Well over one-third of Mississippi’s child deaths in 2015 could have been prevented, according to an annual report released by the State Department of Health on Monday.

The report concluded that of the 590 children who died in Mississippi in 2015, 220 of these deaths could have been prevented by changing either state policies or the practices of caregivers.

In 2015, Mississippi tied with neighbors Alabama and Louisiana for the second-highest death rate for children in the nation, at a rate of 40 deaths per 100,000 children, according to the Annie E. Casey Foundation. This was second to South Dakota, which has a rate of 41 deaths per 100,000 children. The national rate was 25 deaths.

Data on preventable deaths by state was not available.

Monday’s report includes a detailed analysis of child deaths in 2015, the latest year for which data was available, that the Child Review Panel has deemed preventable such as sudden unexpected infant deaths, accidents, injuries, homicide, suicide or undetermined causes.

Of this list, accidents were the leading cause of preventable death in children from birth through age 17, which is the range studied, accounting for 139 cases.

Motor vehicle fatalities were responsible for 83 of these cases — a 54 percent increase over 2014, when 54 children died in car accidents, a trend the report singles out as particularly “worrisome.” This surge in such deaths was most pronounced among children younger than 15 years of age, a finding that suggests adults driving children, and not younger drivers themselves, are responsible.

This is also reflected in national numbers, where car fatalities for all ages rose by 7.2 percent.

“This alarming trend requires the urgent implementation of new state-level preventive initiatives against transportation-related child deaths in Mississippi,” the report says.

Homicides are considered preventable death, and in 2015, 19 children were murdered — a slight dip from 2014 when 21 children were murdered.

Of these homicides, 10, or just over half, were related to gunshots. But another 12 gunshot deaths were either accidental or due to suicide, for a total of 22 gunshot related deaths in 2015.

The report goes on to call gun violence an “American epidemic” and a “growing and urgent public health concern.” The report also urges legislators to pass laws aimed at reducing gun violence and increasing gun safety.

“Many of these deaths were incredibly violent. Some of these deaths were horrifying. None of these deaths should have happened,” the report says.

The report lists several risk factors for gun violence, including the high prevalence of gun ownership, exposure to violent pop culture from early childhood, mental health issues, drug abuse, dysfunctional family relations, economic disparities and improper firearm storage.

Suicides also showed a dramatic increase between 2014 and 2015, rising 100 percent, from eight to 16 deaths.

The total number of all child deaths also increased 13 percent between 2014 and 2015.

Mississippi is notorious for having the nation’s highest infant mortality rate, and 60 percent of all child deaths in 2015 occurred in infants under one year of age. The leading cause among these was suffocation, the panel concluded.

Although infants have been traditionally put to sleep on their stomachs, in the last two decades, the national medical community has pushed to reverse that, educating parents to put children to sleep on their backs in a crib fitted with just a top sheet.

But unsafe sleep practice was far from the only cause of infant death. In fact, deaths related to health conditions that originated in the first month of life rose eight percent between 2014 and 2015. This includes birth trauma, maternal health factors that can affect the newborn, medical disorders associated with the length of gestation and fetal growth.

Of the total child deaths — not just the preventable ones — African American children had a much higher mortality rate than white children, at 101 deaths per 100,000 people versus 68 deaths per 100,000 people. The study does not explain why a difference exists.

The goal of the review process, according to the report, is to identify risk factors
associated with preventable child deaths, improve child death investigation, identify
gaps in prevention, make policy recommendations and share information — all with the ultimate goal of preventing future child deaths in Mississippi.

But not all child deaths have identifiable causes. In fact, between 2014 and 2015, the number of reviewed child deaths with an undetermined manner increased by 175 percent, from 16 cases to 44 cases. During that same period, the unknown causes of child deaths escalated from 13 cases to 34 cases, or 162 percent.

According to the report, the reasons for this dramatic increase remain unclear. But the report says that determining the exact nature and cause of death “can be a complex and difficult task.”

Mortality data is incredibly important, according to the report, but its reliability can be affected by several factors, such as insufficient resources, training or time allotted for performing thorough death investigations.

Due to shortfalls in funding, the key offices that handle Mississippi’s death investigations— the state Medical Examiner’s office and crime lab — are currently facing a steep backlog. At the Medical Examiner’s office, which reviews every potentially preventable child death, waits for finalized autopsy reports can reach well over one year.

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Larrison Campbell is a Greenville native who reports on politics with an emphasis on public health. She received a bachelor’s from Wesleyan University and a master’s from Columbia University's Graduate School of Journalism.Larrison is a 2018 National Press Foundation fellow in public health, a 2019 Blue Cross Blue Shield Foundation of Massachusetts fellow in health care reporting and a 2019 Center for Health Journalism National Fellow.