American children are dying at significantly higher rates than their peers in other wealthy nations, according to a new study published in JAMA Original Investigation. The research reveals that U.S. infants are about 80% more likely to die before their first birthday, and overall, American children face an 80% higher risk of death compared to children in 18 other developed countries.
A Deepening Crisis in Pediatric Health
Analyzing health trends from 2007 to 2023, the study found that the United States experiences an excess of 54 child deaths every day compared to what would be expected if U.S. mortality rates aligned with those of similar high-income nations. Premature birth and sudden infant death syndrome are the leading causes of death among infants, while firearm injuries and car crashes top the list for older children and teens. Notably, firearms are now the leading cause of death for American children.
But the crisis isn’t limited to mortality. Researchers found widespread and worsening health outcomes across every major category they examined:
- The rate of chronic illnesses among children ages 3 to 17 surged from 26% in 2011 to 46% in 2023.
- Childhood obesity now affects 1 in 5 kids.
- Menstruation before age 12 is becoming more common, affecting 1 in 7 girls.
- Physical health complaints such as chronic pain and poor sleep rose from 20% to 30% in children aged 5 to 17.
- Nearly 40% of high school students reported persistent sadness or hopelessness by 2023.
Why Is This Happening?
Unlike previous studies that focused on isolated health issues, this research highlights a broader, interconnected pediatric health emergency. Despite spending nearly twice as much on health care as other wealthy nations, the U.S. continues to see worse outcomes, a trend that has now spread from adults to children.
Prematurity remains a major concern, with rates driven higher by rising maternal conditions like diabetes, obesity, smoking, and substance abuse. Worsening metabolic health—with over 90% of U.S. adults classified as metabolically unhealthy—impacts birth outcomes and increases chronic disease in children.
Technology plays a role too: the increased use of smartphones and social media is linked to disrupted sleep, reduced physical activity, obesity, loneliness, and depression.
The study did not provide a breakdown by race or income, but experts say socioeconomic disparities are major contributors. As noted in the editorial accompanying the study, the U.S. has among the highest child poverty rates and income inequality of any OECD nation. These conditions often lead to reliance on calorie-dense, low-nutrient food and increase the likelihood of living in environments with greater exposure to violence and poor health care access.
Racial and Economic Inequities Amplify the Crisis
Research outside this study shows that Black mothers experience significantly higher rates of preterm birth, often due to barriers such as lack of insurance and limited access to culturally competent health care. Economic hardship further restricts access to healthy food, time for meal prep, and resources for preventive care.
“These limitations accumulate,” said Linda Van Horn, a research nutritionist at Northwestern University, “and create ripple effects across communities and generations.”
The findings also reinforce recent reports that firearm-related deaths, including suicides, are rising among American youth, reflecting the intersection of health, violence, and inequality. Exposure to trauma in childhood has long-lasting impacts on physical and mental health, perpetuating cycles of disadvantage.
Conclusion
The study offers a stark warning: U.S. children are facing a systemic, worsening health crisis that cuts across physical, mental, and social domains. Despite America’s vast health care spending, outcomes remain among the worst in the developed world—especially for its youngest citizens.
