Under-Reported Stories

Child death and its implications are a significant but invisible public health problem. Despite the high prevalence, with some estimates reaching 18 percent of parents by age 80, this issue is not included in the nation’s discourse on family health, stability, and well-being.

Sibling loss, at any age, is poorly understood. In a recent population-based study, “sibling death in childhood was associated with a 71 percent increased all-cause mortality risk among bereaved persons.” Evidence in adolescent bereavement states “the effects of bereavement are severe, and unresolved bereavement has been linked to agitated depression, chronic illness, enduring and intense clinical reactions, such as guilt, and significant disturbances in self-esteem, job and school performance, and interpersonal relationships.” But despite this evidence, sibling death is not considered a risk factor in the Adverse Child Experiences risk assessment.

Like many public health concerns, there is an unequal toll and burden on our nation’s black and Hispanic families. According to Centers for Disease Control and Prevention mortality rates, black populations experience higher child death incidence rates for every age bracket (stillbirth to age 54) when compared to whites, as do American Indian and Alaskan Native populations from ages 15 to 54. Throughout their lives, black Americans lose more family members than white Americans. By age 60, black parents are twice as likely as white parents to have lost a child. And by age 70, they are about three and a half times more likely to have a child die.

Parents are likely to suffer from depressive symptoms, poorer well-being, less purpose in life, more health problems and marital or relationship disruption. Mothers, in particular, face an increased risk of psychiatric hospitalization in the first five years following the death. Mothers also experience increased premature mortality from both unnatural and natural causes, while fathers experience increased mortality from unnatural causes (i.e., suicide and accidents).

The long-term economic ramifications of losing a child, from increased medical expenditures, loss of wages or employment, loss of productivity (e.g., presenteeism and absenteeism), and reduced future income, are just beginning to be investigated. Common public policy protections, such as the Family and Medical Leave Act, do not consider child loss as a qualifying event for job protection, and 63 percent of employers allow only three days of paid leave.