In the movie, A Few Good Men, there is a famous line,” You can’t handle the truth.” It seems in today’s political climate many people think ”the people” can’t handle the truth or maybe they should not know the truth. It is hard to know what the truth is or who is telling the truth. In medicine or research, scientists collect information, run tests and then submit their findings to a journal. To make sure their findings are true they are evaluated by their peers who critically look at their work to see if it has any mistakes or influence from other sources such as drug companies. If it passes all their tests, it is printed to be shared with the world in a peer reviewed journal.
Two very respected peer reviewed journals are the Journal of the American Medical Association (JAMA) and the New England Journal of Medicine (NEJM). The information they have published in 2025 and 2026 may seem unbelievable. In JAMA, Elizabeth R. Wolf et al, reported that US residents have lower life expectancy and worse outcomes than those in other high-income or peer countries despite exorbitant spending on health care that is nearly twice as high relative to gross domestic product of the other peer countries.
They report that this US health disadvantage has spread to the pediatric population. In the NEJM Christopher B. Forrest et al reported the following: “We documented pervasive declines in children’s health over the past two decades. Infants, children, and adolescents are 80% more likely to die than their peers in other high-income countries. Rates of chronic physical, neurodevelopmental, and mental health conditions, including obesity, have increased, and children in the current generation tend to enter puberty earlier, have more trouble sleeping and report more physical and emotional symptoms than those in the previous generation. Another analysis (Office of the Under Secretary of Defense, April 2022) found that 77% of Americans 17 to 24 years of age would be ineligible to enlist in the US military without waiver, for reasons including obesity, mental health problems and other medical conditions. It can no longer be assumed that American children will grow up to be as healthy as their parents.”
Both reports from JAMA and NEJM evaluated the root causes of the health challenges of American children. They describe 5 root causes: fragmented health insurance (5% of children have no insurance), health behaviors (unhealthy diet/physical activity, social media, firearms), social determinants of health (estimated to account for 1/3 to 1/2 of health outcomes), physical and social environment (unsafe neighborhoods and environment hazards) and public policies (high-quality early childhood programs).
Dr. Forrest suggests that child health has deteriorated because the present living environments have made it too difficult to be healthy. To address the drivers of poor health, society should move from responding to health crises one symptom/child at a time to redesigning our present environment to create healthy environments.
As a people, can we handle the truth?
By Sally Robinson MD
University of Texas Medical Branch (UTMB)
Published October 2026