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Mortality rates improve among kids and young adults in the US, especially in poor counties

Recent studies of mortality trends paint a gloomy picture for many middle-aged and older Americans, but a new study focused on children reveals a more optimistic future.

Death rates have declined among children and young adults in the poorest counties in the United States, according to the study published in Science. These children may be more likely to be healthier as they grow older, regardless of the poverty level where they live, the findings suggest.

Better health care, food and nutrition programs and less pollution are all potential contributors, the researchers say. The results should be particularly encouraging to policymakers engaged in projects aimed to promote public health, like anti-tobacco initiatives or food and nutrition programs.

“There have been tremendous improvements in the health of poor American children over the past 20 years, and yet the dominant narrative has completely ignored these improvements,” said co-lead author Janet Currie, the Henry Putnam Professor of Economics and Public Affairs at Princeton University’s Woodrow Wilson School of Public and International Affairs. “This is the reason we got interested in this project. It’s surprising how large the reductions in mortality are for younger people, how they extend through childhood into young adulthood, and how little anyone has paid attention to this incredible health success story.”

“Our big message here is that the health of the next generation in the poorest areas of the United States has improved tremendously, likely due to social policies that helped the most disadvantaged families,” said co-lead author Hannes Schwandt, an assistant professor at the University of Zurich. “It’s an important message, opposing the popular narrative of ‘Everything is getting worse.’ It tells people that their tax money is not wasted. Going forward, we need to find out which policies were most effective and how to scale them up in order to maximize their positive impact on the lives of the poor.”

Recent mortality studies have shown worsening conditions, especially for middle-aged Americans. Anne Case and Angus Deaton from Princeton published a paper in November 2015 that uncovered a “quiet epidemic” of drugs, alcohol and suicides plaguing middle-aged white Americans. Most recently, a study led by Stanford University economist Raj Chetty has shown a huge mortality gap between the rich and poor in the United States.

These mortality studies use data based on older people, who likely have cumulative health issues — making it hard to pinpoint the exact cause of death. Child death rates provide a much more “real time” measure of population health, Currie and Schwandt said, as kids respond more quickly to their external environments. Therefore, evaluating these rates can provide a powerful indicator of conditions at the time.