Child safety in the USA.

Great Debates
1

This report by UNICEF rather alarmingly shows the USA as having a higher child mortality rate through injuries than either Hungary or Poland, placing 23rd over all. Basically, children (aged between 1 and 14) are twice as likely to die from injury in the US as they are in Sweden or the UK.

The report also claims that “If the Unites States…were to bring its injury death rate down to the Swedish level then the lives of more than 4700 American children would be saved each year”.

For the life of me I don’t understand how the USA can fare so badly - why does it have such a disproportionately high figure for child injuries? Does anyone know what factors cause this?

2

Come now, Gary - we both know the reason, but if we say it out loud, legions of conservative Dopers will descend upon us, screeching about their “Constitutional Rights”.

3

Uh, which constitutional rights are involved here?

4

I’d guess that Alessan’s talking about guns, but I don’t think they can account for that sort of number. If 4,700 children were gunned down every year then there’d be one hell of an outcry.

5

Was this report including injuries sustained in automobile accidents? Well, there you go. We have more cars, more drivers, more accidents, and therefore a higher statistic.

Also, prompted by yesterday’s report that yet another small child has hanged herself in the cord to the mini-blinds, I’d like to point out that overall, we have more “stuff”. Most of the child accidental deaths are due to a mishap with “stuff”, like collapsible cribs and Pokemon balls and mini-blinds and small parts to toys, etc. So we have more “stuff” like that, therefore we have more children die from encounters with “stuff” like that.

Not to mention choking on popcorn, gumballs, and other tiny pieces of junk food. We have more junk food than anybody else, too.

6

I can think of a lot of different factors.

  1. More cars (mentioned by Duck Duck Goose already). Americans have more cars and drive more miles per capita than any other country. This means more accidents.

  2. Less parental supervision of children. Unsupervised and inadequately supervised children are more likely to get injured and more likely to be seriously injured than well-supervised children.

  3. Inadequate access to affordable health care, both preventative and ameliorative. Children who get injured are more likely to suffer serious sequelae when inadequate health care is available.

I doubt that guns account for that many childhood injuries. Yes, it happens, but it’s nothing compared to automobiles, slips and falls, and airway obstructions due to foreign objects.

7

For the record, to nip Alessan’s preposterous allegation in the bud (and why, pray tell, does he imagine only conservatives are concerned with Constitutional rights?), according to the Centers for Disease Control, in 1998, 3,792 Americans under the age of 20 were killed by firearms. The number of children between ages 1 and 14 (the ages with which the UNICEF report concerns itself) killed by firearms was 612.

Broken down further, 121 of those 612 were listed as accidental, 154 were suicides, 317 were “homicide or legal intevention by firearms,” and 20 were “undetermined whether accidentally or purposely fired.” (Yes, I know they add up to 615 and not 612. No, I don’t know why–I’m just going by the raw CDC numbers.)

Furthermore, given a quick scan of Gary’s link, the table on page 11 shows firearms accounting for only 1% of child deaths in the countries monitored from 1991-1995. (It goes on to state that the U.S. and Mexico account, respectively, for 3% and 1.7% of all the deaths in this category; but that, in the U.S., firearms are responsible for 42% of all intentional deaths of children between age 10 and 14 and 16% of all deaths in that age group whether intentional or unintentional.)

So we can abandon that silly premise right away, m’kay, Allesan?

As for Gary’s original question, I would like to read the entire report before I venture an opinion. I wonder, off the top of my head, though, whether automobile accidents play a disproportionate role, given the sheer number of miles traveled by the average family in an average year?

8

Okay, it says:

So they ARE including car wrecks.

And I find the whole report rather disingenuous.

Well, duh, people, it’s the Third World, they probably don’t have car safety seats for the kids.

The whole report strikes me as “hey, look, we found some statistics, what can we do with them?” And, ultimately, what do they want?

More funding. [sigh] I’m such a cynic.

And hey, Gary, [nudge, nudge] why doesn’t the OP mention Portugal and South Korea?

Hey, how come Uncle Sam has to be the Bad Guy all the time? Let’s have some hand-wringing over the sad state of affairs in Portugal, why don’t we? :wink:

And as long as we’re reading this report with cynicism, let’s point out that it’s generated by the UK branch of UNICEF, and lo and behold, whose name tops the list of “Safest Places on Earth for Kids to Live”?

Oooo, what a surprise. UK–Good Guy. USA–Bad Guy. Ugh. Me damn yankee, me go back to bashing toddlers…

:smiley:

9

Sorry about my remark earlier. I’m kind of testy today, what with the elections and all.

