When Dr. Christopher Forrest embarked on his journey in pediatrics 25 years ago, it was relatively rare to encounter children suffering from chronic conditions. However, in recent years, this trend has alarmingly shifted. Dr. Forrest, a professor of pediatrics at the Children's Hospital of Philadelphia, has observed that more children are entering hospitals and primary care practices with chronic illnesses than ever before. He notes that these children appear to be sicker, and recent research supports his observations.
A new study published in the journal JAMA reveals that the health of children in America has markedly deteriorated across several critical indicators since 2007. According to the findings, a child in the U.S. is now 15% to 20% more likely to have a chronic condition in 2023 compared to a child in 2011. The study highlights a concerning rise in the prevalence of conditions such as depression, anxiety, sleep apnea, and obesity. Furthermore, there has been an increase in rates of autism, behavioral problems, developmental delays, and attention-deficit hyperactivity disorder (ADHD).
Additionally, reports indicate an uptick in issues like poor sleep, limited physical activity, early-onset menstruation, and feelings of loneliness among children. "The overall message is that children's health in the United States has been declining for almost two decades," asserts Dr. Forrest.
The research team analyzed eight comprehensive data sets, which included nationally representative surveys and millions of electronic pediatric health records. They also examined mortality rates for American infants, young children, and teenagers, comparing these figures to their counterparts in other high-income countries over time. Dr. Forrest notes that in the 1960s, the likelihood of a child dying in the U.S. was on par with that of children in Europe. However, this is no longer the case. "From 2010 to 2023, children in the United States were 80% more likely to die," he states.
Among infants, the significant disparities in mortality rates can be attributed mainly to sudden unexpected infant death and prematurity. For older children and adolescents, the gap has been exacerbated by factors such as gun violence, motor-vehicle crashes, and substance abuse. Alarmingly, by 2020, firearm-related deaths became the leading cause of death among U.S. youth, surpassing motor vehicle accidents.
Dr. Frederick Rivara, a professor of pediatrics at the University of Washington, co-authored an editorial accompanying the study in JAMA. He emphasizes that healthcare coverage is a significant factor contributing to the poorer health outcomes of American children compared to their peers in other affluent nations. Unlike countries such as Canada and the United Kingdom, the U.S. lacks a system of universal health care coverage.
Recent legislative changes have further jeopardized the health of children, particularly with the removal of kids from Medicaid due to substantial cuts in the program for low-income Americans. The Pew Research Center estimates that as of January, approximately 41% of all U.S. children were enrolled in Medicaid. According to Dr. Rivara, while the administration's Make America Healthy Again initiative aims to address chronic diseases and their root causes, it simultaneously pursues policies detrimental to children's health.
These detrimental policies include significant budget cuts within the Department of Health and Human Services, impacting injury prevention programs and eliminating crucial initiatives like the Safe to Sleep campaign, aimed at reducing instances of sudden infant death syndrome. Additionally, there are growing initiatives questioning the safety of childhood vaccines, which could further threaten the health and well-being of America's children.
As the data shows, the decline in children’s health is a pressing issue that demands immediate attention from policymakers, healthcare providers, and society as a whole.
