Pandemic of Chronic Diseases

Health Crisis

In recent decades, American children have experienced a decline in once common childhood infections, such as measles, whooping cough and chickenpox. At the same time, a growing number of children have begun suffering from a wide range of noncommunicable, serious and often incurable illnesses, including neurodevelopmental disorders such as autism and learning disabilities, mental illnesses such as anxiety and obsessive compulsive disorder, and an array of immune-mediated diseases such as asthma and autoimmune diseases. These once rare pediatric anomalies now afflict American children in pandemic proportions.

A 2011 Health Affairs assessment estimated that 43 percent (32 million) of American children currently suffer from at least one of twenty chronic health conditions, which increases to more than half (54.1 percent) when overweight, obesity or being at risk for developmental delays are included. Nearly one-fifth (14.2 million) of children have conditions resulting in a special health care need.

Bethell et al. (2011). A national and state profile of leading health problems and health care quality for US children: key insurance disparities and across-state variations. Academic Pediatrics 11(3 Suppl):S22-S33. https://doi.org/10.1016/j.acap.2010.08.011

The Centers for Disease Control and Prevention (CDC) estimates that more than a quarter (27 percent) of American children have a chronic condition and one in fifteen are burdened with multiple chronic conditions.

Centers for Disease Control and Prevention, Multiple Chronic Conditions Among Outpatient Pediatric Patients, Southeastern Michigan, 2008–2013. BRIEF, Vol. 12, 2015. https://www.cdc.gov/pcd/issues/2015/14_0397.htm

It was reported in The Journal of the American Medical Association (JAMA) that chronic illnesses in children doubled from 12.8 to 26.6 percent between 1994 and 2006, with low-income, racial and ethnic minority children being disproportionately affected in an epidemic that has continued to grow.

Van Cleave et al. (2010). Dynamics of Obesity and Chronic Health Conditions among Children and Youth. JAMA 303(7):623–630. https://doi.org/10.1001/jama.2010.104

Compared to children two generations ago (in the 1960s), as reported in Health Affairs, American children are now more than four times more likely to be burdened with a health condition so severe that it affects their usual daily activities.

Perrin et al. (2014). The rise in chronic conditions among infants, children, and youth can be met with continued health system innovations. Health Affairs 33(12):2099-2105. https://doi.org/10.1377/hltha.2014.0832

A 2018 Pediatrics study reported that one-fifth of American children and adolescents regularly use prescription medication and 12% of boys aged six to 12 years are prescribed more than one drug.

Dima et al. (2018). Prescription Medication Use Among Children and Adolescents in the United States. Pediatrics 142(3):e20181042. https://doi.org/10.1542/peds.2018-1042

Much of this disease burden has come from neurodevelopmental disorders, mental illness, and immune-mediated conditions.

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