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Fact check: How have child mortality rates in the USA changed from 2020 to 2024?
Executive summary
From the available analyses, US child and infant mortality fell through 2020 but rose again during 2021–2023, with data showing a measurable uptick in infant deaths in 2022 and evidence of worsening child health across multiple indicators through 2023; no authoritative, nation-wide 2024 mortality totals are provided in the sources given. Multiple studies attribute the reversal to pandemic-era factors and broader declines in child health, and several highlight that US child mortality remains higher than peer high-income nations [1] [2] [3] [4].
1. Strong headline: an apparent reversal after years of progress
Multiple recent analyses show that the multi-decade decline in US infant mortality continued until about 2020 but then stalled and reversed in the early 2020s. National Vital Statistics data reported a 3% increase in the infant mortality rate from 2021 to 2022, with 20,577 infant deaths in 2022, indicating the first measurable backsliding in this period [2]. Peer-reviewed time-series work that extends through 2022 similarly documents a fall through 2020 and an increase in 2022, connecting the timing to pandemic-era disruptions [3]. These consistent signals across administrative and analytic sources point to a clear short-term rise in infant deaths after 2020.
2. What the peer-reviewed trend analyses say about 2016–2022
Researchers using national vital statistics and modeling found infant and neonatal deaths declined from about 2016 up to 2020/2021 and then increased in 2022, with the COVID-19 pandemic offered as a plausible contributing factor [3]. Another comprehensive analysis published in 2025 extended trend estimates through 2023 and reported that infant death rates fell from 6.93 per 1,000 live births in 2000 to 5.44 in 2020, then increased slightly in 2021–2023, underscoring that the post-2020 rise is detectable across datasets and methods [1]. Both papers emphasize temporal correlation with pandemic-era disruptions but differ in causal framing and model specifics [3] [1].
3. Broader child health declines beyond infants
Beyond infant mortality, systematic studies find broader deterioration in child health metrics across the 2007–2023 window, suggesting mortality trends are part of a wider decline. Investigations into US child health report worsening on multiple domains including chronic conditions, functional status, and mortality, with US children more likely to die than peers in other high-income nations for both infants and 1–19 year-olds (rate ratios ~1.78–1.80) in the 2007–2022 period [4]. A 2025 JAMA analysis echoed these findings, documenting declines across indicators and raising alarms that mortality increases are not isolated but linked to systemic health trends [5].
4. National vs global perspective — how US trends fit into the world picture
Global reporting on child mortality through 2024 highlights overall progress worldwide but does not provide a detailed US-year-by-year breakdown in the materials provided; global analyses nevertheless emphasize the need for sustained investment and collaboration to reduce child mortality [6] [7]. Where US-specific data exist, the US diverges from many high-income peers by showing higher child mortality and recent reversals, meaning global gains have not uniformly protected US children from pandemic-era setbacks [4] [2]. This contrast is important: global improvements can mask national backsliding in wealthy countries like the US.
5. Methodology, data limitations, and why 2024 remains uncertain
Available sources provide robust estimates through 2022 or 2023 but do not present authoritative, final 2024 national mortality totals; this gap constrains definitive statements about 2024 changes [4] [1]. Studies differ in methods—administrative NVSS counts, time-series models, and cross-national comparisons—producing consistent directional signals but variable effect sizes and causal attributions [2] [3]. The pandemic’s multifaceted impacts (direct COVID deaths, healthcare disruptions, socioeconomic shocks) complicate attribution and require careful disaggregation, which many reports acknowledge as ongoing work [3] [1].
6. Conflicting interpretations and potential agendas to watch
Authors and commentators frame the rise in mortality differently: some emphasize pandemic disruption as a proximate cause [3], while others situate mortality trends within a broader failure to address child health determinants in the US [8]. Policy advocates may use the data to argue for systemic reforms—maternal and pediatric care access, social supports—while other stakeholders might stress short-term pandemic effects and recovery. All sources are consistent that mortality rose after 2020, but they diverge on root causes and policy prescriptions [1] [8].
7. Bottom line and what to watch next
The evidence through 2023 shows a clear reversal in the US infant mortality trajectory that had been improving up to 2020, with 2022 showing a notable increase and analyses through 2023 corroborating that trend; no definitive national 2024 data are included in the provided sources, so 2024 conclusions remain provisional [2] [1]. Watch for fully processed NVSS reports, peer-reviewed updates extending to 2024, and disaggregated analyses by age, race/ethnicity, and cause to determine whether the post-2020 rise represents a temporary pandemic-era spike or a sustained deterioration [2] [3].