Issue: June 2019
April 29, 2019
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Number of child deaths cut in half since 1990

Issue: June 2019
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Photo of Nicholas Kassebaum
Nicholas J. Kassebaum

Child and adolescent deaths decreased by more than 50% since 1990, according to findings published in JAMA Pediatrics. Researchers said this progress suggests that children are more likely to reach their 20th birthday than ever before.

Nicholas J. Kassebaum, MD, adjunct associate professor of health metric sciences at the University of Washington’s Institute for Health Metrics and Evaluation, told Infectious Diseases in Children that the study highlights the importance of remembering the context and setting in which pediatric and adolescent patients are presenting.

“This includes consideration of their age, preexisting conditions and socioeconomic status as those will all have a bearing on what sorts of diseases or risk factors a child or adolescent may have,” he said.  

Kassebaum and colleagues analyzed data from the Global Burden of Diseases,

Injuries, and Risk Factors 2017 Study to estimate mortality and morbidity in children and adolescents from 1990 to 2017 in 195 countries and territories.

The researchers observed a 51.7% decrease in child and adolescent deaths during the study period — from 13.77 million (95% uncertainty interval [UI], 13.6-13.93 million) to 6.64 million (95% UI, 6.44-6.87 million). Although deaths decreased considerably by 2017, the cumulative disability increased 4.7% to 145 million years lived with disability around the world (95% UI, 107-190 million).

Children and adolescents residing in low- and low-middle Socio-Demographic Index (SDI) areas accounted for 82.2% of all deaths during the study period. The SDI is a composite indicator of development based on per capita income, adult education and fertility, according to the researchers.

Kassebaum said the causes of death and disability in children and adolescents varied considerably throughout their lives and throughout the world. While he stressed that physicians should be cognizant of the increased vulnerability of children with conditions such as congenital birth defects and blood disorders like sickle cell disease, they should also help reduce children’s risk of deadly injuries.

Furthermore, he said neonatal disorders were a leading cause of death in every location in the study.

“So many of these cases are related to pregnancy problems, delivery complications or inadequate newborn care,” Kassebaum said. “Their pervasiveness really highlights how much work remains to be done in ensuring that women are fully supported during pregnancy and that after birth, they and their babies are likewise able to get what they need.” – by Katherine Bortz

Disclosures: Kassebaum reports receiving personal fees from Vifor Pharmaceuticals LLC, outside the submitted work. Please see the study for all other authors’ relevant financial disclosures.