Content warning: this article contains mentions of suicide.
In its May 2022 annual report, the North Carolina Child Fatality Task Force reported data about child deaths in the state and made recommendations for legislative changes to prevent child death, abuse and neglect.
It showed significant data about infant mortality, youth deaths due to firearms and adolescent suicide.
The CFTF is a legislative study commission that focuses on how to support the safety and well-being of children. According to CFTF Executive Director Kella Hatcher, the task force looks at data from the N.C. State Center for Health Statistics and other sources and utilizes that data to make recommendations to the governor and N.C. General Assembly.
The report shows that infant deaths accounted for 63 percent of all child deaths, making North Carolina’s infant death rate the eighth highest in the nation as of 2020.
“Unfortunately, we have been in the highest dozen in recent years, but going to eight highest is a worse ranking than we've had in recent years," Hatcher said.
Racial disparities also persist with the infant mortality rate; the Black infant mortality rate is more than 2.5 times that of white infants.
Meghan Shanahan, an associate professor in the UNC Department of Maternal and Child Health, said that racial disparities are caused by concurrent and historical racism, which limits individuals’ access to healthcare resources, affordable fresh food and green space.
Hatcher said focusing on social determinants, or risk factors, is important in order to decrease the rate of infant mortality.
“The areas of the state with the highest infant mortality rates also happened to be the areas with the highest social determinant, risk factors such as unemployment, poverty, lower levels of education or access to health care,” Hatcher said.
Shanahan said diversity is important when professors and medical schools consider who they select and train as future doctors, as well as how they are supported so they continue to participate in the medical field.
"Representation in public health and representation in medicine is really important,” she said.
Citing a study conducted by Brad Greenwood, Shanahan said that the survival rate of Black infants significantly improves when they are cared for by a Black physician.
Hatcher said that some of the other most concerning data trends she saw were the significant increase in firearm deaths and youth suicides.
According to the report, firearms were used in 55 percent of youth suicides and 73 percent of homicides in 2020.
525 children who were 17 or younger died due to firearm injuries from 2011 to 2020 – 105 children died due to firearm injuries in 2020 alone.
According to the report, the total number of deaths caused by firearms doubled from 2019 to 2020, and firearm sales increased during the pandemic.
The CFTF hopes firearm death rates will be addressed with a pending bill, House Bill 427, which if passed will launch and fund a statewide firearm safe storage awareness initiative. The bill was passed in the house one vote shy of unanimously in 2021 but never received a hearing in the Senate Rules Committee.
The report also shows that suicidal behaviors have risen in high school students, with almost one in five seriously considering suicide.
This is most pronounced among those who identify as LGBTQ+. According to the report, 44 percent of LGBTQ+ identifying high school students said they had seriously considered attempting suicide in the previous 12 months, compared to 16 percent of heterosexual students.
The data in the report was collected by the Youth Risk Behavior Surveillance System, a Centers for Disease Control and Prevention survey that is conducted every two years. The most recent study was in 2019.
Carolyn T. Halpern, UNC professor and chair of the Department of Maternal and Child Health, said she is worried about what the numbers will look like going forward.
“The thing that's kind of scary, really is that, these were collected in 2019,” she said, “So that's pre-COVID. And pre all the other political things that are happening that are not supportive of this population.”
Halpern said that all adolescents experience stressors, but sexual minorities have additional "minority stressors," which can include rejection from family and the school environments.
She said that changes to the sex education process and LGBTQ+ alliances within schools could help to create a supportive and understanding context for youth.
“It’s really powerful to think about the importance of an affirming environment, both within a school setting, within a family unit and then within broader society in terms of policies, community laws and what impact that has on youth – particularly youth who have been disenfranchised,” Shanahan said.
To combat the youth mental health crisis, the report calls for timely and appropriate funding and school support for mental health. This includes an increase in school nurses, social workers, counselors and psychologists in North Carolina, all of which currently fall short of nationally recommended ratios.
Shanahan said the task force’s reports and studies are important in understanding the prevention of child death.
“It succinctly and clearly lays out some of these key indicators of infant, child and adolescent health and well being and allows us collectively, in this space to think about solutions,” she said.
To get the day's news and headlines in your inbox each morning, sign up for our email newsletters.