Trends, 1997: HC 1.1.b Child and Youth Mortality

HC 1.1.B

CHILD AND YOUTH MORTALITY

Injuries are a common cause of death for children of all ages.⁶ Among children ages one to four, injuries accounted for 44 percent of all deaths in 1993. Following injury, the leading causes of death in this age group were congenital anomalies, malignant neoplasm, diseases of the heart, and HIV or AIDS.⁷ Injuries accounted for 52 percent of deaths to children ages five through 14 in 1993, and 80 percent of all deaths to adolescents ages 15 through 19.⁸

Overall, child mortality rates have decreased substantially over the past several decades⁹ (see Table HC 1.1.B.1). In 1994, the latest year for which data were available, mortality rates per 100 thousand were 42.9 for one- through four-year-olds, 19.9 for five- through nine-year-olds, 25.2 for 10- through 14-year-olds, and 86.8 for 15- through 19-year-olds.

Differences by Age. The most dramatic declines in mortality occurred among children under age 15 — with decreases of approximately 60 percent among children ages one to four and five to nine, and a 43 percent decrease among children ages 10 through 14 since 1960 (see Figure HC 1.1.B.1). Most of the decline in the mortality rate for these groups occurred between 1960 and 1990; mortality rates since then have been fairly constant. In contrast, mortality rates for youth ages 15 through 19 have decreased by only six percent since 1960. Moreover, unlike the fairly steady declines among the younger age groups, the adolescent mortality rate has had a variable pattern over the last thirty years (see Figure HC 1.1.B.1).

Differences by Race and Ethnicity. Multiyear data from the National Center for Health Statistics is used to examine the differences in the mortality rate of children and youth for several racial and ethnic groups across two time periods — 1989-1991 and 1992-1993 (see Table HC 1.1.B.2). For both children and youth ages one to 14 and ages 15 to 24, blacks have the highest mortality rate, followed by Native Americans, Hispanics and whites. Asian children and youth consistently have the lowest mortality rate. The disparity in mortality rates by race and ethnic group is greater among youth ages 15 to 24 than among children ages one to 14 (see Table HC 1.1.B.2).

The mortality rate for children ages one to 14 decreased for all racial and ethnic groups except Native Americans between the periods 1989-1991 and 1992-1993. In contrast, the mortality rate for youth ages 15 to 24 declined only for whites and Native Americans, and increased for blacks, Hispanics and Asians across these two time periods.

Differences by Race for Younger Children. Data for earlier decades are available only for black and white children (see Table HC 1.1.B.1). These data show substantial differences between white and black children since at least 1970 for children ages one through four, five through nine, and 10 through 14. By 1994, the mortality rate for black children ages 10 through 14 was nearly 65 percent higher than the rate for white children in that age group, 81 percent higher for children ages five though nine, and twice as high for children ages one through four.

Differences by Race For Adolescents. The black–white disparity among adolescents ages 15 through 19 was substantial in 1970, but had declined by 1980 to the point where black youth registered lower mortality rates than white youth (see Figure HC 1.1.B.2). This reversal was short lived, however. Black mortality rates surged from a low of 85.2 per 100 thousand in 1985 to 145.0 per 100 thousand by 1994, while white mortality rates remained fairly stable. Much of this recent increase in black teen mortality reflects a substantial increase in black teen male homicide rates, which are reviewed in Section HC 1.2.B of this report.

Differences by Gender. Male child death rates are higher than female rates for all age groups, but the differences are far more pronounced for the older age groups, for whom violent and injury-related deaths disproportionately affect males¹⁰ (see Table HC 1.1.B.1).

Figure HC 1.1.B.1
Child and Youth Mortality Rates by Age Group, 1960-1994
(rates per 100,000 population in age group)

Source: National Center for Health Statistics (NCHS), unpublished data provided by the Statistical Resources Branch and Gardner, P. and Hudson, B.L. “Advance Report of Final Mortality Statistics, 1993.” National Center for Health Statistics. 1996.

