Children in the United States are dying sooner and are sicker now than they were twenty years ago. Chronic disease is more common, along with a stunning range of conditions including anxiety, major depression and sleep apnea, as well as eating disorders, loneliness and obesity. Even sleep has become more disrupted.  

A new quantitative study by LDI Senior Fellow Christopher B. Forrest and colleagues sought to overcome researchers’ past limitations and conduct a more integrated analysis of diverse data sources and over 170 health indicators. 

Using national mortality statistics, a large database of pediatric electronic health records, and data from five nationally representative surveys, Forrest and colleagues examined changes in children’s health from 2007 to 2023. 

What they uncovered was sobering. “There is widespread languishing of children across the nation,” Forrest said on WBUR FM’s On Point podcast in Boston. ”There’s a tremendous amount of suffering that’s hidden and quiet.” 

Here are five findings that point to a “fundamental decline” in children’s health: 

1. U.S. children are more likely to die than children in other high-income countries.

From 2007 to 2023, 54 more children died every day in the U.S. compared with other high-income countries. The leading cause of death for U.S. children ages 1 to 19 was death by guns.

2. One in three U.S. children has a chronic health condition.

As reported by parents in a national survey, one in three children in the U.S. experience at least one of 15 chronic conditions, such as anxiety, vision problems, or autism. Children were 15% to 20% more likely to have a chronic condition in 2023 than in 2011.

3. More U.S. children feel sad, hopeless, and lonely now than before.

High schoolers who felt sad or hopeless every day, and children ages 12 to 18 who felt alone, both increased by more than 50% over 14 years.

4. 20% of children in the U.S. are obese.

Obesity affected 17% of children around 20 years ago. That number has increased to 20.9%, meaning nearly one in five children is obese.

5. Girls in the U.S. are going through puberty early.

About 20 years ago, 9% of U.S. girls went through puberty early. That number has steadily increased to 15%, with nearly one in seven girls beginning menstruation before turning 12.

What should we do next? 

Forrest and colleagues call for the transformation of children’s developmental ecosystems: “In some ways we all take responsibility for this because it’s been happening in our backyards,” said Forrest. 

A JAMA Network editorial accompanying the study called for a review of systemic factors causing these pervasive declines and outlined five areas in which to look for root causes: the fragmented health care system, youth behavior, social determinants of health, physical and social environments, and public policies.

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The study, “Trends in US Children’s Mortality, Chronic Conditions, Obesity, Functional Status, and Symptoms,” was published July 7, 2025 in JAMA. Authors include Christopher B. Forrest, Laura J. Koenigsberg, Frances Eddy Harvey, Matthew G. Maltenfort, and Neal Halfon.  

The editorial, “How We Are Failing U.S. Children,” was published July 7, 2025 in JAMA. Authors include Elizabeth R. Wolf, Frederick P. Rivara, and Steven H. Woolf.

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