COLORADO SPRINGS, Colo. — Americans are more likely to die before they turn 25 than their peers in other wealthy nations, a report co-authored by a University of Colorado-Boulder researcher found, with people of color at even higher risk of dying young.
The report, published in the Population Reference Bulletin last month, found those mortality rates stagnated or worsened in the U.S. between 2013 and 2019 while comparable nations improved at ensuring their younger citizens grow old.
These deaths are often violent: The leading causes of death for American children and young adults are unintentional injuries, suicides and homicides. Many of these losses, the authors wrote, can be prevented through "aggressive" government and societal action to address poverty, discrimination and access to health care, among others.
"More than 50,000 young adults would still be alive today," CU-Boulder sociology professor Richard Rogers and his co-authors wrote, "had the United States achieved a modest annual reduction (2%) in early life mortality among the age group 20 to 24 between 2000 and 2017."
Rogers told The Denver Gazette he had previously studied adult mortality but felt researchers had missed a concerning trend among younger Americans.
"If you ask the general public about trends in the U.S., many people assume the U.S. has one of the better expectancies," he said. "Reasonably low mortality. People presume early life is when children are resilient and can fight off any problems, they have higher survival rates. And we found that's not always the case."
The research is particularly relevant now. Mental health experts say the pandemic has exacerbated the youth mental health crisis, and the virus itself has disproportionately affected Coloradans of color.
The extent to which the pandemic will hurt America's already poor youth mortality rates remains to be seen. Rogers and the other researchers looked at data from 2013 to 2019, when the most recent, complete data sets are available. They found males were more likely than females to die before they reach 25, "largely due to greater risk-taking behavior among adolescent and young adult males."
Males were more than twice as likely to die from homicide or suicide than their female peers.
Rogers specifically noted access to guns: The researchers found that gun violence killed 7,580 Americans under the age of 25 in 2019, 61% of which were suicides. That year, nearly a third of all U.S. firearm deaths were under the age of 25.
"If you're looking at closing the gap between males and females," Rogers said, limiting younger people's access to firearms is a good place to start. The researchers also noted broader societal factors, like the "tough it out" attitude impressed on some, which can worsen mental or physical health issues. Higher levels of risk-taking behaviors is another problem, they wrote.
While rates were higher between males and females, they were further exacerbated based on race, the researchers found. Young Black and Mexican American children were both more likely to die than their white peers.
"Compared with non-Hispanic white children and young adults ages 1 to 24, the risk of death before age 25 is 60% higher among non-Hispanic Black children and young adults, and 32% higher among their Mexican American counterparts, accounting for sex and age," the report found.
Similarly, the United States had the fourth-worst infant mortality rate of any peer nation, behind only Mexico, Turkey and Chile. Like youth mortality overall, people of color endure even worse rates: Even for Black women with at least a bachelor's degree, infant mortality rates are higher than for white women without that level of attainment.
The researchers wrote that explanations for this disparity include lower income, "more stressful neighborhood contexts" and "more prevalent psychosocial stressors among Black women, including exposure to a lifetime of discrimination."
"Stressors, including discrimination and structural barriers, can induce premature births," the authors continued, "which contribute to racial/ ethnic disparities in infant mortality."
The solution, Rogers said, "is more socioeconomic support to families." The United States does not have universal health care, as most peer nations do, and that likely plays a role, he said. High homicide and suicide rates are also largely unique to America.
In the report, the authors advance five goals that they say the Unites States should pursue to reduce youth mortality. The goals are enacting policies to improve educational attainment and reducing child poverty; addressing racial discrimination, particularly within health care contexts; improve mental and behavioral health support for young males; "support quality, accessible care"; and enact "broad safety measures, including related to guns and vehicle safety and crashes.
Despite those suggestions, Rogers said the U.S. will likely slip further behind its peer nations in the coming years even while improvements have been made for older Americans and against chronic or degenerative diseases.
"That's all well and good," he said. "What kind of improvements do we expect in early life? I don't know that we're going to see a whole lot. If you're reducing external causes — there are not a whole lot of signals we've got a handle on that and that we're pushing to reduce mortality."
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