US President Joe Biden is so concerned about the future of American children that he inserted a mandate for affordable child care into a major bill authorising subsidies for vital semiconductor manufacturers.
“Lack of childcare is a significant barrier to labor force participation,” tweeted economist Joseph Stiglitz. Policies like these have the potential to increase the pool of available workers, a win for our economy.”
Although providing child care may be a vote-winner, the larger issue of whether children survive to be cared for is also an issue.
A heart-stopping editorial in JAMA, the journal of the American Medical Association, claims that mortality rates for children and adolescents rose for the first time in more than 50 years between 2019 and 2021. The authors of the article declare: “This increase in all-cause pediatric mortality has ominous implications. A nation that begins losing its most cherished population—its children—faces a crisis like no other.”
The reason? It’s not an increase in childhood diseases, or deaths through Covid-19. “COVID-19 mortality rates at ages 1 to 19 years nearly doubled in 2021 but explained only 20.5% of that year’s increase in all-cause mortality,” they write.
The deaths were caused by social and personal dysfunction: car accidents, overdoses, shooting, and suicides.
“Although the pandemic did not initiate these trends, it may have poured fuel on the fire. Injury mortality at ages 10 to 19 years rose by 22.6% between 2019 and 2020. Much of this surge involved homicides, which increased by 39.1%, and deaths from drug overdoses, which increased by 113.5%. Transport-related deaths at ages 10 to 19 years, which had decreased for decades due to improved vehicle safety measures and greater use of occupant restraints, increased by 15.6% in 2020. Among children aged 1 to 9, injuries explained two-thirds (63.7%) of the increase in all-cause mortality in 2021, including a 45.9% increase in deaths involving fires or burns.”
The authors say that great progress has been made medically, but these advances have been entirely offset by accidents in chaotic environments:
“[They] mark a tragic reversal to years of progress in lowering pediatric mortality rates through advances in injury prevention (eg, safer automobiles, occupant restraints, bicycle helmets, smoke detectors) and the prevention and treatment of lethal pediatric diseases (eg, prematurity, neoplasms, congenital disorders). These advances have reduced pediatric deaths, but the recent increase in all-cause mortality means that these gains are now being entirely offset by injuries, primarily those involving violence, self-harm, and drug misuse.”
“I have not seen this in my career,” said lead author Steven Woolf, M.D., director emeritus of the Center on Society and Health at Virginia Commonwealth University. “For decades, the overall death rate among US children has fallen steadily, thanks to breakthroughs in prevention and treatment of diseases like premature births, pediatric cancer and birth defects. We now see a dramatic reversal of this trajectory, meaning that our children are now less likely to reach adulthood. This is a red flashing light. We need to understand the causes and address them immediately to protect our children.”
There is a clear racial component to these dismal figures. In 2021, Black youths aged 10-19 were 20 times more likely to die by homicide than white and Asian American/Pacific Islander youths and six times more likely than Hispanic youths.
Child care is desperately needed – but perhaps not the kind of care that President Biden is currently promoting.