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Child and Youth Safety
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Why This Topic Is Important
The death of any young person is a tragedy. High death rates also can be an indicator of larger system issues, such as community violence or barriers to health care. In the U.S., unintentional injuries are the leading cause of death among young people ages 1-24: For children ages 1-4, the most common mechanism is drowning; for 5- to 19-year-olds, it is motor vehicle crashes; for young adults ages 20-24, it is poisonings, nearly all from drug overdose (1, 2). Other leading causes of death among children and young adults include suicide, homicide, cancer, heart disease, and birth defects (1). In 2020, firearms overtook motor vehicles as the leading mechanism of injury death among U.S. children ages 0-17 (2).

Death rates from injuries, and overall death rates, generally are higher for boys than girls (2). Disparities by race/ethnicity also persist, statewide and nationally; e.g., among groups with data, African American/black and American Indian/Alaska Native children and youth have had the highest death rates for many years (3). Many fatal injuries can be prevented through environmental, behavioral, social, and legislative change (4).
Find more information about child and young adult death in kidsdata.org’s Research & Links section.

Sources for this narrative:

1.  Centers for Disease Control and Prevention. (2022). Leading causes of death reports, 2020. Retrieved from: https://wisqars.cdc.gov/fatal-leading

2.  CDC WONDER Online Database. (2022). Underlying Cause of Death. Centers for Disease Control and Prevention. Retrieved from: https://wonder.cdc.gov/ucd-icd10.html

3.  As cited on kidsdata.org, Death rate, by race/ethnicity. (2022). California Department of Public Health, et al.

4.  Sleet, D. A. (2018). The global challenge of child injury prevention. International Journal of Environmental Research and Public Health, 15(9), 1921. Retrieved from: https://www.mdpi.com/1660-4601/15/9/1921
Policy Implications
Most child and young adult deaths are due to preventable causes (1). Public policies aimed at prevention, education, and support of young people and their families can address these causes.

Policy options that could reduce child and young adult deaths include:
  • Strengthening, enforcing, and promoting awareness of motor vehicle safety laws concerning car seats, seat belts, distracted and drunk driving, and graduated driver licensing systems (2)
  • Promoting safe, stable, and caring relationships between caregivers and children and addressing risk factors associated with child maltreatment such as neighborhood economic stress and family poverty (3)
  • Addressing depression and preventing youth suicide by providing routine and accessible mental health screening and services; also going beyond the prevention and treatment of problems to promoting positive mental health (4)
  • Reducing student violence, substance use, and other high-risk behaviors by promoting policies that foster positive school climates where students feel safe, connected, and supported (5, 6)
  • Addressing risk factors for gang involvement and violent behavior by strengthening youth connections to family and school, improving community supervision and engagement, and helping young people develop social-emotional skills (7)
  • Continuing efforts to ensure that all infants, children, and young adults—particularly those with special health care needs—and their families have access to quality medical care that is affordable, timely, comprehensive, continuous, patient centered, and culturally appropriate (8)
  • Supporting continued pediatric cancer research to promote advances in the understanding of risk factors and treatments (9)
For more information, see kidsdata.org’s Research & Links section and Policy Implications under Infant Mortality, Injuries, Cancer, and Suicide and Self-Inflicted Injury topics.

Sources for this narrative:

1.  As cited on kidsdata.org, Deaths, by age group and cause. (2022). California Department of Public Health & Centers for Disease Control and Prevention.

2.  Centers for Disease Control and Prevention. (2022). Transportation safety. Retrieved from: https://www.cdc.gov/transportationsafety

3.  Fortson, B. L., et al. (2016). Preventing child abuse and neglect: A technical package for policy, norm, and programmatic activities. Centers for Disease Control and Prevention. Retrieved from: https://www.cdc.gov/violenceprevention/pdf/CAN-Prevention-Technical-Package.pdf

4.  Murphey, D., et al. (2014). Are the children well? A model and recommendations for promoting the mental wellness of the nation's young people. Child Trends & Robert Wood Johnson Foundation. Retrieved from: https://www.childtrends.org/publications/are-the-children-well-a-model-and-recommendations-for-promoting-the-mental-wellness-of-the-nations-young-people

5.  Lee, B. (2016). Improving school climate through LCAPs. Fight Crime: Invest in Kids, California. Retrieved from: https://www.strongnation.org/articles/165-improving-school-climate-through-lcaps

6.  Morgan, E., et al. (2014). The school discipline consensus report: Strategies from the field to keep students engaged in school and out of the juvenile justice system. Council of State Governments Justice Center. Retrieved from: https://csgjusticecenter.org/publications/school-discipline

7.  Ritter, N., et al. (2019). Changing course: Preventing gang membership. National Institute of Justice. Retrieved from: https://nij.ojp.gov/topics/articles/changing-course-preventing-gang-membership

8.  Association of Maternal and Child Health Programs, & National Academy for State Health Policy. (2017). Standards for systems of care for children and youth with special health care needs (Version 2.0). Lucile Packard Foundation for Children's Health. Retrieved from: https://www.lpfch.org/publication/standards-systems-care-children-and-youth-special-health-care-needs-version-20

9.  National Cancer Institute. (2022). Research on childhood cancers. Retrieved from: https://www.cancer.gov/research/areas/childhood
How Children Are Faring
In 2015-2017, the death rate among California young people ages 1-24 was 29.8 per 100,000, lower than the U.S. rate of 40.9 deaths per 100,000. After declining between 2004-2006 and 2013-2015, statewide rates have risen in recent years, echoing national trends. Across counties with data, child and young adult death rates vary widely, from 18.4 per 100,000 (Yolo) to 76 per 100,000 (Calaveras) in 2015-2017.

Young adults ages 20-24 consistently have higher death rates (64.9 per 100,000 in 2015-2017) than other age groups in California, while children ages 5-14 have the lowest (10 per 100,000 in 2015-2017). Since 2000-2002, African American/black and American Indian/Alaska Native youth have experienced the highest rates of death among racial/ethnic groups with data statewide. Both in California and the nation as a whole, unintentional injuries—such as drownings, car crashes, and poisonings (including overdoses)—are the leading cause of death for children and young adults overall, for all age groups, and for all racial/ethnic groups with data except African American/black youth, for whom homicide is the leading cause of death.

In 2020, California young people ages 0-24 died of firearm injuries at a rate of 5.6 per 100,000, an increase of around 30% compared with 2019. Of the 692 firearm-related deaths among children and young adults statewide in 2020, boys and young men accounted for the vast majority (616). Homicide and suicide are the most common causes of firearm-related death across gender and age groups. Disparities exist in firearm death rates by race/ethnicity, statewide and nationally. In California, the firearm death rate among African American/black youth in 2020 (24.8 per 100,000 in 2020) was four times higher than the rate for Hispanic/Latino youth (5.8 per 100,000), seven times higher than that for white youth (3.4 per 100,000), and 16 times that for Asian youth (1.5 per 100,000).