Trends in the Well-Being of America's Children and Youth, 2000

Publication Date

Dec 31, 1999

Acknowledgments

This report, and its earlier editions, would not have been possible without the substantial support of the Federal Interagency Forum on Child and Family Statistics whose member agencies provided data and carefully reviewed relevant sections. The contributing departments and agencies include: the National Center for Education Statistics (NCES); the Centers for Disease Control and Prevention; the National Center for Health Statistics (NCHS); the Bureau of the Census; the Bureau of Labor Statistics; the Department of Housing and Urban Development; the Administration for Children and Families; the Food and Nutrition Service of the Department of Agriculture; the Office of Management and Budget; the Office of Juvenile Justice and Delinquency Prevention; and the Office of the Assistant Secretary for Planning and Evaluation (ASPE) of the Department of Health and Human Services (HHS).

Thanks to the many people in ASPE who contributed to the development, review, and production of this report. Special thanks to Matt Stagner of ASPE who has served as project officer for this report and earlier reports. We have greatly appreciated his guidance. He has a strong commitment to indicators and understanding trends in the well-being of children and youth.

Several non-federal individuals and organizations also supplied data or analyses for this report including Ryan Mahon of Walter R. McDonald & Associates Inc's NCAND Technical Team and Ginger Maggio of the University of Michigan.

This report was produced under contract by Westat. Babette Gutmann served as project director, and Jennifer Hamilton served as project manager. Other Westat staff who contributed to this report include Allison Henderson, Tamara Morse, and Christine Nord. The graphic design of the report was produced by Westat's Graphics Department. Editorial reviews were completed by Westat's Editorial Department.

Introduction

This is the fifth edition of an annual report from the Department of Health and Human Services (HHS) on trends in the well-being of our nation's children and youth. The report presents the most recent and reliable estimates on more than 80 indicators of well-being. It is intended to provide the policy community, the media, and all interested citizens with an accessible overview of data describing the condition of children in the United States.

The indicators have been organized into five broad areas:

Population, family, and neighborhood;
Economic security;
Health conditions and health care;
Social development, behavioral health, and teen fertility; and
Education and achievement.

For each indicator, the report provides graphics to highlight key trends and important population subgroup differences and tables that provide more detailed information for the interested user. These are accompanied by text that briefly describes the importance of each indicator and highlights the most salient features of the data.

Indicators Included in the Report

This report presents a broad and carefully chosen collection of national estimates of child and youth well-being. It reports indicators that have been collected more than once over the last few years so that trends may be presented. Where possible, trends are presented from the 1970s through the 1990s. In a few cases, data for earlier years are also presented, as are projections into the future.

Decisions regarding which indicators to include in the report have been guided by a combination of scientific and practical considerations. In preparation for the first edition of this report, a list of indicators was culled from over 20 papers presented at a major national conference on indicators of child well-being. At this conference, nationally recognized experts representing a broad spectrum of disciplines and research interests related to child well-being recommended key indicators that should be tracked on a regular basis by the federal statistical system.

The final list of indicators was modified based on a number of practical considerations that included data availability (the data needed to be available for a nationally representative sample and on a regular basis), timeliness (the estimates had to be available for 1990 or later), and quality and consistency (the data had to be both reliable and consistently measured over time). Some sections of this report, mostly sections one and two, have been significantly revised since the 1999 edition of this report. Some indicators have been combined, such as low and very low birthweight, while other indicators have been rewritten or replaced with new sources of data. A new indicator on the number of births in the United States (PF 1.6) has been added, while several other indicators have been removed. Indicators have been removed for a variety of reasons, such as out-of-date information or replication of information in other reports produced by the Office of the Assistant Secretary for Planning and Evaluation in the Department of Health and Human Services. The indicators that have been removed are:

Children as a percentage of the dependent population;
Long-term childhood poverty;
Effect of government cash and near-cash transfer programs on poverty among persons living in families with children under 18;
Long-term welfare dependence;
Parental labor force detachment;
Secure labor force attachment; and
Lead exposure.

The Need for Better Data on Children

As this report demonstrates, the data available for tracking the well-being of children and youth at the national level are fairly extensive. Even so, there remain major gaps in the federal statistical system that must be filled if we are to have a complete picture of the quality of our children's lives.

We have few measures of social development and health-related behaviors for very young and pre-teenage children that are measured on a regular basis. For example, we currently lack good indicators of school readiness for young children. Measures of mental health for any age child are rare, though one such measure was recently added to the National Health Interview Survey. Positive measures of social development and related behaviors are also sparse, with the result that the current set of indicators may present a gloomier picture of our children's overall well-being than is in fact the case. New indicators that reflect the positive developments we desire for our children and youth clearly need to be developed and incorporated into the federal statistical system.

We have very few indicators available that reflect important social processes affecting child well-being that go on inside the family and within the neighborhood. Measures of parent-child interactions, critical to the social and intellectual development of children, are only now beginning to work their way into regularly repeated national surveys. We currently lack an annual measure of whether both biological parents of a child are in the household. Reliable indicators of child homelessness also need to be developed.

Other important areas in need of measurement development or improvements in the quality, consistency, and frequency of available data include child abuse and neglect, youth violent crime, day care quality, learning disabilities, and measures of children in institutionalized care.

Finally, data that can be used to track the well-being of children at the state and local levels are much less plentiful than at the national level. As state and local governments take on increasing levels of responsibility for the design and implementation of all sorts of government programs affecting children, youth, and their families, the need for such information is increasing. The federal statistical system is positioned to play a significant role in increasing the availability of such data for use at the state and local levels.

Federal Interagency Forum on Child and Family Statistics

The Federal Interagency Forum on Child and Family Statistics, an interagency group of leaders of federal agencies and departments responsible for collecting data on children and youth, has adopted a mandate to improve the federal statistical system regarding data on children, youth, and their families. Member agencies have played a crucial role in the production of this report, providing data and carefully reviewing relevant text. This forum, created in 1995, will continue to develop strategies for improving the federal statistical system in ways that preserve existing data in these areas while filling in the data gaps described above.

For example, member agencies have recently been working to develop new indicators in several areas where they are currently lacking. A subcommittee on fatherhood has been established and is working with agency researchers and members of the National Institute of Child Health and Human Development (NICHD) Family and Child Well-being Research Network to develop new indicators related to fathering and male fertility and incorporating them into federal surveys where appropriate. In addition, the Department of Agriculture has recently developed a measure of food security for children which is also included in this report. As additional measures from these and similar efforts become available, they will be incorporated into future editions of the report.

Using the Document

In the presentation of data for this report, percents and rates were, as a rule, rounded to the nearest whole number. Estimates based on the Decennial Census, the National Vital Statistics System, and surveys with very large sample sizes were often presented to one decimal place since differences of less than one percentage point are often significant from these sources.

Practical considerations did not allow for the use of tests of statistical significance for all cross-time and between-group differences discussed in the text, though they were used in a few cases. When such tests were not available, differences were either not reported in the text or were reported cautiously. Often in such cases estimates were simply reported without any claims as to statistical significance.

For More Information

This report is intended to provide a broad cross section of the most relevant trend data in the lives of children and adolescents in America. For those interested in more detailed information, a number of additional resources, both print and electronic, are available. New to this report is a detailed bibliography, which is included for more detailed information. If you would like to investigate a topic further, please use the abbreviated footnote reference to find the full citation located in the bibliography. A few of these resources are listed below, by topic area. They should provide the reader with a starting point when searching for additional information in these areas.

Population, Family and Neighborhood

Bureau of the Census. It is possible to access nearly all Bureau of the Census publications, such as the Current Population Reports, from the Bureau's web page, www.census.gov. It is also possible to extract data directly from public use census files using the Federal Electronic Research and Review Extraction Tool (FERRET) available at http://ferret.bls.census.gov/. FERRET allows the user to:

Create crosstabs;
Create frequencies;
Create a SAS data set for downloading; and
Create an ASCII output file where it is possible to either download the file or transfer the data into a spreadsheet.

Economic Security

Office of the Assistant Secretary for Planning and Evaluation (ASPE). As part of the Department of Health and Human Services, ASPE will soon publish its first annual Trends in the Economic Well-Being of Low-Income Americans. This report will provide detailed information on how the distribution of poverty differs across population subgroups such as families with children, working-age adults, and the elderly.

Bureau of Labor Statistics. The Bureau of Labor Statistics produces a variety of employment data and can be found on the web athttp://www.bls.gov/.

Health Conditions and Health Care

Centers for Disease Control and Prevention (CDC). The Centers for Disease Control and Prevention conducts many data collection efforts, including the Youth Risk Behavior Surveillance System (YRBSS). The YRBSS which monitors six categories of priority health-risk behaviors among youth and young adults. The categories are: 1) tobacco use, alcohol and other drug use, 2) sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases, 3) unhealthy dietary behaviors, and 4) physical inactivity. This information can be accessed via CDC's main web page, located at http://www.cdc.gov/.

National Center for Health Statistics (NCHS). The National Center for Health Statistics publishes a number of reports that provide data on the health of children and youth in the United States. Some of these include the National Vital Statistics Reports and the Vital and Health Statistics series. These reports and many others are available at the NCHS web site http://www.cdc.gov/nchs/. Additional NCHS data are available through the Census’ FERRET system at http://www.cdc.gov/nchs/datawh/ferret/ferret.htm. Currently, the 1994 Underlying Cause-of-Death File, the 1993 National Health Interview Survey, and the third National Health and Nutrition Examination Survey, NHANES III, are all available via FERRET.

Social Development, Behavioral Health and Teen Fertility

Bureau of Justice Statistics. It is possible to obtain detailed information on juvenile offenders at the Bureau of Justice Statistics’ main web site, located at http://www.ojp.usdoj.gov/bjs/.

Institute for Social Research. This institute has collected information on the behaviors, attitudes, and values of American secondary school students, college students, and young adults since 1975 in its Monitoring the Future survey. Information and data from this study are available online at http://monitoringthefuture.org/.

Education and Achievement

National Center for Education Statistics (NCES). NCES is the primary federal agency for collecting and analyzing data that are related to education in the United States. Its web site is located at http://nces.ed.gov/ and contains links to its many data collection activities. These surveys include the Common Core of Data (CCD), the Schools and Staffing Survey (SASS), the Private School Universe Survey, and the National Household Education Survey (NHES). In addition, NCES collects and reports on the academic performance of the nation's students. The National Assessment of Educational Progress (NAEP) is NCES' primary assessment of what American elementary and secondary students know and can do in a variety of academic subjects.

