There is a crisis in children’s health in the United States. While rates of disability and death due to cardiovascular disease, stroke, and many cancers among adults have been decreasing over the past half century, the incidence of serious pediatric diseases has been increasing. A recent paper published in the New England Journal of Medicine and written by a diverse selection of science and policy experts — including myself — reviewed the evidence.
Over the past 50 years the incidence of childhood cancer has increased by 35 percent. The prevalence of pediatric asthma has tripled, while childhood obesity has nearly quadrupled and trends in type 2 diabetes have shown a sharp increase. The frequency of reproductive birth defects in boys has doubled. One in six children now show neurodevelopmental disorders and one in 36 are now diagnosed with autism spectrum disorders. Such trends should be of national concern; these non-communicable diseases cause the nation’s largest share of childhood illness and deaths.1
Chemicals linked to health harms
A growing body of clinical and epidemiological research has linked these health conditions with exposure to a broad array of manufactured synthetic chemicals, including heavy metals, halogenated hydrocarbons, and plastic additives. Many of these chemicals are recognized as carcinogens, mutagens, neurotoxicants, endocrine disrupters, and substances hazardous to reproduction. Many others are simply untested.
Hazardous chemicals are now ubiquitous in the global environment. Children everywhere today grow up in a world contaminated with low levels of these chemicals.2 Even children privileged to live in high income communities often breathe polluted air, drink water with limited health standards, eat untested foods, and play with consumer products assumed to be safe simply because they are on the market. Children in lower income communities and economically developing countries are at even greater risk.
A precautious children’s health policy would strive to reduce or eliminate the use of these hazardous chemicals across the economy. Past experience in reducing the use of harmful chemicals in occupational settings, in gasoline, in schools, and in consumer products has demonstrated measurable effectiveness in reducing specific health effects.
A call to action for children's health
The paper was written in 2024 to call national attention to the chemical threats to children’s health. It reviews the relevant pediatric health science and then moves on to critically assess the inadequate federal laws and regulations regarding hazardous chemicals. It closes with a set of ambitious recommendations including new laws, a new international chemical treaty, increased corporate responsibilities for public transparency, and the transition of the chemical manufacturing industry to safer chemistries. The paper was published in January of 2025 and widely covered in the national media.
However, January 2025 also marked the inauguration of a new federal administration. In the months since, much has changed in federal policy. Wide swaths of federal environmental regulations have been waived or weakened, agency staff have been cut or prevented from doing their jobs, on-going safety programs have been terminated, and budgets for health and environmental research have been eliminated. These changes do not respond well to the recommendations of the paper.
Although the administration’s newly announced attention to the chemical hazards of pesticides, dyes, and preservatives in processed foods could lead to a reduction in some childhood exposures, it will not reduce environmental exposures or exposures to the ingredients in domestic products.
It is unlikely that new regulations will emerge from this administration or that existing regulations will be enforced. Research progress on the causes of childhood diseases will be slowed. Instead, there may be a focus on direct discussions with corporations, voluntary agreements, and negotiated deals (a practice that seems popular with the administration). But trends in children’s health will not be simply flipped like a switch, and it will take far more serious efforts than market-oriented deals to make children’s health grand again.
This article first appeared in the Summer/Fall issue of the San Franscisco Marin Medicine journal (Volume 98, Number 3) in a special section on children's environmental health. This and previous issues of the SF/Marin Med Society journal featuring articles from CHE are available in our Resource Library.
Ken Geiser, PhD, is Professor Emeritus of Work Environment and Distinguished University Professor at the University of Massachusetts Lowell. One of the authors of the Massachusetts Toxics Use Reduction Act, he was Director of the Massachusetts Toxics Use Reduction Institute for thirteen years. As founder and past Codirector of the Lowell Center for Sustainable Production, he is also the author of Materials Matter: Toward a Sustainable Materials Policy and Chemicals without Harm: Policies for a Sustainable World. As a recognized expert on environmental and occupational health policy, he has served on various advisory committees for the US Environmental Protection Agency, and the United Nations Environment Program and the International Pollutants Elimination Network.