Starting With Curious

“There can be no keener revelation of a society’s soul than the way in which it treats its children.” Nelson Mandela

I wish I could say I was surprised by the results of a few recent reports about the well-being of American children, but I suspect few of us would be. In the most recent Innocenti report by UNICEF from 2025, US children ranked 38 out of 41 OECD countries in physical health, ahead of Colombia, and just behind Turkey. The Innocenti report assigns ranks for overall well-being, as well as separate ratings for physical health, mental health, and academic and social skills, using data from validated national health surveys and government statistics. The US ranked 29 in skills attainment, and while a few nations (including the US) did not get a ranking on overall or mental health due to incomplete data, the previous report from 2020 showed the US was 32 out of 38 for mental health, and 36 out of 38 for overall wellbeing, just edging out Bulgaria.

Another recent study shows that not only are American children considerably less healthy than their counterparts in other wealthy countries, but their health is deteriorating. Chris Forrest and colleagues from Children’s Hospital of Philadelphia looked at US child health trends from 2007 to 2023. Over that period the prevalence of a wide range of health problems from obesity to anxiety and depression increased, with children in 2023 15-20% more likely to have a chronic health condition compared to 15 years earlier. Overall, 39% of American children have one or more of 24 chronic health conditions. Kids are not only living with more illness, they are also dying. After initially declining in the 2010s, both infant (<1 year) and child (1-19 year) mortality rates have subsequently increased, and both are approximately twice as high as the OECD average.

The kids are not alright.

Everyone will have their theories about why this is the case. The UNICEF report notes that health and well-being are highly multifactorial, involving global, local, family, and individual factors, many of which are interconnected. The COVID pandemic, climate change, armed conflict, socioeconomic and demographic changes, and social media are all discussed. And there are reasons to believe all of those are likely contributing to the worsening heath trends over time. Yet the data on how the US compares fails to explain our dismal rankings. For many of the risk factors discussed, the US performs better than average. Why are we lagging? One striking difference: the other countries effectively have universal healthcare coverage for children.

Makes you wonder, doesn’t it?