Why Americans Are Dying So Young

A memorial of white crosses is erected to the children killed at school in Uvalde, Texas at the starting point of the March for Our Lives protest on June 11, 2022 in the Brooklyn borough of New York City. Across the country in various cities, thousands are gathering to demand for meaningful gun laws following the recent shootings from Uvalde, Texas, to Buffalo, New York. The March For Our Lives movement was spurred by the shooting at Marjory Stoneman Douglas High School in Parkland, Florida, in 2018.

By Laudan Aron and Gavin Yamey

Life expectancy in America fell sharply in 2020. It fell again in 2021. The COVID-19 pandemic certainly played a role, but that’s not the whole story. During this same time period, eight of the ten leading causes of death also increased. Even maternal and child and adolescent mortality increased. In August 2022, federal health officials released new data showing that across all demographic groups, Americans are dying younger.

Ten years ago, a landmark report called “Shorter Lives, Poorer Health” documented for the first time a widespread “U.S. health disadvantage,” a shortfall in the health and survival of Americans relative to other high-income countries [Aron was the report’s study director]. On some measures, such as violent deaths among males aged 15-24, the divergence from other rich countries began growing as early as the 1950s. The report showed that the U.S. had the lowest life expectancy among peer countries and higher rates of injury, illness, and death from dozens of causes. Evidence of this disadvantage was found for young and old, rich and poor, men and women, and Americans of all races and ethnicities.

Another seminal report released in 2021, called “High and Rising Mortality Rates Among Working-Age Adults,” showed that U.S. mortality rates have been increasing in mid-life (ages 25-64), the prime years for family formation, childrearing, caregiving, and employment. More surprisingly the rising mortality among U.S. children and youth between 2019 and 2021 represents a profound crisis. Although not predictive of future mortality conditions, which are likely to change, current survival rates mean that one in 25 American five-year olds will not reach their 40th birthday.

The reasons behind these disturbing trends are many, and one might argue, uniquely American. Here are five:

A poor start in life for many young Americans

Beyond the latest data on rising pediatric mortality rates, it is clear that the U.S. is failing its youngest citizens on multiple fronts. For at least a decade now, cross-national comparisons of child and adolescent wellbeing in rich countries show that the U.S. ranks at or near the bottom on most measures. Such measures include material wellbeing, health and safety, behaviors and risks, education, housing, family friendly policies, and social protection. Further, careful analyses of overall levels of social spending by country show that, compared to other high-income nations, the U.S. is distinct in how it spends, not how much it spends. American spending is much less redistributive, with fewer benefits going to children, families, and the disadvantaged. In addition to high rates of infant and maternal mortality, the latest data show that U.S. children are in the midst of a deepening mental health crisis, with increased access to firearms and opioids driving up rates of suicide, homicide, and overdoses. In 2020, firearm-related injuries surpassed motor vehicle crashes to become the leading cause of death among young Americans ages 1-19.

A dysfunctional and costly healthcare system

Among the many factors driving health and survival is healthcare. The U.S. has long been known for having one of the most complex, fragmented, and expensive healthcare systems in the world. For millions of Americans, quality, affordable, accessible healthcare is simply out of reach (and the uninsured are more likely to die young than the insured), or it is effectively unavailable, or disappearing due to political pressures, as in the case of sexual and reproductive healthcare. The U.S. healthcare system, its high costs, and its poor health outcomes, start to “make sense” when viewed through a business case lens, and its optimization of revenue and profits, rather than health and wellbeing. As Dr. Elisabeth Rosenthal, editor-in-chief of KFF Health News, says about the U.S. medical market, “a lifetime of treatment is preferable to a cure” and “prices will rise to whatever the market will bear.” It should come as no surprise then that that the U.S. healthcare system is one driver of the poor health and survival of Americans, many of whom are uninsured, underinsured, medically undertreated or overtreated, distrustful of the system, and drowning in medical debt. Finally, the astounding $4.3 trillion (or $12,914 per person) spent annually on healthcare in the U.S. far exceeds spending in other countries around the world, and crowds out other social investments that matter to human development, protection, and flourishing.

Societal systems that undermine wellbeing and accelerate inequality

Beyond healthcare, many other aspects of life and the policy-driven systems that underpin them are compromising the health and wellbeing of Americans. Lives are diminished and lost because of the U.S. approach to food and nutrition, housing and civic infrastructure, education and training, employment and entrepreneurship, crime and safety, economic and community development, credit and financial services, social protection and safety nets, and environmental conditions. Deep dives into most of these systems often reach two strikingly consistent conclusions: (1) they are perpetuating or accelerating inequality, and (2) they are working as designed, meaning their seemingly perverse effects are a feature, not a bug. These systems reflect both historical factors and ongoing choices by policymakers and private sector interests. The good news here is that other countries are making different choices, which (in theory) means the U.S. can too. We can rein in negative commercial determinants of health (private sector activities affecting health) and instead build genuine care systems and adopt a health-in-all-policies agenda, defined by the CDC as “a collaborative approach that integrates and articulates health considerations into policymaking across sectors to improve the health of all communities and people.”

