The deaths of 23,000 American children and teenagers each year could be prevented by better health care, universal coverage and other steps to overcome economic inequities, a consumer group said Wednesday.

More than 70,000 children and youths under 20 die each year. The study released by Citizen Action classified almost a third of those deaths as preventable.Premature delivery accounted for the largest number of preventable deaths, according to the report, "Dying Before Their Time: Childhood Mortality in the United States." It was prepared by the Citizens Fund, the research arm of Citizen Action.

If death rates for children across the country had been the same as the rates in the nation's wealthiest counties, "there would have been 23,000 fewer childhood deaths nationwide each year," it said.

The report, underwritten by a grant from the Carnegie Corp., said 115,723 of the 350,118 deaths among children and teen-agers from 1987 to 1991 were preventable. Almost 65,000 of those deaths were among infants.

The government's National Center for Health Statistics reported last week that 34,628 infants died in 1992 before their first birthday. But the infant mortality rate fell to a record low of 8.5 deaths per 1,000 births in 1992, and preliminary figures indicate it fell further, to 8.3 deaths, in 1993.

The United States, however, still ranks 22nd among industrialized countries on infant mortality. Japan, the leader, has just 4.4 infant deaths per 1,000 births.

The study recommended universal prenatal care, increased funding for nutrition and health-care programs for the poor, health reforms including guaranteed coverage, better day care to cut the toll from fires and other unintentional injuries and expanded violence-prevention programs.

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