US Child Mortality Disadvantage Has Persisted Since 1975, International Comparison Finds

A study in Pediatrics used Human Mortality Database vital statistics from 1935–2023 to compare all-cause mortality among people aged 0–19 years in the United States and 13 high-income Organisation for Economic Co-operation and Development peer nations. Researchers estimated mortality rates, rate ratios, annual percentage changes, and annual excess US deaths.

Over the study period, mortality declined by 89.0% in the United States, from 477.6 to 52.4 per 100,000, versus 96.6% in the peer group, from 785.1 to 26.9 per 100,000. US mortality exceeded the peer-group rate beginning in 1975 and remained higher thereafter. From 2006–2023, the annual decline was 1.2% in the United States (95% CI, 0.6%–1.7%) versus 2.3% among peers (95% CI, 2.0%–2.7%).

In 2023, the largest relative disadvantage was among adolescents aged 15–19 years, whose US mortality rate was 2.9 times the peer-group rate. This age group accounted for 40.4% of excess deaths; the authors identified older male adolescents as the main concentration of the current gap.

The findings document a longstanding population-health disparity despite substantial absolute mortality reductions. However, this observational comparison does not establish its causes. Only the abstract was available, limiting assessment of methods and cross-country comparability; cause-specific mortality findings were not provided.