Thriving: Trends in US Children's Mortality, Chronic Conditions, Obesity, Functional Status, and Symptoms
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Abstract
This study investigated how US children’s health—ie, mortality, chronic conditions, obesity, functional status, and symptoms—changed from 2007 to 2023.
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Description
To determine how US children’s health has been changing from 2007 to 2023 using multiple data collection methods and a comprehensive set of health indicators, repeated, cross-sectional analyses using mortality statistics from the US and 18 comparator high-income nations from the Organisation for Economic Co-operation and Development (OECD18), 5 nationally representative surveys, and electronic health records from 10 pediatric health systems (PEDSnet) were conducted.
Cohort Definitions
The populations included individuals younger than 20 years old. Unweighted denominator sample size ranges were 1,623 to 95,677 across the surveys, 1,026,926 to 2,114,638 for PEDSnet, 81.9 million to 83.2 million in the US, and 118.4 million to 121.1 million in the OECD18 for mortality statistics.
Findings
Temporal trends from 2007 to 2023 have significantly worsened for child mortality; chronic physical, developmental, and mental health conditions; obesity; sleep health; early puberty; limitations in activity; and physical and emotional symptoms. From 2007 to 2022, infants (<1 year old) were 1.78 (95% CI, 1.78-1.79) and 1- to 19-year-old individuals were 1.80 (95% CI, 1.80-1.80) times more likely to die in the US than in the OECD18. The 2 causes of death with the largest net difference between the US and OECD18 were prematurity (RR, 2.22 [95% CI, 2.20-2.24]) and sudden unexpected infant death (RR, 2.39 [95% CI, 2.35-2.43]) for infants 12 months or younger, and firearm-related incidents (RR, 15.34 [95% CI, 14.89-15.80]) and motor vehicle crashes (RR, 2.45 [95% CI, 2.42-2.48]) for 1- to 19-year-old individuals. From 2011 to 2023, the prevalence of 3- to 17-year-old individuals with a chronic condition rose from 39.9% to 45.7% (RR, 1.15 [95% CI, 1.14-1.15]) within PEDSnet, and from 25.8% to 31.0% (RR, 1.20 [95% CI, 1.20-1.20]) within the general population. Rates of obesity, early onset of menstruation, trouble sleeping, limitations in activity, physical symptoms, depressive symptoms, and loneliness all increased during the study period.
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