A recent study in the journal Health Affairs had some dismal news for U.S. children: They have a 70 percent greater chance of dying before they reach adulthood than their peers in comparable developed nations. While child death rates in the United States are still much lower than they were 50 years ago, children still face unique risks that resulted in an estimated 600,000 preventable deaths from 1961 to 2010.

Why is the United States so exceptionally dangerous for children? The report suggests that there are three primary groups of U.S. children at risk: children of all ages who die in car crashes, teenagers killed by guns and babies who die before their first birthday.

The first group—representing about 1,000 children younger than 13 per year—is both the least complex and the most difficult to change. Passage or stricter enforcement of laws requiring that children be properly restrained in cars may help, as roughly 20 percent of child deaths in car accidents occur in situations where the victims are not wearing a seatbelt or in a safety seat. Also, about 20 percent of child deaths in car accidents are related to drunk driving, and any interventions to reduce drunk driving will also help to reduce child deaths related to the same. But Americans will continue to make most trips by car as long as our government subsidizes highways and encourages sprawl with all sorts of housing-related restrictions. As long as we are driving fast everywhere, we are going to keep getting into accidents, and it is not going to be easy to dramatically shift where we live and how we get around.

In the second group, there are 1,000 or more children who are killed by guns every year in the United States. Incidents such as the mass shooting at a high school in Florida on Feb. 14 are depressingly common, but gun deaths from suicide are now even more common than those from homicide. Some policies would keep people who might misuse guns from buying new firearms and thus put a small dent in gun deaths, but there are already over 300 million guns in the United States today that could still be misused at any time. The website FiveThirtyEight compiled an excellent report several years ago about interventions that can help prevent suicide and homicide even in a milieu where guns are available, but often these programs are underfunded, and access to much-needed mental health services is limited when people cannot pay for them.

Children face unique risks that resulted in an estimated 600,000 preventable deaths from 1961 to 2010.

Over 20,000 infants die in the United States every year, making the third at-risk group much higher than the other categories. Some have suggested that the discrepancy between the United States and other wealthy nations is due to the way in which our infant death statistics are counted. This does play a role—the United States more frequently counts deaths of extremely premature babies than other countries—but we still fail apples-to-apples comparisons of infant mortality.

Fortunately, there are many clear ways to work toward lowering this number. For one, we can make medical care more accessible to mothers and potential mothers. Medicaid covers prenatal care for any pregnant woman unable to pay for it, but so many factors that determine a child’s health are determined even before a woman gets pregnant. If someone is disconnected from the health care system and already struggling with health issues (including mental health issues, which can raise the risk of preterm birth and thus death) before becoming pregnant, her child is all the more at risk from suffering a complication—all the more so if there is a delay in accessing care. I personally knew a young woman who got an abortion because she could not afford prenatal care and did not even realize the costs would be covered.

There are three primary groups of U.S. children at risk: children of all ages who die in car crashes, teenagers killed by guns and babies who die before their first birthday.

Many factors related to preterm birth and infant mortality are related to behaviors like smoking or drug use, but this is not an excuse to throw up our hands when an innocent child is affected by their parents’ behavior. If we genuinely care about these children, we will find ways to get the necessary resources and support to people who struggle with substance abuse, poor eating habits or the general life chaos that often accompanies parents living in poverty. If we decide not to spend time, energy and money improving our health systems and caring for struggling mothers, we allow the cycle to continue to another generation (if the children in question do not die first). There is no excuse for not ensuring that every citizen in the United States has meaningful access to preventative and chronic health care.

When we fail to create a society that is expressly intended to help children grow and heal, that failure shows up in the number of children who die every year. These shortcomings can occur in relatively mundane things like transportation or in more complex and challenging fields like criminal justice and health care. Yet even those complex systems have clearly identifiable solutions, like violence interruption programs and universal health coverage, that would surely make an impact. And there is no substitute for Christians who want to love their struggling neighbor by choosing to share life with them and walk with them through life’s difficulties. If we do not want to see so many children continue to die, we must choose to restructure the broadest national policies as well as the way that we individually spend our days.

Matthew Loftus is a family physician who has worked in Baltimore and East Africa. You can learn more about his work and writing at MatthewAndMaggie.org.