Child mortality*

Number of deaths among children under age 18 per 100,000 population.

The 2021 County Health Rankings used data from 2016-2019 for this measure.

Reason for Including

The child mortality rate can have a large impact on years of potential life lost (YPLL), so it is an important measure to reference when interpreting a county's YPLL rate.

Key Measure Methods

Child Mortality is a Rate

Child Mortality measures the number of deaths among children under age 18 per 100,000 population. Rates measure the number of events (i.e., deaths, births, etc.) in a given time period (generally one or more years) divided by the average number of people at risk during that period. Rates help us compare data across counties with different population sizes.

Child Mortality is a Rare Event (statistically speaking)

Child death is a relatively rare event in most counties. Counties with smaller populations can see a lot of change in their rates of child death data from year to year. Such changes are usually due to normal variation and are not necessarily caused by any actual change in the underlying risk of child death in the county. To help determine if the child death change in a county is due to normal variation or real change, we recommend examining the provided error margins. Error margins are statistical tools that consider variation in measures. If the error margins overlap year to year, it’s less likely that the variation in child mortality reflects real underlying changes.

What Deaths Count Toward Child Mortality?

Deaths are counted in the county where the individual lived. So, even if a child dies elsewhere in the state, that death is attributed to his/her home county.

Some Data are Suppressed

A missing value is reported for counties with fewer than 10 child deaths in the time frame.


The numerator is the number of total deaths for children under the age of 18.


The denominator is the total population under the age of 18.

Can This Measure Be Used to Track Progress

This measure can be used to track progress with some caveats. Child death is a relatively rare event, especially in small counties. Statistics depend on large numbers of events to detect small changes, and small changes in small communities may be hard to detect. It is also important to note that the estimate provided in the County Health Rankings is a 4-year average.

Data Source

Years of Data Used


National Center for Health Statistics - Mortality Files

Data on deaths and births were provided by NCHS and drawn from the National Vital Statistics System (NVSS). These data are submitted to the NVSS by the vital registration systems operated in the jurisdictions legally responsible for registering vital events (i.e., births, deaths, marriages, divorces, and fetal deaths). In prior years of the Rankings, Premature Death was calculated by the National Center for Health Statistics, but this year the Mortality-All County (micro-data) file was requested. This allowed us to calculate Premature Death and Life Expectancy ourselves. While most calculations of mortality rates can be downloaded from CDC WONDER, the calculation of Years of Potential Life Lost and Life Expectancy requires raw data files. 

Digging Deeper
Age 1
Gender 1
Race 1
Education 0
Income 0
Subcounty Area 0

We recommend starting with the CDC Wonder database, which contains information on death rates by race, ethnicity, age, gender, geography, cause of death, and more. Rates can be exported as crude or age-adjusted. Small counties might need to combine multiple years of data to see rates, as CDC suppresses any rates when there are fewer than 10 deaths.

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