Why Children Dieby Lisa Freeman
When a very young person dies, however, we often feel a special sorrow and outrage when we ask "Why?" The mourning is especially great because of our sense of the deprivation of life's experience in the death of a youth. The deceased "never got the chance" to go on a date, or drive a car, or cash a paycheck, or cast a vote -- in general, to experience the joy of freedom that adult life has to offer. Never mind that these restrictions were all imposed on the child by our laws and societal beliefs, and that the mourners probably never worried about this "deprivation" while the child was alive. We only seem to care that the child's life be preserved -- that the child survive -- long enough to reach the age at which we see fit to grant these rights and freedoms. So, with regard to our youngest Americans, what causes the most fatalities? The National Vital Statistics Reports (2) of the Centers for Disease Control (CDC) divides causes of death into age groups of 1-4 years and 5-14 years of age, so let's look at people up to the age of 14. For this group, the number one cause of death is -- and has been for many years -- accidents. Accidents continue to be the leading cause of death for all of the CDC's age groupings up to age 44, and a major cause of death among people 45 and older as well. What can we do about accidents? It seems we are already doing everything we can to keep children safe from accidents, often by depriving them of the opportunity to meet with accidents. In fact, since 1980, total death rates among children under 15 have steadily dropped, from about 54 to 48 deaths per 100,000 in this age group,(3) largely due to the reduction of accidental death. For this rate to continue to fall, we must probably protect children even more. Perhaps they should never be allowed to ride in motor vehicles at all. Perhaps infants should never be held or carried, to avoid the risk of them being dropped. We could keep kids from swimming, bicycling, climbing, crossing streets. Some parents do use those strategies -- to the point where many kids grow up lacking the skills or confidence to deal with everday life. Although we often hear political figures state that "the death of even one child is one too many", at some point we must accept that some risk is unavoidable in a life that is in any way worthwhile and fulfilling, and that some accidents will simply happen. The second most common cause of death listed by the CDC for people under 15 is "malignant neoplasms", or cancer. Cancer, too, is a leading cause of death among all age groups; here too, great progress has been made in reducing fatalities among all of its victims. The third most common cause of death for Americans under 15 years of age is homicide. Unlike the previous two causes of death, the rate of homicide of 0-14 year olds has not decreased in the past twenty years, but has remained fairly steady. The threat of homicide is small for this age group, hovering around 2 deaths per 100,000 of this population each year. The risk, however, is greatest for those under 5 years of age.(4) When we think of children being murdered, we generally imagine a kidnapping by a psychopathic stranger, or we may envision an innocent victim of a juvenile gang's drive-by revenge. But in fact, even when older minors up to age 17 are included among the victims (the years in which "acquaintance" homicides become more common), only about 25% of all minors are killed by other minors each year, and only about 11% are killed by strangers. For homicide victims under 15, the killer is most often a parent; for victims up to age 5, when the identity of the killer is known, it is a parent in over 60% of the cases.(5) If we as a society approached the problem of children's death by homicide in the same way as we approach the other common causes of death, we might find that there are things we could do to address it. We might conclude that, while most parents love their children and do their best to provide for their physical, emotional and intellectual needs, there are some individuals who simply should not be permitted to be parents. We might decide that delegating the total responsibility of a young child to any one parent or couple, with no concern for their ability to care for a child (or for the possibility that they will murder the child!) means that, as a society, we are abandoning some of our young citizens to the whims of some very unstable individuals. And we might come to look upon parental rights in a different way. Of the remaining common causes of death of young people (including congenital abnormalities, heart disease, and infections, among other illnesses), there is one other for which the rate has not decreased in the past twenty years, and that is suicide. For people younger than age 15, the rate of suicide has increased 113% since 1980.(6) (For 15-19 year olds, the rate has increased slightly over the past twenty years, but has shown a dramatic increase of more than 300% over the rates reported in 1950.)(7) Evidence suggests that the features of mental illness -- primarily depression -- which are commonly associated with adult suicides are often not present in younger people who consider, attempt, or commit suicide.(8) One possible explanation might be as follows: suicide is likely to be considered when one finds one's circumstances intolerable and one believes that: 1) one's circumstances are unlikely to change in the near future, and These two beliefs may be caused by distortions in one's thinking (due to depression or another mental illness, or the use of drugs or alcohol), or they could be the result of a clear-headed and accurate assessment of one's situation. In the case of minors -- especially younger minors -- these two beliefs may often be quite rational conclusions. It may be that suicide by youth, rather than an always irrational act, is sometimes a quite understandable response to the inescapable position in which our society places them. No one can predict how long any one person's life will be, and it is unreasonable to expect that deaths of young people will ever be completely eliminated. But we can try, to the extent possible, to ensure that all Americans have the opportunity to choose their own course, realize their dreams, and enjoy their lives, no matter how long their life span may be. Sources 1. United States Department of Health and Human Services. Healthy people 2010 : understanding and improving health. 2nd ed. Washington, D.C. : GPO, 2000, p. 8. |