Weather-Related Pediatric Fatalities in the United States: 2001 to 2021.

Background and objectives: Major weather and climate disasters are increasing in frequency and severity. How often these events result in child deaths is unknown. We assessed temporal and regional trends in pediatric fatalities due to weather events in the United States over the last 21 years.

Methods: We conducted an ecological study of weather-related pediatric fatalities between 2001 and 2021 using the National Centers for Environmental Information Storm Events Database. Weather-related fatalities were compared with pediatric fatalities included in the Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research database. The change in the proportion of all-cause pediatric fatalities associated with weather events was assessed over time. The frequency of events occurring in regions with Pediatric Disaster Care Centers of Excellence (COE) was examined.

Results: Between 2001 and 2021, weather events were associated with 1423 pediatric fatalities. Sixty percent of fatalities occurred in male children, with a bimodal distribution in age. Flood/currents accounted for the largest proportion of fatalities (37%, n = 524), followed by cold/ice/winter weather (13%, n = 192), tornadoes (13%, n = 183), heat (12%, n = 168), and hurricanes/storms (11%, n = 155). Although no significant difference was noted in the absolute number of fatalities over time (P = .18), the proportion of all-cause pediatric fatalities associated with weather events increased (P = .006) over the course of the study. Forty-six percent of pediatric fatalities occurred in areas with an associated COE.

Conclusions: Pediatric fatalities from weather events make up an increasing proportion of childhood deaths. Expansion of health-system infrastructure for pediatric disaster planning and response may mitigate childhood deaths from weather-related disasters.