An inadequate policy response to growing inequality and precarity

The large and growing U.S. disadvantage in health and survival is, in part, a reflection and accelerant of economic inequality and precarity. U.S. income and wealth inequality is high, has risen substantially over recent decades, and exceeds levels in other advanced democracies. Some might argue that high levels of inequality are acceptable as long opportunity and socioeconomic mobility remain high. But such opportunity and mobility have seen a dramatic reduction in the last half century, with only half of children today earning more than their parents did, compared to 90 percent of children born in 1940. Equally importantly, Americans greatly underestimate actual levels of wealth inequality and still prefer that wealth be more equitably distributed. The conditions producing such high levels of inequality — and ways of mitigating or reversing them — are of course matters of public policy. In addition to more progressive tax and transfer policies, which also affect many middle-class entitlements, any policy that expands access to the social determinants of health – nutrition, education, employment, housing, transportation, safety, justice, caregiving – will in turn improve population health and wellbeing. Policymakers influence their availability, accessibility, and affordability. One reason other high-income nations outperform the U.S. on health and survival is because the many resources that matter to health and wellbeing are distributed (or redistributed) more equitably and they have stronger systems of social care and protection.

Structural racism, racial capitalism, and their attendant injustices

Although the U.S. health disadvantage affects all Americans, even privileged ones, the most marginalized communities have always paid a much higher cost. The latest data on U.S. life expectancy by race/ethnicity confirm this and are a powerful reminder of the ongoing influence of systemic racism in the American landscape. As Dr. Camara Jones, past president of the American Public Health Association, explains, racism is “a system of structuring opportunity and assigning value based on the social interpretation of how one looks (what we call ‘race’), that unfairly disadvantages some individuals and communities, unfairly advantages other individuals and communities, and saps the strength of the whole society through the waste of human resources.” By unfairly structuring opportunity and allocating access to the resources that matter to health and survival, structural racism, racial capitalism (the interlinkages between capital accumulation and racial exploitation), and other forms of injustice directly influence population health. It is critical to acknowledge these root causes of the U.S. disadvantage in health and survival, rather than fall prey to overly simplistic narratives that blame individual people and places for their poor health. Ostensibly race-neutral policies and practices often perpetuate an enduring legacy of racism, protecting the health of some communities at the expense of others. One fascinating example is when the Florida Department of Agriculture banned sugar growers from burning sugar cane “when the wind blows east” in an effort to protect wealthier, whiter communities from their toxic fumes.

Declining life expectancy in the U.S., and especially rising deaths rates of children and adolescents, should be a loud wake-up call for the nation. The more hopeful but still urgent news is that we can change this reality: conditions of life and death are direct reflections of our values and priorities and the policies we choose to govern our communities and the nation as a whole. If we are to enjoy a level of health, wellbeing, and survival similar to those in other advanced democratic nations, Americans will need to make a fundamentally different set of policy choices.

Complete Article HERE!

How do I navigate grief in my twenties?

By Julia Presenza

Growing around your grief.

In your twenties, you’ll find some of your closest friends nursing hangovers from overindulging in vodka Red Bulls, overanalysing text messages and hoping no one saw them doing the walk of shame. On the other end, others are getting married to the loves of their lives, buying houses and having babies. We’ve all had these conversations before – everyone around you seems to be in different stages of life and needless to say, everyone is doing their best.

Still, there’s no how-to guide on ensuring you’re doing it all correctly. It goes without saying there’s no handbook outlining what to do when something major comes around and blows up your life as you know it, especially when it’s a life event you weren’t even considering could happen this early on.

Deep down in the back of our minds, we know eventually, one day in the far future, we will all have to deal with the loss of someone close in our lives. Call me naive, but dealing with grief wasn’t something I thought I’d have to add to the list of worries in my twenties. It seems almost unfair to be entering a point in life where I’m still trying to perfect the schedule of which night I should wash my hair and fake tan, to be then hit with the Earth-shattering experience of dealing with death.

Over recent years, I’ve had personal experiences navigating grief, from losing my dad to losing close friends of family members. As many self-help books will mention, the grieving process will be different for everyone. It’s one thing to try and navigate your own grief, and another trying to be the support person for someone else.

