American children display consistently poorer health outcomes than children in other wealthy nations, notwithstanding substantially higher per capita health care spending on U.S. children.

In a 2004 report, the National Research Council and Institute of Medicine called attention to the rising tide of ill health in American children and its long-term implications, warning that "the nation cannot thrive if it has large numbers of unhealthy adults." Ten years later, in Lancet Neurology, pediatric experts lamented the pandemic of neurodevelopmental toxicity in children that is "silently eroding intelligence, disrupting behaviors, truncating future achievements and damaging societies." Despite these and many other admonitions, U.S. agencies and officials have paid no meaningful attention to the crisis.