Child Injury and Mortality

Although injury death rates have declined in the past 2 decades for children ages 1–14, unintentional injuries remain the leading cause of death for children ages 1–4 and ages 5–14. In addition, nonfatal injuries continue to be important causes of child morbidity, disability, and reduced quality of life.84 The economic cost (medical expenses and productivity losses) of injuries among children under age 15 in 2019 was $396 billion.85 In 2020, there were 4,272 fatal injuries and nearly 3 million emergency department (ED) visits for non-fatal injuries among children ages 1–14.86 The leading causes of injury differ for children and adolescents (see PHY8.A).

Indicator PHY7.A: Emergency department visit rates for children ages 1–4 and 5–14 by leading causes of injury, 2019–2020
Indicator PHY7.A: Emergency department visit rates for children ages 1–4 and 5–14 by leading causes of injury, 2019–2020

‡ Reporting standards not met; estimate is considered unreliable.

NOTE: Visits are the initial visit to the emergency department for the injury. "Struck" denotes being struck by or against an object or person, "natural or environmental" denotes injuries caused by natural or environmental factors such as insect or animal bites, and "cut or pierced" denotes injuries caused by cutting or piercing from instruments or objects.

SOURCE: National Center for Health Statistics, National Hospital Ambulatory Medical Care Survey.

  • Among children ages 1–4 and ages 5–14, falls were the leading cause of injury-related ED visits in 2019–2020.
  • For children ages 5–14, being struck by or against an object or person was the second leading cause of injury-related ED visits in 2019–2020. For children ages 1–4, there was no significant difference between being struck by or against an object or person and natural or environmental factors.
  • In 2019–2020, there were 54 ED visits for falls per 1,000 children ages 1–4 and 28 ED visits for falls per 1,000 children ages 5–14. Falls accounted for 39% of initial injury-related ED visits for children ages 1–4 and 29% of initial injury-related ED visits for children ages 5–14.
  • The rates of injury-related ED visits resulting from being struck by or against an object or person were 19 visits per 1,000 for children ages 1–4 and ages 5–14.
  • Injury-related ED visits for injuries caused by natural or environmental factors, including insect and animal bites, were 12 visits per 1,000 for children ages 1–4 and 6 visits per 1,000 for children ages 5–14.

Indicator PHY7.B: Death rates among children ages 1–14 by all causes, all injury causes, and age group, 2011–2021
Indicator PHY7.B: Death rates among children ages 1–14 by all causes, all injury causes, and age group, 2011–2021

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

Indicator PHY7.C: Death rates among children ages 1–14 by cause of death and age group, 2021
Indicator PHY7.C: Death rates among children ages 1–14 by cause of death and age group, 2021

* Not a cause of death for children ages 1–4. Most suicides in the 5–14 age group are among those ages 10–14.

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

  • From 2011 to 2021, the all-cause death rate among children ages 1–4 declined from 26.3 deaths per 100,000 to 25.0 deaths per 100,000. The injury-related death rate among children ages 1–4 decreased from 11.4 deaths per 100,000 in 2011 to 9.5 deaths per 100,000 in 2019 but did not change significantly through 2021 at 11.2 deaths per 100,000.
  • The all-cause death rate among children ages 5–14 increased from 13.2 deaths per 100,000 in 2011 to 14.3 deaths per 100,000 in 2021. The injury-related death rate increased from 5.5 deaths per 100,000 in 2011 to 6.0 deaths per 100,000 in 2019 but did not change significantly through 2021 at 7.0 deaths per 100,000.
  • In 2021, unintentional injuries (accidents) were the leading cause of death for children ages 1–4 (8.5 deaths per 100,000) and ages 5–14 (4.2 deaths per 100,000). The second leading cause of death was birth defects among children ages 1–4 (2.7 deaths per 100,000) and cancer among children ages 5–14 (1.9 deaths per 100,000).
  • Among both younger and older children, males have higher death rates than females. In 2021, males ages 1–4 had a death rate of 27.0 per 100,000 compared with 22.9 deaths per 100,000 for females. Among children ages 5–14, males had a death rate of 16.4 deaths per 100,000 compared with 12.2 per 100,000 for females.

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84 Peden, M., Oyegbite, K., Ozanne-Smith, J., Hyder, A. A., Branche, C., Fazlur Rahman, A. K. M., Rivara, F., & Bartolomeos, K. (Eds.). (2009). World report on child injury prevention. World Health Organization.

85 Peterson, C., Miller, G. F., Barnett, S. B., & Florence, C. (2021). Economic Cost of Injury—United States, 2019. MMWR Morb Mortal Wkly Rep, 70:1655–1659. DOI: http://dx.doi.org/10.15585/mmwr.mm7048a1.

86 Centers for Disease Control and Prevention. WISQARS—Web-based Injury Statistics Query and Reporting System [Online]. http://www.cdc.gov/injury/wisqars.