Khan SQ, et al. - Experts evaluated the trends in US infant and youth mortality rates from 1999-2015 by age group and race/ethnicity, identify leading causes of death, and compared the mortality rates with those in Canada and England/Wales. They found that, from 1999-2015, the US mortality rates generally declined for infants and youths, owing to reductions in sudden infant death syndrome, unintentional injury death, and homicides. Nonetheless, compared with Canada and England/Wales, US mortality rates remain higher, with particularly elevated rates among black and American Indian/Alaskan Native youth. They also noted a concerning increase in the rates of suicide and drug poisoning deaths among US adolescents and young adults.

Methods

• Researchers conducted this descriptive study to analyze death certificate data from the US National Center for Health Statistics, Statistics Canada, and the UK Office of National Statistics for all deaths among individuals younger than age 25 years.
• They conducted the study from January 1, 1999, to December 31, 2015, and analyses started in September 2017.
• Exposures included race/ethnicity.
• Average annual percentage changes in mortality rates from 1999-2015 and absolute rate change from 1999-2002 and 2012-2015 for each age group, race/ethnicity, and cause of death were the main outcomes and measures.

Results

• Among individuals from birth to age 24 years, 1,169,537 deaths occurred in the United States, 80,540 in Canada, and 121,183 in England/Wales from 1999-2015.
• In total, 64% of deaths occurred among male individuals and 52.6% occurred among white individuals in the United States (25.1% deaths occurred among black individuals and 17.9% among Latino individuals).
• Findings suggested a decline in all-cause mortality for all age groups (infants < 1 year [38.5% of deaths], children aged 1-9 years [10.6%], early adolescents aged 10-14 years [5%], late adolescents aged 15-19 years [17.7%], and young adults aged 20-24 years [28.1%]) in the United States, Canada, and England/Wales from 1999-2015.
• Nonetheless, the United States were highest compared with Canada and England/Wales.
• According to results, within the United States, annual declines in all-cause mortality rates occurred among all age groups of black, Latino, and white individuals, except for white individuals aged 20-24 years, whose rates remained stable.
• From 1999-2002 and 2012-2015, mortality rates declined across most major causes of death, with notable declines observed for sudden infant death syndrome, unintentional injury death, and homicides.
• They noted an increase in unintentional suffocation and strangulation in bed among infants (difference between 2012-2015 and 1999-2002 range, 6.11-29.03 per 100,000).
• Moreover, they noted that the suicide rates among Latino and white individuals aged 10-24 years (range, 0.21-2.63 per 100,000) and black individuals aged 10-19 years (range, 0.10-0.45 per 100,000) increased, as did unintentional injury deaths in white young adults (0.79 per 100,000).
• Findings indicated that the increase in unintentional injury deaths may be attributed to increases in drug poisonings and was also observed among black and Latino young adults.