By Jennifer Fernandez

In North Carolina, 1,360 children died from illness, accidents, homicide or suicide in 2021.

That equates to about 76 classrooms of children, said epidemiologist Kathleen Jones-Vessey with the N.C. Division of Public Health during a briefing Monday afternoon on the new data.

The overall death rate of children ages birth to age 17 — 59.1 per 100,000 resident children — reached its highest level since 2016, according to a separate report to the governor and the General Assembly from the Child Fatality Task Force.

Firearm deaths among children rose to alarming levels from 2019 to 2021, the report’s authors wrote.

“The rise in firearm deaths, along with data showing how easily many high schoolers can access a loaded gun, is quite concerning,” Kella Hatcher, the task force’s executive director, said in an email.

And while the infant mortality rate remained virtually unchanged at 6.8 deaths per 1,000 live births, Jones-Vessey said Monday that that statistic still puts North Carolina among the top 15 percent of U.S. states for deaths of children younger than 1 year.

Usually, infant mortality and other child death data for a given year is released in the fall of the following year, but since the pandemic, the state health department has been plagued with short staffing, which has delayed contracts and projects. 

The Child Fatality Task Force’s 2023 annual report, also released Monday, included 11 recommendations by the group for legislation and funding to address areas of concern, with gun safety legislation at the top of the list. 

The task force, which includes volunteer experts in child health and safety, state agency leaders, community leaders and state legislators, has been working since 1991 to prevent child death and promote child well-being.

A big part of that job is collecting data to determine where to focus their efforts.

“We can’t react to something we don’t understand,” Hatcher said during the briefing.

Firearm deaths 

North Carolina saw an increase of 120.8 percent in firearm-related death rates among youth from 2019 through 2021. From 2011 through 2020, 525 North Carolina children aged 17 and younger died from firearm injuries. 

In 2021 alone, the number of child deaths due to firearms was 121. 

The report’s authors attributed a good portion of that overall increase to the rise in gun-related homicides and suicides among children.  

The report showed children died by firearms in more than 70 percent of suicides and homicides of children in 2021. Of the deaths of children ages 15-17, 83 percent died by firearms in a suicide or homicide.

Homicide rates for the last two years have increased dramatically compared to prior years, according to the report. Nearly all the homicides of children over the age of 4 involved firearms (93 percent).

In its annual report, the Child Fatality Task Force noted that a 2019 study in JAMA Pediatrics “estimated that up to 32% of youth firearm deaths by suicide and unintentional firearm injury could be prevented through safe storage of firearms.”

Several bills dealing with gun issues already have been filed during this session of the General Assembly.

House Bill 72 (Senate Bill 67), the Firearm Safe Storage Awareness Initiative, would create “a two-year statewide firearm safe storage awareness initiative to educate the public about the importance of the safe storage of firearms and to facilitate the distribution of gun locks.”

It passed in the House on Feb. 22; on Monday it was referred to a Senate committee.

The safe storage awareness initiative and gun locks program were then rolled into a separate bill, Senate Bill  41, that would also repeal the requirement to have a permit to buy a pistol  and expand where people with concealed carry permits could have a firearm. Gov. Roy Cooper has vetoed the pistol permit repeal in the past, and its inclusion in the package could prompt another veto from him.

That bill passed in the Senate and is sitting in a House committee, where it was referred on Feb. 21.

Suicide numbers rising

Youth suicide rates have been increasing over the past decade, and firearm-related suicides in particular have increased, the report’s authors said.

The 2021 suicide rate for children ages 10 to 17 was the highest in two decades, according to the report. During that timespan, the rate rose from 2.1 deaths per 100,000 children to 5.7.

The U.S. rate also rose, but more slowly, from 2.9 to 5.1.

Recently released results from the latest North Carolina Youth Risk Behavior Survey show that an increasing number of high school students seriously consider suicide.

That survey also shows the percentage of high school students in the state who reported feeling sad or hopeless rose from 28 percent to 43 percent over the past decade.

LGBQ+ students in North Carolina schools were about three times as likely as their heterosexual peers to report seriously considering suicide, making a suicide plan or attempting suicide, the data show. 

Infant mortality

Infants make up the largest portion of child deaths in the state, with birth anomalies the leading cause of death for that age group. 

In 2021, infants accounted for 60 percent of all child deaths. By comparison, the next closest age group was 15- to 17-year-olds at 17 percent.

The infant mortality rate — 6.8 per 1,000 live births — remains virtually unchanged from recent years. However, that leaves North Carolina among the states with the highest infant mortality rates in the country.

Child death rates include disparities among Black and white infants.

The report also showed:

  • Infant mortality, prematurity and low birthweight rates are consistently higher than U.S. rates.
  • Racial disparities in state infant mortality, prematurity and low birthweight persist in 2021, especially for Black infants.
  • The state’s eastern regions experience the highest rates of infant and child death, as well as social determinant risk factors such as poverty and unemployment.

The Child Fatality Task Force wants legislators to use Medicaid funding to support maternal health care strategies that are known to produce better birth outcomes. 

11 focus areas for 2023

The Child Fatality Task Force has identified nine issues it supports during the General Assembly’s legislative session this year and two issues spearheaded by other groups that it endorses:

  • Support legislation to launch and fund a new statewide firearm safety initiative.
  • Support recurring funds to increase numbers of school nurses, social workers, counselors and psychologists.
  • Support funding to implement an electronic statewide school health data system beginning in 2024.
  • Support legislation, agency action and policy change to strengthen the statewide Child Fatality Prevention System.
  • Support funding to expand efforts to prevent infant deaths related to unsafe sleep environments.
  • Support Medicaid funding to support maternal health care strategies known to produce better birth outcomes.
  • Support legislation to strengthen the Infant Safe Surrender law.
  • Support legislation to strengthen the state’s child passenger safety law to address best practices for safety.
  • Support funding to enable comprehensive toxicology testing in child deaths.
  • Endorse funding for programs to prevent harms to youth and infants caused by tobacco/nicotine use.
  • Endorse legislation requiring lifeguards at children’s day camps that offer time in the water.

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Jennifer Fernandez (children’s health) is a freelance writer and editor based in Greensboro who has won awards in Ohio and North Carolina for her writing on education issues. She’s also covered courts,...

One reply on “What’s killing our children, and what can legislators do about it?”

  1. Motor vehicle crashes remain the leading killer of teens in North Carolina. Yet, the Senate passed a bill on March 16 that would reduce rather than enhance the safety of adolescents in North Carolina. The current driver licensing system has saved thousands of lives since it was re-designed in 1997. Parents overwhelmingly support it. Fatal crashes declined 46% among 16-year-olds when this system was adoped.

    Now, for unknown reasons, the Senate has passed a bill that would eviscerate the protective provisions of the long-established, wise approach to licensing in this state. If enacted, crashes, injuries and deaths will increase as sure as the sun will rise.

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