PEDIATRICS Vol. 82 No. 4 October 1988, pp. 582-595
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Decline in Mortality Among Young Americans During the 20th Century: Prospects for Reaching National Mortality Reduction Goals for 1990

Robert A. Hoekelman MD1 and I. Barry Pless MD1

1 From the Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, and the Departments of Pediatrics, and of Epidemiology and Biostatistics, McGill University School of Medicine, Montreal

A review of mortality data for persons younger than 25 years of age in the United States reveals striking declines in death rates since the turn of the century. Mortality among infants during their first year of life decreased from 1 in 6 in 1900 to 1 in 100 in 1986. Between 1900 and 1984 the annual death rate for children 1 through 4 years of age decreased from 1 in 50 to 1 in 2,000, for children 5 through 14 years of age, from 1 in 250 to 1 in 4,000, and for persons 15 through 24 years of age, from 1 in 165 to 1 in 1,000. Public health measures, advances in medical science, legislative initiatives, and the organization and delivery of health care have all contributed to these improvements in varying degrees during different decades. For the decade 1975 through 1984, the overall death rate decreased by 20%, with declines for all causes except suicide, cardiovascular diseases, and renal diseases. All of the surgeon general's mortality reduction goals for 1990 for America's youth should be reached except those for infant mortality and suicide. Improvement in these death rates will require better access to health care by those in need and reductions in environmental stress.

Key Words: pediatric mortality • death rate

Accepted on November 30, 1987




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