I experienced constant guilt of feeling someone else’s pain but never knowing what it actually felt like for them. I have three sisters, along with my mum, and while we all were experiencing my dad’s loss together, it was very apparent we had different ways of dealing with grief. With many questions circling in my head, I spoke to Carly Dober, psychologist and Headspace App’s Mental Health Expert, to get clarity.

How to navigate losing someone close to you while also being the support person for someone else

Carly acknowledges this can be incredibly difficult to navigate but states it’s important to honour and give your feelings of grief and loss enough time and attention. Often, people will jump into caretaker mode as a distraction from their pain but this can prolong the process of grieving for ourselves. Grieving is a shared effort. She mentions we can often find solace in others who are in pain, too. It’s important to be there to support your loved ones through this difficult time but also lean on your friends and networks so you’re also cared for and fully supported.

How to be supportive when multiple people are grieving the same person differently

Carly says this is very common, “We each have unique relationships with people, so how we will experience their loss is also unique. I’d recommend showing your support but also not lying”. Saying things like, ‘I know you had a very close relationship with them and I’m so sad that this is happening to you’, ‘How can I best help you through this?’ and ‘What do you need from me right now?’ are ways of showing your love for the person grieving while also honouring your relationship with the deceased.

How do you cope with the loss of different people within a short time?

Unfortunately, life isn’t fair. Carly recommends seeking support from a mental health professional early. Losing people is difficult enough, and the chronic stress of losing multiple people in a short time frame can be very destabilising. It’s encouraged to avoid any tempting but ultimately unhelpful coping strategies (such as self-medicating with drugs and alcohol) with helpful ones (such as routines, movement and rest).

Lean on close relationships, be social in whatever capacity you can and engage with pets and nature. Carly suggests clearly expressing your needs to others is also helpful in coping with the loss of multiple people.

What should you do about feeling guilty about moving on and not wanting to be sad anymore?’

Carly points out grieving can make us feel like life will never be the same again. Accepting that life goes on despite the difficulties can be the most challenging truth. Carly’s words were reassuring as she clarified that moving on from losing a loved one doesn’t mean we loved them or are hurting any less. It simply means we’re adapting to life without them and growing around our grief. Grief is a natural part of life; many of us experience it from a young age, while others learn this lesson later in life.

Just like the journey of navigating your twenties, there’s no correct or incorrect way to grieve. It’s crucial to express your emotions with those close to you and give yourself time and understanding to ease you through the difficult moments in life. It’ll make the grieving process a little less painful.

Complete Article HERE!

Surviving the Death Talk With My Kid


The first time death came up, my son was asking about an old photo of my dog Jupiter. Jupiter, an American bulldog I rescued from L.A. just before my now-husband and I moved in together, died just a couple of months before my son was born. For several weeks I cried, unmoving, on the sofa. Agonizing over my loss and worried that my joy about giving birth was being overshadowed by my sorrow, I was nervous that heartbreak was seeping deep into my bones.

When he asked, I was so excited to tell my son, who was 4 at the time, all about this amazing dog’s life. It turned out he was far more interested in his death.

Like so many other hard conversations we’d had before, I initially tried to be as matter-of-fact about dying as I could be. I described how Jupe had been in a lot of pain, that the doctor said he was likely very ill, and that the kindest thing we could do for him would be to relieve him of that pain as peacefully and quickly as possible. “What was he feeling when he died?” my son asked. I wasn’t sure how to answer. In that awful, quiet moment, I only knew how I felt, and I was shattered. So I told him truthfully that I didn’t know what it feels like to die, but as I’ve done a million times before with things I’m not sure of, I promised we could get some books from the library and try to find out. But I knew deep down he wasn’t interested in hypotheticals and esoteric explanations about death. He wanted to know it, to see it up close and poke at it in the same way he investigated the bugs in our backyard.

The books at the library were unsatisfying, but he didn’t have to wait long to find out what the real thing felt like. The next year for our family was anchored by death, and the “what ifs” were left far behind.

Just a few months after our conversation about Jupiter, my husband’s father died. He flew home to be with his family in the very darkest part of the morning, and I sat up waiting for the sun to rise, hoping the light would help me make sense of what was happening, both for me and for the kids. My daughter was just a toddler, but my son — he was that very curious, very aware 4-year-old who would wonder where Daddy had gone and why.< This time I didn’t feel the need to explain as much; I just let him see for himself how death reshapes the room as my grief filled our tiny home like my tears were a million heavy glass balls. Loss was no longer something atmospheric, it was grounded by this now-empty hole in my husband; it became a window through his heart that he tried to hide but couldn’t. Now that death was suddenly tangible, we started talking about it a lot more, but it wasn’t until my mother-in-law died eight months later that the real, unraveling questions about it came. “Does everybody die?” Yes. “Will you and Daddy die?” Someday, yes. “Will I die?!” Yes, but … “When?” Not for a long time. “Is there anything after we die?” I don’t know.

