National Academy of Medicine

Why the United States Needs a National Birth Cohort Study

May 31, 2016 | Discussion Paper

In a list of 17 high-income countries, the United States ranks last in terms of life expectancy for males and second-to-last for females. The U.S. population also experiences worse outcomes compared with its peers in nine key areas: infant mortality and low birth weight; injuries and homicides; adolescent pregnancy and sexually transmitted infections; HIV and AIDS; drug- related deaths; obesity and diabetes; heart disease; chronic lung disease; and disability. In addition, the United States sees persistent racial, ethnic, socioeconomic, and geographic disparities in health.

Why does the United States fare so poorly compared with its peers? There are many possible reasons, ranging from adverse economic and social conditions to individual behaviors and environmental factors. For example, we know that people often have difficulty accessing or affording care in the United States; and the U.S. population has higher rates of risky health- related behaviors, such as alcohol use, injuries, and unprotected sex. The United States also sees greater income inequality, less social mobility, fewer family supports, and higher rates of poverty—especially child poverty—than its peers. Finally, elements of the built environment, such as inadequate public transportation infrastructure, may discourage physical activity and contribute to high obesity levels.

Without the comprehensive, longitudinal data provided by a national birth cohort study, it will be difficult to identify and make wise investments in policies that will promote health at the individual, community, and societal levels. In short, a national birth cohort study is essential for developing evidence-based policies that are capable of improving the United States’ international health standing—and ensuring that every member of the U.S. population has an equal opportunity to thrive.

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This paper is part of a two-part Perspectives series, Lifelong Impact: Why the United States Needs a National Birth Cohort Study, which discusses the reasons why a national birth cohort study is important for the future of health in the United States and how such a study could be designed in a way that is multidisciplinary, focuses on the main drivers of health, engages communities, employs a diverse set of data sources, and includes innovative techniques in data analysis. Learn more about the series >>


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Disclaimer: The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a report of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved.