National Indicators of Child Well-Being

Here's an update from Marcia Rubin that she sent to the NNIP listserve. (Now that I'm back from vacation, I'm trying to catch up in passing some of the information e-mailed to me in my absence.)

From the U.S. Department of Health and Human Services NATIONAL INSTITUTES OF HEALTH:

Compared to national statistics for the previous year, there has been an increase in the percentage of children living with at least one working parent and the percentage of children living in households classified as food insecure has declined. High school students were more likely to have taken advanced academic courses and the percentage of young adults who completed high school has increased. The adolescent birth rate has dropped to a record low.

Increasing were: the percentage of children served by community water systems that did not meet all applicable standards for healthy drinking water, and the percentage of children living in physically inadequate or crowded housing or housing that cost more than 30 percent of household income. The percentage of low birthweight infants also increased, as did the percentage of births to unmarried women. The rate at which youth were perpetrators of serious violent crime increased slightly.

These findings are described in detail in "America's Children: Key National Indicators of Well-Being, 2007", the U.S. government's annual report that monitors the well-being of the Nation's children and youth. (Note: I just got my copies in the mail -- it looks really sharp, and I highly encourage folks to take a look at this report.)

The report is a compendium of the most recently released federal statistics on the nation's children, issued by the Federal Interagency Forum on Child and Family Statistics. It presents a comprehensive look at critical areas of child well-being. These encompass family and social environment, economic circumstances, health care, physical environment and safety, behavior, education, and health.

"The increase in the percentage of children living with a working parent is welcome news," said Duane Alexander, M.D., Director of the National Institute of Child Health and Human Development of the National Institutes of Health. "Secure parental employment helps to reduce the psychological toll on families, brought on by parental unemployment and underemployment."

"This year also saw a rise in the percentage of children with low birthweight," Dr. Alexander said. Low birthweight infants are at increased risk of dying in the first year of life, as well at risk for serious disability. He added that a variety of research efforts were under way to prevent preterm birth, a major cause of low birthweight.

For the report's 10th anniversary, the Forum members revised the structure of the report, adding two new sections: Physical Environment and Safety, and Health Care. Nine new indicators were also added. These include indicators on child maltreatment, oral health, drinking water quality, lead in the blood of children, child injury and mortality, adolescent injury and mortality, sexual activity, college enrollment, and asthma.

ECONOMIC CIRCUMSTANCES
In 2005, 78.3 percent of children had at least one parent working year round, full time -- up from 77.6 percent in 2004, but below the peak of 80 percent in 2000. The report states that this percentage has remained relatively high, given the historical context of the early 1990s, when the percentage was 72 percent.

The report noted that secure parental employment reduces the occurrence of poverty and its attendant risks on children. Because most parents obtain health care for themselves and their children through their employers, a secure job for a parent can be important for determining if a child has health care.

"Secure parental employment may also enhance children's psychological well-being and improve family functioning by reducing stress and other negative effects that unemployment and underemployment can have on parents," the report explained.

Black, non-Hispanic children and Hispanic children were less likely than white, non-Hispanic children to have a parent working year round, full time. About 74 percent of Hispanic children and 62 percent of black, non-Hispanic children lived in families with secure parental employment in 2005, compared with 84 percent of white, non-Hispanic children.

The report stated that about 12 million children (17 percent) lived in households classified as food insecure in 2005, down from 19 percent in 2004. The report explains that a family's food security is its access at all times to enough food for an active, healthy life. The report's food security status is assessed on the basis of household self-reports of difficulty in obtaining enough food, reduced food intake, reduced diet quality, and anxiety about an adequate food supply.

"In some households classified as food insecure, only adults' diets and food intakes were affected, but in a majority of such households, children's eating patterns were also disrupted to some extent and the quality and variety of their diets were adversely affected," the report noted. "In a subset of food-insecure households -- those classified as having very low food security among children -- a parent or guardian reported that at some time during the year one or more children were hungry, skipped a meal, or did not eat for a whole day because the household could not afford enough food."

The percentage of children living in households with very low food security declined from 1.3 percent in 1995 to 0.7 percent in 1999 and has remained in the range of 0.6 to 0.8 percent since then.

PHYSICAL ENVIRONMENT AND SAFETY
In 2005, 60 percent of children lived in counties in which concentrations of one or more air pollutants rose above allowable levels, up from 46 percent in 2004, but a decrease from 65 percent in 1999. The report noted that children have increased potential for exposure to pollutants because they eat, drink, and breathe more, in proportion to the size of their bodies, than adults. Ozone, particulate matter, sulfur dioxide, and nitrogen dioxide are air pollutants associated with increased asthma episodes and other respiratory illnesses. Lead, often a component of polluted air, can affect the development of the central nervous system in young children and exposure to carbon monoxide can reduce the capacity of blood to carry oxygen.