Those were hard. I wanted to tell him the truth — I think kids are owed at least that much. My husband actually had to stop me from answering “When will I die” with something a little too honest. I just felt he deserved at least my attempt at the full picture of what it means to be alive, of the true price of this incredible experience. That a long life is not promised, it’s only what we hope for, and when and how we die is something no one knows. That death is arbitrary and often meaningless, and how finite our lives really are. Would I be denying him something fundamental by not making all of those things clear? Or was it actually cruel to burst that bubble of innocence for a kid who adamantly believes in Santa and the Easter Bunny? So instead I told him how lucky we are that before we die we get to taste mangos and read our favorite books. That we get to swim in the salty ocean and collect smooth, green glass on the beach.

I worried a lot that first year if I’d been too forthcoming. I didn’t want him to feel burdened by this idea of loss, and I didn’t want him to be afraid. But I also wanted to offer an explanation for why it sometimes felt like the roof of our house was sagging under with grief. I remember when my own dad’s dad died, I was quite a few years older than my son, but my parents shielded my sisters and I from what was happening. All we knew was that suddenly everything felt different around the house and our once stoic dad was felled by a pain we couldn’t understand. I thought and still do think when the emotional tenor of the household changes so dramatically and instantly, it’s important to let everyone know why. Especially since the aftermath of death can feel like a punctuated silence. You’re not sure what to say or how to say it; grief can feel invisible, so naming it, talking about it is a necessary flare to send up, to be clear that this house is in mourning.

I reminded myself of what a privilege it is to watch each other grow and that in the inevitability of death is also a promise to relish life.

Sometimes it felt like he was prodding at us like a couple of worms he’d dug up, seeing which questions would make us recoil or squirm. He often recited that his grandparents had died like it was an animal fact or something he’d learned at school, as a reminder to himself that yes, something had changed this year, we really were different.

>The next summer, my son got really into space. We started talking about all the different galaxies and planets and stars, the bigness of everything around us and the smallness of us. And I told him, a few weeks after the memorial for his grandparents, that he, too, is made of stardust, that part of what’s out there is also in both of us. He loved the idea of being a part of something so huge and the thought that when you died, you might still leave something behind. I knew he’d been seeking that kind of comfort since our very first conversation about it, but I couldn’t promise him something I didn’t know to be true. In stardust though, I was finally able to say with confidence that after we die, we don’t just disappear.

It’s been a couple of years now, and we don’t talk about death as frequently. Some light has come back into our house, and I’ve noticed that my son isn’t as scared of the idea anymore. He understands how momentous death can be, but along the way, because we always answered his questions openly, honestly, and with care, it has become something normal. It’s as much a part of life as anything else, and he’s seen that firsthand now. The only thing that has really changed is that he won’t let me kill bugs in the house anymore because he says they deserve a long life too.

Complete Article HERE!

‘I see the world through corpse-colored glasses,’ says popular mortician, author and YouTuber Caitlin Doughty

— Caitlin Doughty will be in Fargo to speak at Thursday’s Humanities North Dakota event, A Brave Conversation About Death.

Author and YouTuber Caitlin Doughty incorporates humor and history to discuss death and the funeral business.

By John Lamb

When she was eight years old, Caitlin Doughty saw a child fall to its death at a shopping mall and was immediately ushered away and encouraged not to talk or think about it.

“That was a pretty defining moment of my life. I was scared of death,” Doughty says. “We didn’t have the vocabulary for it, the safe area to hold fears. I just had to deal with it.”

Caitlin Doughty’s first book, “Smoke Gets in Your Eyes and Other Lessons from the Crematory”.

She may have not had the means to express her questions and concerns as an 8 year-old, but 30 years later she’s written three books and created a popular YouTube series all about death.

The mortician, author and YouTuber is the guest of Humanities North Dakota for a sold-out event Thursday night at the Avalon Event Center.

So what is, as the event is called, a “Brave Conversation About Death”? Doughty says she will come warm up the crowd, plant some food for thought on the topic, then leave the stage to let the audience talk among itself about death. She’ll then return to the stage and follow-up with a discussion.

“If you grew up in America, we don’t have death literacy, a safe way to talk about death. We were never taught how to do it,” she says, though she adds that over the last decade, things have gotten better.

“With the internet, people are not comfortable not knowing something,” she says.