Last, additional information can be found in our sister report, America’s Children: Key National Indicators of Well-Being, 2000, which is available online at http://childstats.gov/ac2000/ac00.asp.

Section 1: Population, Family, and Neighborhood (PF)

Child Population Characteristics

PF 1.1 Number of Children Under Age 18 in the United States

In 1999, there were 70.2 million children under age 18 in the United States. This number is expected to increase to 77.2 million by 2020. The total number of children under age 18 has increased by 48 percent since 1950. Most of that increase occurred during the “baby boom” years of the 1950s and early 1960s, when record numbers of children were born in these prosperous post-World War II years. During the 1970s and 1980s, the number of children initially declined and then grew slowly. Beginning in 1990, the rate of growth in the number of children increased, although not as rapidly as during the baby boom. These trends gave rise to the terms “baby bust” or “birth dearth,” and “echo baby boom.”

In 1999, there were approximately equal numbers of children—between 23 and 24 million—in each age group 0-5, 6-11, and 12-17 years of age. In 1950 and 1960, there were more children under age 6 than there were ages 6-11 or 12-17, reflecting the large number of babies being born during these years.

Table PF 1.1 Number (in millions) of children under age 18 in the United States, by age: Selected years, 1950-1999, and projected, 2000-2020

							Projected
	1950	1960	1970	1980	1990	1999	2000	2010	2020
ll children	47.3	64.5	69.8	63.7	64.2	70.2	70.4	72.1	77.2
Under age 6	19.1	24.3	20.9	19.6	22.5	22.8	22.7	24.0	26.3
Ages 6-11	15.3	21.8	24.6	20.8	21.6	24.0	24.1	23.4	25.6
Ages 12-17	12.9	18.4	24.3	23.3	20.1	23.4	23.5	24.6	25.2

Sources: U.S. Bureau of the Census, Current Population Reports, Series P-25, no. 311, no. 519, no. 917, no. 1130 (Table 2 in each); and unpublished data, U.S. Bureau of the Census.

Figure PF 1.1 Number (in millions) of children under age 18 in the United States: 1950-1999, and projected, 2000-2020

Sources: U.S. Bureau of the Census, Current Population Reports, Series P-25, no. 311, no. 519, no. 917, no. 1130 (Table 2 in each); and unpublished data, U.S. Bureau of the Census.

PF 1.2 Children as a Percentage of the Total Population

Though children represent a smaller proportion of the population today than they did in 1960, they are still a substantial segment of the U.S. population and will remain so in the coming decades. In 1999, children under age 18 made up 26 percent of the population, down from 36 percent in 1960 at the end of the baby boom.

Projections by the U.S. Bureau of the Census predict that this proportion will drop further—to 24 percent—by the year 2010 and will remain at that level through 2020.

In contrast, the proportion of the population ages 65 and older has increased from 8 percent in 1950 to 13 percent in 1999. That percentage is projected to increase to 17 percent by the year 2020.

Together, children and senior citizens make up the “dependent population” that is, those persons considered economically inactive because of their age. Children’s share of the dependent population fell from 79 percent in 1960 to 67 percent in 1990, and has remained unchanged since then. That percentage is projected to continue to decline to 59 percent by the year 2020.

Table PF 1.2 Persons in selected age groups as a percentage of the total U.S. population and children under age 18 as a percentage of the dependent population: Selected years, 1950-1999 and projected, 2000-2020

							Projected
	1950	1960	1970	1980	1990	1999	2000	2010	2020
Percent of total
Ages 0-17	31	36	34	28	26	26	26	24	24
Ages 18-64	61	55	56	61	62	62	62	63	60
Ages 65+	8	9	10	11	13	13	13	13	17
Percent of dependent population^a
Ages 0-17	79	79	78	71	67	67	67	64	59

^aThe dependent population includes all persons ages 17 and under, and 65 and older.

Sources: U.S. Bureau of the Census, Current Population Reports, Series P-25, no. 311, no. 519, no. 917, no. 1130 (Table 2 in each); and unpublished data, U.S. Bureau of the Census

Figure PF 1.2 Children under age 18 and adults ages 65 and over as a percentage of the U.S. population: 1950- 1999, and projected, 2000-2020

Figure PF 1.2 Children under age 18 and adults ages 65 and over as a percentage of the U.S. population: 1950- 1999, and projected, 2000-2020

Sources: U.S. Bureau of the Census, Current Population Reports, Series P-25, no. 311, no. 519, no. 917, no. 1130 (Table 2 in each); and unpublished data, U.S. Bureau of the Census.

PF 1.3 Racial and Ethnic Composition of the Child Population of the United States

The United States has become increasingly racially and ethnically diverse over the last several decades and is projected to become even more so in the future. As recently as 1980, nearly three-quarters (74 percent) of all children in this country were non-Hispanic whites (see Table PF 1.3). This proportion diminished to 65 percent in 1999 and is expected to continue a steady downward trend so that, by the year 2020, non-Hispanic whites will constitute just over one-half (55 percent) of the U.S. child population.

Prior to 1997, non-Hispanic blacks were the largest minority population of children in the United States. In 1997 and 1998, however, Hispanics and non-Hispanic blacks each constituted about 15 percent of the total child population, with more Hispanic than black children (10.7 versus 10.2 million) in 1998. These were followed by non-Hispanic Asian Americans at 4 percent and non-Hispanic Native Americans at 1 percent. By the year 2020, more than one in five American children are expected to be Hispanic, more than double the percentage in 1980. The Asian/Pacific Islander population is also expected to continue its growth, increasing from 4 percent in 1999 to 6 percent by the year 2020.

Table PF 1.3. Number (in millions) and percentage distribution of children under age 18 in the United States, by race and Hispanic origin:a Selected years, 1980-1999, and projected, 2000-2020

						Projected
Number (in millions)	1980	1990	1997	1998	1999	2000	2010	2020
White, non-Hispanic	47.1	44.2	45.6	45.5	45.6	45.4	42.7	42.4
Black, non-Hispanic	9.3	9.5	10.2	10.2	10.5	10.6	11.3	12.2
Hispanic^a	5.7	7.9	10.4	10.7	10.8	11.0	13.7	17.2
Asian/Pacific Islander^b	1.1	2.0	2.7	2.8	3.0	3.1	4.0	5.0
American Indian/Alaska Native^b	0.5	0.6	0.7	0.7	0.7	0.7	0.7	0.8
						Projected
Percentage of population	1980	1990	1997	1998	1999	2000	2010	2020
White, non-Hispanic	74	69	66	65	65	64	59	55
Black, non-Hispanic	15	15	15	15	15	15	16	16
Hispanic^a	9	12	15	15	15	16	19	22
Asian/Pacific Islander^b	2	3	4	4	4	4	6	6
American Indian/Alaska Native^b	1	1	1	1	1	1	1	1

^a Persons of Hispanic origin may be of any race.

^bExcludes persons who are of Hispanic origin.

Sources: U.S. Bureau of the Census, Current Population Reports, Series P-25, no. 1095, Table 1; and no. 1130, Table 2; also unpublished data, U.S. Bureau of the Census. Percentage estimates as published in America's Children: Key National Indicators of Well-Being, 2000. Federal Interagency Forum on Child and Family Statistics, Washington, D.C.: U.S. Government Printing Office, Table POP3.

Figure PF 1.3. Percentage distribution of children under age 18 in the United States, by race and Hispanic origin:a 1980-1999, and projected, 2000-2020

^a Persons of Hispanic origin may be of any race. Estimates for whites, blacks, Asian/Pacific Islanders, and American Indian/Alaska Natives exclude persons of Hispanic origin.

Sources: U.S. Bureau of the Census, Current Population Reports, Series P-25, no. 1095, Table 1; and no. 1130, Table 2; also unpublished data, U.S. Bureau of the Census.

PF 1.4 Immigrant Children and Children of Immigrants

The United States is a nation of immigrants. Rates of immigration have varied substantially over time, as have the countries and cultures from which these immigrants originate. Immigrant children and children of immigrants are of particular interest, since they may have special needs (cultural and lingual adjustment and misunderstandings, etc.) that must be addressed throughout the education system.

Immigrant Children

The percentage of America’s children and youth under age 20 who are foreign born has been increasing steadily over the last several decades, from 1.2 percent in 1970 to 3.7 percent in 1990.

Differences by Age. Older children are more likely than younger children to be foreign born. In 1990, 6.5 percent of youth ages 15 through 19 were foreign born, compared with only 1.4 percent of children under age 5 (see Table PF 1.4.A).

Differences by Race and Hispanic Origin. The percentage of children and youth under age 20 who are foreign born varies substantially by racial and ethnic background (see Table PF 1.4.A). In 1980, less than 2 percent of whites, blacks, and Native Americans were foreign born, compared with 40 percent of Asians and 14 percent of Hispanics. By 1990, the percentage of foreign-born Asian children had declined from 40 to 33.2 percent, while the percentage of foreign-born Hispanic children increased to almost 16 percent. More recent data for children under age 18 show a similar pattern, though differences in both data source and age range prevent direct comparison with earlier data (see Table PF 1.4.B).

Children of Immigrants

The Current Population Survey periodically collects information on fertility among the foreign born. According to data from the Current Population Survey, the number of foreignborn women of childbearing age almost doubled between 1983 and 1994, increasing from 3.3 million to 6.2 million. Birth rates among foreign-born women increased between 1983 and 1986, but have decreased somewhat since that time.¹ The children of these foreignborn women need to be watched closely as they move through the educational system in order to ensure healthy cultural and linguistic adjustment and understanding. While a large number of children of immigrants seem to adjust well in schools, problems can and do arise (see Table PF 1.4.C).

Table PF 1.4.A. Percentage of children under age 20 in the United States who were foreign born,^a by age, and by race and Hispanic origin:b 1970, 1980, and 1990

	1970	1980	1990
All foreign-born children	1.2	2.9	3.7
Under age 5	0.6	1.4	1.4
Ages 5-9	1.1	2.6	2.7
Ages 10-14	1.4	3.2	4.3
Ages 15-19	1.8	4.1	6.5
Race and Hispanic origin^b
White	1.2	1.7	1.8
Black	0.5	1.8	2.2
American Indian/Alaska Native	—	1.5	1.1
Asian/Pacific Islander	—	40.0	33.2
Hispanic	—	14.0	15.8

^a Includes both immigrants (citizens and non-citizens) and illegal aliens.

^b Persons of Hispanic origin may be of any race. Estimates for whites, blacks, Asians, and Native Americans include persons of Hispanic origin.

