 100,000).
  • Death rates for suicide were higher for adolescents in rural (17 per 100,000) and micropolitan counties (16 per 100,000) than in metropolitan counties (11 per 100,000).
  • Death rates for homicide were higher for adolescents in metropolitan counties (9 per 100,000) than in micropolitan (6 per 100,000) and rural counties (5 per 100,000).
  • Death rates for heart disease were higher for adolescents in rural counties (2 per 100,000)
    than in metropolitan counties (1 per 100,000).
  • In 2018, there was no statistically significant difference by metropolitan status for death rates from cancer among adolescents ages 15–19.

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39 Guyer, B., Freedman, M. A., Strobino, D. M., & Sondik, E. J. (2000). Annual summary of vital statistics: Trends in the health of Americans during the 20th century. Pediatrics, 106(6), 1307–1317. https://doi.org/10.1542/peds.106.6.1307

40 National Center for Health Statistics. (2018). Multiple cause of death data file 2020. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.

41 Cunningham, R. M., Walton, M. A., & Carter, P. M. (2018). The major causes of death in children and adolescents in the United States. New England Journal of Medicine, 379(25), 2468–2475. https://www.nejm.org/doi/10.1056/NEJMsr1804754