In the mid-2000s she wanted to learn more about the funeral industry and got a job in a crematory then attended school for a mortuary science program and graduated as a certified mortician.

Her real work had just begun. Doughty saw things in the funeral industry that could be changed and started The Order of the Good Death, which advocates for reforming attitudes and practices around death, funerals and mourning.

In 2012 she started the YouTube series “Ask a Mortician,” which features her addressing questions people may have about death and funerals in an often entertaining way. The show quickly attracted a following among the general public and now has 1.96 million subscribers, thanks to episodes like “Morbid Minute: Coffins vs. Caskets” and “ Preparing Severely Decomposed Bodies for a Viewing”.

Between the YouTube videos and her books, “Smoke Gets in Your Eyes & Other Lessons from the Crematory,” “From Here to Eternity: Traveling the World to Find the Good Death” and “Will My Cat Eat My Eyeballs? Big Questions from Tiny Mortals About Death” Doughty has developed a following. She’s heard of people dressing like her for Halloween (“The hair is low hanging fruit,” she says, referring to her signature dark bangs) and even had a drag queen parody her in a video.

“I think I have such a specific advocacy that there’s not a cult of personality,” she says, adding that followers who share her stance on funeral reform are called “Deathlings”.

Still, the segments drew criticism from the old guard in the funeral industry.

“There was discomfort and anger that I’m doing it in this medium and talking about a different future for the industry,” Doughty says. “Most funeral directors believe that the way they provide for the families is the right way.”

But Doughty says changing some practices can help us have a better experience with death and mourning. In particular, she feels the family should have the option to be more involved, mostly by spending time with the deceased.

“For so long we’ve been trained to call the funeral home as soon as someone dies so they can take the body away,” Doughty says. “In reality, death is not an emergency. Your mom is dead now and will still be dead in two days. You’re allowed to take the time you need to process. Being present with a dead body is the simplest and scariest thing to do, but without fail people have an incredible experience.”

She adds that with the exception of an extremely rare case like someone dying of Ebola, “it’s perfectly safe to be around the dead.”

People may wonder what those in the funeral industry were like as kids and Doughty says she wasn’t so different from others her age, though she was a bit of a goth kid.

“A lot of funeral directors held funerals for their pets. That wasn’t me. I wasn’t morbid. I wasn’t Wednesday Adams,” she says. “I was always interested in death as a cultural thing. I see the world through corpse-colored glasses.”

So what does someone who spends all of their time talking about death have planned for her own funeral? While she’s made some plans, she’s still undecided about what will happen to her body. For years she’d wanted a simple, green, or natural burial, to be wrapped in a sheet and buried in a hole in the ground to allow for easier decomposition. After learning more about the practice of human composting, she’s becoming more interested in that.

“I definitely want people to spend time with my dead body in my own house,” she says. “Put flowers on my body, have something to eat or drink and just hang out with me.”

Complete Article HERE!

How to talk to your kids about Death

— An age-by-age guide

Talking to your child about death can be daunting, especially when you are also grieving.

By Kelly Fradin

As a pediatrician and a parent myself, I often hear from families in times of need. A child’s beloved grandparent died after a struggle, a child’s father died in an accident, a child’s teacher or friend died unexpectedly, or even a beloved pet dies, and I get a panicked call.

As parents, we want to protect our children, but we also want to raise them to be prepared for life’s realities. While talking to kids about death is hard, it’s important. And we can explain death in a way that’s developmentally appropriate while minimizing the trauma and fear our children experience.

Mom talking to daughter, both somber

Get ready to talk to your kids about death

Before diving into a discussion, consider your own emotional state. Are you feeling ready to discuss the death? Do you have all the details yet? While you will never look forward to sharing upsetting news with your child, it’s important that you feel prepared. 

On the other hand, this isn’t a talk you can put off forever. Even if they can’t explain it, a child knows when there has been a tragedy. Nonverbal communication, like body language, distractedness and tears, cannot be hidden from our observant children.

And kids have big imaginations. It’s better to tell them the truth than to let them imagine the worst.

Get help if you need it

Sometimes a grieving parent is not in a mindset to support a child’s needs. If you are in this difficult space, ask your community to step in and care for your child until you’re better able to do so. Prioritizing your own well-being in these moments is one of the best things a parent can do.

Don’t be afraid to cry

Many parents fear falling apart in front of their children and showing their grief. I think this fear is largely unfounded. We want our children to know that big feelings are okay. Crying in front of your child will not traumatize them.

In fact, allowing them to support you in your sadness can be helpful because it’s an opportunity for connection.

