What’s Killing Kids?

We explore America’s childhood death rate.

If I drew you a graph that showed the death rate among American kids, you would see a backward check mark: Fewer kids died over the last several decades, thanks to everything from leukemia drugs to bicycle helmets. Then, suddenly, came a reversal.

I first noticed this in 2021 while poking around in mortality data from the virus-ridden year before. It looked bad. I knew that kids who contracted Covid tended to fare better than older people, but was the virus killing them, too?

Nope. It wasn’t the virus. It was injuries — mostly from guns and drugs. From 2019 to 2021, the child death rate rose more steeply than it had in at least half a century. It stayed high after that. Despite all of the medical advances and public health gains, there are enough injuries to have changed the direction of the chart.

Horrified, I started making phone calls. It turned out that I was not the only one who wanted to understand what was happening to America’s children. In today’s newsletter, I’ll explain what we now know.

Guns and drugs

When life expectancy in the United States plateaued around 2010, it was big news. Problems that grabbed people in midlife — chronic disease, depression, opioids and alcohol — were bringing down the average. Yet the survival rate for children kept improving, thanks to better neonatal care, vaccines and even swimming lessons.

The first real alarm bells coincided with the pandemic. That’s when the mortality rate among children and adolescents shot up by more than 10 percent in a single year. These children weren’t felled by some spreading contagion; their deaths were sudden and “almost always preventable,” as Dr. Coleen Cunningham, the pediatrician in chief at Children’s Hospital of Orange County, puts it. Deadly car accidents among tweens and teens climbed nearly 16 percent. Murders went up 39 percent. Fatal overdoses more than doubled.

In Brooklyn, New York. Victor J. Blue for The New York Times

New patterns emerged with race and gender, too. Black and Native American children were dying at much higher rates than white children. And the disparities — which had been narrowing — were now widening again. Black kids were mostly shot by other people. Native American kids mostly shot themselves.

There were harbingers before 2020. Suicides started to increase in 10- to 19-year-olds after the 2007 recession alongside the rise of social media and cyberbullying. Homicides climbed as access to firearms rose. Overdose deaths spiked shortly before the pandemic began as cartels laced their drugs with fentanyl.

But guns were at the center of it all, replacing car crashes as the leading killer of kids. Gun deaths alone accounted for almost half of the increase in young people. They are now equivalent to 52 school buses of children crashing each year.

Seeking answers

Of course, how children die is not the same as why, and answering the latter question could prove increasingly difficult in the years ahead.

That’s because of politics. Three decades ago, major health studies began to reveal the danger of guns. The National Rifle Association took notice. That’s when Congress barred the Centers for Disease Control and Prevention from spending money to “advocate or promote gun control.” Grants from the agency ended. Without the funding, the research stopped.

But a researcher helped persuade Congress to restore the money in 2019, just before the children’s mortality rate spiked. Gun-violence research is now going through a sort of renaissance. Epidemiologists are gathering better data on what’s behind the rise in gun deaths and what could help prevent them, from expanded background checks to gun safes.

But politics change, and that means funding could, too.

For more

  • Robert F. Kennedy Jr., Donald Trump’s nominee to run the health department, says American children face an epidemic of chronic diseases in part because of fluoride in water and vaccines. Medical experts agree there is a health crisis. They disagree on the source.

  • Kennedy could be in a position to undermine childhood immunizations if confirmed. See how.

THE LATEST NEWS

Trump Administration

Protesters in New York. Victor J. Blue for The New York Times

  • Trump, in a 4 a.m. Truth Social post, confirmed that he would declare a national emergency and use the U.S. military to help deport undocumented immigrants en masse. His team also plans to open holding camps for migrants and to try to end birthright citizenship.

  • Sean Duffy, a Fox News host and former Republican congressman, is Trump’s pick to be transportation secretary.

  • Trump privately admits that the Senate may not confirm Matt Gaetz to be attorney general but believes his other contentious nominees will be approved.

  • A woman who testified that Gaetz paid her for sex described witnessing him having sex with an underage girl at a party in 2017, the woman’s lawyer said.

  • Russian state media celebrated Trump’s nomination of Tulsi Gabbard to be director of national intelligence. She has blamed the U.S. for provoking Russia to invade Ukraine.

  • Mika Brzezinski and Joe Scarborough, whose MSNBC show regularly criticizes Trump, traveled to Mar-a-Lago to meet with him.

  • Trump plans to attend a SpaceX rocket launch in Texas today. Elon Musk, a consistent presence during Trump’s transition, owns the company.