The Primary National Ambient Air Quality Standard for ozone is the standard exceeded most often. High levels of ozone are influenced by high summer temperatures. The report noted that ozone concentrations tended to be lower in 2004 than in other years due to generally lower summer temperatures that year.

The percentage of children served by community water systems that did not meet all applicable health-based drinking water standards rose from 8 percent in 2004 to 10 percent in 2005. However, the percentage of children served by community drinking water systems that did not meet all applicable health-based standards declined from 20 percent in 1993 to about 8 percent in 1998. Since 1998, this percentage has fluctuated between 5 and 10 percent. The report explained that contaminants in drinking water may be quite varied and may cause a range of diseases in children, including acute diseases such as gastrointestinal illness, developmental effects such as learning disorders, and cancer.

Regarding the housing that children lived in, the report stated that, in 2005, 40 percent of U.S. households with children had one or more of three housing problems: physically inadequate housing, crowded housing, or cost burden resulting from housing that costs more than 30 percent of household income. In 2003, 37 percent of households with children had a housing problem. This percentage has increased over the long term from 30 percent in 1978.

"The increase in housing problems among families primarily reflects high housing costs," said Darlene Williams, Ph.D., Assistant Secretary of Policy Development and Research at the
Department of Housing and Urban Development. "As a direct result of increased housing
costs we have seen significant increases in the number of households experiencing cost burdens, including cost burdens exceeding 50 percent of household income. Rent burdens among very low income renters with children accounted for about one-fourth of the increase in families with housing problems during the 2003-2005 period," stated Dr. Williams.

The report added that inadequate housing (housing with severe or moderate physical problems) continues to decrease. In 2005, 5 percent of households with children had inadequate housing, compared with 9 percent in 1978.

FAMILY AND SOCIAL ENVIRONMENT
In 2005, 37 percent of all births were to unmarried women, up from 36 percent in 2004. The percentage of all births to unmarried women rose sharply from 18 percent in 1980 to 33 percent in 1994. From 1994 to 2000, the percentage ranged from 32 to 33 percent. The percentage has increased more rapidly since 2000, reaching 37 percent in 2005. The report noted that children are at greater risk for adverse consequences when born to a single mother because the social, emotional, and financial resources available to the family may be more limited.

In 2005, the adolescent birth rate dropped to a record low, to 21 per 1,000 young women ages 15-17, down from 22 per 1,000 in 2004, and 39 per 1,000 in 1991. This decline follows an increase of one-fourth between 1986 and 1991. There are substantial racial and ethnic
differences among the birth rates for adolescents ages 15-17. In 2005, the birth rate per 1,000 females for this age group was 8 for Asians/Pacific Islanders, 12 for white, non-Hispanics, 31 for American Indians/Alaska Natives, 35 for black, non-Hispanics, and 48 for Hispanics. The birth rate for black, non-Hispanic females ages 15-17 dropped by three-fifths between 1991 and 2005, completely reversing the increase between 1986 and 1991.

The report noted that adolescent child bearing is often associated with long-term difficulties for the mother and her child. Compared with babies born to older mothers, babies born to adolescent mothers are at higher risk of low birthweight and infant mortality. They are more likely to grow up in homes that offer lower levels of emotional support and cognitive stimulation, and they are less likely to earn high school diplomas.

In 2005, 20 percent of school-age children spoke a language other than English at home, up from 19 percent in 2003. Children who speak languages other than English at home and who also have difficulty speaking English may face greater challenges progressing in school and in the labor market, the report explained. In 2005, 5 percent of school-aged children had difficulty speaking English.

This year's report included a new indicator, on child maltreatment in the Section on Family and Social Environment. The report defined child maltreatment as including "physical, sexual, and psychological abuse, as well as neglect (including medical neglect)." In 2005, there were 12 substantiated reports of child maltreatment per 1,000 children. From 1998 through 2002, the rate of substantiated reports of child maltreatment varied between 12 and 13 reports per 1,000 children and has remained at approximately 12 reports per 1,000 children since 2002.

BEHAVIOR
In 2005, the serious violent crime offending rate was 17 crimes per 1,000 juveniles ages 12-17, up from 14 crimes per 1,000 in 2004. The report noted that while the 2005 rate is "somewhat higher" than the 2004 rate, it is significantly lower than the 1993 peak rate of 52 crimes per 1,000 juveniles ages 12-17.

"The level of youth violence in society can be viewed as an indicator of youths' ability to control their behavior, and the adequacy of socializing agents such as families, peers, schools, and religious institutions to supervise or channel youth behavior to acceptable norms," the report explained.

This year's report included a new indicator on sexual activity. The rate of high school students who reported ever having had sexual intercourse remained at 47 percent from 2003 to 2005, a decline from the rate of 54 percent in 1991. The report noted that early sexual activity is associated with emotional and physical health risks.

EDUCATION
In 2004, students were more likely to have taken advanced academic course work in mathematics, science, and foreign languages than they were in 2000. In 2004, 50 percent of graduates had taken at least one advanced mathematics course (defined as a course above
Algebra II), up from 45 percent in 2000 and almost double the 1982 percentage of
26 percent. The percentage of students taking an advanced science course also increased, from 63 percent in 2000, to 68 percent in 2004.

