Boys at Risk Beyond Male Fragility: The Gender Gap in Child Injury Deaths in the United States, 2000-2020

For decades, scholars in demography, public health, and medicine have documented a gender gap in early childhood mortality rates, primarily attributing this gap to male biological fragility (susceptibility to disease and perinatal conditions and disorders). However, unintentional injury is a leading cause of death for boys in early childhood (0-4 years of age), suggesting social causation of at least part of the gap. Using restricted detailed mortality and compressed vital statistics data from the U.S. over the period 2000-2020, we show that accounts of the innate fragility of boys have been overemphasized. While boys have higher rates of leading natural causes of death in infancy, they have similar rates to girls between the 1-4 years of age. We also show that boys have higher risk of mortality among causes where adult supervision is a key contributing factor, such as drowning, poisoning, falls, or firearms. These patterns have remained largely unchanged over time. Extending prior work on supervision and incorporating gender theory, this paper suggests that a gendered supervision context likely accounts for some of the gender differences in fatalities in early childhood.