Besides, my PC at work can’t open pdf files, so I was making an educated - but incorrect - guess.

10

You are a little unfair DDG - although not much so. There may or may not be an agenda, as you say (actually I agree with you that there almost certainly is) - nevertheless death rates per 10,000 are death rates per 10,000. That figure at least is not open to interpretation.

I’m not surprised that the UK has amongst the lowest rates - our safety measures for kids in particular are incredibly anal and venturing out of this sceptr’d isle always comes as a bit of a shock.

I’d hope that noone is saying “US bad”, or even that the US has an actual problem. It may still be instructive to find out the cause for the discrepancy however, if only so we can dismiss it as cultural and/or acceptable.

pan

11

Sorry. It’s probably because I haven’t lived in Korea or Portugal, so wasn’t as curious.

By the way, on page 14 of the report it breaks down the different categories where countries are more/less prone to child mortality. You’re right, DDG - transportation is one of the big risk areas in the US. Worryingly, “intentional” deaths is one of the other areas where we’re more at risk.

I’m sure there may be a regional bias of some sort to this report, but don’t see how they could change the basic figures by that much without it becoming apparent?

12

According to the link, 40% of child deaths are due to car accidents. Many of these deaths could be prevented by using car seats and seat belts. Does Sweden have disproportionately fewer drivers than we do? Or are they more likely to use car seats and belts? Or is it because they have more Volvos?

The link also states that higher child mortality is closely tied with poverty, single-parenthood, low maternal age, large family size, poor housing, low level of maternal education, and parental abuse of drugs/alcohol (which may all just be other names for poverty).

In the USA, 1/4 of children don’t have health insurance. (I’ll find the cite upon request; I may be talking out of my arse, but I don’t think so.) Sweden has socialized medicine, so theoretically 100% of Swedish children are insured. Sweden is also more socialized in general, so perhaps their children are unlikely to be subjected to the miserable poverty that many US children face.

13

“In the USA, 1/4 of children don’t have health insurance.”

But the study is specifically about child mortality from injuries and poverty or lack of medical insurance is less of a factor for injury deaths because the ambulance still comes out and the emergency room at the hospital still has to take you if you’re an emergency case whether you’re rich or poor. Contrary to how the U.S. may or may not be portrayed elsewhere, uninsured people who get shot or end up in a car accident aren’t left to bleed in the street here in the uncaring U.S. any more than they are in more enlightened and civilized countries. :rolleyes:

14

I’m gonna go out on a limb here and say that parental ignorance and carelessness accounts for more of this than any single underlying cause.

For example, let’s say your toddler is wandering around the house, and you run to answer the phone. In the minute or two that the call takes, that child can go under the kitchen sink and drink a bottle of cleaner. A simple cabinet door latch can prevent that from happening. Many of my friends live in houses that aren’t safe for their young kids. An afternoon at a good hardware store can prevent so many tragedies.

People often rationalize not wearing seatbelts or using child safety seats because they’re only going up the street for a few minutes, but even in that short span, it’s entirely possible to get into a serious, even fatal accident.

Furthermore, for the poorer families, there often isn’t the support available that would help the parents with proper parenting skills, drug and alcohol rehabilitation, and life-skills training.

Finally, even among all economic sectors, there is a lack of first-aid and safety training that would prevent or minimize most of these kinds of accidents. Perhaps aweek or two of birthing education classes can be spent on these topics, if it’s not there already. This isn’t stuff that is necessarily instinctive. It needs to be taught.

Robin

15

To John Bredin: Point taken. (Note to myself: duh!)

Nevertheless, I do think that inability to provide health insurance for your own children is a factor in poverty. Children of wealthy people have insurance. Children of poor people (and many middle class people) do not. If your child isn’t insured, then develops some condition that requires hospitilization, you’re screwed. As a personal example, my husband and I have started a care home for the elderly, which has required my husband to quit his job. Temporarily, we don’t have health insurance. Naturally, my son suffered a severe and potentially fatal asthma attack Sunday night and was in the hospital for two days. (Children never, ever get sick during working hours or on weekdays.)

Our bill is close to $3,000. Fortunately, we’re able to continue our previous health insurance through COBRA, but we still have to pay out of pocket the $275 deductible, plus the $700 for insurance for this month. We can come up with this money, but many people cannot.

{sigh}

16

Does England and Sweden offer socialized child care? I know that Sweden has so pretty extensive maternity leave laws. Perhaps it boils down to supervision.

