Child Mortality in the United States: Bridging Palliative Care and Public Health Perspectives.

Abstract

* Abbreviations: ED — : emergency department PPC — : pediatric palliative care Child and adolescent mortality rates in the United States have fallen fairly consistently since the 1960s.1 And yet, infant mortality and deaths in adolescents and young adults are not infrequent. In 2015, 1 out of every 270 infants in the United States died before their first birthday, while 1 out of every 1438 Americans aged 15 to 24 died.2 Among children and adolescents, nonintentional injuries, suicide, and homicide are leading causes of death (Table 1). These cause-of-death statistics provide powerful data to inform public health initiatives, preventive medicine programs, and child health advocacy around end-of-life care. View this table: TABLE 1 2015 Child and Adolescent Mortality in the United States, Both Overall and Due to Unintentional Injuries, Suicide, and Homicide (Grouped Together as Injuries) In this issue of Pediatrics , Trowbridge et al3 take the novel approach of studying modes of death rather than causes of death. Following chart review of all deaths at a freestanding children’s hospital from 2011 to 2014, they created the following 5 mutually exclusive categories: (1) withdrawal of life-sustaining technology, (2) nonescalation of care, (3) failed … Address correspondence to JoAnna K. Leyenaar, MD, PhD, MPH, Dartmouth-Hitchcock Medical Center, WTRB, 1 Medical Center Way, Lebanon, NH 03766. E-mail: joanna.k.leyenaar{at}hitchcock.org