Sources: U.S. Bureau of the Census, National Origin and Language, PC(2-1A), 1970; U.S. Bureau of the Census, Detailed Characteristics of the Population, 1980, Chapter D, U.S. Summary; U.S. Bureau of the Census, The Foreign-Born Population in the U.S., 1990, CP-3-1, and 1990 STF-3A census files.

Table PF 1.4.B. Percentage of children under age 18 in the United States who were foreign born,^a by race and Hispanic origin:b 1994-1997

	1994	1995	1996	1997
All foreign-born children	4	4	4	4
Race and Hispanic origin^b
White	3	3	3	—
Black	2	2	2	—
Asian/Pacific Islander	25	28	27	—
Hispanic	14	14	13	—

^a Includes both immigrants (citizens and non-citizens) and illegal aliens.

^b Persons of Hispanic origin may be of any race. Estimates for whites, blacks, and Asians include persons of Hispanic origin.

Sources: U.S. Bureau of the Census, Current Population Reports, Series P-20, no. 486, Tables 1 and 2; U.S. Bureau of the Census, Paper Listing, Series PPL-58, Series PPL-59, Series PPL-92, The Foreign-Born Population, 1995, 1996, 1997, Detailed Tables, Tables 1 and 2. All percentages calculated by Child Trends, based on number estimates from these sources.

Table PF 1.4.C. Percentage of children with selected student outcomes by immigrant status and children's race and ethnicity: Children ages 3 to 8, 1996

	Total children ages 3–8	Children of Immigrants
	Total children ages 3–8	Total	NativeBorn	ForeignBorn	Hispanic	Asian	White
Total (thousands)	22,959	3,213	2,782	430	1,734	239	837
Student Outcome
Child gets mostly A's^a	58%	54%	54%	53%	41%	63%	51%
Child enjoys school^a	50	45	46	37	37	51	56
Child participates in extracurricular activities^b	74	63	65	56	49	78	79
Child experienced problems at school^b	29	25	26	24	30	17	22
Child ever repeated a grade^b	5	5	5	6	8	3	3

^a Applies to children in grades 1 and above.

^b Applies to children in kindergarten and higher grades.

Source: Nord, & Griffin, 1999.

¹ Nord, C.W. 1996. What is Causing School Enrollment to Increase? A Demographic Explanation. Rockville, MD: Westat

PF 1.5 Fertility Rates

The fertility rate in the United States dropped dramatically between 1960 and 1980 from 118.0 to 68.4 live births per 1,000 women ages 15 to 44. The declines occurred in all age groups (see Figure PF 1.5) and among both whites and blacks (see Table PF 1.5). Fertility rates for Hispanics, Asians, and American Indians/Alaska Natives were not tabulated separately in 1960.

Since 1980, the birth rate has remained between 65 and 71 live births per 1,000 women ages 15 to 44. In 1999 the fertility rate was 65.8 live births per 1,000 women these ages.

During the 1960s, age-specific fertility rates – the number of births per thousand women in a given age group—were highest among women ages 20 to 24. This pattern began to change during the 1980s as more and more women delayed childbearing. Since 1983, women ages 25 to 29 have had the highest age-specific fertility rates, followed closely by women ages 20 to 24 (see Figure PF 1.5).

In recent years, Hispanic women have had a much higher fertility rate than women from the other race and ethnic groups. In 1999, Hispanic women had 101.8 births per 1,000 women ages 15 to 44, while non-Hispanic, white, black, Asian, and American Indian women had between 57.9 and 70.2 births per 1,000 women ages 15 to 44 (see Table PF 1.5). There is, however, wide disparity in fertility rates within the Hispanic population. In 1998, the fertility rate for Mexican-origin women was 112.1 compared to 75.5 for Puerto Ricanorigin and 50.1 for Cuban-origin women.²

There is widespread policy interest in teenage childbearing. Between 1960 and 1985, birth rates for teens ages 15 to 19 dropped from 89.1 to 51.0 per 1,000 teen women. This trend reversed between 1985 and 1991, and the teen birth rate increased to 62.1 per 1,000 teen women. Since 1991, the teen birth rate has again turned downward, declining to 49.6 per 1,000 teen girls by 1999. The birth rate for black teens has remained about twice that of white teens since 1960. In 1999, the birth rate for black teens ages 15 to 19 was 81.1 per 1,000 girls compared to 34 per 1,000 white teen girls. The highest teenage childbearing rates, however, are found among Hispanic teens. In 1999, the teen fertility rate among Hispanics was 93.1 for girls ages 15 to 19.

Figure PF 1.5. Birthrates by selected age of mother (per 1,000 women) in the United States: 1960-1997

Source: Ventura, et al., 1999. Births, Tables 4 and 9.

Table PF 1.5. Birth rates in the United States by race and hispanic origin and age of mother for selected ages (births per 1,000 females in each age group): Selected years: 1960-1999

	1960	1970	1980^a	1990	1995	1996	1997	1998	1999^f
All races
All ages^b	118.0	87.9	68.4	70.9	65.6	65.3	65.0	65.6	65.8
Ages 10-14	0.8	1.2	1.1	1.4	1.3	1.2	1.1	1.0	0.9
Ages 15-19	89.1	68.3	53.0	59.9	56.8	54.4	52.3	51.1	49.6
Ages 15-17	43.9	38.8	32.5	37.5	36.0	33.8	32.1	30.4	28.7
Ages 18-19	166.7	114.7	82.1	88.6	89.1	86.0	83.6	82.0	80.2
White non-Hispanic^c
All ages^b	113.2	84.1	65.6	62.8	57.6	57.3	57.0	57.7	57.9
Ages 10-14	0.4	0.5	0.6	0.5	0.4	0.4	0.4	0.3	0.3
Ages 15-19	79.4	57.4	45.4	42.5	39.3	37.6	36.0	35.2	34.1
Ages 15-17	35.5	29.2	25.5	23.2	22.0	20.6	19.4	18.4	17.1
Ages 18-19	154.6	101.5	73.2	66.6	66.1	63.7	61.9	60.6	59.0
Black non-Hispanic^c,f
All ages^b	153.5	115.4	84.7	89.0	74.5	72.5	72.4	73.0	70.2
Ages 10-14	4.3	5.2	4.3	5.0	4.3	3.8	3.4	3.0	2.6
Ages 15-19	156.1	140.7	97.8	116.2	99.3	94.2	90.8	88.2	81.1
Ages 15-17	—	101.4	72.5	84.9	72.1	66.6	62.6	58.8	52.1
Ages 18-19	—	204.9	135.1	157.5	141.9	136.6	134.0	130.9	122.9
Hispanic^d,e
All ages^b	—	—	95.4	107.7	105.0	104.9	102.8	101.1	101.8
Ages 10-14	—	—	1.7	2.4	2.7	2.6	2.3	2.1	2.0
Ages 15-19	—	—	82.2	100.3	106.7	101.8	97.4	93.6	93.1
Ages 15-17	—	—	52.1	65.9	72.9	69.0	66.3	62.3	61.2
Ages 18-19	—	—	126.9	147.7	157.9	151.1	144.3	140.1	139.0
Asian/Pacific Islander^c
All ages^b	—	—	73.2	69.6	66.4	65.9	66.3	64.0	65.7
Ages 10-14	—	—	0.3	0.7	0.7	0.6	0.5	0.4	0.4
Ages 15-19	—	—	26.2	26.4	26.1	24.6	23.7	23.1	22.8
Ages 15-17	—	—	12.0	16.0	15.4	14.9	14.3	13.8	12.6
Ages 18-19	—	—	46.2	40.2	43.4	40.4	39.3	38.3	38.8
American Indian^c
All agesb	—	—	82.7	76.2	69.1	68.7	69.1	70.7	69.4
Ages 10-14	—	—	1.9	1.6	1.8	1.7	1.7	1.6	1.7
Ages 15-19	—	—	82.2	81.1	78.0	73.9	71.8	72.1	67.7
Ages 15-17	—	—	51.5	48.5	47.8	46.4	45.3	44.4	41.3
Ages 18-19	—	—	129.5	129.3	130.7	122.3	117.6	118.4	110.4

^a Births from 1980 onward are by race of mother. Tabulations prior to 1980 are by race of child, which assigns the child to the race of the nonwhite parent, if any, or to the race of the father, if both are nonwhite.

^b Fertility rates were computed by relating total births, regardless of age of mother, to women ages 15 to 44.

^c Includes persons of Hispanic origin until 1990. After 1990, persons of Hispanic origin are not included.

^d Persons of Hispanic origin may be of any race.

^e White and black non-Hispanic excludes data for New Hampshire and Oklahoma, which did not report Hispanic origin.

^f Data for 1999 are not available for black non-Hispanic women; data shown for 1999 are for all black women.

Sources: Ventura, et al., 1999. Births, Tables 1, 4, and 9; Ventura, 1983. Births, Table 5; also unpublished data, National Center for Health Statistics; Curtin, & Martin, 2000. Births: Preliminary Data for 1999.

² Ventura, S.J., Martin, J.A., Curtin, S.C., & Park, M.M. 2000. Births: Final Data for 1998. National Vital Statistics Reports 48, (3.) Hyattsville, MD: National Center for Health Statistics.

PF 1.6 Number of Births

In 1999, there were nearly 4.0 million births in the United States. Twenty-seven percent of the births were to women ages 25 to 29, 25 percent were to women 20 to 24, and 23 percent were to women 30 to 34 years of age. The percentage of births occurring to older women (those 30 and older) has increased since the mid-1980s. In 1980, 20 percent of all births were to women ages 30 and older. In 1999, the proportion of all births to women age 30 and older had increased to 36 percent. About 60 percent of all births were to white nonHispanic women, 15 percent to black women, and 19 percent to women of Hispanic origin (see Table PF 1.6).

Most births are to women who have at least a high school degree. In 1998, 22 percent of births were to women who had less than a high school education, 33 percent were to high school graduates, and 46 percent were to women with one or more years of college (see Table PF 1.6).

