In 2020, according to the newly released report from the 28th Annual Arizona Child Fatality Review Program (CFRP), 838 children died in Arizona, an increase from the 777 deaths in 2019.
There was a 30 percent increase in the suicide rate, a 41 percent increase in the firearm injury death rate and a 54 percent increase in the motor vehicle crash (MVC) death rate from 2019 to 2020.
The most commonly identified risk factors for suicide deaths were relationship problems (69 percent), access to firearms (37 percent), history of maltreatment (37 percent) and child mental health disorder (37 percent). The most commonly identified risk factor for a firearm injury death was access to firearms (100 percent), with 86 percent involving a handgun. The child MVC and firearm injury mortality rates were the highest recorded by the CFRP since 2012.
Deaths due to natural causes also increased by 3 percent in 2020. There was a 32 percent increase in the substance use related death rate from 2019 to 2020. Among substance use related deaths, poisoning (42 percent) was the leading factor that caused or contributed to the death for children ages 0-17 years. Of the 66 poisoning deaths, 60 were opiate overdoses and fentanyl was responsible for 57 opiate poisonings.
After detailed analysis, the CFRP determined that there were at least 41 deaths in which the COVID-19 pandemic was directly or indirectly related in the child’s death. Twelve child deaths were directly related to COVID-19 in 2020, and 58 percent of these were less than 12 years old. The Arizona Direct COVID-19 child mortality rate was 0.73 per 100,000 children (ages 0-17 years), while the national rate was 0.27 per100,000 children (ages 0-17 years).
Poverty (58 percent) was the leading risk factor among direct COVID-19 deaths. Fifty percent of direct COVID-19 deaths were children who lived in a rural area. Most of the of direct COVID-19 child deaths had no underlying medical conditions. There were 29 children whose deathswere indirectly related to COVID-19. An indirect COVID-19 child death is a death where the child or caregiver experienced changes or disruptions in how they lived, worked or accessed services due to COVID-19. The COVID-19 pandemic was determined to have played a role in these deaths due to decreased access to health services, counseling, childcare, school services and other disruptions due to the pandemic. While only 7 percent of the direct COVID-19 deaths were preventable, the CFRP determined that 97 percent of these indirect COVID-19 deaths could have been prevented.
The data and recommendations included in this report will help provide an understanding of the broader impacts of the pandemic and inform pandemic recovery plans moving forward. The CFRP aims to support prevention opportunities and pandemic preparedness to better support children and families. The mission of the CFRP is to reduce preventable child fatalities through systematic, multidisciplinary, multiagency and multi-modality review of child fatalities in Arizona through interdisciplinary training, community-based prevention education and data-driven recommendations for legislation and public policy.
Arizona is among the first in the nation to report on COVID-19 direct and indirect child deaths. The full report and recommendations are available in the Arizona Department of Health Services’ webpage.
The Arizona Chapter of the American Academy of Pediatrics (AzAAP) is the state's leading professional pediatric organization dedicated to promoting the physical, mental and social health and well-being of every Arizona child. Representing more than 1,100 health care professionals including pediatricians, nurses, dentists, psychiatrists, hospital administrators and other allied health practitioners, AzAAP aspires to the highest standards in providing the latest evidence-based and current recommended guidelines to its members. AzAAP also works year-round to educate and engage lawmakers, parents, school professionals, community caregivers and all who impact the lives of children with the goal of fostering a statewide focus on promoting child health preventive care and wellness. For more information, call 602.532.0137, ext. 402, or visit www.azaap.org.