17

Yes, federal law requires hospitals to provide “life-saving” care for uninsured patients and all that. It is, however, the simple truth that hospitals routinely merely “stabilize” uninsured or underinsured patients, “streeting” them as soon as they won’t keel over dead immediately. Many of these patients then subsequently die from lack of adequate aftercare. Hospitals also routinely cut corners on patients with no known insurance. It is quite fair to say that an uninsured injured person is at greater risk of morbidity or mortality because of these practices than someone with insurance.

18

I don’t know why I feel compelled to babble. Please disregard.

19

DDG Babble Detector detected no babble. :slight_smile:

Yeah, but once the hospital emergency room has you stabilized, if you don’t have insurance sometimes you’re S.O.L. They’ll address the basic life-threatening condition, the gunshot wound or the broken head, but then they send you home. And sometimes after you get home, the stitches still wet, you have complications that set in that are themselves life-threatening, like blood clots or hemorrhages, that could have been better dealt with in the hospital. But you’re at home, so you have to do another 911 call, and sometimes you don’t survive the trip to the hospital.

Also, if have no insurance and you deliver a baby via emergency room, they give you one night, tops, and then you’re outta there. And sometimes after you get home, the baby turns out to have breathing problems or jaundice that might have been detected if the pediatric resident on duty had had more time to look him over and say, “Hey, let’s keep this one another day and watch him.”

As Holly points out (without babbling), kids without health insurance can sometimes not get the medical care they need. If you know you don’t have insurance, you might be more reluctant to take the kid to the Emergency Room, and so delay prompt treatment. And, again, the Emergency Room will only stabilize him. If he needs ongoing treatment by a doctor (like for asthma), he might not get it if his folks don’t have insurance to pay for at least part of it. Those $65 office visits sure do add up. So you just don’t take him to the doctor, 'cause you don’t have the 65 bucks.

So I think the presence or absence of health insurance ought to be factored in.

20

I’ve had a little sleep, so hopefully I’ll be able to manage a coherent post. Thanks, everyone, for not chastising me.

When I was a nurse in ICU, we did not take into consideration what sort of insurance or lack thereof our patients had when administering care. In fact, we almost never knew how our patients paid their bills; at one time, the mode of payment was printed on each patient label (eg, Medicare, Medicaid, private insurance) and we were so outraged that the practice was immediately discontinued.

Everyone received the same treatment, regardless of financial circumstance. I’m sure our hospital (a privately owned, for-profit institution, BTW) would not discharge people in an extremely dangerous condition due to the risk of liability, although it’s very true that the trend in recent years has been to push for the shortest possible hospital stays.

Nevertheless, people with good insurance do tend to receive better care, overall, because these people have many more resources available to them.

Child mortality is closely tied with poverty, poor housing, etc. I’m reminded here of our neighbors who lived across the street in a duplex; they had three young children and lived in a decidedly unsafe and crowded little apartment. It had one room downstairs, and one room upstairs; the kids slept upstairs. Those kids played with our kids; their parents were wonderful people who were just plain poor. One year ago this month, the mom made the mistake of leaving her cleaning supplies a little too close to the floor furnace, and the home went up in flames.

My husband and I watched in horror as the firemen dragged the children out of the house. The first child was rescued by the father, who ran through the flames to carry him to safety. This boy was already in full arrest; he spent two months in ICU. I don’t know what permanent damage was done.

The second boy was retrieved by firefighters, CPR was begun at once, but he was declared dead at the hospital.

The third child, a little girl who was my daughter’s close friend, was pulled out of the inferno by a fireman. It was clear by the expression on his face and the rigid set of her body that she was already charred beyond hope. I can still hear her footsteps on my stairs and her voice echoing through my house.

I had nightmares about this for a long time and I probably will again, now that I’ve just relived it.

In my town, there is a sharp dichotomy between the ‘haves’ and the ‘have-nots’. The large population of ‘have-nots’ and even many better-off people rely on their kitchen gas stoves to heat their homes, or they have ancient floor furnaces or space heaters. Most do not have working smoke detectors.

Many, many automobile fatalities could be reduced if everyone used car seats and seatbelts for their children, and if these were used properly. One factor in child mortality the link mentioned was large family size. If you have six kids and one vehicle, there is no way in the world you can seat-belt them all properly.

I would be interested in seeing a breakdown of those statistics: how many children die of gunshot wounds vs fires vs child abuse vs drownings, etc.