Table PF 1.6. Percentage of births in the United States by mother's age, race and Hispanic origin, and education level: Selected years, 1990- 1999

	1990	1995	1996	1997	1998	1999
Total number	4,158,212	3,899,589	3,891,494	3,880,894	3,941,553	3,957,829
Age of mother
Ages 15-19	13%	13%	13%	13%	12%	12%
Ages 20-24	26	25	24	24	24	25
Ages 25-29	31	27	28	28	27	27
Ages 30-34	21	23	23	23	23	23
Ages 35-39	8	10	10	11	11	11
Ages 40-44	1	2	2	2	2	2
Race and Hispanic origin
White^a	64	61	61	60	60	59
Black^a	16	15	15	15	15	15
Hispanic^b	14	17	18	18	19	19
Education level
Less than high school	24	22	22	22	22	—
Completed high school	38	34	33	32	33	—
Some college	20	22	22	22	22	—
Four + years of college	18	21	22	22	23	—

^a Estimates for whites and blacks do not include persons of Hispanic origin. In 1999 figures for black women include Hispanics. Hispanics may be of any race.

^b Births by Hispanic origin are based on 48 states and the District of Columbia in 1990; and 50 states and the District of Columbia in 1995 through 1997.

Sources: Curtin & Martin, 2000; Ventura, et al., 2000, Births, Tables 17, 18, 19 and 21; Ventura, et al., 1999, Births, Tables 2, 17, and 21; Ventura, et al., Natality 1996; Ventura, et al., 1997, Tables 2, 6, and 21; Ventura, et al., 1997, Natality 1995, Tables 2, 6, 14, and 18; National Center for Health Statistics, 1994, Vital Statistics, Table 1-35; also, 1985, Table 1-54, 1980, Table 1-54, and 1970 editions of this annual report.; National Center for Health Statistics, 1987, Natality, Monthly Vital Statistics Report, 36(4, Supp), Table 2, and Monthly Vital Statistics Report, 31(8, Supp.), Table 2; Ventura, 1983, Table 2; Center for Disease Control, National Center for Health Statistics, 1974, Table 2.

PF 1.7 Percentage of All Births to Unmarried Women

Children who are born to single women, regardless of the age of the women, are considerably more likely than children born to two parents to grow up poor, to spend large portions of their childhood without two parents, and to become single parents themselves.

Differences by Age. Nonmarital childbearing increased among women of all age groups between 1960 and 1994 before dropping off modestly in 1995 (see Figure PF 1.7.A). However, data for 1996 through 1999 show continued increases for women ages 15 through 19, 20 through 24, and 25 through 29. Younger mothers are far more likely than older mothers to be unmarried. In 1999, 78.6 percent of births to women ages 15 through 19 were to unmarried women. In contrast, 48.4 percent of births to women ages 20 through 24 were to unmarried women, and only 13.9 percent of births to women ages 30 through 34 were to unmarried women (see Table PF 1.7.A). Bearing children outside of marriage is a particularly troubling development for teenagers because these young women often have little education and lack the ability to support their families economically, especially as single parents.

Nonmarital births as a percent of all births have increased among teens of all ages and across all racial and ethnic groups since 1960 (see Figures PF 1.7.A and B). Among all young women ages 15 through 19, 15 percent of births were nonmarital in 1960, compared with 79 percent in 1999 (see Table PF 1.7.B). The percentage of births to teens that occurred outside of marriage rose fairly steadily through 1999; however, the rather sharp increase between 1993 and 1994 (from 71 to 75 percent) is largely the result of improvements in the identification of nonmarital births in two states: Texas and Michigan.³

Differences by Race and Hispanic Origin. The percentage of all births to unmarried women increased for whites, blacks, American Indians, and Hispanics between 1980 and 1998 (see Table PF 1.7.A). Asian women have experienced a steady increase in the percentage of all births to unmarried women from 1980 to 1996, but the percentage decreased in 1997 and was unchanged in 1998.

In 1998, Asian and white women had the lowest percentage of nonmarital births at 15.6 and 21.9 percent, respectively. Hispanics were next at 41.6 percent, followed by American Indian and black women at 59.3 percent and 69.3 percent, respectively. This ordering is the same for most age groups, though the size of the difference can vary substantially by the age of the mother. For young women ages 15 through 19 in 1999, for example, whites and Hispanics have very similar percentages of births to unmarried women—72.6 and 72.9 percent, respectively—while the percentage among young black women ages 15 through 19 is much higher at 95.4 percent. By ages 25 through 29, however, percentages for Hispanic women move midway between white and black rates, with whites at 13.8 percent, Hispanics at 32.0 percent, and blacks at 56.7 percent (see Table PF 1.7.A).

Figure PF 1.7.A. Percentage of all births to unmarried women in the United States, by age: 1960-1999.

Figure PF 1.7.A Percentage of all births to unmarried women in the United States, by age: 1960-1999

Sources: Ventura, et al., 2000, Births, Tables 17, 18, 19, and 21; Ventura, 1995, Births to Unmarried Mothers, Table 5; Ventura, et al., 1997, Natality, 1996, Table 17; Also previous issues of this annual report (volume 45, no.11; volume 44, no. 11; volume 44, no. 3, Table 14 in each); Ventura, et al., 1999, Births, Table 17; Ventura, et al., 2000, Births, Table 17; Curtin & Martin, 2000, Table C; unpublished data from S. Ventura, National Center for Health Statistics.

Table PF 1.7.A. Percentage of all live births to unmarried women in the United States, by race and Hispanic origin and by age: 1960-1999

	1960	1965	1970	1975	1980b	1985	1990	1991a	1992	1993	1994	1995	1996	1997	1998	1999
All races
All ages	5.3	7.7	10.7	14.3	18.4	22.0	28.0	29.5	30.1	31.0	32.6	32.2	32.4	32.4	32.8	33.0
Ages 15-19	14.8	20.8	29.5	38.2	47.6	58.0	67.1	68.8	70.0	71.3	75.5	75.2	75.9	77.8	78.5	78.6
Ages 20-24	4.8	6.8	8.9	12.3	19.4	26.3	36.9	39.4	40.7	42.2	44.9	44.7	45.6	46.6	47.7	48.4
Ages 25-29	2.9	4.0	4.1	5.4	9.0	12.7	18.0	19.2	19.8	20.7	21.8	21.5	22.0	22.0	22.5	22.8
Ages 30-34	2.8	3.7	4.5	5.3	7.5	9.7	13.3	14.0	14.3	14.7	15.1	14.7	14.8	14.1	14.0	13.9
Ages 35-39	3.0	4.0	5.2	7.0	9.4	11.2	13.9	14.6	15.2	15.6	16.1	15.7	15.7	14.6	14.4	14.3
White^a
All ages	2.3	4.0	5.7	7.3	11.2	14.7	16.9	18.0	18.6	19.5	20.8	21.2	21.5	21.5	21.9	22.0
Ages 15-19	7.2	11.4	17.1	22.9	33.1	44.8	55.6	57.8	59.8	62.3	66.6	67.9	69.3	70.9	71.9	72.6
Ages 20-24	2.2	3.8	5.2	6.1	11.7	17.7	24.5	26.8	28.3	30.1	32.5	33.3	34.4	35.3	36.4	37.1
Ages 25-29	1.1	1.9	2.1	2.6	5.2	8.1	9.7	10.4	10.7	11.4	12.4	12.7	13.2	13.3	13.6	13.8
Ages 30-34	1.0	1.6	2.1	2.7	4.6	6.3	6.9	7.3	7.5	7.8	8.2	8.3	8.4	7.9	7.9	7.8
Ages 35-39	1.3	1.9	2.7	3.9	6.4	8.1	7.8	8.2	8.5	8.9	9.4	9.4	9.6	8.8	8.8	8.7
Black^a
All ages	—	—	37.6	48.8	56.1	61.2	66.7	68.2	68.4	68.9	70.7	70.0	70.0	69.4	69.3	68.8
Ages 15-19	—	—	62.7	76.9	85.7	90.2	92.1	92.5	92.8	93.1	95.5	95.3	95.5	95.8	95.8	95.4
Ages 20-24	—	—	31.3	43.0	57.0	65.4	72.8	74.9	75.4	76.9	79.2	79.3	79.9	80.0	80.5	80.4
Ages 25-29	—	—	20.3	26.8	36.8	45.2	53.4	54.9	55.1	55.9	57.5	56.8	57.5	56.9	57.1	56.7
Ages 30-34	—	—	19.6	24.1	29.6	37.0	45.2	46.6	46.7	46.9	47.4	46.5	45.6	44.1	43.6	43.2
Ages 35-39	—	—	18.6	23.9	28.4	35.1	42.1	43.8	44.7	44.8	45.7	45.3	44.2	42.5	41.6	40.8
Hispanic^b
All ages	—	—	—	—	23.6	29.5	36.7	38.5	39.1	40.0	43.1	40.8	40.7	40.9	41.6	42.1
Ages 15-19	—	—	—	—	41.9	51.3	59.4	61.2	61.9	62.8	69.7	67.3	67.7	71.6	72.9	72.9
Ages 20-24	—	—	—	—	23.8	30.9	39.6	41.5	42.3	43.4	47.0	45.0	45.2	46.1	47.5	48.5
Ages 25-29	—	—	—	—	15.9	22.2	28.6	30.3	30.8	31.7	33.2	31.1	31.2	30.4	31.2	32.0
Ages 30-34	—	—	—	—	15.2	19.6	25.5	26.6	27.2	27.5	28.6	26.4	26.0	24.6	24.4	25.0
Ages 35-39	—	—	—	—	16.2	20.8	26.5	27.6	28.5	29.0	30.3	27.4	26.9	25.7	24.7	25.3
Asian/Pacific Islander^a
All ages	—	—	—	—	7.3	9.5	13.2	13.9	14.7	15.7	16.2	16.3	16.7	15.6	15.6	—
Ages 15-19	—	—	—	—	40.6	47.7	57.0	58.4	59.6	60.7	62.7	63.1	62.7	72.0	72.1	—
Ages 20-24	—	—	—	—	10.9	15.5	23.5	25.1	27.0	29.0	30.0	30.1	31.0	31.8	32.4	—
Ages 25-29	—	—	—	—	4.2	5.7	8.3	8.8	9.6	10.6	11.3	12.1	12.9	11.5	11.4	—
Ages 30-34	—	—	—	—	3.0	4.6	6.3	6.4	7.1	7.7	8.0	8.0	8.9	6.6	6.4	—
Ages 35-39	—	—	—	—	4.0	5.8	7.5	7.9	8.4	9.0	8.8	8.9	9.2	6.9	6.5	—
American Indian^a
All ages	—	—	—	—	39.2	46.8	53.6	55.3	55.3	55.8	57.0	57.2	58.0	58.7	59.3	—
Ages 15-19	—	—	—	—	61.9	72.5	78.9	79.1	80.3	80.6	82.9	82.5	84.1	84.4	85.9	—
Ages 20-24	—	—	—	—	38.6	48.5	57.2	58.7	58.6	59.5	60.6	60.7	61.7	63.2	63.3	—
Ages 25-29	—	—	—	—	28.1	35.9	43.2	45.2	45.3	45.2	45.5	45.7	46.4	47.3	47.6	—
Ages 30-34	—	—	—	—	22.2	31.8	38.3	39.0	39.6	40.0	40.6	40.6	41.4	41.2	42.0	—
Ages 35-39	—	—	—	—	22.5	27.7	35.5	38.8	38.2	38.1	38.5	40.6	40.1	40.3	41.1	—

