One of the scariest charts I ever read was in The Economist in 2012. We had just made the family choice to move to New York from The Netherlands. The chart accompanied an article about child mortality, based on a new report. It showed that teenagers are about 50% more likely to die in the US than in Europe, with The Netherlands having the second lowest child mortality in Europe behind Sweden (as usual).
You won’t be surprised that I never shared this report with my family. I comforted myself that 3.1 deaths per 10,000 kids still did not amount to all that much, and that probably the death rate for white kids in affluent families was closer to Europe’s 2.0 per 10,000. I took a deep breath and moved on to the next article.
Both kids having made it safely to 18, and one of them back in Europe, I can exhale now to an extent. And now I can revisit the statistic from a less involved point of view. For it is a damning statistic to US society. Surely one of the best, most basic measures of a successful civilization is how many of its kids it delivers to maturity?
I was reminded of the chart while reading last week’s Economist, which looked at deaths from car accidents, a leading cause of death of young people and especially of young drivers. France has seemingly managed to reduce its car accident death rate by about 30% over the last ten years. Once again the comparators given were Sweden and the US, both places where road deaths have declined only very slowly. 10 years ago France sat about 15% better than the US, and now it is only 15% worse than Sweden. Once again, the US has become an outlier among developed economies.
I witness the difference every time I set forth in my car. There are many contributing factors. The roads are in poor condition with poor lighting. Acceleration lanes often fail to meet European standards. Lane discipline is terrible, with overtaking on either side tolerated. And there are many more reckless drivers on the roads.
Thanks to Vision Zero, the infrastructure related factors seem to have been improved in New York since I’ve lived here. But I believe the dangerous driving has got worse, especially in the last two years, and I can identify two possible causes.
The first is taxis. In most of the world where I have driven, taxis are among the best drivers. They know the roads better and the miles of their clocks have taught them good habits. Here it is the opposite. Most of the clueless driving I observe here is from taxi drivers. My guess is that this is a consequence of Uber and Lyft. There are simply more inexperienced drivers out there, trying too many manoeuvres, getting lost, multi-tasking with GPS and apps, and generally messing things up.
The other reason may be opioids. There have always been a small minority of crazily reckless drivers on the roads in NYC, usually kids, driving over 100mph in heavy traffic, weaving between lanes, often in racing packs. It seems to be a particular bane on Long island. My guess is that the opioid epidemic has increased the prevalence, since now there are more delusional kids out there, sometimes high, always reckless.
I used to think that big cities were less safe than rural areas for driving, due to heavier traffic. But in the US it is different. The bigger cities have lower death rates per mile driven. New York City is one of the safer ones. And, as usual, the south and the red states fair worse than the coasts.
Vehicle deaths account for maybe a third to a half of the difference between the US and Europe in teenage mortality. Most of the rest is about guns.
I can’t really add much to the mountain of print about guns in the US. I confess I simply don’t understand why anyone sane would ever want to be anywhere near a gun, save for recreational hunting. The continuous school shootings are heart breaking, but somehow the prevailing trend in legislation is still to make matters worse rather than better. Perhaps these Parkland kids can somehow change the politics. Something has to.
Of course gun death is much more prevalent in poorer areas, and to a degree I was right to conclude that my kids were not in as much danger as they would have been if we had been moving to the south side of Chicago. But the risks are everywhere, not just deprived areas. As an example, suicide is amount twice as common here as in Europe (except for a few outlying countries). My guess is that the level of suicidal thoughts here is not that different to Europe’s. Actually, it is good to note that teenage suicide is not increasing overall, despite the horror stories about social media. The difference here is probably that more kids have an easier means available to kill themselves when they feel down, namely a gun. Add in all the daft accidents with guns, and you quickly realise that this problem is not limited to fanatic school shooters and gangs.
Playing around on google this afternoon revealed another statistic reflecting poorly on the US, one I really struggle to explain. Infant deaths here, that is deaths before a first birthday, are skewed even higher compared with Europe, so a child is 70% more likely to die before their first birthday here. This is despite all the money spent on healthcare.
Part of the gap must be to do with those without health insurance. But as far as I can tell, that only explains some of the difference. Blacks and Latinos are at greater risk than Whites but not by enough to account for the variation from Europe. Unless there are genetic factors, there must also be worse medical practices here than in Europe, though why that would be I have no idea.
Wouldn’t that be a great, simple, political agenda? Let’s keep our kids alive! And how is it that such a wealthy country has strayed so far away from good practice in this regard. An extended agenda would include not just survival, but offering kids the tools to thrive as adults. That would centre on education, where the US also lags, but not by quite so much.
To be fair, in NYC and other big cities, the agenda is not so far removed from this one. Vision Zero is a laudable program and it is delivering results. Pre-school for all is similarly well envisioned and professionally implemented. Sadly, the rest of the education discussion is swallowed by the politics of teachers unions and charter schools.
But at least locally there is something laudable going on. Nationally, there is nothing. I can’t recall a single comment among the thousands of sound bites from this president that could conceivably move the kids’ death rate closer to Europe’s. Yet the cacophony is so loud that no one seems to call this out, or even notice, or even care. Oh how I wish policymakers and journalists treated these international studies more seriously.
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