A new study published in the journal JAMA finds that children's health in the U.S. has worsened since 2007, with researchers reporting that a child in this country was 15% to 20% more likely to have a chronic condition in 2023 than a child in 2011.

In particular, they found that kids are more likely to die as infants due to prematurity, sudden infant death syndrome (SIDS), congenital anomalies, and respiratory infections compared to 17 years ago. At the same time, older children are more likely to die due to gun violence, motor vehicle accidents, and substance abuse. Likewise, the rates of depression, anxiety, obesity, and sleep apnea increased, as did rates of autism, developmental delays, and attention-deficit hyperactivity disorder (ADHD).

The study also found that kids in the U.S. were roughly 80% more likely to die than their peers in European countries. The two causes of death that are greatest for kids younger than 12 months are premature birth and SIDS. For kids older than 1 year, the greatest causes of death are gun violence and motor vehicle crashes.

"These findings are a call to action to address the underlying root causes and to renew the focus on promoting the health of the whole population," says Alex Kemper, MD, MPH, division chief of Primary Care Pediatrics at Nationwide Children’s Hospital.

According to Dr. Kemper, children’s health should not be viewed in isolation since it reflects the overall health of our communities. For instance, the biggest cause of infant mortality in the United States is prematurity, so improving maternal health reduces the risk of prematurity, he says. 

"For older children, the biggest cause of death is related to firearms, which we must address," says Dr. Kemper. "Other factors that contribute to the decline in child health include access to high-quality nutritious foods and green space. Other studies have shown that children whose families have food insecurity are more likely to have obesity."

Many complex social factors lead to health inequalities, he says. In addition to addressing these issues, Dr. Kemper says we also need to ensure that children and teens have access to medical care to prevent or treat health problems.

"There are additional threats on the horizon," says Dr. Kemper. "We now have the [highest] number of cases of measles in this country in more than 25 years, despite easy access to a safe and highly effective vaccine. Vaccine skepticism is likely to have long-term negative consequences. Reducing access to medical care for families by cutting Medicaid will also make the trends worse."

School shootings are at an all-time high, according to a study published last year in Pediatrics. Plus, in the last 10 years, there have been more fatalities and injuries than in the previous 15 years.

"Gun violence is now the leading cause of death in U.S. children and adolescents," says Heather Felton, MD, a pediatrician at Norton Children's in Louisville, Kentucky. "These are preventable deaths, and this is a uniquely American crisis."

Part of the issue could be easy access to firearms—especially at home—and a need for more policies around gun restrictions and ownership. "The increase in mortality due to gun violence is staggering," says Jomarie Rivera, MD, a pediatrician with IWS Children’s Clinic in Oak Park, Illinois. "As a student, I learned that motor vehicle accidents were the number one cause of death, though by 2009, firearms became the leading cause and have continued to be the leading cause of mortality to this day."

According to Dr. Kemper, it has taken a long time for these problems to develop, and there will be no quick fix—especially on an individual level. To start, he says, addressing the underlying problems will require policy solutions. 

"We should not just focus on keeping children and teens from developing health problems, but focus on what it will take to have them thrive and be successful adults," he says. "This is complicated and hard work, but critical for our future."

To improve these numbers across the board, Dr. Rivera says it has to be a concerted effort by our politicians, health care leaders, and communities to prioritize children's health.

"There should be a focus on prevention, ensuring pregnant women have resources to get high-quality prenatal care to help with a healthy delivery, as well as giving parents access to high-quality health care providers for scheduled well-child visits and vaccinations," says Dr. Rivera. "In recent years, there has also been a decline in the number of medical students choosing to enter pediatrics, and I don't think the field's reputation as being the lowest paid medical specialty helps."

Families and caregivers should talk to their child’s health care provider about the things that can be done to help their kids thrive. "This ranges from safe sleep practices, the appropriate use of car seats and seatbelts, vaccination, safe gun storage, and healthy nutrition and exercise." 

However, he says parents and community members also need to talk to each other about the lessons from this study and other similar studies and come up with ways to implement evidence-based solutions that are beneficial for everyone.

In the meantime, here are some things Dr. Felton and Dr. Rivera say you can do to prioritize your child's health today and help change the trajectory of this trend for your child.

"There are often too few resources for children to access mental health services," says Dr. Felton. "School and community support, firearm safety legislation, and programs to address inequity in things like healthy food, safe places to learn and play, education, and access to health care [could help address this issue]."