A significantly higher number of children died in Arizona in 2020 compared to the year before, and researchers found many deaths were either directly or indirectly attributable to the pandemic.
The newly released 28th Annual Arizona Child Fatality Review found 838 children died, an increase of about 8% from the 777 deaths in 2019.
The death rate from COVID-19 was 0.73 per 100,000 children, substantially higher than the national rate of 0.27 per 100,000 children.
Arizona has the second highest number of childhood deaths due to COVID-19, second only to Texas, said Dr. Sean Elliott, an emeritus professor of pediatrics at the University of Arizona’s College of Medicine who specializes in pediatric infectious diseases.
Most of 12 children in Arizona who died of COVID-19 infections in 2020 were otherwise healthy children from rural parts of the state where access to health care and services are lacking, researchers said.
“Children who lived in rural areas and were poor were more likely to have died of COVID,” said Dr. Mary Ellen Rimsza, who oversees the annual fatality review as part of the Arizona Child Fatality State Team. Findings are shared with the Arizona Department of Health Services and the Arizona Chapter of the American Academy of Pediatrics in an effort to reduce child deaths.
Poverty, a reality in 58% of those COVID-19 deaths, was the leading risk factor among the direct COVID deaths of children in Arizona, and 50% of those deaths were among families living in rural areas.
Nearly all of the direct COVID-19 child deaths involved children who had no underlying medical conditions, and more than half of the children were under age 12.
The deaths considered indirectly related to COVID-19 include children who died from suicide, firearm injuries and motor vehicle crashes, which accounted for much of the increase. The report found a 30% increase in the suicide rate, a 41% increase in the firearm injury death rate, and a 54% increase in the motor vehicle death rate.
Many of these indirect deaths happened because children couldn’t attend school and were left unsupervised while their parents worked, or they happened because children isolated at home began to have significant mental health challenges, Rimsza said.
A common factor in both suicide deaths and firearm deaths was access to firearms, and 86% of those involved a handgun, said Elliott.
“This is especially concerning as a parallel trend in the COVID-19 pandemic has been mental health diseases, especially including depression, anxiety, and suicidal thoughts,” Elliott said.
“Pediatricians, emergency department physicians and other front-line providers fear these numbers will only get worse for 2021, as the pandemic continues to create social isolation and prevent access to preventative health care,” he said.
Other findings:
There was a 32% increase in the substance-use death rate from 2019 to 2020. Among the 66 substance-use deaths, which are considered poisonings, 60 were opiate overdoses and fentanyl was the drug in 57 of those opiate poisonings.
There was a 5% decrease in abuse/neglect deaths from 2019 to 2020. Of the 95 children who died from abuse or neglect, 66% had prior involvement with the Department of Child Safety and, in 11% of these deaths, the families had an open case at the time of the child’s death. Roughly 73% of children who died of maltreatment were under 5 years old.
Rimsza and Elliott both emphasized how badly the pandemic is harming children overall, whether by illness, isolation or by losing a parent or grandparent to the virus.
“The importance of vaccination can’t be over-emphasized,” Rimsza said. “The key to ending the pandemic is increasing our vaccination rates.”
Elliott said the report “serves as yet another alarm bell warning of further fatal consequences of a persistent pandemic, and hopefully will encourage those vaccine-hesitant people in our community to get COVID-19 vaccinated, if not for their own safety and health, then for the sake of Arizona’s children.”
