A new study led by researchers at Children’s Hospital of Philadelphia (CHOP) has found that children’s health in the United States is declining across several key measurements ranging from increased chronic illnesses, higher rates of physical and mental health conditions and related symptoms, and increased mortality rates compared with other countries. The study also reveals that the issues are broad and systemic and require new ways of thinking about supporting and prioritizing the health of children. The findings were published this week in the Journal of the American Medical Association (JAMA).
The health of children provides an important foundation for the overall health of a country, with healthy children more likely to grow up to be healthy adults. However, recent scientific assessments suggest that the United States is facing a major crisis with poor and worsening health for children, which has stimulated a strong interest in understanding the root causes of these issues.
Most studies focus on singular issues, like anxiety and obesity, but since they are conducted separately, there is a critical gap in knowledge. In this study, researchers suggested that a more effective response to these issues may be to address underlying systemic factors and identify areas to improve the developmental ecosystem for children growing up in America.
“In the course of conducting this study, there wasn’t a single statistic that was startling, but instead comprehensive data over several years including millions of children all pointed to the same trends, which was an overall decline in the health of children and youth,” said senior study author Christopher B. Forrest, MD, PhD, a Professor of Pediatrics at CHOP, Director of the Applied Clinical Research Center, and Director of PEDSnet.
In this study, the researchers utilized data from five nationally representative surveys, national mortality statistics, and a large database of pediatric electronic health records (EHRs) to assess changes in children’s health from 2007 to 2023. The study looked at more than 170 children’s health indicators, including chronic physical, developmental and mental health disorders, mortality, obesity, functional impairments, and physical and emotional symptoms.
The study found that from 2007 to 2022, the death rate for infants younger than 1 year was 1.78 (95% CI, 1.78-1.79) times higher and 1.80 (95% CI, 1.80-1.80) times higher in children between 1- and 19-years-old in the United States compared with 18 countries comparable high-income nations in the Organization for Economic Co-operation and Development (OECD). Prematurity and sudden unexpected infant death accounted for the widest disparities in infants and firearm-related incidents and motor vehicle crashes having the widest disparities among other children.
From 2011 to 2023, the prevalence of 3- to 17-year-old children with a chronic condition rose from 39.9% to 45.7% within the PEDSnet cohort of 10 pediatric medical centers and from 25.8% to 31.0% within the general population. Additionally, rates of obesity, early onset of menstruation, trouble sleeping, limitations in activity, physical symptoms, depressive symptoms and loneliness all increased during the study period.
While the authors strongly advocate for identifying and addressing the root causes associated with these issues, they also strongly advocate for broader methods of addressing them. A developmental ecosystem that connects human relationships, environments and social systems that supports children, particularly those in low-income and marginalized communities, needs to be prioritized and supported with more high-quality early childhood education, better family support, safer neighborhoods and culturally attuned care.
“Children are naturally resilient and adaptive,” Forrest said. “If we can improve the ecosystems that surround them and meet the challenges we identified in this study, we can lay the foundation for a healthier future for our nation’s youth.”
This study was supported by institutional funds managed by the Applied Clinical Research Center at CHOP.
Forrest et al, “Trends in US Children’s Mortality, Chronic Conditions, Obesity, Functional Status, and Symptoms.” JAMA. Online July 7, 2025. DOI: 10.1001/jama.2025.9855.
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A new study led by researchers at Children’s Hospital of Philadelphia (CHOP) has found that children’s health in the United States is declining across several key measurements ranging from increased chronic illnesses, higher rates of physical and mental health conditions and related symptoms, and increased mortality rates compared with other countries. The study also reveals that the issues are broad and systemic and require new ways of thinking about supporting and prioritizing the health of children. The findings were published this week in the Journal of the American Medical Association (JAMA).
The health of children provides an important foundation for the overall health of a country, with healthy children more likely to grow up to be healthy adults. However, recent scientific assessments suggest that the United States is facing a major crisis with poor and worsening health for children, which has stimulated a strong interest in understanding the root causes of these issues.
Most studies focus on singular issues, like anxiety and obesity, but since they are conducted separately, there is a critical gap in knowledge. In this study, researchers suggested that a more effective response to these issues may be to address underlying systemic factors and identify areas to improve the developmental ecosystem for children growing up in America.
“In the course of conducting this study, there wasn’t a single statistic that was startling, but instead comprehensive data over several years including millions of children all pointed to the same trends, which was an overall decline in the health of children and youth,” said senior study author Christopher B. Forrest, MD, PhD, a Professor of Pediatrics at CHOP, Director of the Applied Clinical Research Center, and Director of PEDSnet.
In this study, the researchers utilized data from five nationally representative surveys, national mortality statistics, and a large database of pediatric electronic health records (EHRs) to assess changes in children’s health from 2007 to 2023. The study looked at more than 170 children’s health indicators, including chronic physical, developmental and mental health disorders, mortality, obesity, functional impairments, and physical and emotional symptoms.
The study found that from 2007 to 2022, the death rate for infants younger than 1 year was 1.78 (95% CI, 1.78-1.79) times higher and 1.80 (95% CI, 1.80-1.80) times higher in children between 1- and 19-years-old in the United States compared with 18 countries comparable high-income nations in the Organization for Economic Co-operation and Development (OECD). Prematurity and sudden unexpected infant death accounted for the widest disparities in infants and firearm-related incidents and motor vehicle crashes having the widest disparities among other children.
From 2011 to 2023, the prevalence of 3- to 17-year-old children with a chronic condition rose from 39.9% to 45.7% within the PEDSnet cohort of 10 pediatric medical centers and from 25.8% to 31.0% within the general population. Additionally, rates of obesity, early onset of menstruation, trouble sleeping, limitations in activity, physical symptoms, depressive symptoms and loneliness all increased during the study period.
While the authors strongly advocate for identifying and addressing the root causes associated with these issues, they also strongly advocate for broader methods of addressing them. A developmental ecosystem that connects human relationships, environments and social systems that supports children, particularly those in low-income and marginalized communities, needs to be prioritized and supported with more high-quality early childhood education, better family support, safer neighborhoods and culturally attuned care.
“Children are naturally resilient and adaptive,” Forrest said. “If we can improve the ecosystems that surround them and meet the challenges we identified in this study, we can lay the foundation for a healthier future for our nation’s youth.”
This study was supported by institutional funds managed by the Applied Clinical Research Center at CHOP.
Forrest et al, “Trends in US Children’s Mortality, Chronic Conditions, Obesity, Functional Status, and Symptoms.” JAMA. Online July 7, 2025. DOI: 10.1001/jama.2025.9855.
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