The United States is one of only eight countries where child and adolescent health has improved but maternal mortality has worsened since 1990

According to a new scientific study, the United States is one of eight countries in the world where the reduction of infant and adolescent mortality over a 27-year period has not been accompanied by a reduction maternal mortality.

This divergent trend has also been observed in American Samoa, Canada, Greece, Guam, Jamaica, St. Vincent and the Grenadines and Zimbabwe. The United States recorded the largest increase in the maternal mortality rate, with 67.5%.

"Our findings are particularly alarming because children's health is very closely tied to that of their mother," said Dr. Nicholas Kbadebaum, lead author of the study and badociate badociate professor at the Institute of Metrics and Metrics. of Health Assessment (IHME) of the University of Washington Medical School. "This paradox deserves further investigation in the United States to determine how to prioritize improvements in maternal health alongside those of children and adolescents."

Kbadebaum pointed out that the study also identified uneven progress in the health of children and adolescents over a 27-year period, with inequality increasing between countries with the highest and lowest scores for children. Sociodemographic index (SDI). The IDS, a measure of development, takes into account per capita income, adult education and the total fertility rate of women under 25 years of age.

For example, the results show that the gap between the best and the worst performers has widened. Countries with low IDS and average IDS accounted for 82.2% of all child and adolescent deaths, compared to 70.9% in 1990.

Published today in the international medical journal JAMA Pediatrics, the study covers the period from 1990 to 2017 and concerns 195 countries and territories. This new badysis, part of the Global Burden of Disease (GBD) study, is a global effort to quantify the health of children and adolescents internationally. The results are presented for the age group from birth to 19 years, but also separately for newborns, infants, children and adolescents. The study authors defined newborns as those under 28 days of age, infants such as those under one year of age, children under 10 years of age, and adolescents aged 10 to 19 years. .

The researchers found that today 's children are more likely than ever to reach their 20 years through a substantial reduction in mortality. The deaths of children and adolescents were halved between 1990 and 2017, from 13.8 million to 6.6 million. These dramatic gains are largely due to the worldwide decline in deaths from diarrhea, lower respiratory infections and other common infectious diseases, especially among children aged 1 to 4, who have experienced the fastest of the mortality.

Despite this considerable progress, lower respiratory tract infections, diarrhea and acute malnutrition remained among the leading killers of children and adolescents in 2017. In addition, HIV / AIDS remains an imminent threat to health and the well-being of children and adolescents. countries of sub-Saharan Africa, including South Africa, Zimbabwe, Lesotho, Swaziland, Botswana and Zambia.

With the reduction in communicable disease mortality, many middle- and high-income countries have experienced an increased deterioration of diseases caused by noncommunicable diseases (NCDs) such as birth defects, mental and behavioral disorders, and high blood pressure. ;asthma. Injuries also remain a major cause of early mortality and long-term disability among older children and adolescents in all countries.

"The increasing and growing burden of mental health disorders and addiction among older children and adolescents worldwide," said Dr. Bobby Reiner, lead author of the study and badistant professor at IHME. "As more and more children survive early childhood, already overburdened health systems will have to adapt to the challenge of fighting noncommunicable diseases in older children and adolescents."

Reiner also noted that few countries had shown signs of improving adolescent health over the 27-year period, beyond what was expected with overall gains in societal development.

Additional results include:

• More than half of the 6.64 million deaths recorded in 2017 occurred in infants under one year of age, and 47% of these occurred in the first week of life.
• In a total of 50 countries, the probability of death through self-harm and interpersonal violence increased between 1990 and 2017.
• In all countries of sub-Saharan Africa, neonatal disorders, malaria, or HIV / AIDS were the leading cause of disability-adjusted life years (DALYs), diarrhea, or infections. respiratory tract often being ranked second.
• In 2017, iron deficiency anemia, vitamin A, headaches, driving disorders, neonatal disorders, anxiety disorders, skin disorders, lower back pain, conbad disorders and Depression was the 10 leading causes of years lived with disability in the world.
• YLD rates decreased only slightly between 1990 and 2017 and increased with age.

The study is entitled "Diseases, injuries and risk factors for the health of children and adolescents, 1990 to 2017".

DEATH, BOTH SEXES, 2017

Under 20 years

1. India: 1,299,265 deaths
2. Nigeria: 866,170
3. Pakistan: 421,784
4. Democratic Republic of Congo: 286,991
5. China: 243,609
6. Ethiopia: 232,389
7. Indonesia: 147,791
8. Bangladesh: 143,528
9. Tanzania: 138,382
10. Mali: 113,600

DEATH, BOTH SEXES, 1990

Under 20 years

1. India: 3,399,581 deaths
2. China: 1,629,696
3. Nigeria: 877,069
4. Bangladesh: 654,730
5. Pakistan: 601,805
6. Ethiopia: 471,391
7. Indonesia: 470,377
8. Democratic Republic of Congo: 299,385
9. Brazil: 267,476
10. Tanzania: 188,343

CHANGE IN PERCENTAGE OF DEATHS, BOTH SEXES, 1990-2017

Under 20 – the biggest decrease

1. Serbia: -86.9% (4,839 to 636 deaths)
2. Armenia: -86.6% (3,836 to 514)
3. Estonia: -86.5% (611 to 82)
4. China: -85.0% (1,629,696 to 243,609)
5. Maldives: -84.8% (488 to 74)
6. Latvia: -84.5% (1,066 to 165)
7. Albania: -84.0% (4,070 to 651)
8. Portugal: -83.5% (3,013 to 499)
9. South Korea: -82.7% (14,748 to 2,545)
10. Romania: -82.3% (13,607 to 2,411)

Under 20 – the biggest increase

1. Papua New Guinea: 40.5% (12,624 to 17,736)
2. Vanuatu: 36.1% (238 to 324)
3. Chad: 31.0% (67,124 to 87,908)
4. Central African Republic: 24.3% (21,360 to 26,545)
5. Zimbabwe: 12.5% ​​(28,549 to 32,117)
6. Iraq: 10.8% (40,510 to 44,894)
7. South Sudan: 9.2% (48,460 to 52,897)
8. Qatar: 4.9% (287 to 301)
9. Afghanistan: 4.2% (96,809 to 100,823)
10. United Arab Emirates: 2.8% (1,431 to 1,471)