^a Beginning in 1980, births were tabulated by race and ethnicity of the mother. Prior to 1980, births were tabulated by race of child, assigning a child to the race of the nonwhite parent, if any, or to the race of the father, if both are nonwhite. Data for black and white births include births of Hispanic origin until 1990. Beginning 1990, persons of Hispanic origin are not included, except in 1999 where figures for blacks include Hispanics

^b Persons of Hispanic origin may be of any race. Data for Hispanics have been available only since 1980, with 22 states reporting in 1980, representing 90 percent of the Hispanic population. Hispanic birth data were reported by 23 states and the District of Columbia in 1985; 48 states and the District of Columbia in 1990; 49 states and the District of Columbia in 1991 and 1992; and all 50 states and the District of Columbia since 1993

Sources: Curtin, & Martin, 2000, Table C; Ventura, et al., 2000. Births, Table 17; Tables 17, 18, 19, and 21; Ventura, et al., 1999, Births, Table 17; Ventura, 1995, Table 5; Ventura, et al., 1998, Natality, Table 17. Also previous issues of this annual report (Volume 45, no. 11; Volume 44, no. 11; Volume 44, no. 3, Table 14 in each); Ventura, Births, 1985, Tables 6 and 7; Ventura, 1983, Table 11; unpublished data from S. Ventura, National Center for Health Statistics.

Figure PF 1.7.B. Percentage of all births to unmarried women ages 15 through 19 in the United States, by race^a and Hispanic origin:^b 1960-1999

Sources: Ventura, et al., 2000, Births, Tables 17, 18, 19, and 21; Ventura, 1995, Table 5; Ventura & Curtin, 1999, Table 17; Ventura, et al., 1999, Births, Table 17; Ventura, et al., 2000 Births, Tables 2, 7, and 17; also unpublished data, National Center for Health Statistics.

Table PF 1.7.B. Percentage of all births to unmarried women ages 15 through 19 in the United States, by age of mother and by racea and Hispanic origin: Selected years, 1960-1999

	1960	1965	1970	1975	1980	1985	1990	1991	1992	1993	1994^c	1995	1996	1997	1998	1999
All races
Ages 15-17	24	33	43	51	62	71	78	79	79	80	84	84	84	87	88	88
Ages 18 or 19	11	15	22	30	40	51	61	63	65	66	70	70	71	73	74	74
Ages 15-19	15	21	30	38	48	58	67	69	70	71	75	75	76	78	79	79
White^a
Ages 15-17	12	17	25	33	45	58	68	70	72	73	78	79	81	83	83	83
Ages 18 or 19	5	9	14	17	27	38	50	52	54	57	61	62	64	65	67	67
Ages 15-19	7	11	17	23	33	45	56	58	60	62	67	68	69	71	72	73
Black^a
Ages 15-17	—	—	76	87	93	96	96	96	96	96	98	98	98	98	98	98
Ages 18 or 19	—	—	52	68	80	86	90	90	91	91	94	93	94	94	94	94
Ages 15-19	—	—	63	77	86	90	92	93	93	93	96	95	96	96	96	95
Hispanic^b
Ages 15-17	—	—	—	—	51	61	68	69	69	70	77	75	75	80	82	82
Ages 18 or 19	—	—	—	—	36	46	54	56	57	58	65	62	63	66	67	67
Ages 15-19	—	—	—	—	42	51	59	61	62	63	70	67	68	72	73	73

^c Increases between 1993 and 1994 were due primarily to improvements in the identification of nonmarital births in Texas and Michigan

Sources: Ventura, 1995, Table 5; Ventura, & Curtin, 1999, Table 3; Ventura, et al., 1999, Table 17; Ventura, et al., 2000, Births, Tables 2, 7, and 17. Also unpublished data from S. Ventura, National Center for Health Statistics.

³ Ventura, S.J., Martin, J.A., Mathews, T.J.,& Clarke, S.C. 1996. Advance Report of Final Natality Statistics, 1994. Monthly Vital Statistics Report, 44, (11, Supp.). Hyattsville, MD: National Center for Health Statistics.

Family Structure

PF 2.1 Percentage of Families with Children and Distribution of Families by Number of Children

Since 1960, Americans have been moving toward having families with fewer children. Indeed, a growing percentage of families have no minor children of their own in their household. Between 1960 and 1990, the percentage of families with four or more of their own children under age 18 in the household decreased from 9 percent to 3 percent, where it has remained (see Figure PF 2.1). During the same period, the proportion of families with no minor children grew from 43 percent to 51 percent.

Differences by Race and Hispanic Origin. These general trends are also evident when white, black, and Hispanic families are considered separately, though the levels are substantially different for each group (see Table PF 2.1). For example, between 1970 and 1999 the percentage of black families with four or more children dropped from 19 percent to 4 percent. The percentage for whites during that period went from 9 percent to 3 percent. For Hispanic families, the percentage dropped from 10 percent to 6 percent between 1980 (the first year for which Hispanic estimates are available) and 1999.

In 1999, black and Hispanic families were considerably less likely than white families to be without any minor children, with proportions of 44 percent and 37 percent respectively, compared to 53 percent for whites. They were also more likely than white families to have four or more children, though these differences were smaller than in previous decades.

Figure PF 2.1. Percentage of families in the United States with no children, and with four or more resident children: Selected years, 1960-1999

Figure PF 2.1 Percentage of families in the United States with no children, and with four or more resident children: Selected years, 1960-1999

Sources: U.S. Bureau of the Census, Households and Family Characteristics: 1998, no. 515; also previous issues of this annual report (Series P-20, no. 509, no. 495, no. 488, no. 483, no. 477, no. 467, no. 458, no. 447, and no. 366, Table 1 in each; no. 218, Table 5; and no. 106, Table 7).

Table PF 2.1. Percentage distribution of families in the United States by number of own children under age 18 and by race and Hispanic origin:a Selected years, 1960-1999

	1960	1970	1980	1990	1991	1992	1993	1994	1995	1996	1997	1998	1999
All families
Without own children	43	44	48	51	51	51	51	50	51	51	51	51	52
One child	19	18	21	21	20	20	20	20	20	20	20	20	20
2 children	18	17	19	19	19	18	19	19	19	19	19	19	18
3 children	11	11	8	7	7	7	7	8	7	7	7	8	7
4 or more children	9	10	4	3	3	3	3	3	3	3	3	3	3
White^a families
Without own children	43	45	49	51	53	53	53	52	52	52	52	52	53
One child	19	18	21	21	19	20	19	19	20	19	20	20	19
2 children	18	18	19	19	18	18	19	19	19	19	19	18	18
3 children	11	11	8	7	7	7	7	7	7	7	7	7	7
4 or more children	9	9	4	3	3	3	2	2	2	3	2	2	3
Black^a families
Without own children	—	39	38	41	41	42	42	40	42	43	42	42	44
One child	—	18	23	25	25	24	25	25	24	24	24	23	24
2 children	—	15	20	19	19	19	18	20	20	18	20	21	19
3 children	—	10	10	9	9	10	10	9	9	9	9	9	9
4 or more children	—	19	8	6	6	5	5	5	5	5	5	4	4
Hispanic^a families
Without own children	—	—	31	37	36	36	37	36	36	36	35	36	37
One child	—	—	23	23	22	22	23	22	23	23	24	23	23
2 children	—	—	23	21	23	22	22	23	23	23	23	23	22
3 children	—	—	13	12	12	13	12	13	12	12	12	12	12
4 or more children	—	—	10	7	7	7	7	6	7	7	6	6	6

^a Persons of Hispanic origin may be of any race. Estimates for whites and blacks include persons of Hispanic origin. Source: U.S. Bureau of the Census. Current Population Reports, Series P-20.

PF 2.2 Percentage Distribution of Children by Number of Parents in Household

Family structure is one of many factors that contributes to child well-being. It is also associated with the well-being of the child as an adult. For example, children from disrupted families or families where the parents never married are somewhat more likely to use alcohol and drugs, to become teen parents, and are less likely to earn a high school diploma than children from intact families. These associations are evident even after controlling for family socioeconomic status, race, and other background factors.⁴ Nevertheless, the great majority of children brought up in single-parent families do well. In particular, differences in well-being between children from divorced and those from intact families tend, on average, to be moderate to small.⁵

Between 1970 and 1999, the proportion of children in two-parent families (about 84 percent of whom live with both biological parents)⁶ decreased from 85 percent to 68 percent (see Table PF 2.2.A)

In 1999, 23 percent of children lived with their mother only; 4 percent lived with their father only;⁷ and 4 percent lived with neither parent (see Table PF 2.2.A).⁸ Of those who lived with neither parent, more than one-half were residing with one or more grandparents as of 1993 (see Table PF 2.2.B).

Differences by Race and Hispanic Origin. The decrease in the proportion of children living in two-parent families is evident for black, white, and Hispanic children, though the decline is somewhat steeper for black children (see Figure PF 2.2.A). Between 1970 and 1996, the proportion of black children living in two-parent families fell by 25 percentage points from 58 percent to 33 percent (see Table PF 2.2.A). However, between 1996 and 1999, that percentage increased modestly to 35 percent. Between 1970 and 1999, the drop for white children was 16 percentage points, from 90 percent to 74 percent. For Hispanic children, the percentage living in two-parent families decreased from 78 percent to 63 percent.

