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The mortality rate for U.S. children and teens surged to the highest levels in decades between 2019 and 2021, according to research published Monday in JAMA.

Researchers at the Virginia Commonwealth University School of Medicine and the University of Washington reported that all-cause mortality increased 10.7% for people ages 1 to 19 between 2019 and 2020, and an additional 8.3% between 2020 and 2021.

The excess deaths were not caused by COVID-19, but by injuries, including incidents involving firearms, drugs and car accidents, the researchers said.

"Medicine and public health have made remarkable progress in lowering pediatric mortality rates, but the lives they have saved are now endangered by man-made pathogens," the authors wrote.

"Bullets, drugs, and automobiles are now causing a youth death toll sufficient to elevate all-cause mortality rates," they said in the paper.

The researchers argued the increase in pediatric injury deaths is a trend that predates the COVID-19 pandemic, pointing to the "nadirs" of rising suicide rates since 2007, and homicide rates since 2013, and to increasing access to opioids over the last several years.

The pandemic, they said, "did not initiate these trends," but they concede "it may have poured fuel on the fire."

Not everyone agreed. Denis Rancourt, Ph.D., all-cause mortality researcher and former physics professor at the University of Ottawa in Canada, told The Defender the JAMA article "spins" the research findings to make it seem as if the spike in all-cause mortality for children is part of a larger trend linked to broad societal dynamics affecting youth, rather than to the draconian lockdown policies that disproportionately affected the poor and vulnerable across U.S. society.

"The piece is what I would call spin, right up there with the best spin that a politician could make, but it's by three M.D. scientists," Rancourt said. "The spin is disgusting, shameful and misleading."

Rancourt said the paper is peer-reviewed, but added, "I think peer review just means ensuring that the establishment doctrine is communicated with little regard to the actual data."

He said the data in the paper show a large, stepwise increase in mortality rates in 2020 and 2021:
"That should be the basis of trying to interpret this data. In other words, the data clearly tells you that something dramatic happened that caused mortality to increase in this age group, in 2020 and was maintained in 2021.

"That's unambiguous. Something dramatic happened. Okay. So that should be the focus of the article. Instead, what these authors do is they couch this as though it were just part of an increase in the recent historical trend.

"They word it as though this were just, you know, oh, there could be a contribution from whatever happened during the COVID period, but generally this is increasing."
What the JAMA article leaves out

It's what the authors left out of their analysis that's important, Rancourt said in an interview.

For example, the increase in all-cause child mortality during 2020 and 2021 happened alongside a much greater rise in all-cause mortality among other age groups.

In the U.S., among people ages 25-44, there was a 40% increase in all-cause mortality since the World Health Organization announced the global pandemic on March 11, 2020.

For ages 45-64 it was an approximately 25% increase. For ages 65-74 it was about a 30% increase and for ages 75-84 it was just under 25%, according to research by Rancourt and his colleagues at CORRELATION, a nonprofit research organization that conducts public interest research.

"They are talking about the youngest age group where it happens to be the smallest in percent increase," he said, but those numbers can't be understood in isolation from the entirety of the all-cause mortality data.

They also didn't address the fact that the vaccine rollout occurred halfway through the study period and had no positive impact on all-cause mortality, he added.

But perhaps most importantly, Rancourt said, "There is no mention of the fact that this excess mortality that's generally seen for all age groups is highly correlated in the United States to poverty."

He added:
"The Pearson correlation coefficient with poverty for the excess mortality during the COVID period in the United States is plus 0.86, which is a very significant correlation coefficient not normally seen to have such high values in the social sciences or in epidemiology.

"It is an absolutely strong correlation with poverty. Poverty is the main, associated social factor that determines whether or not you're gonna be part of this cohort."
The JAMA paper commented on gender, race and ethnicity, but not economic status. For example, it found the increase in injury-related deaths in 2020 mostly occurred in males.

Non-Hispanic Black individuals made up almost two-thirds of the homicide deaths, while suicides among American Indian and Alaska Native youth ages 10 to 19 were twice as likely as those among non-Hispanic white individuals in that age group.

Based on those statistics, the authors end the paper saying that "research and policy efforts to address the underlying causes — eg, depression, suicidality, opioid use, systemic racism, widening inequities, societal conflict — are urgently needed, as is system redesign to provide help for people affected by these conditions."

Rancourt said when they point to those underlying causes, they're "just talking from a script, they're not actually showing data to support what they say.

He added:
"There's the, 'of course, you know, in our point of view, it's known that there's structural racism in the United States, and therefore that must be part of the cause.'

"In other words, they're conveying points of the dominant ideology. They're not conveying the result that comes from empirical measurements of what's going on.

"And that's another disturbing aspect of a paper like this. It's a political paper rather than being scientists limiting themselves to what you can reasonably conclude from hard data."
For example, he said, the paper blames "bullets, drugs and automobiles" for increasing death rates.

According to the researchers, "Current efforts to understand gun violence, overcome political gridlock, and enact sensible firearm policies are not progressing with the speed that pediatric suicides and homicides require."

But, he said, those are the vectors that cause death, not the underlying cause. "The problem is this: It's not the firearms that are causing the deaths," he said, adding:
"The fundamental cause has to be the government's assault on people and families and institutions during the COVID period, which dramatically increased psychological stress and social isolation of adolescents and children and on adults ...

"This is absent from the paper, there's not even a mention of it."
Canadian researcher and Substack writer Jessica Rose, Ph.D., in an email to The Defender, agreed that guns aren't the underlying cause.

"It's not gun violence that needs to be understood, in my opinion, it's the kids themselves," she said. "There likely are sensible firearm policies enacted, but if you're in a certain destructive mindset, and likely on readily available drugs, then no amount of sensible anything is going to matter."

Kids need "better circumstances and supportive communities," Rose said.

Rancourt said lockdown policies disproportionately affected the poor, the institutionalized and the mentally ill, who were the most vulnerable.
"This is an article in a major medical journal that's supposedly addressing a major problem and doesn't even mention or try to explore the question of who died?

"Who are the people in this cohort that actually died? Where do they live? Under what social conditions? Under which family conditions? ... There's no mention who they are. It's just a general population that you imagine.

"But you never ask the real question, which a social scientist and someone who's really concerned about public health must ask, which is where are these people dying and who is dying under what circumstances? What are the social groups that we're talking about? Are they institutionalized people? Are they suffering from various disabilities?"
Instead of recommending further research on these questions, he said, "The only thing they recommend is that we eliminate bullets, drugs and automobiles. I mean, come on. What kind of a crazy recommendation is this?"

Rancourt added:
"You cannot address underlying causes without looking at the granularity of the human condition, because it is specific people who are dying, who are mostly at risk because of their circumstances.

"And if you're not doing that, you're not doing medicine, you're not doing science, and you're not addressing the problems.

"If you have to talk about homogenized statistics then never use the term 'underlying causes.'

"If you cannot go in and look at what is actually happening, and you don't have a plan to study that, and you don't have a recommendation that it should be looked at, then you should not be allowed to use the term 'underlying causes,' because those are simply vectors."