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Child deaths increasing, but many are preventable

Child deaths in Arizona have increased from 838 in 2020 to 863 in 2021, according to a report from the Arizona Chapter of the American Academy of Pediatrics. Last year, 128 children died from abuse/neglect, a 36% increase from 2020. Most of these deaths were due to neglect. PHOTO BY PEXELS

Child deaths in Arizona have increased and nearly half of those fatalities were preventable.  

That’s according to the Arizona Chapter of the American Academy of Pediatrics, which presented some grim numbers related to 2021 child deaths. In 2021, it found that 863 Arizona children died, an increase from 838 such deaths in 2020. Of those deaths in 2021, 410 or 48% were determined to be preventable. Most of these reported deaths were from abuse/neglect, Covid, drowning, firearm injury, substance use-related, and sudden unexpected infant deaths, or SUID.  

The Arizona direct Covid mortality rate skyrocketed by 171% from .73 deaths per 100,000 children in 2020 to 1.92 deaths per 100,000 children in 2021, the Arizona Chapter of the American Academy of Pediatrics reported. 

The Arizona Child Fatality Review Program, an initiative with the Arizona Department of Health Services and the Arizona Chapter of the American Academy of Pediatrics, has been tracking all Arizona deaths for youths ages 17 and younger for the last 28 years. One of its main goals is to determine the steps those around children can take to prevent child deaths. 

Last year, 128 children died from abuse/neglect, a 36% increase from 2020. Most of these deaths were due to neglect. Substance use and poverty were the most common risk factors in abuse/neglect deaths. To prevent these deaths, the Child Fatality Review Program, or CFRP recommends increasing the availability of affordable and accessible substance use treatment, home visiting programs, and access to food, housing and childcare for Arizona families. 

Out of all factors listed in the report, substance use by a child or another person was the highest factor in preventable child death. In 2021, 176 children died due to a substance use-related death, a 12% increase from 2020. Almost half of these deaths were related to marijuana, meaning it was in the child’s system when they died. Many other deaths were related to opioids, including fentanyl. In some instances, the child was using more than one substance at the time of death.  

In most instances of substance-related deaths, the cause of death was poisoning, motor vehicle accidents, firearm injury or prematurity. And 49 children died from drug poisoning, with 44 of them due to fentanyl.  

The pandemic also caused those who hadn’t previously struggled to begin using substances as a coping mechanism. 

CFRP recommends expanding the availability and awareness of how to use naloxone, a drug that reverses the effects of opioid overdose. It also suggests spreading awareness of the risks associated with legal substances, including marijuana.  

Dr. Mary Ellen Rimsza, a pediatrician who was been chair of the CFRP for over 25 years, said she suspects that Covid deaths in children increased year-over-year due to classes being back in person, but schools not being allowed to require masks. Due to children being back in person, more children were exposed to the virus. Although Covid is generally less severe in children than in older adults, it caused 31 child deaths in 2021 compared to 12 in 2020.  

A direct Covid death is one where the Covid infection was the immediate or underlying cause of the child’s death. Covid was an indirect cause of death for 27 children in 2021. CFRP recommended schools be well-ventilated and enact Covid safety protocols to help lower these deaths.   

Drowning-related deaths also increased 108% from 2020 to 2021, with 75% of those deaths occurring in a pool or spa. The most common cause of death in children ages 1 to 4 years old was drowning, the report showed. CFRP recommends adults set up child-proof barriers around pools and always supervise children around bodies of water. 

Firearm injuries were the second most common cause of preventable death in 2021, with 56 children in Arizona dying from such injuries. Out of the 44 child suicides in 2021, 17 used a firearm and 89% of the preventable firearm deaths used a handgun. CFRP recommends increasing awareness of the fact that having a firearm in the home increases the risk of suicide. It also urges adults to remove firearms from households to prevent accidental and intentional firearm-related deaths.  

The report revealed that in 2021, 65 infants died from SUID,, an increase of 23% over 2020. Oftentimes this occurs because of suffocation from sleeping in an unsafe environment. CFRP recommends parents do not share beds with babies and place their babies to sleep on their backs on a firm, flat surface.  

Dr. Harold Shinitzky , a psychologist from Florida, said boys and young men, as well as people of color and those living in poverty are more likely to experience preventable childhood deaths.  

There is a gender gap among preventable childhood deaths, according to the Population Reference Bureau. Baby boys are more medically fragile than baby girls, thus more likely to die. As they grow up, the way they are socialized may contribute to higher death rates.  

Boys are more likely to engage in risk-taking behavior, making them more likely to die from homicide and unintentional injuries. They also are more likely to die from suicide, possibly due to the stigma around mental health impacting boys more than girls.  

There are also racial disparities among childhood deaths, where Black and Indigenous children are more impacted. According to Kaiser Family Foundation, due to health disparities, women of color are less likely to have access to health care, meaning they receive less prenatal and maternal care. This causes a higher death rate among infants. 

Jesenia Pizarro, a professor with Arizona State University’s School of Criminology & Criminal Justice, said preventable deaths are higher in people in poverty. Those who are struggling financially may be at higher stress levels, which can lead to violent behavior, Pizarro said. She also said those who are unable to find employment might turn to illegal activities to make money.  


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