Table PF 2.2.A Percentage distribution of living arrangements of children under age 18 in the United States, by race and Hispanic origin:a Selected years, 1970-1999

	1970	1980	1990	1991	1992	1993	1994b	1995^b	1996^b	1997^b	1998^b	1999^b
Total
Two parents	85	77	73	72	71	71	69	69	68	68	68	68
Mother only	11	18	22	22	23	23	23	23	24	24	23	23
Father only	1	2	3	3	3	3	3	4	4	4	4	4
No parent	3	4	3	3	3	3	4	4	4	4	4	4
White^a
Two parents	90	83	79	78	77	77	76	76	75	75	74	74
Mother only	8	14	16	17	18	17	18	18	18	18	18	18
Father only	1	2	3	3	3	3	3	3	4	4	5	4
No parent	2	2	2	2	2	2	3	3	3	3	3	3
Black^a
Two parents	58	42	38	36	36	36	33	33	33	35	36	35
Mother only	30	44	51	54	54	54	53	52	53	52	51	52
Father only	2	2	4	4	3	3	4	4	4	5	4	4
No parent	10	12	8	7	7	7	10	11	9	8	9	10
Hispanic^a
Two parents	78	75	67	66	65	65	63	63	62	64	64	63
Mother only	—	20	27	27	28	28	28	28	29	27	27	27
Father only	—	2	3	3	4	4	4	4	4	4	4	5
No parent	—	3	3	4	3	4	5	4	5	5	5	5

^a Persons of Hispanic origin may be of any race. Estimates for whites and blacks include persons of Hispanic origin.

^b Numbers in these years may reflect changes in the Current Population Survey because of newly instituted computer-assisted interviewing techniques and/or because of the change in the population controls to the 1990 Census-based estimates, with adjustments.

Sources: U.S. Bureau of the Census, Current Population Reports, Series P-20, no. 410, no. 461, no. 468, no. 478, no. 491, no. 496u, no. 506u, no. 514u (Table 4 in each); and no. 484, Table A-5; also unpublished data, U.S. Bureau of the Census.

Table PF 2.2.B. Percentage distribution of children under age 18 in the United States in two-parent, one-parent, or no-parent families, by age, race and Hispanic origin, poverty status, and parent’s education level: 1993

	Two-Parent Families			Single-Parent Families			No Parents Present
	Total^a	Biological Parents	One Biological, One Step-parent	Total^a	Biologic^aMother	Biological Father	Total^a	Grandparents
All children	70.8	59.8	7.1	26.5	22.6	2.1	2.4	1.5
Ages 0-5	72.8	67.4	1.8	25.4	22.5	1.2	1.8	1.3
Ages 6-11	70.8	58.9	7.9	26.7	22.8	1.9	2.4	1.8
Ages 12-17	68.8	52.3	12.2	27.5	22.4	3.2	3.2	1.6
Race and Hispanic origin^b
White, non-Hispanic	80.1	67.8	8.2	18.4	15.2	2.2	1.4	0.9
Black, non-Hispanic	35.9	28.2	4.4	56.9	48.9	2.2	7.1	4.7
Hispanic	61.5	52.9	5.6	35.3	32.6	1.4	2.7	1.6
Poverty status
Below poverty	37.1	31.1	3.5	58.4	52.4	1.9	4.2	2.5
At or above poverty	80.6	68.2	8.2	17.2	13.9	2.1	1.9	1.2
Parent's education level^b
Less than high school	45.2	38.7	4.3	54.8	47.3	2.6	—	—
Completed high school	67.8	55.8	8.1	32.2	27.2	2.8	—	—
At least some college	76.5	63.1	9.4	23.5	20.3	1.9	—	—
Four or more years of college	90.3	79.1	6.2	9.7	7.8	—	—	—

^a Totals for two-parent, one-parent, and no-parent families include categories beyond those presented separately.

^b Education level in two-parent families is determined by the higher educated parent.

Source: Survey of Income and Program Participation, 1993. Analysis by Child Trends.

Figure PF 2.2 Percentage of children under age 18 in the United States who are living with two parents, by race and Hispanic origin:^a 1970-1999^b

^aPersons of Hispanic origin may be of any race. Estimates for whites and blacks include persons of Hispanic origin.

^b Numbers in the years 1994 and beyond may reflect changes in the Current Population Survey because of newly constituted computer-assisted interviewing techniques and/or because of the change in the population controls to the 1990 Census-based estimates, with adjustments.

Sources: U.S. Bureau of the Census, Current Population Reports, Series P-20, no. 410, no. 461, no. 468, no. 478, no. 491, no. 496u, no. 506u, no. 514u (Table 4 in each); and no. 484, Table A-5; also unpublished data, U.S. Bureau of the Census. As published in America’s Children: Key National Indicators of Well-Being, 1998. Federal Interagency Forum on Child and Family Statistics, Washington, D.C.: U.S. Government Printing Office, Table POP5.

⁴ Amato, P.R. 1993. Children’s Adjustment to Divorce: Theories, Hypotheses, and Empirical Support. Journal of Marriage and the Family, 55: 23-58.

⁵ Zill, N., Morrison, D., & Coiro, M. 1993. Long-Term Effects of Parental Divorce on Parent-Child Relationships: Adjustment and Achievement in Early Adulthood. Journal of Family Psychology 7 (1): 91-103.

⁶ Analyses by Child Trends of the 1993 Survey of Income and Program Participation indicates that 84 percent of children in married-couple families live with both biological parents (see Table PF 2.2.B).

⁷ The Current Population Survey overestimates the proportion of children living in father-only families, because it identifies many cohabiting biological-parent couples as father-only. Though the precise size of the overestimate is not known, analyses of the 1993 Survey of Income and Program Participation indicate that a little over 2 percent of all children actually lived in father-only families in that year (see Table PF 2.2.B).

⁸ Data from the 1996 Current Population Survey (not shown) indicate that 11 percent of all children under age 18 who are living in families live with single parents who are divorced. See Saluter, A. 1997. PPL-66, Household and Family Characteristics: March 1996 (Update), U.S. Bureau of the Census.

PF 2.3 Children Living in Foster Care (9)

A child is placed in foster care when a court determines that his or her family cannot provide a minimally safe environment. This determination often follows an investigation by a state or county child protective services worker. Placement most commonly occurs either because a member of a household has physically or sexually abused a child or because a child’s caretaker(s) has severely neglected the child. In some cases, children with severe emotional disturbances may also be put into foster care.

Since both federal and state laws discourage removal of children from their families unless necessary to ensure a child’s safety, placement in foster care is an extreme step taken only when a child is in immediate danger or when attempts to help the family provide a safe environment have failed; thus, the frequency of placements in foster care is an indicator of family dysfunction that is so severe that a child cannot remain safely with his or her family

The number of children in foster care rose sharply from 262,000 in 1982 to 560,000 in 1998 (see Table PF 2.3). As shown in Figure PF 2.3, the rate of children living in foster care (i.e., the number of children in foster care per 1,000 children under age 18) also rose dramatically during the same time period, from 4.2 per 1,000 children under age 18 in 1982 to 8.0 per 1,000 in 1998.

Table PF 2.3 Number and rate (per 1,000) of children in the United States living in foster care: 1982-1998

	1982	1983	1984	1985	1986	1987	1988	1989	1990	1991	1992	1993	1994	1995	1996a	1997	1998
Total number (in thousands)	262	269	276	276	280	300	340	383	400	414	427	445	468	483	507	537	560
Rate	4.2	4.3	4.3	4.3	4.5	4.8	5.4	6.0	6.2	6.4	6.5	6.6	6.9	7.0	7.3	7.7	8.0

Note: Estimate of total is the number of children in foster care on the last day of the fiscal year.

^a 1996 was the last year in which data on foster care were collected through the Voluntary Cooperative Information System (VCIS). The Administration on Children and Families (ACF) has implemented the Adoption and Foster Care Analysis and Reporting System (AFCARS) as a replacement for VCIS. While VCIS was a voluntary reporting system, states are required to participate in AFCARS and must use uniform definitions. Most importantly, AFCARS collects case-level foster care data. Estimates in this table may not be comparable to estimates provided in previous issues of Trends in the Well-Being of America's Children and Youth due to the population estimates provided by the U.S. Bureau of the Census.

Sources: Estimate of children in foster care for 1997 and 1998 from special analysis by John Gavdiosi, Department of Health and Human Services, Administration for Children and Families, Children’s Bureau, 1999; estimates of children in foster care for years 1982-1996 from Tashio Tatara, 1995, and 1997; population estimates for 1982-1990 from U.S. Bureau of the Census, Statistical Abstract of the United States, 1996; population estimates for 1990-1998 from Population Estimates Program, Population Division, U.S. Census Bureau, Table ST-99-9.

Figure PF 2.3 Children in the United States living in foster care (rate per 1,000 children): 1982-1998

Note: Estimate of total is the number of children in foster care on the last day of the fiscal year.

a 1996 was the last year in which data on foster care were collected through the Voluntary Cooperative Information System (VCIS). The Administration on Children and Families (ACF) has implemented the Adoption and Foster Care Analysis and Reporting System (AFCARS) as a replacement for VCIS. While VCIS was a voluntary reporting system, states are required to participate in AFCARS and must use uniform definitions. Most importantly, AFCARS collects case-level foster care data. Estimates in this table may not be comparable to estimates provided in previous issues of Trends in the Well-Being of America’s Children and Youth due to changes in the population estimates provided by the U.S. Bureau of the Census.

Sources: Estimate of children in foster care for 1997 and 1998 from special analysis by John Gavdiosi, Department of Health and Human Services, Administration for Children and Families, Children’s Bureau, 1999; estimates of children in foster care for years 1982-1996 from Tatara, 1995, and 1997, no. 13; population estimates for 1982-1990 from U.S. Bureau of the Census, Statistical Abstract of the United States, 1996; population estimates for 1990-1998 from Population Estimates Program.

⁹ For purposes of this report, “foster care” is defined as a living arrangement where a child resides outside his or her own home, under the case management and planning responsibility of a state child welfare agency. These living arrangements include relative and nonrelative foster homes, group homes, child-care facilities, emergency shelter care, supervised independent living, and nonfinalized adoptive homes.

Neighborhoods

PF 3.1 Residential Stability: Percentage of Children Under Age 18 (10) Who Have Moved Within the Last Year

Research has demonstrated a strong relationship between residential stability and child well-being, with frequent moves associated with such negative outcomes as dropping out of high school, delinquency, depression, and nonmarital teen births. Some researchers theorize that these negative associations may result from a lack of attachment to a local community and its institutions on the part of frequent movers.

The United States has long been a highly mobile society. In 1960, 21 percent of children under the age of 18 had moved to a new residence during the previous year. The general trend since that time has been toward somewhat lower rates of mobility, with a rate of 18 percent in 1997.¹¹

Differences by Age. Young children were the most mobile of any child age group (see Table PF 3.1). In 1999, 23 percent of children between the ages of 1 and 4 had changed residences in the previous year, compared with 18 percent among children ages 5 through 9, 13 percent of ages 10 through 14, and 13 percent of youth ages 15 through 17.

