The American Child Death Toll Is Mortifying
US children are 80 percent more likely to die before adulthood than children in peer nations. Causes range from lax gun laws to privatized health care. What connects them is a corrosive culture of individualism that makes child safety parents’ private business.
A mother straps her son into a car seat at their home in Walnut Creek, California. (Paul Chinn / the San Francisco Chronicle via Getty Images)
At some point or another, something will happen to you as a parent that will turn you — no doubt a once normal, fun-loving person — into an obsessive lunatic. In my case, it happened when my son was just six months old and I learned that the supposedly “organic” baby food pouches that he was addicted to were, in fact, chock full of carcinogenic heavy metals that have been linked to numerous neurological disorders, including autism. This would not be the last time I was confronted with the alarming prospect that the products sold to us at our grocery stores, pharmacies, and online retailers are possibly poisonous — even the ones labeled “organic.” Despite living in this country my entire life, the fact that US food safety hovers dangerously close to The Jungle levels of noxiousness somehow evaded me.
It was this little episode that turned my husband and me into complete neurotics. Apparently, we’re not alone in our neuroses: In 2024, the US surgeon general declared parental stress dangerous enough to warrant a public health advisory. And who wouldn’t be stressed? In a country where those who produce, market, and distribute our food operate under little government oversight, it’s up to parents themselves to become experts in food safety — not to mention experts in safe sleeping, car safety, and every single chemical that touches their skin. Should we use elemental chlorine–free diapers or totally chlorine-free ones? Do we need an organic mattress? Is that mineral sunscreen approved by the Environmental Working Group? It’s maddening!
All of this is to say that when I saw the headline “US children are much more likely to die than kids in similar countries,” you better believe I thought I was prepared. Inevitably, I assumed, American children were dying from one of the countless chemicals or particles I had already painstakingly driven from my home. What was it going to be? Sulfates? Microplastics? Heavy metals? Nitrates? Synthetic dyes?
Unfortunately, the problem isn’t so simple to root out. Instead, it seems to be holistic, multifactorial, and staggering in scale. According to a recent study by Christopher B. Forrest and others published in the Journal of the American Medical Association (JAMA), over the past seventeen years American children’s health has deteriorated across virtually every measurable indicator, with US children now dying at rates 78 percent to 80 percent higher than children in other wealthy nations.
The team responsible for the study closely examined eight different datasets — including five nationally representative studies, national mortality surveys, and electronic health records from ten major pediatric health systems — and compared American outcomes to those of eighteen other wealthy countries. Their research revealed a horrifying finding: in the years studied, the researchers estimated 315,795 excess deaths of American children.
The list of contributing factors is long and disturbing. Chronic health conditions among American children rose from 40 percent to 46 percent during the period studied. The researchers further found that US children face a fifteen-fold higher risk of dying from firearms and more than double the risk of dying in car accidents compared to their international peers. While American children were already 80 percent more likely to die than children in other wealthy countries, this gap grew even wider during the pandemic years, when the mortality rate increased so rapidly that they became two times more likely — that is, over 100 percent more likely — to die than their international peers.
Mental health disorders also skyrocketed, with depression increasing by 230 percent and anxiety by 206 percent during the study period, and loneliness among teens jumping from 20 percent to 31 percent. Nearly 40 percent of high schoolers now report feeling “sad or hopeless,” illustrating how American children aren’t just dying at higher rates but also suffering psychologically in ways that would be unthinkable in peer countries with stronger social support systems. Moreover, this mental health crisis may help explain why American children also die from substance use at more than five times the rate of their international peers and could account for some portion of the fifteen-fold higher firearm death rate.
While the editorial accompanying the study suggests some societal reasons for this situation, the researchers’ focus on individual health indicators misses the bigger picture. The wider scope becomes obvious when we put the American situation in dialogue with those of other countries. Other countries have free, or at least government-subsidized, health care, while we do not. Their health services focus on prevention; ours focus on treatment. Other countries have strict firearm regulations; we have the opposite. Other countries have paid parental leave; we are one of the only nations on God’s green earth that forces working new parents to financially fend for themselves.
What these differences have in common is that where peer nations are organized according to the principles of solidarity and common welfare, the United States is organized according to the principles of individualism and self-reliance. American children are dying due to a culture of isolation that treats child welfare as the parents’ individual responsibility rather than a collective commitment.
Children Are Everyone’s Responsibility
While we obviously need universal health care, paid parental leave, and gun control, we require more than just discrete policy interventions. We need to shift in orientation from a society that tells parents “tough luck” to one that considers children’s well-being a matter of shared concern and their protection a mutual endeavor.
The study’s time frame contains clues about what’s gone wrong. It begins just before the 2008 recession and ends right after the COVID pandemic — two massive crises that revealed how the United States abandons families when they most need support. Whereas other wealthy nations provided robust safety nets during these upheavals, American families were left to navigate job losses, health care disruptions (did you know health care premiums rose 15.9 percent in 2020?), and economic instability mostly on their own.
And things aren’t getting better. They’re only getting worse. Though Donald Trump and Robert F. Kennedy Jr’s “Make America Healthy Again” (MAHA) rightly brought attention to microplastics and provisionally reduced the ubiquity of potentially dangerous food dyes, Republican initiatives are rendered near-meaningless as the same administration dismantles the very programs that actually save children’s lives, including injury prevention programs, the “Safe to Sleep” campaign, Medicaid, and pollution and emissions regulations set by the Environmental Protection Agency.
Public programs built during the New Deal and Great Society eras have been on the chopping block since the 1980s. What makes Republican efforts even more harmful than usual, however, is that they distract parents with small-bore fixes as they strip away the (already insufficient) structures that support parents and protect children. MAHA offers the performance of care while parents are no better off than they were before: alone, overwhelmed, and shouldering responsibilities that should be fulfilled by a functioning government.
Consequently, many American parents have been turned into anxious researchers, frantically Googling ingredient lists at 2 a.m. — not because we’re naturally paranoid, but because our government has abandoned the basic task of keeping the next generation safe and healthy.
Unfortunately, the Left is almost nowhere to be found on the issue of child safety. While we’ve rightly embraced universal programs like Medicare for All, we’ve failed to develop a comprehensive vision that recognizes children’s welfare as the foundation of a just society. Skittish about making normative claims about family structure, we don’t talk much about children at all, which creates a massive opening for the Right on this issue.
This is a grievous mistake. We can’t keep ceding “family values” to people who offer thoughts, prayers, and superficial quick fixes instead of universal health care, gun reform, public safety programs, parental leave, and a new ethos of solidarity to replace the corrosive individualism running through American political and social life.
The data shows that children are healthiest in countries that don’t just have good policies but also cultures of social responsibility and collective care. The American left must become the movement that promotes what every other developed nation already knows: protecting children requires that we overcome social fragmentation.
We need a Left that champions not just universal health care but a cultural transformation that makes children’s welfare everyone’s responsibility, not a private burden shouldered by overwhelmed parents armed with nothing but Google, good intentions, and, if we’re fortunate, a steady supply of Xanax.