The Morning: What’s killing kids?

Plus, Trump's appointments, Hong Kong and a magician society.
The Morning

November 19, 2024

Good morning. Today, Emily Baumgaertner explores America's childhood death rate. We're also covering Donald Trump's appointments, Hong Kong and a magician society.

An image of a woman and a child holding candles, taken from above.
A vigil for the victims of the Uvalde shooting. Mark Felix for The New York Times

Guns, drugs and children

Author Headshot

By Emily Baumgaertner

I cover public health issues affecting children.

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.

A chart that shows a decrease in the child mortality rate from 1968 through 2015, followed by an increase from 2019 through 2021.
The chart shows the mortality rate for children ages one through 19 | Source: Centers for Disease Control and Prevention WONDER database | By The New York Times

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.

The first real alarm bells coincided with the pandemic. That's when the mortality rate among children and adolescents shot up by more than 10 percent in a single year. These children weren't felled by some spreading contagion; their deaths were sudden and "almost always preventable," as Dr. Coleen Cunningham, the pediatrician in chief at Children's Hospital of Orange County, puts it. Deadly car accidents among tweens and teens climbed nearly 16 percent. Murders went up 39 percent. Fatal overdoses more than doubled.

An empty basketball court. A torn net is crumpled on the floor.
In Brooklyn, New York.  Victor J. Blue for The New York Times

New patterns emerged with race and gender, too. Black and Native American children were dying at much higher rates than white children. And the disparities — which had been narrowing — were now widening again. Black kids were mostly shot by other people. Native American kids mostly shot themselves.

There were harbingers before 2020. Suicides started to increase in 10- to 19-year-olds after the 2007 recession alongside the rise of social media and cyberbullying. Homicides climbed as access to firearms rose. Overdose deaths spiked shortly before the pandemic began as cartels laced their drugs with fentanyl.

But guns were at the center of it all, replacing car crashes as the leading killer of kids. Gun deaths alone accounted for almost half of the increase in young people. They are now equivalent to 52 school buses of children crashing each year.

A line chart showing some of the leading causes of death for children between 1999 and 2022. In 2019, the rate of drug-related deaths surpassed drowning deaths. In 2020, the rate of child deaths from firearm-related causes surpassed the number of deaths from traffic-related causes, including car crashes.
The chart shows mortality rates for children ages one through 19 | Source: Centers for Disease Control and Prevention WONDER database | By The New York Times

Seeking answers

Of course, how children die is not the same as why, and answering the latter question could prove increasingly difficult in the years ahead.

That's because of politics. Three decades ago, major health studies began to reveal the danger of guns. The National Rifle Association took notice. That's when Congress barred the Centers for Disease Control and Prevention from spending money to "advocate or promote gun control." Grants from the agency ended. Without the funding, the research stopped.

But a researcher helped persuade Congress to restore the money in 2019, just before the children's mortality rate spiked. Gun-violence research is now going through a sort of renaissance. Epidemiologists are gathering better data on what's behind the rise in gun deaths and what could help prevent them, from expanded background checks to gun safes.

But politics change, and that means funding could, too.

For more

  • Robert F. Kennedy Jr., Donald Trump's nominee to run the health department, says American children face an epidemic of chronic diseases in part because of fluoride in water and vaccines. Medical experts agree there is a health crisis. They disagree on the source.
  • Kennedy could be in a position to undermine childhood immunizations if confirmed. See how.

THE LATEST NEWS

Trump Administration

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Protesters in New York.  Victor J. Blue for The New York Times

More on Politics

International

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In Hong Kong.  Peter Parks/Agence France-Presse — Getty Images

Other Big Stories

Opinions

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Ema Ryan Yamazaki

"We're each a piece of a heart": First graders at a Japanese school form an orchestra for a school ceremony. See what it reveals about the country's education system.

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Here is a column by Paul Krugman on how Musk runs X.

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MORNING READS

A side view of a two-story house with pink walls. The moon is visible through an aperture in the roof.
Sophie Park for The New York Times

By the sea: An old battered — and pink — house on the North Shore of Boston was going to be demolished. Artists and local residents fought to save it.

Daring deception: A British society of magicians expelled a woman who tricked her way into membership by disguising herself as a man. Three decades later, it wants her back.

Diet: How healthy are sweet potatoes?

Lives Lived: The critic, scholar and poet Sandra Gilbert co-wrote "The Madwoman in the Attic: The Woman Writer and the Nineteenth-Century Literary Imagination," a groundbreaking work of literary criticism that became a feminist classic. She died at 87.

SPORTS

N.F.L.: The Dallas Cowboys continued a misery-filled season with a 34-10 home loss against the Houston Texans. Before the game, pieces of the AT&T Stadium roof fell to the turf.

Baseball: Juan Soto, a free agent, will meet with the Los Angeles Dodgers, the team he lost to in the World Series as a member of the New York Yankees.

Soccer: The U.S. men's national team secured a 4-2 victory over Jamaica, sealing the Americans' place in the Nations League semifinals.

ARTS AND IDEAS

A bartender wearing a black T-shirt prepares a cocktail behind a bar. In front of the bar are pink-and-brown bar seats.
One for the flight.  Jennifer Chase for The New York Times

José Andrés, a Michelin-starred chef and head of a disaster relief nonprofit, has a new venture: airport dining. Andrés is opening Landing, a 5,500-square-foot lounge-restaurant at Ronald Reagan National Airport near Washington. He hopes to elevate the airport dining experience with a menu of tapas, caviar cones and Basque cheesecake. Read more about the venture.

More on culture

  • The Grammy-winning artist Jon Batiste is returning to his classical music roots on his latest album. Hear him improvise on some of Beethoven's classics.
  • On "Real Time," Bill Maher chided Democrats for losing touch with average Americans. "Maybe take the clothespins off your noses and actually converse with the other half of the country," he said.

THE MORNING RECOMMENDS …

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Johnny Miller for The New York Times. Food Stylist: Susan Spungen.

Make these two-tone cranberry lemon bars.

Try these expert tips on staying healthy while flying.

Improve the performance of your microwave.

Explore Walmart's early Black Friday deals.

GAMES

Here is today's Spelling Bee. Yesterday's pangram was pinewood.

And here are today's Mini Crossword, Wordle, Sudoku, Connections and Strands.

Thanks for spending part of your morning with The Times. See you tomorrow.

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Editor: David Leonhardt

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Associate Editor: Lauren Jackson

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News Assistant: Lyna Bentahar

Saturday Writer: Melissa Kirsch

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