The US spends more per person on children’s healthcare than any other country, yet American kids are much more likely to die than those in other rich nations.

That’s the conclusion of a new study which looked at 50 years’ worth of child mortality data.

It compared childhood outcomes in the US with those in 19 OECD countries, including Canada, Australia, Switzerland, Italy and Germany, all of which have similar levels of economic development.

Whilst globally child mortality has reduced significantly over the last five decades, the improvement in the US has been the smallest among wealthy countries. Over the time period, 600,000 more children died in the US than in other countries in the study.

Image: John Hopkins Medicine

Who is most at risk?

Infants and teenagers were most at risk.

Around 90% of those deaths were either infants under one year old, or teenagers aged between 15 and 19.

The top two causes of infant mortality were premature deaths and sudden infant death syndrome (SIDS). Looking at the most recent decade, 2001-2010, infants in the US were 76% more likely to die than their OECD counterparts. The risk of death was 57% greater for American children aged one to 19.

Teenagers in the US were most likely to die either in car accidents or from gunshot wounds.

Firearms are the third-biggest cause of injury-related deaths in the US.

What the study tells us

The study, undertaken by the Johns Hopkins Hospital and published in Health Affairs, used data from the Human Mortality Database, which takes census data, population estimates and vital statistics from 38 countries and uses them to compute mortality rates for different age groups.

It added data from the WHO Mortality Database, which tracks both mortality and causes of death according to age and sex for the 114 countries that belong to the World Health Organization.

The authors of the study say that they think it’s the first to describe the full picture of child mortality in the US for children and adolescents of all ages.

“Overall child mortality in wealthy countries, including the US, is improving, but the progress our country has made is considerably slower than progress elsewhere,” said Ashish Thakrar, MD, lead author of the study.

He added that America’s fragmented healthcare system was partly at fault. In the US not everyone has access to the same healthcare, which means, for example, that a mother may have untreated health issues that can impact her baby’s health outcomes.

The US also saw a rise in childhood poverty in the 1980s, something that could well have been behind the slowdown in its improvements in child mortality.