America's Children: Key National Indicators of Well-Being 2005

The adolescent birth rate has reached another record low, the death rate for children between ages 1 and 4 is the lowest ever, young children are more likely to receive their recommended immunizations, and fourth graders are scoring better in math, according to a yearly compendium of statistics from federal agencies concerned with children.

Children also are more likely to live in poverty, infants are more likely to be of low birthweight, youth are more likely to commit or be a victim of a violent crime, and reading scores of older children have declined slightly.

These findings are described in America's Children: Key National Indicators of Well-Being 2005, the U.S. government's 9th 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 health status, behavior and social environment, economic security, and education.


The report said that the adolescent birth rate for 2003 was 22 for every 1,000 girls ages 15 to 17, down from 23 in 2002. Since 1991, the adolescent birth rate dropped by more than two-fifths, from 39 births for every 1,000 girls. The decline followed a one-fourth increase in the teen birth rate from 1986 to 1991.

"For the sixth consecutive year, the adolescent birth rate has reached a record low," said Duane Alexander, M.D., Director of the National Institute of Child Health and Human Development of the National Institutes of Health. "We welcome this trend and hope it continues."

Dr. Alexander noted that teen mothers face a number of problems unique to their age. Teen mothers are much less likely to finish high school or to graduate from college than are other girls their age. Infants born to teen mothers are more likely to be of low birthweight, which increases their chances for infant death and for blindness, deafness, mental retardation, mental illness, and cerebral palsy.

Adolescent birth rates varied by racial and ethnic group. The rate for Black, non-Hispanic adolescents dropped by more than half since the 1991 peak of 86 births for every 1,000 girls, to 39 for every 1,000 girls in 2003. The birth rate was at 9 for every 1,000 Asian/Pacific Islanders girls in 2003, 12 for White, non-Hispanics, 30 for American Indians/Alaska Natives, and 50 for Hispanics. The report's health indicators showed two other strong gains for children as well. The percentage of young children receiving the recommended series of immunizations-the 4:3:1:3 combined series to protect against diphtheria, tetanus and pertussis; polio; measles; and Haemophilus influenzae type b (Hib) vaccine-has increased. In 2003, 81 percent of children ages 19-35 months had received the 4:3:1:3 series, up from 78 percent in 2002. Children living below the poverty level were less likely to receive the immunization series (76 percent) than were children above the poverty line (83 percent).

"Immunizations are one of the most important ways to protect our children against serious disease," said Dr. Edward J. Sondik, Director of the National Center for Health Statistics. "We need to continue efforts to monitor immunization rates as an important health indicator."

Another indicator, child mortality, showed that children from ages 1 to 4 years were less likely to die than in recent years. In 2002, there were 31 deaths for every 100,000 children in this age group, down from 33 deaths per 100,000 in 2001. The report noted that death rates for this age group had been declining in the last two decades, dropping by more than half between 1980 and 2002. This decline reflects the drop in injuries-the leading cause of death in children-and, in particular, the drop in these deaths due to motor vehicle crashes.

Dr. Sondik explained that increased use of safety seats and other child restraint systems could greatly reduce early childhood deaths. The death rate for children from 5 to 14 years of age did not change between 2001 and 2002. However, the death rate for children in this age group, 17 deaths per every 100,000 children, had dropped by approximately 45 percent since 1980.

The percentage of infants born at low birthweight increased, from 7.8 in 2002, to 7.9 in 2003. The report stated that the percentage of low birthweight infants has increased slowly and steadily since 1984, when it was 6.7 percent. Low birthweight infants are those weighing less than 2,500 grams, or 5 lb. 8 oz. Low birthweight results from an infant's being born preterm (less than 37 weeks) or from being small for his or her gestational age.

The report attributes part of the increase to a rise in the number of twin and other multiple pregnancies, because multiples are more likely than singletons to be born prematurely. The report added, however, that low birthweight had also increased among singletons. Changes in obstetric practices have also contributed to the rise in low birthweight and preterm delivery, particularly the increased rates of Cesarean delivery and induced labor. Both procedures may be undertaken preterm, because the fetus is in distress.

This year's report also includes special features related to health. The first special feature, on asthma, points out that at some point in their lives, about 13 percent of children had been diagnosed with asthma. In 2003 about 9 percent of children were reported to currently have asthma and two-thirds of these children had one or more asthma attacks in the previous 12 months. In some cases, asthma can seriously limit a child's activities, cause visits to hospitals and emergency rooms, and even result in death.

Another special feature, on lead in the blood of children, reported that, in 1999-2002, about 2 percent of children from ages 1 to 5 had elevated blood lead levels (greater than or equal to 10 micrograms per deciliter). This figure decreased substantially from 1976-1980 when 88 percent of children had elevated blood lead levels.

Behavior and Social Environment

The percentage of eighth graders who had used any illicit drugs in the past 30 days declined, from 10 percent in 2003 to 8 percent in 2004. The report noted that rates for illicit drug use in the past 30 days for tenth and twelfth graders had not changed during the same time period.

