What’s Killing Kids?

If I drew you a graph that showed the death rate among American kids, you would see a backward check mark: Fewer kids died over the last several decades, thanks to everything from leukemia drugs to bicycle helmets. Then, suddenly, came a reversal.

I first noticed this in 2021 while poking around in mortality data from the virus-ridden year before. It looked bad. I knew that kids who contracted Covid tended to fare better than older people, but was the virus killing them, too?

Nope. It wasn’t the virus. It was injuries — mostly from guns and drugs. From 2019 to 2021, the child death rate rose more steeply than it had in at least half a century. It stayed high after that. Despite all of the medical advances and public health gains, there are enough injuries to have changed the direction of the chart.

Horrified, I started making phone calls. It turned out that I was not the only one who wanted to understand what was happening to America’s children. In today’s newsletter, I’ll explain what we now know.

Guns and drugs

When life expectancy in the United States plateaued around 2010, it was big news. Problems that grabbed people in midlife — chronic disease, depression, opioids and alcohol — were bringing down the average. Yet the survival rate for children kept improving, thanks to better neonatal care, vaccines and even swimming lessons.