  • Football players and a U.F.C. fighter have imitated Trump’s signature dance moves, rocking their hips and pumping their fists.

More on Politics

  • Texas education officials will vote this week on whether to add Bible teachings into elementary school lessons on reading and language arts.

  • The Pennsylvania Supreme Court ordered election officials to stop counting mail ballots that are missing dates or have errors on the outer envelope. The ruling could help decide the Senate race there.

  • A Wyoming judge ruled that two state abortion bans violated the Wyoming Constitution and could not be enforced.

  • Martin O’Malley, a former Maryland governor who ran for president in 2016, is running to lead the Democratic National Committee. Ken Martin, the party’s Minnesota chairman, is also in the race.

  • President Biden urged Congress to pass another $100 billion in disaster aid for communities damaged by hurricanes, tornadoes and wildfires.

  • Interviews with hundreds of working-class minority voters revealed that they no longer trust Democrats to improve the economy.

International

In Hong Kong. Peter Parks/Agence France-Presse — Getty Images

  • A court in Hong Kong sentenced 45 former politicians and activists under a Beijing-imposed national security law. See who was sentenced and for how long.

  • Nearly 100 aid trucks were looted at gunpoint in Gaza. It was not clear who was responsible for the attack.

  • Venezuela’s government released at least 131 people arrested in a crackdown after the country’s disputed presidential election. The move was seen as a gesture to Trump.

  • As the glaciers of South America retreat, the supply of freshwater is dwindling and its quality is getting worse.

  • Russia made its largest territorial gains in over two years last month.

Other Big Stories

  • A former U.S. Army soldier was sentenced to more than four years in prison for assaulting police officers during the Jan. 6 riot — 20 years after he was found guilty in the killing an Iraqi civilian.

  • The Associated Press will cut its staff by 8 percent. Its union said the cuts were a result of a decline in revenue.

Opinions

Ema Ryan Yamazaki

“We’re each a piece of a heart”: First graders at a Japanese school form an orchestra for a school ceremony. See what it reveals about the country’s education system.

Polls reflect the messiness of politics. We have to get used to that, Nate Silver writes.

Here is a column by Paul Krugman on how Musk runs X.

MORNING READS

Sophie Park for The New York Times

By the sea: An old battered — and pink — house on the North Shore of Boston was going to be demolished. Artists and local residents fought to save it.

Daring deception: A British society of magicians expelled a woman who tricked her way into membership by disguising herself as a man. Three decades later, it wants her back.

Diet: How healthy are sweet potatoes?

Lives Lived: The critic, scholar and poet Sandra Gilbert co-wrote “The Madwoman in the Attic: The Woman Writer and the Nineteenth-Century Literary Imagination,” a groundbreaking work of literary criticism that became a feminist classic. She died at 87.

SPORTS

N.F.L.: The Dallas Cowboys continued a misery-filled season with a 34-10 home loss against the Houston Texans. Before the game, pieces of the AT&T Stadium roof fell to the turf.

Baseball: Juan Soto, a free agent, will meet with the Los Angeles Dodgers, the team he lost to in the World Series as a member of the New York Yankees.

Soccer: The U.S. men’s national team secured a 4-2 victory over Jamaica, sealing the Americans’ place in the Nations League semifinals.

ARTS AND IDEAS

One for the flight. Jennifer Chase for The New York Times

José Andrés, a Michelin-starred chef and head of a disaster relief nonprofit, has a new venture: airport dining. Andrés is opening Landing, a 5,500-square-foot lounge-restaurant at Ronald Reagan National Airport near Washington. He hopes to elevate the airport dining experience with a menu of tapas, caviar cones and Basque cheesecake. Read more about the venture.

More on culture

  • The Grammy-winning artist Jon Batiste is returning to his classical music roots on his latest album. Hear him improvise on some of Beethoven’s classics.

  • On “Real Time,” Bill Maher chided Democrats for losing touch with average Americans. “Maybe take the clothespins off your noses and actually converse with the other half of the country,” he said.

THE MORNING RECOMMENDS …

Johnny Miller for The New York Times. Food Stylist: Susan Spungen.

Make these two-tone cranberry lemon bars.

Try these expert tips on staying healthy while flying.

Improve the performance of your microwave.

Explore Walmart’s early Black Friday deals.

GAMES

Here is today’s Spelling Bee. Yesterday’s pangram was pinewood.

And here are today’s Mini Crossword, Wordle, Sudoku, Connections and Strands.

Thanks for spending part of your morning with The Times. See you tomorrow.

Sign up here to get this newsletter in your inbox. Reach our team at themorning@nytimes.com.