Prevalence and Trends in Pediatric-Onset Chronic Conditions in the United States, 1999-2018

Abstract

Objective: We sought to provide an updated estimate of the current prevalence and recent trends (over the past two decades) in pediatric-onset conditions among a nationally-representative sample of youth to identify opportunities for prevention and intervention.

Methods: We performed a secondary data analysis of nationally-representative data on 236,412 participants (ages 5-25 years) from the 1999 to 2018 National Health Interview Survey. Chronic conditions (CCs) and functional limitations (FLs) were self-reported by the participant or a qualified proxy-respondent. We employed multivariate linear probability models to estimate annual average increase in CC/FL prevalence and differences in prevalence across sociodemographic characteristics.

Results: The prevalence of children (5-17 years) with a CC/FL has risen from 22.57% in 1999/2000 to 30.21% in 2017/2018 - an adjusted annual increase of 0.24% points per year (P<.0001) or about 130,000 additional children per year. The prevalence of young adults (18-25 years) with a CC/FL has risen similarly (adjusted annual increase of 0.33% points per year, P<.0001). Asthma and mental/behavioral health conditions were some of the leading CC and FL (respectively) contributors to this increase for both age groups. We estimate that approximately 1.2 million youth with a CC or FL currently turn 18 each year.

Conclusions: The US is currently seeing an unprecedented number of youth with pediatric-onset conditions. It is incumbent for the US health system to seek ways to treat these patients in pediatric settings and eventually matriculate them into adult care.

Keywords: children; chronic conditions; functional limitation; health care disparities; young adults.