Table HC 1.1.B.1
Child and Youth Mortality Rates by Age Group, Gender and Race: Selected Years, 1060 to 1994 (rates per 100,000 population in age group)

1960 1965 1970 1975 1980 1985 1990 1991 1992 1993 1994

1-4 years

All Children 109.1 95.9 84.5 69.9 63.9 51.8 46.8 47.4 43.6 44.8 42.9

Gender

Male 119.5 104.3 93.2 76.7 72.6 58.5 52.4 52.0 48.0 49.5 47.3

Female 98.4 87.1 75.4 62.7 54.7 44.8 41.0 42.7 39.0 39.9 38.2

Race

White 95.2 83.2 75.1 63.3 57.9 46.6 41.1 41.7 38.1 38.3 36.5

Black __ __ 140.0 106.2 97.6 80.7 76.8 79.7 73.2 79.1 77.2

5-9 years

All children 49.0 43.9 42.1 35.2 30.4 25.0 22.2 21.5 20.4 21.1 19.9

Gender

Male 56.3 50.8 49.7 41.4 35.0 28.5 25.6 24.5 23.7 23.2 22.6

Female 41.5 36.8 34.2 28.6 25.6 21.4 18.5 18.4 16.8 19.0 17.0

Race

White 46.2 40.8 39.9 33.0 28.4 22.9 20.3 19.8 18.3 19.0 17.6

Black __ __ 56.4 47.4 41.7 36.2 32.3 32.0 32.1 32.9 31.8

10-14 years

All Children 44.0 40.5 40.6 35.3 30.8 28.0 26.0 25.8 24.6 25.6 25.2

Gender

Male 55.0 50.9 51.3 44.9 38.3 35.0 31.6 32.9 30.7 31.7 31.2

Female 32.6 29.7 29.5 25.3 22.9 20.6 20.2 18.2 18.2 19.2 18.8

Race

White 41.4 38.6 38.4 33.7 29.8 27.0 24.3 24.2 22.8 23.7 23.0

Black __ __ 54.6 44.3 36.6 34.8 36.6 36.4 35.3 37.2 37.9

15-19 years

All Children 92.2 95.3 110.3 100.2 97.9 80.5 87.9 89.0 84.3 86.9 86.8

Gender

Male 130.1 136.0 157.8 145.4 141.4 113.4 127.2 128.6 122.4 126.0 126.6

Female 54.0 53.9 61.7 53.8 53.1 46.2 46.4 47.2 44.0 45.6 44.8

Race

White 87.9 90.9 103.1 98.0 99.1 80.2 81.4 80.5 75.6 77.0 76.8

Black __ __ 158.0 114.4 92.3 85.2 127.7 141.2 135.5 143.6 145.0

Source: National Center for Health Statistics (NCHS), unpublished data provided by the Statistical Resources Branch and Gardner, P. and Hudson, B.L. "Advance Report of Final Mortality Statistics, 1993." National Center for Health Statistics. 1996.

Table HC 1.1.B.2
Child and Youth Mortality Rates by Age Group, Gender, Detailed Race and Hispanic Origin^a for 1989-1991 and 1992-1993 (rates per 100,000 population in age group)

