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American pediatrician and health sciences researcher
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Christopher B. Forrest is an American pediatrician and health sciences researcher who is Professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania and Children's Hospital of Philadelphia (CHOP).[1] He is the Founder and Director of PEDSnet, a national pediatric learning health system comprising the nation's leading pediatric medical centers.[1][2] His work has helped establish the fields of child health services research,[3] learning health systems science,[4] and life course health science.[5] He co-edited the Handbook of Life Course Health Development, which has been downloaded more than one million times.[6] Forrest is the co-author of the forthcoming book Thriving (MIT Press, 2027), which makes the case for a new science, social contract, and societal transformation approach to ensure that all people have the opportunity for lives filled with health, well-being, and resilience.[7] He was elected to the National Academy of Medicine in 2023.[2]
Forrest is co-developer of the Johns Hopkins Adjusted Clinical Groups (ACGs) System,[40] a widely used health risk assessment tool. ACGs are used by ministries of health, health plans, sickness funds, health systems, and researchers to evaluate the health risk of populations. ACG risk measures are used to adjust for differences in patient mix in provider performance assessment, resource allocation formulas, and case management programs. They are compatible with both health plan claims and electronic health records, and each day they are used in over 20 countries to improve the care and equity of service provision for millions of people. The ACG System received the AcademyHealth Health Services Research Impact Award in 2015.[41]
Forrest founded PEDSnet, a national pediatric learning health system that is one of the clinical research networks within PCORnet, the national patient-centered clinical research network funded by the Patient-Centered Outcomes Research Institute (PCORI).[1][43] PEDSnet is devoted exclusively to pediatric research and, as of 2026, included twelve pediatric academic health systems with data representing nearly 10 percent of all children in the United States.[2] The network has supported more than 200 observational studies and clinical trials, with cumulative grant funding exceeding $300 million.[1]
Forrest led the development of the AHRQ Learning Health System Researcher Core Competencies, which provided the basis for the AHRQ/PCORI-funded Learning Health Science Centers of Excellence.[4] He directs the PEDSnet Scholars program, an AHRQ/PCORI-funded faculty development initiative that has trained nearly 50 faculty across the country in learning health systems science.[1]
Patient-reported outcomes (PROMIS)
Forrest has been a central figure in the development of pediatric patient-reported outcome measures within the Patient-Reported Outcomes Measurement Information System (PROMIS), an initiative of the National Institutes of Health.[44] He served as Chair of the PROMIS Executive Committee from 2009 to 2014 and led the NIH PEPR (Pediatric Patient-Reported Outcomes) Consortium as Chair of its Steering Committee.[44] His research group has developed more than 50 pediatric patient-reported outcome measures, covering domains such as sleep, global health, happiness, physical activity, family relationships, and school performance in both child self-report and parent-proxy formats.[1][45][46]
Life course health science
Forrest is a major U.S. contributor to the emerging scientific field of life course health science. Life course health science is concerned with how interactions between individuals and their developmental environments produce health and well-being across the lifespan.[5][2] He co-edited the Handbook of Life Course Health Development (Springer, 2018), an open-access volume that has been downloaded more than one million times.[6]
A 2018 study co-authored by Forrest in Health Affairs compared child mortality rates across 20 OECD nations over a fifty-year period and found that children in the United States were significantly more likely to die than their counterparts in peer nations.[47] The study received coverage in outlets including CNN and ScienceDaily.[48][49] In 2025, Forrest and colleagues extended this line of work in JAMA, reporting worsening trends in U.S. children's mortality, chronic conditions, obesity, functional status, and symptoms from 2007 to 2023, reinforcing the life course importance of developmental ecosystems and child well-being trajectories.[50] The 2025 study also received media coverage from outlets including NPR, CNN, PBS NewsHour, AP, and Fox News.[51][52][53][54][55]
Thriving
Beyond his work in health services and outcomes research, epidemiology, data science, and outcomes measurement, Forrest has pursued a broader inquiry into what it means for children and communities to truly thrive, describing the concept as one that unifies health, well-being, and resilience into a single framework.[7] He has argued that American cultural and social systems have become oriented away from investment in children and toward economic output and productivity.[7]
Forrest is currently co-authoring a book titled Thriving that builds the case for a new science of thriving; a new social contract in which people commit to collectively creating a world that promotes thriving for all people; and a new approach for creating the ecosystems that generate thriving as the expected outcome for all.[7]
Forrest, CB; Margolis, P; Seid, M; Colletti, RB (2014). "PEDSnet: how a prototype pediatric learning health system is being expanded into a national network". Health Affairs. 33 (7): 1171–1177. doi:10.1377/hlthaff.2014.0127. PMID25006143.
