Trends in opioid-, alcohol-, and drug-related mortality among US children aged 0-4 years: an analysis of the CDC WONDER Database trends, 1999-2023.

Over the past two decades, the USA has observed fluctuating increases in opioid-, alcohol-, and drug-related mortality amongst children under the age of 4. Many factors contribute to mortality, and identifying preventative measures represents a critical gap in public health. This study aims to identify trends in related deaths and highlight potential target areas to combat mortality increases. Data was extracted from the Center for Disease Control and Prevention Wide-ranging Online data for Epidemiologic Research (CDC WONDER) database, and trends in crude mortality rate were analyzed for children ages 0-4 from 1999 to 2023. Results were stratified according to sex, region, race, and age; trends were assessed utilizing Joinpoint analysis software. Overall, crude mortality rates demonstrated an upward trend. Across every census region, there was an increase in mortality, noting the highest in the Midwest region. In nearly every year, rural regions are noted to have a higher crude mortality rate. Male sex was associated with a higher crude mortality rate, and the Non-Hispanic Black or African American population had the largest increase in crude mortality rate compared to other racial/ethnic groups. Conclusion: Complex factors contribute to mortality in this population, with clear disparities across geographic locations and demographic groups. These disparities highlight the need for further exploration regarding the effects of the opioid epidemic in the pediatric population. Integrating preventative measures and educational tools into medical education and healthcare systems across the country represents a notable absence in current practice, and direction for future research.