Opinion: Child health is the national security crisis we keep ignoring

Sept. 29, 2026 Cheng is the B.K. Rachford professor and chair of pediatrics, University of Cincinnati, and director of the Cincinnati Children’s Research Foundation. Perrin is professor of pediatrics emeritus, Harvard Medical School, and the John C. Robinson distinguished chair in pediatrics, Mass General Brigham for Children. McChrystal is a former commander of U.S. and coalition forces in Afghanistan and founder of the McChrystal Group. Concerns about military readiness, workforce shortages, rising health care costs, affordability, and America’s ability to compete in an increasingly challenging world seem to play on a loop without any sign of progress. Maybe that’s because these challenging and seemingly intractable problems are usually treated as separate crises requiring separate solutions. They are not. The root cause they share is the declining health and well-being of America’s children, a situation that threatens our future safety and security militarily, economically, and globally. According to a 2020 Department of Defense study, a staggering 77% of young Americans do not qualify for military service due to health concerns. Is it any wonder that for the first time three military branches did not reach recruitment goals in fiscal year 2023? (There has been some rebound since then due to increased pay, pre-boot camp programs, and loosening requirements.) While this may be framed as a military problem, the problem stems from the decade before a young person reaches enlistment age. A study last year in JAMA found that children’s health deteriorated alarmingly between 2007 and 2023. It noted American children were 1.8 times more likely to die in the U.S. than in other industrialized countries. Four in 10 American kids will become adults hampered by obesity, chronic illness, anxiety, depression, or other conditions that can limit their opportunities and shorten their lives. These health challenges impact how well they do at school, which in turn affects how or even if they participate in the workforce and their long-term productivity. There’s no path for the U.S. to remain a strong country if its children struggle to thrive. A healthy, capable workforce is the foundation on which we build America’s prosperity. Yet we see falling birth rates and with them, the related slowing of our labor-force growth, even as employers need greater numbers of healthy, adaptable, and well-educated employees. When children face preventable health problems, food insecurity, untreated mental health conditions, or barriers to learning, it does not bode well for the future. Those challenges become tomorrow’s workforce shortages, rising health care costs, and lost economic potential. What happens in childhood shapes the health, productivity, and resilience of the nation for decades to come. We’ve been here before. In the 1960s, military leaders discovered that nearly one-third of young men were unfit for service because of conditions rooted in childhood poverty, poor health care, and limited educational opportunities. We responded with urgency. Policymakers expanded investments in training programs and anti-poverty programs and strengthened Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment benefit so all kids could thrive avoiding educational and health problems from becoming burdens they will carry throughout their lives. That generation understood a simple truth: Investing in children goes well beyond good social policy. It’s a path to building national strength. Today, we face a similar decision point. The National Academies of Sciences, Engineering, and Medicine’s recent “Launching Lifelong Health” report, which two of us co-chaired, outlines practical steps to improve children’s health today together with their long-term outcomes. The solutions are neither radical nor untested. They include ensuring access to health care, supporting nutrition and healthy development, investing in research, strengthening early childhood programs, and reducing the economic hardships that can hobble children’s health from the very beginning of life. From the work done in a previous generation, we know these investments work. What remains unclear is how to build the will we need to treat them as national priorities. Many of the challenges dominating today’s policy debates — from military readiness and economic competitiveness to rising health care costs and declining life expectancy — have roots in childhood. Healthier children become healthier adults. They are more likely to succeed in school, participate in the workforce, serve their communities, and contribute to economic growth. America’s children are tomorrow’s workers, innovators, caregivers, leaders, and defenders. We cannot build a strong military, a dynamic economy, or a secure future on a weakened generation of children. National security does not begin at the Pentagon. It begins in childhood. Tina L. Cheng, M.D., M.P.H., is the B.K. Rachford professor and chair of pediatrics, University of Cincinnati, and director of the Cincinnati Children’s Research Foundation. James M. Perrin, M.D., is professor of pediatrics emeritus, Harvard Medical School, and the John C. Robinson distinguished chair in pediatrics, Mass General Brigham for Children. Gen. (Ret.) Stanley McChrystal is a former commander of U.S. and coalition forces in Afghanistan and founder of the McChrystal Group, where he advises global leaders on navigating complexity and building high-performing teams.