Differences by Race and Hispanic Origin. For all children under age 18 in 1999, white children were the least mobile, with 16 percent moving during the previous year compared with 23 percent of black and 19 percent of Hispanic children.

Table PF 3.1 Percentage of children in the United States under age 18a who have moved within the last year, by age and by race and Hispanic origin:b 1990-1999^c

	1990	1991	1992	1993	1994	1996	1997	1998	1999
All children
All ages	18	17	18	17	17	18	18	17	17
Ages 1-4	24	23	22	23	22	25	24	23	23
Ages 5-9	19	18	18	17	17	18	19	18	18
Ages 10-14	15	14	15	14	13	15	15	14	13
Ages 15-17	15	15	14	14	15	13	14	13	13
White^b children
All ages	18	17	17	16	16	17	17	16	16
Ages 1-4	23	22	21	22	21	24	23	22	21
Ages 5-9	18	17	17	16	16	18	18	16	17
Ages 10-14	14	13	15	13	12	14	15	13	13
Ages 15-17	14	14	14	14	13	12	13	12	12
Black^b children
All ages	21	21	21	20	20	22	23	22	23
Ages 1-4	26	26	27	26	25	29	29	28	32
Ages 5-9	22	22	22	20	22	22	26	24	27
Ages 10-14	19	17	18	17	16	18	18	20	17
Ages 15-17	18	16	16	14	18	14	17	16	15
Hispanic^b children
All ages	25	21	24	23	21	23	23	21	19
Ages 1-4	32	27	27	28	26	31	28	26	24
Ages 5-9	28	20	25	24	20	23	21	21	19
Ages 10-14	18	19	21	19	15	18	22	16	14
Ages 15-17	21	19	19	20	21	19	17	17	16

^a Estimates are based on children ages 1 and older at time of survey

^b Persons of Hispanic origin may be of any race. Estimates for whites and blacks include persons of Hispanic origin.

^c Estimates for 1995 are not available.

Sources: U.S. Bureau of the Census, 1999. Geographical Mobility, and earlier reports; also previous issues of this annual report (Series P-20, no. 510, P-20, no. 497, no. 485, no. 481, no. 463, no. 456, Table 26 in all).

¹⁰Estimates were based on children ages 1 and older at time of survey.

¹¹ Wood, D., Halfon, N., Scarlata, D., Newacheck, P., & Nessim, S. 1993. Impact of Family Relocation on Children’s Growth, Development, School Function, and Behavior. JAMA 270: 1334-1338; Coleman, J. 1988. Social Capital and the Creation of Human Capital. American Journal of Sociology 94: s95-s120.

PF 3.2 Children in Poor and Very Poor Neighborhoods

Recent research has demonstrated a significant relationship between neighborhood quality and the well-being of the children and youth who live in them. Even after controlling for relevant personal and family background characteristics, residence in a low-income neighborhood has been shown to have negative effects on early childhood development, associated with higher rates of dropping out of high school, and with teen parenthood.¹² In 1997, 55.8 percent of children living below the poverty level lived in a very poor neighborhood— defined as a census tract in which 40 percent or more of the residents live in poor families13 (see Table PF 3.2).

Differences by Race and Hispanic Origin. Hispanic children were the most likely to live in very poor neighborhoods, followed by white children and black children. Sixty-one percent of Hispanic children in poverty lived in more than 40 percent poor neighborhoods, compared to 56 percent of white children and 53 percent of black children (see Figure PF 3.2).

Differences by Family Structure. Children in single-parent families in poverty were much more likely to live in a very poor neighborhood than were children in two-parent families (70.8 percent versus 38.6 percent) (see Figure PF 3.2)

Table PF 3.2. Percentage of related childrena in the United States below the poverty levelb by the poverty level of their neighborhood, by age, family structure, and race and Hispanic originc : 1997

	All Areas	Neighborhood Poverty Level
	Poor	Non-Poor	Poor	30+ Percent Poor	40+ Percent Poor
Total	19.2	13.2	41.5	51.0	55.8
Age of child
Under 6 years	21.6	15.2	45.4	54.8	57.6
6 - 17 years	18.0	12.2	39.6	49.0	54.9
Family structure
Married couple families
Under 6 years	10.6	7.7	26.9	38.0	38.2
6 - 17 years	8.8	6.0	23.7	33.1	38.8
Single parent families (female)
Under 6 years	59.1	51.0	70.3	72.3	78.5
6 - 17 years	44.7	35.8	60.3	64.0	67.6
Race and Hispanic origin^c
White^c	15.4	11.2	38.3	51.9	56.0
Black^c	36.8	28.6	45.5	48.5	53.0
Hispanic^c	36.4	25.9	52.2	58.6	61.1

^aUnder 18 years of age.

^b Poverty rate of neighborhood in 1979, poverty status of persons in 1997.

^c Persons of Hispanic origin may be of any race. Estimates for whites and blacks include persons of Hispanic origin. Estimates for whites also include all other persons not white, black, or Hispanic.

Note: Neighborhoods are defined as census tracts and block-numbering areas. Both metropolitan and nonmetropolitan areas are included. The poverty rate is the percentage of all persons in the neighborhood living in families below the federal poverty line in 1990.

Source: U.S. Bureau of the Census, Current Population Survey: March Supplement. Available online at http://ferret.bls.census.gov/macro/031998/pov/5_001.htm.

Figure PF 3.2. Percentage of children below the poverty level in the United States who live in very poor (40+ percent poverty) neighborhoods, by race and family structure, 1997

Source: U.S. Bureau of the Census, Current Population Survey: March Supplement. Available online at http://ferret.bls.census.gov/macro/031998/pov/5_001.htm.

¹² Brooks-Gunn, J., Duncan, G., Klebanov, P., & Sealand, N. 1994. Do Neighborhoods Influence Child and Adolescent Behavior? American Journal of Sociology 99 (2): 353-395. See also Crane, J. 1991. The Epidemic Theory of Ghettos and Neighborhood Effects on Dropping Out of High School and Teenage Childbearing. American Journal of Sociology 96 (5): 1126-1159.

¹³ While trend data for children are not available, trends for the entire population show that between 1970 and 1990, the percent of all persons living in very poor neighborhoods increased from 3 percent to 4.5 percent, and the numbers nearly doubled from 4.1 million to 8 million. See Jargowsky, P.A. 1996. Poverty and Place: Ghettos, Barrios, and the American City, Table 2.1. New York: Russell Sage.

Section 2: Economic Security (ES)

Poverty and Income

ES 1.1 Median Family Income

Median income¹ of families with children is a good starting point for assessing the economic well-being of children since it measures the ability of a family at the midpoint of the income distribution to purchase food, shelter, clothing, child care, and other basic goods and services required to raise children.²

However, median family income fails to capture important economic resources that may also be available to a family, such as employer-paid health benefits, Medicaid, or Food Stamps; moreover, it says nothing about changes in the distribution of income across families. For a more complete picture of children’s economic well-being, it is necessary to look at several measures of economic well-being, including those in the following sections.

Median Family Income of All Families with Children. Between 1975 and 1998, median income of all families with children (in constant 1998 dollars)³ increased gradually from $41,304 in 1975 to $45,442 in 1998 (see Table ES 1.1).⁴

Median Family Income by Family Type. Throughout the period from 1975 through 1998, median income of mother-only families has never exceeded 35 percent of median income of two-parent families (see Figure ES 1.1). In 1998, the median family income of mother-only families was $18,409, compared with $57,022 for married-couple families with children. During the same time period, the median income of father-only families never exceeded 62 percent of median income of two-parent families (see Figure ES 1.1). In 1998, median income of father-only families was $30,869.

Differences in Median Family Income by Race and Hispanic Origin. Median family incomes are substantially higher for white families with children than for black or Hispanic families with children. In 1998, whites enjoyed median family incomes that were about 89 percent higher than those of black families and 76 percent higher than those of Hispanic families (see Table ES 1.1).

Table ES 1.1 Median income of families in the United States with related children under age 18, by race and Hispanic origina and family structure (in constant 1998 dollars):b Selected years, 1975-1998

	1975	1980	1985	1990	1995	1996	1997	1998
All families	$41,304	$42,315	$41,969	$42,689	$42,799	$42,578	$44,223	$45,442
White	—	—	—	$45,522	$46,088	$46,258	$47,498	$48,878
Black	—	—	—	$24,143	$24,248	$23,803	$25,629	$25,841
Hispanic	—	—	—	$27,441	$24,671	$25,576	$26,527	$27,742
Married-couple families
All races	$45,611	$48,139	$49,005	$51,457	$53,445	$53,781	$55,242	$57,022
White	—	—	—	$51,987	$54,113	$54,388	$56,092	$57,974
Black	—	—	—	$44,549	$47,003	$44,357	$48,373	$48,536
Hispanic	—	—	—	$34,264	$31,737	$32,841	$33,751	$34,243
Mother-only families
All races	$15,908	$16,763	$15,264	$16,327	$17,364	$17,026	$17,525	$18,409
White	—	—	—	$18,542	$19,358	$18,844	$19,234	$20,799
Black	—	—	—	$12,853	$13,982	$14,178	$15,346	$15,356
Hispanic	—	—	—	$12,648	$12,627	$11,678	$13,185	$14,083
Father-only families
All races	$34,131	—	—	$31,441	$28,867	$27,531	$29,115	$30,869
White	—	—	—	$32,635	$30,146	$28,771	$30,671	$32,606
Black	—	—	—	$25,647	$23,866	$23,091	$22,155	$25,012
Hispanic	—	—	—	$25,909	$20,861	$23,430	$20,340	$24,661

^a Persons of Hispanic origin may be of any race. Estimates for whites and blacks include persons of Hispanic origin.

^b Income statistics converted to constant 1998 dollars using the CPI-U-X1 (all items) price index. CPI-U-X1 is a rental equivalence approach to homeowners’ costs for the consumer price index prior to 1983, the first year for which the official index (CPI-U) incorporates such a measure.

Sources: Unpublished tabulations of the March Current Population Survey supplied by U.S. Bureau of the Census; U.S. Bureau of the Census, Current Population Survey, Annual Demographic Survey: March Supplement, Table FINC-04 available online at www.census.gov/hhes/income/histinc.html; Council of Economic Advisors, 1997. Economic Report of the President, 1997, Table B-58; U.S. Bureau of the Census, 1998. Current Population Reports, Money Income (with separate data on valuation of noncash benefits), Table B-1. U.S. Bureau of the Census, Historical Income Tables — Families, Table F9, F10, F10A, F10B, F10C, available online at www.census.gov/hhes/income/histinc.html.8/9/00

Figure ES 1.1 Median income of families in the United States with related children under age 18, by family structure (in constant 1998 dollars):^a Selected years, 1975-1998

^a Income statistics converted to constant 1998 dollars using the CPI-U-X1 (all items) price index. CPI-U-X1 is a rental equivalence approach to homeowners’ costs for the consumer price index prior to 1983, the first year for which the official index (CPI-U) incorporates such a measure.

