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A comprehensive new report published in JAMA reveals a troubling decline in the health of US children over the past 17 years, with rates of mortality, chronic conditions, obesity, and mental health issues worsening and now comparing poorly to those in other high-income countries.
Researchers led by Dr. Christopher B. Forrest at the Children’s Hospital of Philadelphia analyzed data from US mortality statistics, five national surveys, and electronic health records, comparing them with data from 18 other high-income nations in the Organization for Economic Co-operation and Development (OECD). The findings are stark: as of 2022, mortality rates for US infants and children aged 1 to 19 were 1.78 and 1.8 times higher, respectively, than those in peer countries.
Key findings include:
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: US infants are 78% more likely to die than those in other high-income countries, with prematurity and sudden unexpected infant death as leading causes.
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: The risk of death from firearm-related incidents is over 15 times higher in the US, and deaths from motor vehicle crashes are 2.45 times higher than in peer nations.
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: A US child in 2023 was 15%-20% more likely to have a chronic condition than in 2011.
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: Rates among 2- to 19-year-olds have surged from 5.2% in the early 1970s to 19.3% by 2017-2018.
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: Depressive symptoms in high schoolers increased from 26.1% in 2009 to 39.7% in 2023, while feelings of loneliness among 12- to 18-year-olds rose from 20.2% in 2007 to 30.8% in 2021.
Editorialists from Virginia Commonwealth University warn that the longstanding US health disadvantage, once confined to adults, now affects children as well. They cite poverty and income inequality as major root causes, noting that the US has some of the highest child poverty rates among OECD countries. Poverty can drive families toward unhealthy, calorie-dense foods and older, less safe vehicles, increasing health risks for children.
Access to healthcare remains a challenge, with about 5% of US children uninsured and 40% relying on public insurance that often limits access to primary and specialist care due to low reimbursement rates. The report calls for interventions such as expanding child tax credits, broadening health insurance coverage, investing in primary care, and enacting firearm safety laws.
Experts not involved in the report, such as Dr. Leslie Sude of Yale School of Medicine, emphasize that significant improvements in children’s health will require transformative changes to social and health policies. Pediatricians and health systems are urged to advocate for robust investments in family well-being and to integrate broader health-promoting services within primary care centers.
Mental health services for children are also insufficient, with many facing long wait times for care. However, some states are expanding crisis support and pediatric mental health care access programs, and evidence-based interventions in schools are showing promise in reducing anxiety, depression, and suicidality among students.
Disclaimer: This article is based on a summary of findings from a report published in JAMA and expert commentary as reported by Medscape. The information is intended for general informational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with any questions regarding a medical condition.