Choose your words thoughtfully

When you are ready to talk to your child, choose your words carefully and do not hesitate to say you’re not sure. We don’t want to use euphemisms for death like “sleeping” or “crossing a bridge” that might confuse a child.

We also want to reinforce a child’s sense of safety and anticipate that they may need reassurance that they are okay and the other people they care about are okay.

Age-appropriate ways to talk about death

As we dive into considering death by age, also remember that children develop at their own pace and children’s cognitive and developmental stage may not match their chronologic age and that’s okay.

Mom talking to daughter, both somber

Children under two or children who are developmentally pre-verbal

Be upfront, even with toddlers

Children in this age bracket may not be able to fully understand death and loss. However, when someone in their orbit dies they still deserve to know about it, particularly if it disrupts their routine. Using short declarative statements “Nana is not coming because she died” and not going into too much detail would be advised.

Consider your spiritual beliefs

When your children are young, it’s a great time to consider your values and beliefs and discuss them with your coparent. If you are religious or were raised with religious beliefs, decide if you’ll be sharing those with your child.

Talk about death in general

Little ones can learn about death through nature. Dead plants, dead bugs, or even roadkill can be relatively benign opportunities to expose children to the concept of death.

Many parents try to avoid talking about death when it’s not an immediate issue, but it’s a lot easier for a child to confront the death of a plant or even an animal than the loss of a loved one or another human being. Talking about these kinds of deaths is a good way to introduce the topic.

Children three to eight

Prepare for lots of questions

Children in this age group can generally understand death and may ask a lot of questions. Developmentally, it’s normal for them to fixate on new information they’ve learned.

This can translate to a child who never used to talk about death talking about death a lot, even up to 10 times a day. This age group will also draw pictures or play games about death as a way to process this new knowledge.

Parents often worry that an ongoing focus on death is a symptom of trauma—and it can be. But thinking about death a lot when it’s a new concept or someone you care about has died—even for weeks—is also a normal adjustment reaction.

Younger children can have magical thoughts about death, that maybe it will be reversible or that perhaps thoughts can cause death. Sometimes hearing their thoughts can help us target what information we share.

Show them that it’s okay to talk about death

Many parents find their children’s questions about and focus on death difficult, especially when grieving themselves. As uncomfortable as it is, we want to teach our children that talking about death (or any hard thing) with their parent or supportive caregiver is welcome.

We may need to discourage talking about it in socially awkward situations such as telling strangers at the grocery store, but we do not want to teach them that death and anxiety about death are totally taboo. If we do, they may continue to have questions and worries about death and feel alone.

Talk about death in general

If a child this age isn’t experiencing an acute loss, it can still be a good idea to introduce the concept of loss, both to prepare a child for the inevitable experience or to build empathy and understanding.

Look at books like The Invisible String for kids under five. For older children, many movies and books have death involved in the storyline. This passive exposure is a safe way to start the conversation. Talking to your children about the deaths in books or movies may feel safer for them because of the distance, but still may trigger a lot of questions.

dad talking to son on a dock overlooking a lake

Children nine and up

Let them seek support from friends

Children in this age group may be nearly adult-size on the outside, but in some ways, their budding maturity can make them more fragile. They are less likely to ask a lot of questions and more likely to internalize a lot of worries.

Parents of children this age who grieve should also understand that their child may not come to them for support. Tweens and teens often want to spare their parent and look to their peers instead.

Make sure they have someone to talk to

If your child withdraws or doesn’t want to talk to you about the loss, the first question should be, “If you’re not talking to me about it are you talking to someone else?” Friends, parents of friends, teachers, coaches and school counselors can all be part of the team supporting your child’s grief.

Sometimes a heads up for these important people in your child’s community can help them to be more empathetic and receptive to supporting your child. It’s best to be clear about what you’re asking, “My child is grieving a loss, so I would appreciate it if you could check in with them.

On the other hand, privacy matters to children too and taking a break from thinking about their loss can be restorative.

For some children, it may be better to say “My child is grieving a loss and has a lot of people speaking with them about it. Please don’t feel like you have to say something or check in, but I wanted to let you know in case they bring it up or if you see something that has you concerned in any way.”

Give them a sense of control

Regardless of your child’s age, after you inform them of a loved one’s death, you want to leave them with feelings of safety and agency. What that means is acknowledging that while they may feel terrible, it’s okay to be sad and things will get better. There will be happy days and things to look forward to despite your tragedy.

To encourage a child’s feelings of control over the situation, sometimes a project like a memory box or a special card or photo for a loved one who may be hurting can be helpful.

For older children, advocacy can be healing in addition to potentially making positive change in the community, connecting with others who have lost loved ones for the same reason can make them feel less alone in their grief.

