Long-term trends in childhood diabetes mortality: 1968-1998.
OBJECTIVE
In the context of recent improvements in type 1 diabetes therapy, to describe longitudinal trends in mortality attributable to childhood diabetes and to investigate socioeconomic and health services correlates of mortality.


METHODS
We extracted mortality data for 1968-1998 from National Center for Health Statistics files and covariates from the Bureau of Health Professions Area Resource File. Analytical techniques included linear and Poisson regression and standard descriptive statistics.


RESULTS
Childhood (defined as 0-19 years of age) age-adjusted mortality from diabetes declined from 9.5 (1968) to 3.0 (1984) deaths per 10 million but remained relatively constant subsequently. All-cause childhood mortality, however, continued to decline. Older children experienced higher mortality rates, as did those living in counties with higher levels of unemployment.


CONCLUSIONS
Despite recent improvements in therapy, diabetes-related mortality among children has not declined for 14 years. This finding may be partially attributable to sociodemographic factors influencing access to care, but the remaining mortality may defy available treatment methods. Reducing childhood diabetes mortality rates below the current apparent plateau may require new prevention and/or treatment strategies.
DiLiberti
J H
JH
Department of Pediatrics, University of Illinois College of Medicine, Peoria, Illinois 61637, USA. jdiliberti@nc.rr.com
Lorenz
R A
RA
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002423:Cause of Death; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000401:mortality*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009309:National Center for Health Statistics, U.S.; D012044:Regression Analysis; D013997:Time Factors; D014481:United States