The well-being of America's children has shown strong gains in some areas but has declined in others, according to a yearly report by federal agencies compiling statistics on children.
The teen birth rate hit a record low, youth are less likely to commit violent crimes or become the victims of violent crimes, and the death rate has declined for children and young teens.
The prevalence of overweight among children has increased. In addition, there has been a small increase in the percentage of low birth weight infants, the percentage of infants who die before their first birthday, and the percentage of children related to their householders who are living in poverty.
These findings are described in America's Children in Brief: Key National Indicators of Well-Being 2004, the U.S. government's 8th annual monitoring report on the well-being of the Nation's children and youth. The report was compiled by the Federal Interagency Forum on Child and Family Statistics, and presents a comprehensive look at critical areas of child well-being, including economic security, health status, behavior and social environment, and education.
"The adolescent birth rate dropped to a record low in 2002," said Duane Alexander, M.D., Director of the National Institute of Child Health and Human Development at the National Institutes of Health. "This is an extremely favorable development, as teen childbearing poses added burdens for both mothers and infants."
Dr. Alexander explained that girls who give birth during their teen years and the infants to which they give birth face a number of problems. Teen mothers are much less likely to finish high school or to graduate from college than are other girls their age. Similarly, infants born to teen mothers are more likely to be of low birth weight, which increases an infant's chances for dying during infancy and for such health problems as blindness, deafness, mental retardation, mental illness, and cerebral palsy.
According to the report, birth rates for adolescents have declined steadily since 1991, reaching a record low in 2002 — 23 births for every 1,000 girls ages 15 to 17, compared to 39 in 1991. Black, non-Hispanic teens showed the greatest decline, from 86 per 1,000 in 1991 to 41 per 1,000 in 2002. The report noted that the drop in adolescent birth rates was a direct result of the declining adolescent pregnancy rates, as evidenced by a decline in live births as well as declines in the rates of induced abortions and miscarriages.
Coverage for the varicella vaccine (chicken pox) reached an all-time high of 81 percent in 2002, and coverage for the Hepatitis B vaccine was at 90 percent in 2002. The percentage of children from 19 to 35 months of age who received coverage for the recommended combined series of four key vaccines was 78 percent in 2002, not statistically different from 77 percent in 2001. Coverage for the vaccine series has ranged from 76 percent to 78 percent, since reaching a high of 79 percent in 1998.
In contrast to these improvements, the prevalence of overweight among U.S. children increased in recent years. During the time period 1988 to 1994, 11 percent of children from ages 6 to 18 were overweight. That figure had increased to 16 percent for the period from 1999 to 2002. From 1976 to 1980, only 6 percent of children were overweight.
"This increase in overweight jeopardizes our children's future, making them vulnerable to chronic conditions such as diabetes and hypertension previously associated more with adults than with children," said Edward J. Sondik, Ph.D., Director of CDC's National Center for Health Statistics. "Overweight is not only a problem for our children but a problem for our Nation, as overweight children too often become overweight adults, with the accompanying increase in health problems."
According to the report, Mexican American boys were at the highest risk, with 27 percent overweight, followed by Black, non-Hispanic girls, at 23 percent overweight.
Among the favorable developments cited in the report was the decline in child mortality. In 2000, there were 18 deaths for every 100,000 children from ages 5 to 14, whereas in 2001 there were 17 deaths for every 100,000 children in this age group.
However, there was a slight increase in the infant mortality rate. In 2002, 7 out of every 1,000 infants died before their first birthday, increasing from a record low of 6.8 per thousand in 2001. The report said that preliminary analyses indicated that most of the increase in deaths occurred among infants less than 28 days old, with most in the first week of life.
One factor that may be contributing to this small increase, Dr. Sondik said, is that improvements in fetal medicine have allowed infants who would otherwise have died before delivery to survive into the early newborn period. Dr. Sondik hopes that additional information, due this fall, will provide a more detailed explanation for the increase.
The rate of low birthweight infants also rose slightly in 2002, to 7.8 percent, up from 7.7 percent in 2001. Low birthweight (about 5.5 lbs) is a risk factor for infant death. The increase is part of a continuing slow, steady rise in low birth weight, beginning at 7 percent in 1990. The rate of low birthweight infants was highest for Black, non-Hispanic infants, at 13.4 percent.
"Growth in multiple births (largely due to increasing use of fertility treatments) partially explains the low birthweight increase, but low birthweight also increased among singleton infants," the report said.
Among the report's economic security indicators, the percentage of children under age 18 who were related to the householder and living in poverty increased from 15.8 percent in 2001 to 16.3 percent in 2002. However, the poverty rate for all people under age 18 — which includes some children who were not related to the householder — showed no statistical change between 2001 (16.3 percent) and 2002 (16.7 percent).
"Although this was the first statistically significant annual increase in the poverty rate for related children since 1991, this increase followed a period of decline from a recent peak of 22 percent in 1993," the report said. "The drop in poverty from 1996 to the recent low point in 2000 was larger than the decline from 1993 to 1996."
The report noted, however, that the 2001 poverty rate for children related to the householder did not change significantly from the rate in 2000.
The poverty rate for children related to the householder also varied among groups. For children living in female householder families with no husband present, 40 percent were living in poverty. This is in comparison to 9 percent of children living in married-couple families.
Children classified as Black and of no other race had a poverty rate of 32 percent and Hispanic children had a poverty rate of 28 percent in 2002, compared to a poverty rate of 9 percent among white non-Hispanic children of no other race. With respect to the behavioral and social environment indicators, American youth were less likely to be victimized in a serious violent crime---murder, rape, robbery, or aggravated assault--- or to commit one. In 2002, there were 11 serious violent crimes per 1,000 youth ages 12 to 17, down from 15 in 2001.
"The reductions in youth violence are part of a longer-term trend which has been occurring over the last 10 years," said Lawrence Greenfeld, the Director of the Bureau of Justice Statistics in the U.S. Department of Justice. The serious violent crime victimization rate against youths fell from a high of 44 crimes per 1,000 youth ages 12 to 17 in 1993, a decline of 74 percent by 2002.
"The dramatic consequences of the decline in violence among youth, both as victims and offenders, are especially powerful when we examine how many victimizations did not take place because of the reduction in serious crime," Mr. Greenfeld said. "Had the rate of violence recorded in 1993 occurred in each year over the decade, by 2002 we would have seen more than 4.2 million additional serious violent victimizations of youth including nearly 10,000 additional murder victims."
Declines in the rates of commission of serious violent crimes by juveniles also continued into 2002. Over the last decade, based upon the self-reports of victims, the serious violent crime-offending rate dropped 78 percent--- from 52 crimes per 1,000 youth (ages 12-17) in 1993 to 11 crimes per 1,000 youth in 2002.