Decline in U.S. kids’ health seen by LI families, docs

Faith Grullon’s anxiety was so bad during much of her senior year at Oceanside High School, she had a hard time sitting still in class.

“You feel your heart rate dramatically increase. You start to get sweaty and panicky, and there’s nothing you can do to stop it,” she said.

Grullon, 20, overcame the worst of her anxiety. But what Long Island families have talked about with each other, and pediatricians have seen in their practices, is now backed by a peer-reviewed study: American children’s mental and physical health has been in a yearslong decline. In some cases, as with anxiety, millions more kids are impacted than just a few years ago.

Long Island pediatricians said they have seen more of their patients having a harder time coping with day-to-day life, and dealing with physical ailments and limitations.

The question now is why, as researchers seek to find ways to stop the decline and reverse the trends.

The study, published July 7 in the journal JAMA, concludes that “U.S. children’s health has deteriorated across a broad spectrum of indicators, highlighting the need to identify the root causes of this fundamental decline in the nation’s health.”

Researchers, looking primarily at health statistics from 2007 to 2023, found increases in a number of physical, developmental and mental health conditions, including obesity, anxiety, depression, developmental delay, behavioral problems, speech and language problems, autism and attention-deficit/hyperactivity disorder. Children have poorer sleep and feel lonelier compared to the past, and they are more likely to die than kids in other high-income countries.

Dr. Sara Siddiqui, a pediatrician at NYU Langone Huntington Medical Group, said she was alarmed by the trend, but because she has seen the change in her patients, she was not surprised by the study’s findings.

“All pediatricians know this information already,” she said.

She said she hoped the study leads to more resources and research.

The biggest increase in a chronic mental or physical health condition between 2011 and 2023 was for anxiety, researchers found when they looked at results of parent responses to the National Survey of Children’s Health.

The increase began before COVID-19 and continued during the pandemic, studies show. Anxiety rates were highest among adolescents: The percentage of those 12 to 17 with diagnosed anxiety rose 63% between 2017 and 2023, from 9.9% in 2017 to 16.1%, with rates highest among girls, according to a federal analysis of health survey results.

Grullon said her pediatrician, Dr. Suanne Kowal-Connelly, director of pediatrics of the nonprofit Harmony Healthcare Long Island, recommended an antianxiety medication.

“I can’t even explain to you how much that medication changed my life,” said Grullon, now an honor-roll criminal justice student at the University of South Carolina.

Possible causes: Screen time, substance abuse, chemicals

Many researchers and doctors blame the skyrocketing rates of anxiety and depression — the depression rate among adolescents rose 50% between 2017 and 2023, to 8.4% — in part on increased screen time and social media use, although Grullon said she doesn’t believe that was a factor for her. She doesn’t know what triggered her anxiety.

Former U.S. Surgeon General Vivek Murthy said in a 2023 advisory that excessive time on social media creates “a profound risk of harm to the mental health and well-being of children and adolescents,” although an American Psychological Association advisory on potential harms of social media said it can be beneficial for some kids, depending on how it’s used.

Dr. Saurabh Gupta, a child and adolescent psychiatrist at Stony Brook Medicine, said research has shown strong links between too much screen time, especially while alone, and anxiety and depression, as well as poorer social skills and lower-quality relationships.

The new study found that an American child or adolescent was 80% more likely to die than counterparts in 18 other high-income countries, with especially large differences in death rates from substance use, firearms and vehicle crashes.

There’s a relationship between the inferior health outcomes for U.S. adults — life expectancy in the United States is years lower than in other wealthy nations — and health problems in children, said Jason Niu, an assistant professor of epidemiology at the University at Buffalo.

A study published in May that Niu co-authored found that children born to mothers with health problems during pregnancy were more likely to have high blood pressure as they grew up.

“If the mother has poor health, the baby will have poor health too,” he said.

Less regulation in the United States of chemicals in food and water compared with many other countries likely is another factor in health issues in kids, he said.

Siddiqui said the food that U.S. kids eat is often unhealthy, in part because fresh fruits and vegetables typically are more expensive than highly processed foods. Lower family incomes also often mean less access to health care, after-school sports programs and parks where kids can exercise, she said. Obesity rates are higher in low-income children than in higher-income kids, research shows.

In the United States, more than 21% of people ages 2 to 19 had obesity in 2021-23, compared with fewer than 14% in 1999-2000 and 5% in 1971-74, according to federal data.

Dianadys Batista said her son, Angel, 12, began having weight problems when he began remote learning during the start of the pandemic.

“There wasn’t a lot of movement, not much activity going on,” compared with before the pandemic, when he played football, she said.

Two years ago, Angel’s doctor, Kowal-Connelly, said she put him on a weight-management program, and he no longer is obese.

Batista, 50, of North Baldwin, said Angel “has been more active,” riding his bike, playing basketball and walking. She also more carefully controls what he eats.

Better diagnosis for some conditions

The study noted how the rate of autism spectrum disorder has increased dramatically over the past few decades. Prevalence increased from 1 in 150 8-year-olds in 2000 to 1 in 32 8-year-olds in 2022, according to findings of a long-term federal autism surveillance project. But unlike conditions like obesity, that’s because children with autism are more likely to be diagnosed, experts said.

Increased awareness and understanding among medical professionals and parents of disorders such as autism, and of children’s mental health needs, is cause for optimism, because it means more kids are obtaining services that improve their lives, doctors say.

Kowal-Connelly said two or three decades ago, many pediatricians did not screen for autism and believed that symptoms reflected behavioral issues the kids might grow out of. The American Academy of Pediatrics did not begin recommending screening for autism and other developmental disabilities until 2006.

Rosa Calderon, of Freeport, recalled how she realized when her son Angel, now 23, was six months old that he was developing differently than her two daughters had.

“I told the pediatrician, ‘Angel is very distracted, he doesn’t look at me, he doesn’t pay attention to me,’ ” Calderon recalled in Spanish. “She told me not to worry.”

At subsequent exams, she expressed more concern, that “he doesn’t say anything. He doesn’t rest. He doesn’t sleep.” But the doctor kept insisting Angel was fine, Calderon, 66, said.

“She wasn’t taking into account what I was saying,” she said.

The pediatrician finally recommended an evaluation, and at 2½ years old, he was diagnosed with autism. Calderon said her son is moderately autistic and is in programs that she hopes will allow him to one day work.

Kowal-Connelly said medical professionals now understand that autism is on a wide spectrum, and that high-functioning, often highly intelligent children who in the past may have been disparagingly labeled “that weird kid” by classmates also are on the spectrum and can benefit from services.

Autism still carries a stigma, but parents increasingly realize that their children would benefit from treatment, she said.

“They’re more inclined to ask for help if they think something is developmentally awry with their child and seeing the different services that might help their child,” Kowal-Connelly said.