‘All-cause mortality’

Spikes in youth mortality and violence linked to homicide, suicide, drugs and truancy

George Copeland Jr. | 3/16/2023, 6 p.m.
A series of shootings in Richmond last week has sparked renewed calls for solutions to end gun violence. The urgent …

Child and teen mortality in the U.S. experiences largest increase in decades

A series of shootings in Richmond last week has sparked renewed calls for solutions to end gun violence. The urgent cries come as new research shows growing rates of death among young people throughout the country.

Last Friday evening, Binford Middle School student Marquan Mitchell-Nash was accidentally shot and killed on Stockton Street. Within the same hour, a separate shooting was reported on Halifax Avenue that left three youths injured, with one shot and two who were grazed by gunfire.

“My heart breaks for the Nash-Mitchell family who lost their 13-year-old son last night,” Mayor Levar M. Stoney said in a statement released Saturday. “As I have said before, we have too many damn guns in our community. Guns that are too easily accessible by our children and result in tragedies, like what occurred last night.

“If you own a gun, I am begging you, lock it up so that we can prevent unnecessary loss that will be felt for a lifetime,” Mayor Stoney added.

Child and teen mortality

The recent increase in “all-cause mortality,” a measure of all deaths in children and teens, is largely driven by increases in certain injury-related deaths, which began well before the COVID-19 pandemic, according to new research detailed in the Journal of the American Medical Association.

• Researchers found that suicide rates at ages 10-19 began increasing in 2007 and climbed by 70 percent by 2019;

• Homicide rates began increasing in 2013, rising by 33 percent by 2019;

• The number of overdose deaths began to rise in 2019;

• Deaths from car accidents dramatically jumped in frequency in 2020 and 2021.

The risk of injury-related death also varied sig- nificantly by race and ethnicity:

• In 2021, Black youths ages 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;

• Death by suicide was more than twice as likely among Black and American Indian/Alaska Native youths than white youths;

• American Indian/Alaska Native youths faced the greatest risk of dying in a motor vehicle accident.

The Richmond shootings occurred days before new research was released showing that child and teen mortality rates in the U.S. are seeing its largest increase in 50 years. An editorial published Monday in the Journal of the American Medical Association, points out that the increases “follow decades of progress in lowering the rate of death from childhood diseases. As a result, alarming spikes in pediatric mortality primarily is due from homicide, accidental drug overdoses, motor vehicle accidents and suicide among those ages 10 to 19.”

The JAMA editorial is co-authored by Dr. Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University, Dr. Elizabeth Wolf, an assistant professor in the Department of Pediatrics at the VCU School of Medicine and a pediatrician at the Children’s Hospital of Richmond at VCU, and Dr. Frederick Rivara, a professor of pediatrics at the University of Washington and Seattle Children’s Research Institute.

The research is based on analyzing death certificates from the Centers for Disease Control and Prevention, which found a roughly 20 percent increase in mortality for people ages 1 to 19 between 2019 and 2021.

“Medicine and public health have made remarkable progress in lowering pediatric mortality rates, but the lives they have saved are now endangered by manmade pathogens,” the co-authors wrote in the editorial. “Bullets, drugs, and automobiles are now causing a youth death toll sufficient to elevate all-cause mortality rates, the largest such increase in recent memory.

“Without bold action to reverse the trend, children’s risk of not reaching adulthood may increase.”

While statistical information for similar mortality rates and their causes among Richmond youths isn’t readily available, the solutions the editorial’s co-authors suggest are similar to ones being advocated by city and community leaders.

Gun safety and easy access to firearms were cited by the researchers and local officials as a major problem in need of addressing, with several solutions proposed by those involved and those concerned.

“There’s clearly a need for sensible gun reform laws, but I know this is a very volatile subject politically in our country right now,” said Dr. Woolf. “But when it gets to the point where your kids are less likely to reach adulthood, then it’s time to take some action to try to save their lives.”

The Richmond Branch NAACP’s James E. Minor III, like Mayor Stoney, has stressed the need for proper gun safety within the community. He also has spoken of the need for more pro- grams and spaces where youths can go to safely interact with their peers and grow. He said the Richmond NAACP is in the midst of trying to further efforts in this area when it comes to options available in the city.

“We need more things for our youths to do, period,” Mr. Minor said. “I think we’re moving in the right direction when it comes to after-school programs or recreation for our youths, but we need to expedite it.”

Mental health and economic opportunity also are cited as major concerns and contributing factors to these mortality rates by the researchers, particularly when it comes to underserved and marginalized communities of color.

Mr. Minor, for his part, suggested that greater access to mental health counselors could help alleviate this issue. He acknowledged that progress on this front is not as clear, but saw greater attention on this matter, like other solutions to the recent rise in deaths, as a critical need to prevent further tragedy.

“I don’t know what the whole plan looks like when it comes to that, but we need to be really thinking about that,” Mr. Minor said. “I know that we’ve done some things to address mental health, but we can do more as a city, as a region and as a state.”