Parenting Pressures: Why the Surgeon General Warns about Public Health Risks

In August 2024, U.S. Surgeon General Dr. Vivek Murthy issued an advisory that declared parental stress a public health crisis1. Amid a recent push to approach more mental health concerns from a public health approach, this move highlights the significant impact that chronic stress among caregivers has on family health, well-being, and even broader societal outcomes. The advisory emphasizes the urgent need for policy changes, community support, and systemic interventions to alleviate stress among parents, particularly as the pressures of modern parenting have escalated dramatically in recent years. These concerns can be expected to grow as new parents are faced with shifting norms around best practices for raising children. 

Understanding the Surgeon General’s Warning

Dr. Murthy’s advisory is part of a broader effort to acknowledge and address the growing mental health crisis, specifically among parents in the U.S. A better understanding of the burdens of mental health concerns on the family sphere translates into more effective strategies for solutions that engage the entire family unit. The document points out that when parents are stressed, overwhelmed, and unsupported, their ability to care for themselves and their children is severely impacted1. Long-term parental stress doesn’t just affect adults—it also undermines children’s development, exacerbating mental health issues like anxiety, depression, and behavioral problems in the next generation 

The Surgeon General’s office has highlighted financial pressures, work-family balance, and mental health struggles as primary factors contributing to stress2. These issues have been compounded by economic uncertainty, rising childcare costs, and insufficient social support 

systems for parents. The isolation brought on by technology and changes in modern life, such as the blurred lines between work and home due to remote work, has only added to this growing stress burden. 

Major Contributing Factors to Parental Stress

1. Economic Pressures and Lack of Childcare Support: Many parents face severe economic challenges that heighten stress levels. The lack of affordable childcare and paid family leave are key issues contributing to stress. The U.S. lags behind many other countries in providing these essential supports. Families are often forced to choose between caregiving responsibilities and maintaining their income. Recent research has shown that childcare costs have risen sharply in the past decade, with many families spending as much as 10-20% of their annual income on childcare4. This excludes the costs associated with deliveries as well, especially in light of the rise in the rates of emergency C-sections performed5. When longitudinal reproductive healthcare and child care are made prohibitively burdensome, by time, distance, or cost, every member of the family structure suffers.  Paid family leave, where available, provides some relief, but it is often limited in duration and scope. For example, in Washington State, paid leave offers up to 12 weeks of partial wage replacement6. However, this leaves out many part-time and gig workers, and the wage replacement rate is insufficient for many families, covering only 50-90% of their wage. The unwritten message when new parents are not supported at a structural level is that productivity and output are more important at their workplace than their personhood and wellbeing.
2. Work-Family Balance and Gendered Expectations: In today’s society, parents—especially mothers—are under immense pressure to “do it all.” Modern parenting often involves juggling full-time jobs, caregiving, and managing a household. A Portland-based pediatrician, Dr. Whitney Casares, described these expectations as unrealistic and unsustainable, particularly for women7. According to Dr. Casares, mothers feel societal pressure to maintain successful careers while also fulfilling the roles of perfect caregivers and homemakers. These expectations contribute significantly to mental burnout, especially without the needed social support3. This burnout and stress can compound postpartum risk for depression, anxiety, and OCD. Each of these conditions are linked to the growing proportion of maternal mortality rooted in mental health concerns, whether from suicide or overdose.
3. Racial and Social Inequities: Parental stress is also deeply intertwined with systemic racism and social inequities. For parents of color, particularly Black mothers, stress levels are often compounded by the daily realities of racism and discrimination. This has been recognized by both the Surgeon General’s Office and organizations like the Alabama Institute for Social Justice2. Many marginalized parents face added stress from healthcare disparities, financial insecurity, and social injustice. Interestingly, climate change and the increased prevalence of extreme weather events contributes to this impact, layering onto existing disparities that make certain populations more vulnerable to the effects of environmental effects. In the perinatal period, exposure to extreme weather events adversely impacts maternal functioning, from coping to resilience9. For those already living on the margins of society, this can be expected to disproportionately increase parental stress, especially if climate exposures were traumatic to the parent or family.
4. Technology and Digital Overload: The rise of digital technology has introduced additional stress for parents. Many are increasingly concerned about their children’s use of technology, including exposure to social media and online content. Monitoring children’s online behavior, managing screen time, and navigating issues like cyberbullying add another layer of complexity and stress for today’s parents, who may not have grown up with the same level of digital interaction. This relates closely to the recent news of Instagram’s move to make social media spaces safer for the health of teens, adding to the tools that parents have to manage the role of technology within their family. Even with advocates moving towards safer virtual interactions, the proliferation of digital devices has created an environment where work, caregiving, and personal life are constantly intertwined. For one example, comparison between parents on online forums, especially targeted towards mothers, on the best practices for raising children can further extend stress1.

The Broader Public Health Impact

The Surgeon General’s advisory points to research showing the long-term impacts of parental stress on children. High levels of stress in parents can lead to neglect, emotional dysregulation, inconsistent caregiving, and even abusive behavior, as stressed-out parents are less able to provide stable, nurturing environments. According to a study by Child Trends, children who grow up in high-stress households are more likely to experience emotional and behavioral issues, which may persist into adulthood10. The parenting styles that a child’s caregivers model impact their approach to future care-giving, implicating parental stress as a generational, cyclic issue. 

The advisory also connects parental stress to a broader decline in birth rates across the U.S.11. In recent years, fewer Americans are choosing to have children (and those who do are having fewer children) with financial concerns, work-life balance, and stress over the responsibilities of parenting being major contributing factors. In Washington State, for example, the number of births has steadily declined, reflecting national trends11. Many families cite the lack of adequate childcare, financial instability, and insufficient parental leave as reasons for delaying or avoiding having children altogether. While a decrease in birth rates is not a negative outcome in its own right, the impact of stress and external pressures as determinants for family planning are worthy of concern. 

Policy Recommendations and Support Systems

Dr. Murthy’s advisory calls for significant policy changes to better support parents. These recommendations include expanding access to affordable childcare, improving paid family leave, and increasing funding for mental health services targeted at parents. Additionally, community-based programs and workplace policies must evolve to support work-life balance and reduce the stress burden on caregivers. The stress of having a child is not best handled alone, and it can take a village to share the responsibilities that are so often placed on one individual. 

The advisory stresses that tackling parental stress requires systemic change—not just individual resilience strategies. Parents need better access to resources, from financial aid to mental health care, and communities must provide stronger support networks. Organizations like the American Academy of Pediatrics and the Center for Parent Information and Resources have long advocated for such systemic reforms to ensure healthier environments for families12. 

At the local level, some states are taking steps to address these issues. While policies like Washington’s Paid Family and Medical Leave Act (PFML) offer a start, many experts argue that the U.S. should follow other developed nations by providing more comprehensive support like universal healthcare and extended parental leave. 

Conclusion

The U.S. Surgeon General’s declaration of parental stress as a public health crisis reflects the serious, widespread impact of chronic stress on caregivers and their families within the general increase in chronic stress within the US1. Factors such as financial insecurity, work-family balance, systemic racism, and the challenges of modern life all contribute to the stress burden. While policy solutions like paid family leave and affordable childcare represent a step forward, much more needs to be done to support parents, namely tailoring public health interventions to those in marginalized communities. By addressing parental stress at a systemic level, society can improve the mental health of both parents and children, ensuring a healthier and more resilient future generation of parents to come.