US Children Face 80 Percent Higher Risk of Death Than Peers in Wealthy Nations

The United States sees 54 excess child deaths a day, driven by rising obesity, chronic conditions, and mental health issues.

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U.S. children are dying at rates far exceeding those in other wealthy nations, with a new study showing that U.S. infants are about 80 percent more likely to die before their first birthday, and children overall face an 80 percent higher death rate than their peers in 18 other developed countries.

The findings, published in JAMA Original Investigation, paint a troubling picture of pediatric health in the United States.

The Scope of the Health Crisis

The comprehensive study, which examined health trends from 2007 to 2023, reveals that the United States experiences an excess of 54 child deaths every day compared with what would be expected if America matched the mortality rates of other wealthy nations.

For infants, premature birth and sudden infant death syndrome drive the higher mortality rates. Among children ages 1 to 19, deaths from firearm injuries and motor vehicle crashes far exceed those in other developed countries, with firearms now representing the leading cause of death for U.S. children.

However, the crisis extends well beyond mortality. The study, which analyzed eight major data sources including national mortality statistics and large-scale health surveys, found deteriorating health across every measured category.

Over the 16-year period, this daily toll remained consistent, underscoring the systemic nature of the crisis. Chronic conditions have surged: A child in 2023 was 15 percent to 20 percent more likely to have a chronic disease compared with a child in 2011. The proportion of children ages 3 to 17 with at least one chronic condition rose from about 26 percent to 46 percent.

An obesity epidemic has taken hold. Today, one in five children is affected by obesity, and one in seven girls begins menstruation before age 12. The share of children ages 5 to 17 experiencing at least one physical symptom—such as poor sleep, chronic pain, or activity limitations—increased from 20 percent to 30 percent.

Mental health has deteriorated sharply. Depressive symptoms have risen at an alarming rate, with nearly 40 percent of high school students reporting persistent feelings of sadness or hopelessness by 2023.

What Is Driving the Decline?

Unlike previous research that focused on single health issues, this study’s comprehensive approach reveals how multiple factors are converging to create a pediatric health emergency.

Despite spending nearly twice as much on health care as other high-income nations, the United States continues to see worse health outcomes. The editorial accompanying the study noted that Americans have long had poorer health compared with other wealthy countries, and though this was previously mainly seen in adults, it has now spread to the pediatric population.

Prematurity rates in the United States are at historic highs, driven by maternal chronic conditions such as diabetes and pre-pregnancy hypertension, unhealthy weight, smoking, and alcohol and substance abuse.

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Ninety-three percent of U.S. adults are metabolically unhealthy, reflecting widespread chronic disease and poor metabolic health. Every year, one in 10 to one in 20 pregnant women in the United States develop gestational diabetes, with the United States and Canada showing higher prevalence compared with Europe, depending on the screening method used. The United States also has the highest chronic disease burden and an obesity rate nearly twice the Organisation for Economic Co-operation and Development (OECD) average.

The increasing use of smartphones and social media disrupts sleep patterns and reduces physical activity, creating a cascade effect that leads to loneliness, depression, and obesity.

Researchers noted that while the study did not classify results by socioeconomic status, race, or ethnicity, they stated these disparities are likely significant drivers.

An editorial in JAMA observed, “The US has among the highest child poverty rates and income inequality in the OECD,” adding that poverty leads families to rely on cheaper, calorie-dense foods that fuel obesity and older vehicles that heighten crash risks.

Racial and Economic Gaps Deepen the Crisis

While the study didn’t break down results by demographic groups, existing research reveals stark disparities that likely drive the overall poor outcomes. Black mothers face significantly higher preterm birth rates, linked to factors including lack of insurance.

“As usual, limited economic resources can minimize nutrient-dense food sources, access to such food sources, preparation approaches to available food sources and/or limitations in language, time, energy and knowledge,” Linda Van Horn, a research nutritionist at Northwestern University’s Feinberg School of Medicine who was not involved in the study, told The Epoch Times.

Van Horn said that these economic disadvantages create cumulative effects across families and communities, broadly influencing U.S. public health in ways that perpetuate cycles of poor health outcomes.

The findings also support recent research showing that firearms are now the leading cause of death among children in the United States, with firearm-related suicide rates among young people rising steeply.

These health disparities often overlap with social conditions that contribute to violence and crime. Like chronic health conditions, health and crime appear to have a two-way relationship. For example, childhood exposure to violence has been linked to chronic physical illnesses and later mental health problems. Violent and criminal behaviors have also been linked to poor nutrition.