NC’s child death rate is rising, with a big jump in teen homicides

North Carolina had the 12th highest child mortality rate in the nation in 2024, losing ground to other states from the previous year when it had the 17th highest child death rate. 

Excluding infants, North Carolina’s child death rate in 2024 was 27.5 per 100,000, up slightly from the year before. The national rate was 21.8 per 100,000 in 2024.

The national child death rate decreased 15% from 2005 to 2024, while the rate in North Carolina increased 3% over those years. 

Motor vehicle accidents, non-motor vehicle accidents, and homicides were the three leading causes of death among children ages 1 through 17, Kathleen Jones-Vessey of the N.C. Department of Health and Human Services said during a Tuesday webinar organized by the N.C. Child Fatality Task Force. 

The Child Fatality Task Force recommends new laws and policies to reduce child deaths. 

The group will use the data to inform future discussions, said Executive Director Kella Hatcher.

In all, 1,386 children in North Carolina, from 17-year-olds down to infants, died in 2024. 

“This equates to approximately 77 classrooms of children lost that year,” Jones-Vessey said. “Let that sink in.”

Fifty-six percent of those children didn’t live to see their first birthdays.

North Carolina’s child homicide rate has declined after peaking at 4.4 in 2022. But the state’s rate of 3.5 child homicides per 100,000 in 2024 remained higher than the national rate of 2.7.

The proportion of children dying after being shot increased from 2020-2024 compared to 2015-2019. Over the most recent 5-year period, 73% of 460 child homicides were firearms-related, while from 2015-2019, 54% of 264 child homicides were connected to firearms. 

Teenagers 15-17 years old account for the biggest increase in child homicides over the last 10 years. 

“Child death rates associated with homicides have increased more than any other cause of death category,” Jones-Vessey said. 

The death rate from motor vehicle accidents among children from infants to 17 year olds was 21% higher in 2024 compared to 2015. The rate increased from 3.9 per 100,000 in 2015 to 4.7 per 100,000 in 2024.The national rate of 3.3 deaths per 100,000 from motor vehicle accidents was the same in 2024 as it was in 2015, Jones-Vessey said. Her information was drawn from an analysis of death certificate data and CDC data. 

Teenagers old enough to drive unsupervised —  those ages 16 and 17 years old — had the highest rates of motor vehicle-related deaths among children. The death rate for these driving-age teens from motor vehicle accidents was 19.5 per 100,000 in 2024, up from 14.7 in 2023 and 10.8 in 2015. 

While North Carolina’s ranking for deaths of children more than a year old was comparatively worse in 2024, the state’s infant mortality ranking improved. 

NCDHHS announced last month that the state’s infant mortality rate hit an historic low. North Carolina had the 10th highest infant mortality rate in 2023. Its ranking improved to 18th highest in 2024, Jones-Vessey said. 

But racial disparities persist. 

NC’s infant mortality rate and drug overdose deaths declined in 2024

The death rate for Black infants is higher than for any other racial or ethnic group. Black babies were nearly 3 times more likely to die before their first birthdays than white babies. 

The Black infant death rate decreased 5.9% in 2024 after rising the two previous years. But considering five-year spans, from 2015-2019 and 2020-2024, it remained unchanged at 12.9 per 1,000 live births, while the death rates for other racial and ethnic groups declined. 

The state is failing to achieve goals in the Healthy North Carolina 2030 plan or a DHHS plan on perinatal health to reduce the racial difference in infant death rates, Jones-Vessey said.

In its annual report, the task force advised state lawmakers 

• To prevent people younger than 21 from obtaining tobacco and cannabis products
• To grow and investment in the early childcare system
• To appropriate recurring money to increase school nurses, social workers, counselors and psychologists
• To strengthen child passenger safety laws