Every family’s take will be different

Undoubtedly every family is unique in how they consider loss. Our own upbringing, values, religion and culture will determine the words we choose. But death is universal and an inevitable part of life. When connecting with your child to teach them about death remember that there is no one perfect way to do it.

What’s important is to be authentic and connect with your child to talk about it in a way that makes sense to you. As with grieving adults, grieving children can have an unpredictable course, with holidays, songs, places, and memories often causing more sadness weeks or months after a death. Continued check-ins and connection can help a child feel safe and supported in these moments.

Death is an ongoing conversation

If you’re not acutely in a loss and still trying to teach a child about death, just as with other topics it’s often not just one conversation, but rather a series of small conversations where your children will learn and understand more.

Great resources for teaching kids about death

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Rise in infant deaths hits Black families hardest, study finds

Black babies experienced the highest rate of sudden unexpected deaths in 2020 and nearly three times the rate of deaths among White babies.


A new federal study highlights a striking racial disparity in infant deaths: Black babies experienced the highest rate of sudden unexpected deaths in 2020, dying at almost three times the rate of White infants.

The findings were part of research released Monday by the Centers for Disease Control and Prevention, which also found a 15 percent increase in sudden infant deaths among babies of all races from 2019 to 2020, making SIDS the third leading cause of infant death in the United States after congenital abnormalities and the complications of premature birth.

“In minority communities, the rates are going in the wrong direction,” said Scott Krugman, vice chair of the department of pediatrics and an expert on SIDS at Sinai Hospital in Baltimore.

The study found that rising SIDS rates in 2020 was likely attributable to diagnostic shifting — or reclassifying the cause of death. The causes of the rise in sleep-related deaths of Black infants remain unclear but it coincided with the arrival of the coronavirus pandemic, which disproportionately affected the health and wealth of Black communities.

“Evidence does not support direct or indirect effects of the … pandemic on increased rates of sudden unexpected infant death, except for non-Hispanic Black infants,” said the study, to be published in the April issue of the journal Pediatrics.

The study’s authors, who call for further research into their findings, point out that the pandemic exacerbated overcrowded housing, food insecurity and other stressors, particularly among Black families — potentially leading to less safe sleeping practices, such as bed sharing.

Before the pandemic, overall infant mortality — including diseases, accidents and injuries, and unexplained deaths had been on a downward trend in the United States. Some of that drop can be attributed to the enormously successful campaign launched in the 1990s to encourage putting babies to sleep on their backs, as opposed to facedown when they may re-breathe the carbon dioxide they exhaled or suffocate in soft bedding.

Tracking and understanding the causes of sudden and unexpected infant deaths on a national scale has been challenging in part because of different local practices of reporting and investigating the deaths. Data based on death certificates is notoriously inaccurate, and the pandemic introduced further complications, including shortening the time overburdened examiners could devote to investigating individual deaths.

The CDC’s Division of Reproductive Health has tried to address those problems by setting up monitoring programs in 22 states and jurisdictions across the country and by working with medical examiners and coroners to standardize reporting procedures. The new study draws on that research.

“This study is using good quality data, putting what some of us have been doing on a local basis on a national scale,” Krugman said.

In addition, a shift in terminology has complicated the picture. SIDS, or crib death, refers to the sudden death of an infant under the age of 1, usually during sleep and for unknown reasons, though often related to suspected genetic or environmental factors.

That term has fallen out of favor among some medical examiners and coroners who have replaced it with the broader term SUID, or sudden unexpected infant death under the age of 1. SUID refers to the often sleep-related deaths of babies in which the causes include suffocation from being caught between cushions of a couch or strangulation beneath a sleeping parent as well as SIDS and other unknown causes. About half of SUID deaths are SIDS deaths.

>“It’s a terrible situation,” said Richard Goldstein, director of the Robert’s Program on Sudden Unexpected Death in Pediatrics at Boston Children’s Hospital. “There is so much inconsistency in what these deaths are called. That’s not tolerated in any other area of medicine.”

On average, about 3,400 U.S. babies die suddenly and unexpectedly each year, according to CDC data.

To examine racial disparities, researchers chose to use the overall SUID rate, which allowed for consistent comparisons that were not affected by the different ways medical examiners report infant deaths.

In 2020, the SUID rate was highest among Black infants (at 214 deaths per 100,000 live births), followed by American Indian or Alaskan Native infants (at 205 deaths per 100,000 live births), and nearly three times the rate for White infants (75.6 deaths per 100,000 live births).

Understanding the causes of those deaths, many of which are unobserved, is key to preventing them.

