Children’s health in U.S. getting worse, study finds

The health of children in the U.S. has “significantly worsened” over the past 17 years in a variety of areas, including deaths, chronic mental and physical illness, obesity, sleep health, activity levels and more.

That’s the finding of a new study by researchers at Children’s Hospital of Philadelphia and the University of California Los Angeles. The study was published this week by JAMA Network, part of the Journal of the American Medical Association.

The study compared children’s health in the U.S. to 18 similarly high-income countries that are part of the Organization for Economic Cooperation and Development. It also included five nationally representative surveys and electronic health records from 10 pediatric health systems. In all, data included millions of health records.

“The surprising part of the study wasn’t with any single statistic; it was that there’s 170 indicators, eight data sources, all showing the same thing: a generalized decline in kids’ health,” Dr. Christopher Forrest, one of the authors, told The Associated Press.

“I think we all should be disturbed by this,” Forrest, a professor of pediatrics at Children’s Hospital of Philadelphia and director of the Applied Clinical Research Center, told CNN. “Kids in this country are really suffering.”

Children’s health in America

Only asthma rates got better during the study period. Everything else worsened, including depression, anxiety, loneliness, autism, behavior problems, developmental delays, speech-language challenges and attention deficit/hyperactivity disorder.

The study found that:

• Between 2007 and 2022, U.S. infants were 78% more likely to die than were infants in similar high-income countries. The researchers said the causes of death driving the excess numbers were being born prematurely, sudden unexpected infant deaths and congenital anomalies.
• Children ages 1 to 19 were 80% more likely to die. The factors behind those excess deaths were firearms, motor vehicle crashes, substance use and homicide. In 2020, firearm deaths became the leading cause of death among children and youth in the U.S. “This study’s results indicate that U.S. children were 15 times more likely than their counterparts in the OECD18 to die by a firearm,” the authors wrote.
• The pediatric health records showed almost half of children receiving care at one of the centers had at least one chronic health condition.
• One-third of children in the general population experience one of 15 chronic conditions, based on a parent’s report.
• More than 20% of children have obesity.
• Early puberty is increasingly common, with 1 in 7 girls beginning menstruation before age 12.
• The study also documents “deterioration in sleep health and increasing limitations in activity, alongside worsening of an extensive range of physical and emotional symptoms.”

Long slide in health

Not all of the worsening-health trends began in the study period. The researchers note that child mortality rates in the U.S. were comparable to other OECD nations in the 1960s, but surpassed them in the early ’70s.

Obesity rates among children more than tripled between 1971 and 2018. And sleep duration dropped an average of 1.1 minutes every year between 1905 and 2008 for children, while it was increasing for children in the United Kingdom, Scandinavia and Australia.

Autism rates “increased markedly from fewer than 3 in 10,000 children in 1970 to greater than 30 per 10,000 by the 1990s,” per the study.

Others note health challenges

The study is not the first by any means to highlight challenges with children’s health. The very recent “Make America Healthy Again” report released by U.S. Health and Human Services Secretary Robert F. Kennedy Jr. called this generation of children “the sickest” in U.S. history.

As Deseret News reported of the study, “America’s children have a health crisis that’s built on the poor diet caused by ultra-processed foods, toxic environmental chemicals, too little physical activity, chronic stress and ‘overmedicalization.’”

Per that federal report, about 40% of the 73 million U.S. children under age 18 have one or more chronic conditions, and 20% over age 6 have obesity. The report noted that three-fourths of those ages 17 to 24 are “ineligible for military service — primarily due to obesity, poor physical fitness and/or mental health challenges."

In an editorial published with the new JAMA study, pediatricians from Virginia and Washington said there’s reason to fear children’s health will get worse. And it called out politics as potentially problematic.

“While the administration’s Make America Healthy Again movement is drawing welcome attention to chronic diseases and important root causes such as ultra-processed foods, it is pursuing other policies that will work against the health interests of children,” they wrote. Among concerns cited were budget cuts to programs like safe sleep messaging, Medicaid, injury prevention and reduced funding for mental health.

One of the JAMA editorial’s authors, Dr. Frederick Rivara, a professor of pediatrics at the University of Washington, told NPR that the new federal cuts to Medicaid are likely to reduce the access children have to the health care they need. Pew Research Center data found more than 4 in 10 U.S. children receive their health care through Medicaid.

Study limitations

The authors of the JAMA study do note some limitations of their research. For instance, they didn’t stratify the findings by characteristics, which would have allowed them to see if one socioeconomic group did worse than another, or if other demographic differences could be teased out, though they said they suspect that race, ethnicity and other socioeconomic disparities play a role in the findings.

They didn’t discover the “why” behind the findings, focusing rather on trying to quantify it. They wrote that further study is needed to determine why children’s health is worsening.

And the health system data covered 10 states, so might not be generalizable to the population as a whole, though that was just one piece of the determination that children’s health is worse than in the past.