Halfon, N.; Forrest, C. B.; Lerner, R. M.; Faustman, E. M. (2018). Halfon, N; Forrest, CB; Lerner, RM; Faustman, EM (eds.). Handbook of Life Course Health Development. Springer. doi:10.1007/978-3-319-47143-3. ISBN978-3-319-47143-3. PMID31314220.
Thakrar, AP; Forrest, AD; Maltenfort, MG; Forrest, CB (2018). "Child Mortality In The US And 19 OECD Comparator Nations: A 50-Year Time-Trend Analysis". Health Affairs. 37 (1): 140–149. doi:10.1377/hlthaff.2017.0767. PMID29309221.
Forrest, CB; Meltzer, LJ; Marcus, CL; de la Motte, A; Kratchman, A; Buysse, DJ; Pilkonis, PA; Becker, BD; Bevans, KB (2018). "Development and validation of the PROMIS Pediatric Sleep Disturbance and Sleep-Related Impairment item banks". Sleep. 41 (6) zsy054. doi:10.1093/sleep/zsy054. PMID29546286.
Awards and honors
Boston University Award for Excellence in Pediatrics (1986)[9]
^ abHalfon, N; Forrest, CB (2018). "The Emerging Theoretical Framework of Life Course Health Development". In Halfon, N; Forrest, CB; Lerner, RM; Faustman, EM (eds.). Handbook of Life Course Health Development. Springer. doi:10.1007/978-3-319-47143-3. ISBN978-3-319-47141-9. PMID31314301.
^Grant, CC; Forrest, CB; Starfield, B (1997). "Primary care and health reform in New Zealand". The New Zealand Medical Journal. 110 (1037): 35–39. PMID9066566.
^Forrest, CB; Whelan, EM (2000). "Primary care safety-net delivery sites in the United States: a comparison of community health centers, hospital outpatient departments, and physicians' offices". JAMA. 284 (16): 2077–2083. doi:10.1001/jama.284.16.2077. PMID11042756.
^Forrest, CB (2006). "Strengthening primary care to bolster the health care safety net". JAMA. 295 (9): 1062–1063. doi:10.1001/jama.295.9.1062. PMID16507809.
^Forrest, CB (1999). "Gatekeeping and referral of children and adolescents to specialty care". Pediatrics. 104 (1): 28–34. doi:10.1542/peds.104.1.28. PMID10390256.
^Forrest, CB; Glade, GB; Baker, AE; Bocian, A; von Schrader, S; Starfield, B (2000). "Coordination of specialty referrals and physician satisfaction with referral care". Archives of Pediatrics & Adolescent Medicine. 154 (5): 499–506. doi:10.1001/archpedi.154.5.499. PMID10807303.
^Forrest, CB; Reid, RJ (2001). "Prevalence of health problems and primary care physicians' specialty referral decisions". The Journal of Family Practice. 50 (5): 427–432. PMID11350708.
^Forrest, CB; Nutting, PA; von Schrader, S; Rohde, C; Starfield, B (2006). "Primary care physician specialty referral decision making: patient, physician, and health care system determinants". Medical Decision Making. 26 (1): 76–85. doi:10.1177/0272989X05284110. PMID16495203.
^Starfield, B; Forrest, CB; Nutting, PA; von Schrader, S (2002). "Variability in physician referral decisions". The Journal of the American Board of Family Practice. 15 (6): 473–480. PMID12463293.
^Bevans, KB; Meltzer, LJ; de la Motte, A; Kratchman, A; Viél, D; Forrest, CB (2019). "Qualitative development and content validation of the PROMIS Pediatric Sleep Health items". Behavioral Sleep Medicine. 17 (5): 657–671. doi:10.1080/15402002.2018.1461102. PMID29693445.
^Forrest, CB; Margolis, P; Seid, M; Colletti, RB (2014). "PEDSnet: how a prototype pediatric learning health system is being expanded into a national network". Health Affairs. 33 (7): 1171–1177. doi:10.1377/hlthaff.2014.0127. PMID25006143.
^Forrest, CB; Meltzer, LJ; Marcus, CL; de la Motte, A; Kratchman, A; Buysse, DJ; Pilkonis, PA; Becker, BD; Bevans, KB (2018). "Development and validation of the PROMIS Pediatric Sleep Disturbance and Sleep-Related Impairment item banks". Sleep. 41 (6) zsy054. doi:10.1093/sleep/zsy054. PMID29546286.
^Thakrar, AP; Forrest, AD; Maltenfort, MG; Forrest, CB (2018). "Child Mortality In The US And 19 OECD Comparator Nations: A 50-Year Time-Trend Analysis". Health Affairs. 37 (1): 140–149. doi:10.1377/hlthaff.2017.0767. PMID29309221.
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