The health of American children has deteriorated significantly over the past 17 years, according to a comprehensive new study published Monday in the Journal of the American Medical Association, which found that children in the United States are nearly twice as likely to die as their peers in other high-income countries.
Researchers analyzed data from eight national health sources covering the period between 2007 and 2023. "There's 170 indicators, eight data sources, all showing the same thing: a generalized decline in kids' health," said Dr. Christopher Forrest, professor of pediatrics at Children's Hospital of Philadelphia and co-author of the study.
The report found that U.S. children were 1.8 times more likely to die than children in other developed nations. Deaths from firearm injuries and motor vehicle crashes were key drivers of this disparity. According to the data, American children are 15 times more likely to die by gun violence and more than twice as likely to die in car accidents compared to children in peer nations.
In addition to elevated mortality rates, the study uncovered a dramatic increase in chronic and mental health conditions among children. Between 2011 and 2023, U.S. children were 15% to 20% more likely to suffer from conditions like anxiety, depression, autism, developmental delays, and ADHD. Physical health issues such as obesity, early onset menstruation, limited mobility, and sleep difficulties also increased.
"Kids in this country are really suffering," Forrest said. "Our kids are being raised in a very toxic environment, and it's not just the chemicals. It's not just the food and the iPhones. It's a much broader... developmental ecosystem."
Asthma was the only chronic condition for which prevalence declined during the study period.
The findings align with a recent report from the Make America Healthy Again Commission, led by Health Secretary Robert F. Kennedy Jr., which labeled U.S. children "the sickest generation in American history" and attributed the crisis to ultraprocessed food, environmental toxins, excessive screen time, and medical overprescription.
However, the editorial accompanying the study warned that the Trump administration's cuts to Medicaid, mental health programs, and research funding could exacerbate the problem. "The health of kids in America is not as good as it should be, not as good as the other countries, and the current policies of this administration are definitely going to make it worse," said Dr. Frederick Rivara, pediatrician and researcher at Seattle Children's Hospital.
Infant mortality was also significantly worse in the U.S. due to high rates of prematurity and sudden unexpected infant death. Between 2020 and 2022, more than 10,000 excess preterm births occurred in areas classified as maternity care deserts, where access to prenatal care is limited.
Colleen Kraft, pediatrician at Children's Hospital Los Angeles and former president of the American Academy of Pediatrics, noted a marked shift in her own clinical experience. "Nothing here surprises me at all," she said. Kraft highlighted that chronic disease has replaced infectious disease as the dominant concern in pediatric practice, in part due to the success of childhood vaccinations-progress she fears could unravel due to rising anti-vaccine sentiment.
Forrest emphasized that addressing the crisis will require systemic reforms in child care, education, and community infrastructure. "It's time to rethink how we treat kids and how we're supporting families," he said. "Children in our nation are like the proverbial canary in the coal mine. When their health is deteriorating, that means the foundation of our nation is also deteriorating."