–— Combined Years 1989-1991 —– –— Combined Years 1992-1993 —–

Total Male Female Total Male Female

———— ———— ———— ———— ———— ————

ONE TO 14 Years

All Races 31.4 36.2 26.3 29.3 33.7 24.6

White 28.4 32.8 23.8 26.1 30.3 21.7

Black 48.3 56.1 40.3 47.1 53.4 40.7

Asian^b 22.7 25.3 20.0 20.3 23.1 17.4

Native American^c 37.3 45.1 29.2 38.9 47.0 30.6

Hispanic Origin 30.2 34.7 25.5 28.4 32.4 24.2

15 TO 24 YEARS

All Races 99.1 146.1 50.0 97.0 144.0 47.9

White 89.3 129.5 47.0 84.2 122.3 44.1

Black 161.9 254.9 69.8 174.8 279.5 70.6

Asian^b 50.1 70.8 28.1 56.1 80.1 31.1

Native American^c 142.0 208.3 71.1 129.4 184.2 71.4

Hispanic Origin 103.3 156.5 40.9 107.5 167.3 40.2

Note: ^aPersons of Hispanic origin may be of any race. The four race groups listed in the table include persons of Hispanic and non-Hispanic origin. Death rates reported for white, black, and Hispanic persons are based on highly consistent information. However, persons identified as American Indian or Asian in the data from the Census Bureau (denominator of death rates) are sometimes misreported as white on the death certificate (numerator), resulting in underestimate of about 22-30 percent for death rates of American Indians and 12 percent for death rates of Asians (National Centers for Health Statistics, Health United States 1993, Table 33; Sorlie, P.D., Rogot E., and Johnson, N.J. "Validity of demographic characteristics on the death certificate," Epidemiology 3(2): 181-184, 1992).
^bAsian and Pacific Islander.
^cNative American or Alaskan Native.
Source: 1989-1991 data from: Centers for Disease Control and Prevention, National Center for Health Statistics (1994), Health United States 1993, Table 32; NCHS: Data computed by the Division of Analysis from data compiled by the Division of Vital Statistics and from national population for race groups from national population estimates for race groups. 1992-1993 data computed by Infant and Child Health Studies Branch, National Center for Health Statistics from Mortality Data compiled by Division of Vital Statistics.

⁶ Injury-related mortality includes death from motor vehicle crashes, fires and burns, drowning, suffocation, and accidents caused by firearms and other explosive materials, among others.

⁷ Gardner, P., and Hudson, B.L. (1996) "Advance Report of Final Mortality Statistics, 1993." Monthly Vital Statistics Report. Vol. 44, No.7 (S). Hyattsville, Maryland: National Center for Health Statistics; and, National Center for Health Statistics (1996). 1993 Detail Mortality File. Unpublished data. Cited in: Health Resources & Services Administration. Child Health USA ‘95. DHHS Pub. No. HRSA-M-DSEA-96-5. Public Health Service, Washington, 1996.

⁸ Discussion and data regarding motor vehicle crashes, the largest category of injury-related death for 15-19 year olds, follows in the next section [HC 1.2].

⁹ Health Resources & Services Administration. Child Health USA ‘95. DHHS Pub. No. HRSA-M-DSEA-96-5. Public Health Service, Washington, 1996.

¹⁰ Section HC 1.2 further highlights the differences in mortality rates between males and females ages 15-19 for violent and injury-related deaths.

Back to Table of Contents Previous Indicator Next Indicator

Table HC 1.1.B.1 Child and Youth Mortality Rates by Age Group, Gender and Race: Selected Years, 1060 to 1994 (rates per 100,000 population in age group)
		1960	1965	1970	1975	1980	1985	1990	1991	1992	1993	1994
1-4 years
All Children		109.1	95.9	84.5	69.9	63.9	51.8	46.8	47.4	43.6	44.8	42.9
Gender
	Male	119.5	104.3	93.2	76.7	72.6	58.5	52.4	52.0	48.0	49.5	47.3
	Female	98.4	87.1	75.4	62.7	54.7	44.8	41.0	42.7	39.0	39.9	38.2
Race
	White	95.2	83.2	75.1	63.3	57.9	46.6	41.1	41.7	38.1	38.3	36.5
	Black	__	__	140.0	106.2	97.6	80.7	76.8	79.7	73.2	79.1	77.2
5-9 years
All children		49.0	43.9	42.1	35.2	30.4	25.0	22.2	21.5	20.4	21.1	19.9
Gender
	Male	56.3	50.8	49.7	41.4	35.0	28.5	25.6	24.5	23.7	23.2	22.6
	Female	41.5	36.8	34.2	28.6	25.6	21.4	18.5	18.4	16.8	19.0	17.0
Race
	White	46.2	40.8	39.9	33.0	28.4	22.9	20.3	19.8	18.3	19.0	17.6
	Black	__	__	56.4	47.4	41.7	36.2	32.3	32.0	32.1	32.9	31.8
10-14 years
All Children		44.0	40.5	40.6	35.3	30.8	28.0	26.0	25.8	24.6	25.6	25.2
Gender
	Male	55.0	50.9	51.3	44.9	38.3	35.0	31.6	32.9	30.7	31.7	31.2
	Female	32.6	29.7	29.5	25.3	22.9	20.6	20.2	18.2	18.2	19.2	18.8
Race
	White	41.4	38.6	38.4	33.7	29.8	27.0	24.3	24.2	22.8	23.7	23.0
	Black	__	__	54.6	44.3	36.6	34.8	36.6	36.4	35.3	37.2	37.9
15-19 years
All Children		92.2	95.3	110.3	100.2	97.9	80.5	87.9	89.0	84.3	86.9	86.8
Gender
	Male	130.1	136.0	157.8	145.4	141.4	113.4	127.2	128.6	122.4	126.0	126.6
	Female	54.0	53.9	61.7	53.8	53.1	46.2	46.4	47.2	44.0	45.6	44.8
Race
	White	87.9	90.9	103.1	98.0	99.1	80.2	81.4	80.5	75.6	77.0	76.8
	Black	__	__	158.0	114.4	92.3	85.2	127.7	141.2	135.5	143.6	145.0

Source: National Center for Health Statistics (NCHS), unpublished data provided by the Statistical Resources Branch and Gardner, P. and Hudson, B.L. "Advance Report of Final Mortality Statistics, 1993." National Center for Health Statistics. 1996.

