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Death rates for children of all ages have fallen markedly in recent decades –within some groups, by half or more. However, disparities—by age group, gender, and race/ethnicity—persist.

Importance

The death of a child is a tragedy for family and friends, and a loss to the community. Unintentional injuries are the leading cause of death among children and youth, accounting for more than a quarter of all deaths among children ages 1 to 4, 5 to 9,and 10 to 14, and more than 1 in 3 of deaths among teens ages 15 to 19. [1] Among infants, the leading causes of death include congenital and chromosomal abnormalities, problems related to short gestation and low birthweight, maternal complications of pregnancy, and sudden infant death syndrome (SIDS).[2]

Along with the direct impact of a child’s death, the child or infant death rate in a community can be an important indicator for researchers or policymakers. A high rate can point to underlying problems, such as poor access to prenatal care, violent neighborhoods, or inadequate child supervision. It can also point to inequities: for example, in access to health care or safe places to play, or exposure to environmental toxins. While not nuanced measures, data on child deaths are highly accurate, and allow comparisons both within and across geographic areas.

Trends

Death rates for children have fallen dramatically since 1980. For example, rates for infants (under 1 year) fell from 1,288 to 687 per 100,000 between 1980 and 2001. Between 2001 and 2005, however, death rates for infants rose, reaching 710 deaths per 100,000 in 2005. (Figure 1) The Centers for Disease Control and Prevention attributed the increase to a rise in the number of babies born at very low birthweight.[3] Between 2005 and 2011, infant mortality resumed its previous downward trend, decreasing to 600 deaths per 100,000. Since then, rates have stagnated, and were at 588 per 100,000 in 2014. (Figure 1)

Between 1980 and 2014, rates of death for children ages 1 to 4 dropped from 64 to 24 per 100,000, while rates for children ages five to 14 dropped from 31 to 13 per 100,000. The steepest decline in both groups occurred between 1980 and 1985. The death rate for teens ages 15 to 19 also declined between 1980 and 2014, from 98 to 46 per 100,000, though there was a period of considerably higher rates during the late 1980s. (Figure 2)

Differences by Age

Children are much more likely to die during the first year of life than they are at later ages. For example, in 2014, the death rate for children under age 1 was nearly 13 times higher than the rate for children ages 15 to 19, the group with the next highest mortality (588 and 46 per 100,000, respectively). Among children who have survived past their first year of life, the likelihood that they will die decreases with age, then increases as they reach high school age. (Figure 2)

Differences by Gender

Death rates for boys are substantially higher than rates for girls in every age group examined here. The largest percentage difference is among teens ages 15 to 19, where males are more than twice as likely as females to die (63 versus 29 deaths per 100,000, in 2014). Among infants, males had a death rate of 639 per 100,000 in 2014, while females had a death rate of 535 per 100,000. Among children ages 1 to 4, the rates for males and females were 27 and 21, respectively, and among children ages 5 to 14 the rates were 15 and 11, respectively. (Figure 3)

Differences by Race and Hispanic Origin [4]

In 2014, consistent patterns by race and Hispanic origin (with the exception of American Indians) were evident for children in all age groups: black children had the highest rates of death, while Asian/Pacific Islander children had the lowest rates. Rates for Hispanic and white children fell in-between, with rates higher for whites. Trends in rates for American Indian children were inconsistent across age groups. (Appendix 1)

For example, in 2014, death rates were 1,043 per 100,000 for black infants, compared with 502 per 100,000 for white infants, 471 per 100,000 for Hispanic infants, and 362 per 100,000 for Asian/Pacific Islander infants. (Figure 4)

Rates of death for American Indians show a different pattern. In 2014, the rate of death among American Indian infants was the second-lowest among racial/ethnic groups, at 462 per 100,000. However, American Indians had the second-highest death rate for children ages 1 to 4, and 15 to 19. (Appendix 1)

State and Local Estimates

State-level mortality information, through 2014, for all ages, is available from the CDC WONDER Online Database.

State-level estimates are also available through the KIDS COUNT Data Center. for infants are mortality rates rather than death rates. Mortality rates for infants present deaths relative to the number of live births in a given year, rather than as a proportion of the total population under age 1.

Infant mortality rates for congressional districts, and child mortality rates for states, are available from the Social Science Research Council’s Measure of America project.

International Estimates

Estimates for infant and neonatal mortality and mortality for children under age five are available from UNICEF, Child Survival and Health.

National Goals

The Healthy People 2020 initiative has a goal for reducing infant mortality from 6.7 deaths per 1,000 live births in 2006, to 6.0 deaths per 1,000 live births in 2020. For children ages 1 to 4 years, the goal is to reduce the rate of deaths from 29.4 per 100,000 population in 2007, to 26.5; for children ages five to nine, from 13.8 per 100,000 population (2007), to 12.4; for adolescents ages 10 to 14, from 16.5 deaths per 100,000 population (in 2007) to 14.8; and for adolescents 15 to 19, from 60.3 deaths per 100,000 population (2007), to 54.3.

Additional information is available here.

Related Indicators

• Life Expectancy
• Unintentional Injuries
• Infant Homicide
• Teen Homicide, Suicide, and Firearm Deaths
• Motor Vehicle Deaths
• Low and Very Low Birthweight Infants

Definition

Death rates are defined as deaths per hundred thousand persons of that age.

These estimates are based on death certificate data collected by law on every death in the United States, and compiled through the National Vital Statistics System.

Data Sources

Data for 1999-2014: Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 1999-2014 on CDC WONDER Online Database. Available at: http://wonder.cdc.gov/ucd-icd10.html

Data for total and by gender ages 0 to 14, 1980-1998: Pastor, P.N., Makuc, D.M., Reuben, C., Xia, H. (2002). Health: United States: Chartbook on trends in the health of Americans. Hyattsville, Maryland: National Center for Health Statistics. Available at: http://www.cdc.gov/nchs/data/hus/hus02.pdf

Data by race/ethnicity, ages 1 to 14 and total for ages 15 to 19, 1980-1998: Federal Interagency Forum on Child and Family Statistics. (2002) America’s Children: Key National Indicators of Well-Being, 2002. Federal Interagency Forum on Child and Family Statistics, Washington, DC: U.S. Government Printing Office. Tables Health 6.A., Health 6.B. and Health 7. Available at: http://www.childstats.gov/pdf/ac2002/ac_02.pdf

Raw Data Source

Mortality Data, National Vital Statistics System

http://www.cdc.gov/nchs/deaths.htm