“We don’t know how to prevent SIDS,” said Michael Goodstein, a neonatologist at York Hospital in Pennsylvania, who said research is examining factors such as brainstem abnormalities and respiratory problems. “But we should be able to prevent suffocation deaths.”

Sharyn Parks, one of the study’s authors and a senior scientist at the CDC’s Division of Reproductive Health, said there are two clear messages to take from the study — the need for researchers to examine factors like poverty that make some families more vulnerable to poor health outcomes as well as the need for parents to remember the practical steps they can take.

“We want to continue emphasizing safe infant sleep practices, putting babies on their backs and removing all soft bedding,” Parks said.

Once it is available, data from 2021 and 2022 should provide a clearer sense of the role the pandemic may have played in widening disparities between different racial groups.

“We are getting more and more a sense that poverty and multi-factorial issues are really important for being able to protect children,” Goodstein said.

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Featuring death and grief in children’s books can equip them with skills to navigate emotional terrain

— We don’t need to overload young people with everything that adults carry, but we should be as truthful as we can for their age

By Nova Weetman

When I was eight, mum read me EB White’s classic, Charlotte’s Web. We took it in turns to cry. Hers were the tears of a mother fearing leaving her babies, and mine were the tears of a kid feeling everything for Wilbur the pig when his beloved friend Charlotte died.

When I was 10, Katherine Paterson’s Bridge to Terabithia broke my heart. Huddled under blankets, I read late into the night, between gulps of tears. I had to know if Jesse would survive his grief and guilt after his best friend, Leslie, drowned in the river.

The book also grapples with class and poverty, bullying and religion. An ambitious work, it won many literary awards. It has also been banned and challenged hundreds of times in American schools and public libraries. The reasons are complex but include the fact the book deals with death, witchcraft, swearing and atheism (Leslie doesn’t attend church).

Bridge to Terabithia was my literary introduction into the idea that a girl like me could die. Yes, it upset me, but it didn’t scare me or make me wary of living. Instead, it allowed me to feel the depths of sadness, anger and acceptance that Jesse feels.

As parents, we want to protect our children from experiencing unnecessary heartache. We want them to feel safe, loved and happy. The world is grim enough without handing them books that make them contemplate death. But dying isn’t something we can shield them from. They watch films, they talk to their friends, they lose grandparents and pets and sometimes even parents, and they understand that life isn’t forever, and that sometimes people can die too soon.

I believe that death, grief and other intense emotions have a place in children’s fiction. We must trust authors and illustrators to know how to present these experiences to children in age-appropriate ways. We don’t need to overload young people with everything that adults carry, but we do need to honour them by being as truthful as we can for their age, and we can do this by leading them gently, and by giving them hope that things can change, or be survived.

Now more than ever, in the light of everything that is going on in the world, we need to equip children with the skills to navigate emotional terrain – not protect them from it. Books can help children to process emotions while feeling safe.

My latest middle grade book, The Jammer, is about a 12-year-old girl called Fred whose mother has died before the story starts. It is not about her death, it is about Fred’s journey to finding a new family of disparate people, and about her realising that it is OK to feel sad and happy and everything in-between. It is also about love, hope, friendship and joy, because those are often the feelings that accompany the grief and the loss.

We can explore death in children’s books through humour, fantasy, ghost stories and realism. And the beauty of books is that children will take what they need when they are reading. If they don’t understand something, then they’ll skip that bit or simply close the book.

In The Jammer, Fred doesn’t talk about her mum dying. She won’t discuss it with anyone, not even her dad. And then slowly she starts to let her step-uncle Graham share little moments of her grief because his mother died when he was young, and he understands what it feels like to mourn.

When my kids lost their dad, they didn’t want to talk about it. They didn’t want to be known as the kids with the dead dad when they went back to school after the lockdowns ended. So much so that six months after he had died, some of my daughter’s social group still didn’t know.

My teenage son made a new friend this year. A girl whose mum died when she was two. They never talk about death. Or losing a parent. They just understand.

I think books are like that too. Characters can seem like our best friends when we are kids. They don’t have to be the same as us. They just have to make us feel like we belong. Like we aren’t alone. Like we are understood.

Not every kid will want to read about a parent dying. It won’t happen to most children in their young lifetimes. But it does happen to some. And I think it’s important to help children understand the incomprehensible so they can be more empathic and kinder. Books are a way we can teach young people how to understand the world is not just theirs. It is not just one experience. But many.

And I think we owe it to young readers to be honest, and not to pretend things are easy just because they are children. Regardless of the genre and of the tone of our stories, books are a place children come to hide, to learn, to laugh, and sometimes even, to cry. And when they finish a book, it might stay with them and change their world, just a little, like Wilbur the Pig did for me.

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