The rate at which youths were victims of serious violent crimes went up, from 10 per 1,000 youth ages 12 to 17 in 2002, to 18 per 1,000 in 2003. However, this rate was lower than the peak of 44 victims per 1,000 youth in 1993. The report noted that the rate of serious violent crime against youth decreased by 60 percent from 1993 to 2003.

In 2003, males were more likely to be victims of serious violent crime than were females, with 25 males per 1,000 male youth, compared with 10 females for every 1,000 female youth.

The rate at which youth committed serious violent crimes also increased, from 11 youth offenders of serious violent crimes per 1,000 youth ages 12 to 17 in 2002 to 15 per 1,000 in 2003. Although the 2003 rate is higher than the 2002 rate, the 2003 rate is 71 percent lower than the 1993 peak of 52 violent crimes committed per 1,000 youth.

Economic Security

The percentage of all children ages 0 to 17 living below the poverty threshold was 18 percent in 2003, up from 17 percent in 2002. According to the report, in 2003, the official poverty threshold for a family of four was an annual income of $18,810. The percentage of children living in households below the poverty threshold has fluctuated since the 1980s, reaching a high of 23 percent in 1993, and dropping to 16 percent in 2000. The poverty rate was higher for Black-alone children (34 percent) and Hispanic children (30 percent) than for White-alone, non-Hispanic children (10 percent).

About 13 million children (18 percent) lived in households that were classified as food insecure by the USDA in 2003, unchanged from 2002. Households are classified as food insecure based on survey reports of difficulty obtaining enough food, reduced diet quality, and anxiety about the household's food supply. Eighteen percent of children lived in food-insecure households, and 0.6 percent of children lived in households classified as food-insecure with hunger among children and adults.

In 2003, 89 percent of children had health insurance coverage at some point during the year. The report noted that the number of children who had no health insurance coverage at any time during 2003 was estimated to be 8.4 million (11 percent of all children), which was unchanged from 2002.


The average mathematics score increased for fourth graders, from 226 in 2000 to 235 in 2003, on the National Assessment of Educational Progress, the Nation's Report Card on elementary and secondary school performance. Similarly, the average mathematics score for eighth graders rose from 273 to 278 over the same period. In 2003, the percentages of fourth and eighth graders scoring at or above the Proficient achievement level in math were higher than in all previous assessments. Twelfth-graders were not tested in reading or mathematics in 2003, but twelfth grade mathematics scores had not changed significantly from 1996 to 2000.

The average reading score for fourth graders did not change from 1992 to 2003. Eighth graders' reading score changed only from 264 in 2002 to 263 in 2003; the 2003 score was higher than in 1992. The reading score of twelfth graders was lower in 2002 than in 1992 or 1998.

Girls had higher reading scores than did boys in grades 4 and 8 in 2003 and in grade 12 in 2002. However, boys had higher math scores than did girls in grades 4 and 8 in 2003, and in grade 12 in 2000.

In 2003, 87 percent of young adults ages 18-24 had completed high school with a diploma or an alternative credential, such as a General Education Development certificate. The high school completion rate has increased slightly since 1980, when it was 84 percent.

The proportion of Black-alone, non-Hispanic youth (ages 16 to 19) who were neither in school nor working was 10 percent in 2004, down from 12 percent in 2003. More Black-alone, non-Hispanic youth moved from the category "not enrolled in school and not working" into the category of "enrolled in school and not working" in 2004. The report categorizes people who responded to a question on race by indicating only one race as a "race-alone" population. For example, those who indicated their race as only "Black" and no other race are referred to as "Black-alone."

Population and Family Characteristics

The number of children under age 18 living in America increased, from 72.8 million in 2002 to 73.0 million in 2003. Children have decreased as a proportion of the population, from a peak of 36 percent in 1964, to 25 percent in 2003. The report noted that the racial and ethnic diversity of the nation's children has increased over time. In 2003, 60 percent of American children were White-alone, non-Hispanic, 16 percent were Black-alone, and 4 percent were Asian-alone. From 2002 to 2003, the percentage of children who were Hispanic increased from 18 percent to 19 percent. The percentage of children who are Hispanic has increased faster than that of any other racial and ethnic group, from 9 percent of the child population in 1980, to 19 percent in 2003.

In 2004, 20.3 percent of American children lived with at least one foreign-born parent, up from 19.6 percent in 2002. The report stated that the foreign-born population has grown since 1970, and that this increase has largely been from Latin America and Asia. The proportion of births to unmarried women also increased, from 34 percent in 2002 to 35 percent in 2003. The sharpest increase in the proportion of births to unmarried women occurred between 1980, when 18 percent of all births were to unmarried women, and 1994, when births to unmarried women reached 33 percent.

Accompanying backgrounders describe an additional special feature, on parental reports of emotional and behavioral difficulties, and a special section on family structure and children's well-being.

As in previous years, not all statistics are collected on an annual basis and, for this reason, some data in the report may be unchanged from last year's brief.

The 2005 America's Children report appears in its full-length version. The Forum publishes a condensed version of the report in alternate years.


The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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