"In science, two-thirds (68 percent) of all high school graduates in 2004 had taken a physics, chemistry, or advanced biology course, almost twice the percentage of graduates in 1982 who had taken this level of science course (35 percent)," the report stated.

In foreign languages, 35 percent of high school graduates had taken a year three, year four, or advanced placement course in 2004, up from 30 percent in 2000 and double the percentage in 1982 (15 percent).

In 2005, 88 percent of young adults ages 18-24 had completed high school with a diploma or an alternative credential such as a General Education Development (GED) certificate. This was a 1 percentage point increase from 2004 and a 4 percentage point increase from 1980.

In 2005, 69 percent of young adults who had completed high school enrolled in a two- or four-year college in the fall of the year they completed high school. By comparison, in 1980 only 49 percent of students who completed high school enrolled immediately after completing school.

HEALTH
The percentage of low birthweight infants (less than 5 pounds. 8 ounces) increased to 8.2 percent in 2005, up from 8.1 percent in 2004 and 7.9 percent in 2003. Among blacks, the percentage of infants with low birthweight for 2005 was higher than for any other racial or
ethnic group, at 14 percent.

The report explained that low birthweight infants are at higher risk of death or long-term illness and disability than are infants of normal birthweight. The report noted that one reason for the increase is the rise in the number of twin, triplet, and higher order multiple births. However, low birthweight has increased even among singleton births. The report added that changes in obstetrical practices, such as the increasing trend toward inducing labor and cesarean delivery, may also have contributed to the increase in low birthweight. An increase in the use of assisted reproductive technology may have also played a role in the increase.

The infant mortality rate was 6.8 deaths per 1,000 live births in 2004, unchanged from the rate in 2003. In the U.S., about two-thirds of infant deaths occur in the first month after birth and are due mostly to health problems of the infant or the pregnancy, such as preterm delivery or birth defects.

The rates for two of the most frequent health conditions among children, overweight and asthma, have not changed significantly over the past few years but remain at a high level. During 2003- 2004, 18 percent of children ages 6-17 were overweight. The rate was highest among black non-Hispanic girls with one-quarter being overweight, compared to 16 percent among young white non-Hispanic girls and 17 percent of Mexican American girls.

"Almost one in ten children have asthma," said Edward J. Sondik, Director, National Center for Health Statistics, "but like overweight there are significant disparities." In 2005, 13 percent of black, non-Hispanic children under age 18 were reported to currently have asthma, compared with 8 percent of white, non-Hispanic and 9 percent of Hispanic children under age 18. Within the Hispanic population, there are differences, with 20 percent of Puerto Rican children and 7 percent of children of Mexican origin reported to currently have asthma. For the first time, asthma is included as a regular indicator in the report. "This 10th anniversary edition of America's Children includes important new indicators of how our children are faring," said Dr. Sondik. "It's been critical that, over the past decade, this report grew to reflect new issues and new challenges and report on them with the latest and best information available," he said.

DEMOGRAPHIC BACKGROUND
The report noted that in 2006, there were 73.7 million children from ages 0-17 in the United States, representing 25 percent of the population. This was down from a peak of 36 percent at the end of the baby boom in 1964. In 2006, 58 percent of U.S. children were white, non-Hispanic; 20 percent were Hispanic; 15 percent were black; 4 percent were Asian; and 4 percent were all other races. The percentage of children who are Hispanic has increased faster than that of any other racial or ethnic group, growing from 9 percent of the child population in 1980 to 20 percent in 2006.

Most other indicators in the report did not change significantly from the previous year statistics were compiled. Among those indicators that did not change were the percentage of children in poverty, the percentage of children who received some form of nonparental child care on a regular basis, the percentage of children with at least one foreign born parent, the percentage of students who smoked cigarettes regularly, and the percentage of students who had five or more alcoholic beverages in a row.

Members of the public may access the report on-line at <http://childstats.gov> on July 13.

Alternatively, members of the public also may obtain printed copies from the Health Resources and Services Administration, Information Center, P.O. Box 2910, Merrifield, VA 22116, by calling 1-888-Ask-HRSA (1-888-275-4772), or by e-mailing .

The Forum's Web site at <http://childstats.gov> contains all data updates and detailed statistical information accompanying this year's America's Children in Brief report. As in previous years, not all statistics are collected on an annual basis and therefore, some data in the Brief may be unchanged from last year's report. Members of the public may access the report at <http://childstats.gov>. While supplies last, single copies of the report are available from:

Marcia Rubin, Ph.D. MPH
Director, Research & Sponsored Programs
American School Health Association
7263 Stae Route 43 / P.O. Box 708
Kent, OH 44240
T: 330.678.1601 x 129
F: 330.678.4526
www.ashaweb.org