Table HC 1.1.B.2 Child and Youth Mortality Rates by Age Group, Gender, Detailed Race and Hispanic Origin^a for 1989-1991 and 1992-1993 (rates per 100,000 population in age group)

			–— Combined Years 1989-1991 —–			–— Combined Years 1992-1993 —–
			Total	Male	Female	Total	Male	Female
			————	————	————	————	————	————
ONE TO 14 Years
	All Races		31.4	36.2	26.3	29.3	33.7	24.6
		White	28.4	32.8	23.8	26.1	30.3	21.7
		Black	48.3	56.1	40.3	47.1	53.4	40.7
		Asian^b	22.7	25.3	20.0	20.3	23.1	17.4
		Native American^c	37.3	45.1	29.2	38.9	47.0	30.6
		Hispanic Origin	30.2	34.7	25.5	28.4	32.4	24.2

15 TO 24 YEARS
	All Races		99.1	146.1	50.0	97.0	144.0	47.9
		White	89.3	129.5	47.0	84.2	122.3	44.1
		Black	161.9	254.9	69.8	174.8	279.5	70.6
		Asian^b	50.1	70.8	28.1	56.1	80.1	31.1
		Native American^c	142.0	208.3	71.1	129.4	184.2	71.4
		Hispanic Origin	103.3	156.5	40.9	107.5	167.3	40.2

Note: ^aPersons of Hispanic origin may be of any race. The four race groups listed in the table include persons of Hispanic and non-Hispanic origin. Death rates reported for white, black, and Hispanic persons are based on highly consistent information. However, persons identified as American Indian or Asian in the data from the Census Bureau (denominator of death rates) are sometimes misreported as white on the death certificate (numerator), resulting in underestimate of about 22-30 percent for death rates of American Indians and 12 percent for death rates of Asians (National Centers for Health Statistics, Health United States 1993, Table 33; Sorlie, P.D., Rogot E., and Johnson, N.J. "Validity of demographic characteristics on the death certificate," Epidemiology 3(2): 181-184, 1992). ^bAsian and Pacific Islander. ^cNative American or Alaskan Native. Source: 1989-1991 data from: Centers for Disease Control and Prevention, National Center for Health Statistics (1994), Health United States 1993, Table 32; NCHS: Data computed by the Division of Analysis from data compiled by the Division of Vital Statistics and from national population for race groups from national population estimates for race groups. 1992-1993 data computed by Infant and Child Health Studies Branch, National Center for Health Statistics from Mortality Data compiled by Division of Vital Statistics.

Figure HC 1.1.B.1 Child and Youth Mortality Rates by Age Group, 1960-1994 (rates per 100,000 population in age group)

Figure HC 1.1.B.2 Mortality Rates for White and Black Youth Ages 15 to 19, 1970-1994 (rates per 100,000 population in age group)

Table HC 1.1.B.1 Child and Youth Mortality Rates by Age Group, Gender and Race: Selected Years, 1060 to 1994 (rates per 100,000 population in age group)

Table HC 1.1.B.2 Child and Youth Mortality Rates by Age Group, Gender, Detailed Race and Hispanic Origina for 1989-1991 and 1992-1993 (rates per 100,000 population in age group)

Figure HC 1.1.B.1
Child and Youth Mortality Rates by Age Group, 1960-1994
(rates per 100,000 population in age group)

Figure HC 1.1.B.2
Mortality Rates for White and Black Youth Ages 15 to 19, 1970-1994 (rates per 100,000 population in age group)

Table HC 1.1.B.1
Child and Youth Mortality Rates by Age Group, Gender and Race: Selected Years, 1060 to 1994 (rates per 100,000 population in age group)

Table HC 1.1.B.2
Child and Youth Mortality Rates by Age Group, Gender, Detailed Race and Hispanic Origin^a for 1989-1991 and 1992-1993 (rates per 100,000 population in age group)