- NEW YORK - While overall mortality among US children decreased 33.5 percent
between 1979 and 1995, the number of homicides and suicides among American
children have dramatically increased over the last two decades, according
to a report issued Friday by the Public Health Policy Advisory Board (PHPAB).
- The PHPAB, a private, independent, nonprofit
organization founded by former Secretary of Health and Human Services Dr.
Louis W. Sullivan, notes in the report that the increases in homicide and
suicide among teenaged black males "are so striking that they warrant
the term 'epidemic."'
- These "epidemics among black males
constitute a genuine public health emergency demanding immediate aggressive
preventive action, unrelenting commitment to understand causation, and
scientific inquiry," write the report's authors.
- The PHPAB report lists the five leading
causes of death among American children from birth to age 19 as unintentional
injury (42 percent), homicide (14 percent), suicide (7 percent), cancer
(7 percent), and birth defects (5 percent).
- Among infants, the leading causes of
death are perinatal complications. Among children from age 1 to age 19,
the number one cause of death is injury, according to the report.
- Death rates among black infants were
2.5 times greater than among white infants, and 2 times higher in black
children than in white children.
- Suicide has become the third leading
cause of death among teens aged 15 to 19, and the fourth leading cause
of death among adolescents aged 10 to 14. Among older teens, unintentional
injury, homicide and suicide account for 80 percent of all deaths.
- The report's authors note that since
the turn of the century, children have benefited from advances in medicine
and social policy, with the result that "the health and safety of
children in America in the 1990s are better than at any time in recorded
- But they add that there are exceptions
to this favorable trend, most notably the rising incidence of injuries,
homicides, and suicides among US children and teens over the last 20 years.
- An additional factor: "the increase
in both morbidity and mortality due to asthma in children," an increase
that has yet to be explained.
- "The causes of death in children
that have increased most dramatically over the past 20 years relate to
social, cultural, and behavioral changes in our society," the report's
authors conclude. "Violence - by adults against children, and in older
children, by children against other children, and children against themselves
" is one of the biggest threats to children's health."
- The PHPAB has devised a number of recommendations
to reduce childhood mortality. Among the recommendations are:
- " emphasize the role of family
- " address disparities in health
- " recognize homicide and suicide
as public health emergencies
- " reduce alcohol and drug
- " reduce motor vehicle injuries
- " reduce availability of firearms
- " reduce child abuse
- " establish child death reporting
and investigation systems for
- unintentional injuries
- " comprehensively address
- " and prevent obesity in children