¹ Median income is the amount that divides the income distribution into two equal groups, half having incomes above the median, half having incomes below the median.
² When median family income is rising, the likelihood is that children in a typical family are enjoying a rising standard of living.

³ In constructing income figures in constant 1998 dollars, we have followed the practice of the Bureau of the Census and used the CPI-U-X1 consumer price index. This index differs from the standard CPI-U index in its treatment of the costs of owner-occupied housing for years prior to 1986. After 1986, it is identical to the CPI-U.

⁴ However, this apparent stagnation was in part the result of a shift in the living arrangements of families with children. As shown in Table PF 2.1.A, between 1970 and 1997 the percentage of children living in female-headed families increased from 11 percent to 24 percent. Since, as will be described in the next section, female-headed families have much lower incomes than two-parent families, this shift in living arrangements depressed the median income of all families with children.

ES 1.2 Children in Poverty

Being raised in economically deprived circumstances can have far-reaching negative consequences for children. Growing up at or near the poverty line ($16,530 for a family of four in 1998) means not only that a child has a much lower level of consumption than other children but also that he or she is more likely than a nonpoor child to experience difficulties in school,⁵ to become a teen parent,⁶ and, as an adult, to earn less and experience greater unemployment.⁷ The effects of being raised in a family with income significantly below the poverty line are correspondingly more damaging.⁸

Differences by Family Structure. The chances of a child experiencing poverty are strongly influenced by the type of family in which he or she lives. Throughout the period from 1960 through 1994, over half of the children living in female-headed families were poor. This percentage decreased in the late nineties to 46 in 1998 (see Table ES 1.2.A). In contrast, during the 1990s, only about 10 percent of children living in married-couple families were poor (see Figure ES 1.2.A).

Differences by Race and Hispanic Origin. The proportion of black and Hispanic children at or below 100 percent of the poverty line has declined between 1996 and 1998 (from 40 percent to 36 percent for black children and from 40 percent to 34 percent for Hispanic children). In contrast, the proportion of white children dropped only slightly from 16 percent to 14 percent. There was also a significant drop between 1996 and 1998 in the proportion of black and Hispanic children living at or below 200 percent of the poverty line (from 68 percent to 64 percent for black children and from 72 percent to 66 percent for Hispanic children) (see Table ES 1.2.B).

Children At, Below, and Slightly Above the Poverty Level. Figures ES 1.2.B and ES 1.2.C illustrate trends in the proportions of children living in various degrees of poverty and near-poverty.

Children in families with incomes below 50 percent of the poverty line. Between 1975 and 1993, the proportion of children living in extreme poverty, that is, at or below 50 percent of the poverty line, doubled from 5 percent in 1975 to 10 percent by 1993. By 1998, this percentage had dropped back to 8 percent (see Table ES 1.2.B).
Children in families with incomes at or below the poverty line. Less dramatic but still striking, the proportion of children at or below 100 percent of the poverty line increased by 31 percent9 from 17 percent in 1975 to 22 percent by 1993 before dropping to 18 percent in 1998 (see Figure ES 1.2.A).
Children above but near the poverty line. In contrast, the proportion of children living at or below 150 percent of the poverty line was about the same in 1998 (29 percent) as it was in 1975 (30 percent). As shown in the upper line of Figure ES 1.2.C, the proportion of children living at or below 200 percent of the poverty line in 1998 was 40 percent, compared with 43 percent in 1975.

Table ES 1.2.A Percentage of children in the United States under age 18 living below the poverty level,^a by family structure, age, and race and Hispanic origin:b Selected years, 1960-1998

	1960	1965	1970	1975	1980	1985	1990	1991	1992	1993	1994	1995	1996	1997	1998
All families with related children under age 18	26	21	15	17	18	20	20	21	22	22	21	20	20	19	18
White	20	14	10	12	13	16	15	16	16	17	16	16	16	15	14
Black	—	—	42	41	42	43	44	46	46	46	43	41	40	37	36
Hispanic	—	—	—	33	33	40	38	40	39	40	41	39	40	36	34
Asian	—	—	—	—	—	—	17	17	16	18	18	19	19	20	—
Related children ages 6-17	—	—	14	16	17	19	18	19	19	20	19	18	18	18	21
White	—	—	10	12	12	14	14	15	15	15	15	14	14	14	17
Black	—	—	41	42	40	41	41	42	43	43	40	37	37	35	35
Hispanic	—	—	—	—	32	39	36	37	37	38	39	37	38	35	32

Related children under age 6	—	—	17	18	20	23	23	24	26	26	25	24	23	22	17
White	—	—	12	14	16	18	18	19	20	20	19	18	18	18	13
Black	—	—	42	41	45	47	50	51	53	52	49	49	45	40	35
Hispanic	—	—	—	—	34	41	40	44	43	43	44	42	42	38	32
Married-couple families with related children under age 18	—	—	—	—	—	—	10	11	11	12	11	10	10	9	9
White	—	—	—	—	—	—	9	10	10	11	10	9	9	9	8
Black	—	—	—	—	—	—	18	15	18	18	15	13	14	13	12
Hispanic	—	—	—	—	—	—	26	29	29	30	30	28	29	26	23
Asian	—	—	—	—	—	—	—	—	—	16	—	15	15	—	—
Related children ages 6-17	—	—	—	—	—	—	9	10	10	11	10	9	9	9	10
White	—	—	—	—	—	—	8	9	9	10	9	9	8	8	10
Black	—	—	—	—	—	—	17	14	16	17	14	12	14	13	10
Hispanic	—	—	—	—	—	—	25	26	26	28	28	27	28	25	25
Related children under age 6	—	—	—	—	—	—	12	12	13	13	12	11	12	11	8
White	—	—	—	—	—	—	11	11	12	13	11	11	11	10	8
Black	—	—	—	—	—	—	20	17	22	20	15	14	14	13	13
Hispanic	—	—	—	—	—	—	28	33	32	33	33	31	32	28	22
Female-headed families with related children under age 18	68	64	59	53	51	54	53	55	55	54	53	50	49	49	46
White	60	53	43	44	42	45	46	47	46	46	46	42	43	44	40
Black	—	—	68	66	65	67	65	68	67	6	63	62	58	55	55
Hispanic	—	—	—	—	65	72	68	69	66	66	68	66	67	63	60
Related children
ages 6-17	—	—	49	49	46	48	47	50	49	48	47	45	45	45	55
White	—	—	38	40	36	40	39	41	39	40	40	37	38	39	50
Black	—	—	66	66	62	63	60	65	63	62	59	56	55	53	60
Hispanic	—	—	—	—	62	70	64	65	62	63	65	62	65	60	67
Related children under age 6	—	—	64	62	65	66	66	66	66	64	64	62	59	59	42
White	—	—	59	58	60	59	60	60	61	58	59	55	54	57	36
Black	—	—	71	67	72	75	73	74	73	72	70	71	64	61	52
Hispanic	—	—	—	—	70	78	77	74	72	72	74	72	72	68	55

^a The poverty level is based on money income and does not include noncash benefits, such as Food Stamps. Poverty thresholds reflect family size and composition and are adjusted each year using the annual average Consumer Price Index (CPI) level. The average poverty threshold for a family of four was $16,530 in 1998. Related children include biological children, stepchildren, and adopted children of the householder and all other children in the household related to the householder (or reference person) by blood, marriage, or adoption.

^b Persons of Hispanic origin may be of any race. Estimates for whites, blacks, and Asians include persons of Hispanic origin.

Sources: U.S. Bureau of the Census, Current Population Reports, Series P-60, 4; 86, Table 1; 106, Table 11; 133, Table 11; 158, Table 7; 175, Table 6; 181, Table 5; 185, Revised Table 6; 188, Table 8; 189, Table 9; 194, Table 2; 198, Table 2; and 201, Tables 2, A-1, and C-2; U.S. Bureau of the Census, Current Population Reports, The Asian and Pacific Islander Population,Table 8; 77, Table 5; and 81, Table 5.

Figure ES 1.2.A Percentage of children in the United States under age 18 living below the poverty level,^a by family type: Selected years, 1960-1998

Sources: U.S. Bureau of the Census, Current Population Reports, Series P-60, no. 81, Table 4; no. 86, Table 1; no. 106, Table 11; no. 133, Table 11; no. 158, Table 7; no. 175, Table 6; no. 181, Table 5; no. 185, Revised Table 6; no. 188, Table 8; no. 189, Table 9; no. 194, Table 2; no. 198, Table 2; and no. 201, Tables 2, A-1, and C-2.

Table ES 1.2.B Percentage of children in the United States under age 18 living below selected poverty^a thresholds, by age and by race and Hispanic origin:^b Selected years, 1975-1998

	1975	1980	1985	1990	1991	1992	1993	1994	1995	1996	1997	1998
Under 50% of poverty
Related children under age 18	5	7	8	8	9	10	10	9	8	8	8	8
White	4	5	6	6	6	6	6	6	6	6	6	5
Black	14	17	21	22	25	27	26	23	20	20	19	17
Hispanic	—	—	—	14	14	15	14	17	16	14	16	13
Under 100% of poverty
Related children under age 18	17	18	20	20	21	22	22	21	20	20	19	18
White	12	13	16	15	16	16	17	16	16	16	15	14
Black	41	42	43	44	46	46	46	43	41	40	37	36
Hispanic	33	33	40	38	40	39	40	41	39	40	36	34
Under 150%
of poverty
Related children
under age 18	30	29	32	31	32	33	33	32	32	31	30	29
White	24	24	26	25	26	27	27	27	26	26	26	24
Black	60	57	59	57	60	60	61	58	56	56	51	52
Hispanic	—	—	—	55	58	58	59	58	59	57	56	52
Under 200%
of poverty
Related children
under age 18	43	42	43	42	43	44	44	43	43	43	41	40
White	38	37	38	37	38	38	38	38	37	37	36	34
Black	73	70	71	68	70	71	72	68	68	68	64	64
Hispanic	—	—	—	69	71	70	72	72	72	72	69	66

Financial Support

ES 2.1 Means-Tested Assistance: AFDC(10) and Food Stamps

Many poor children have depended on Aid to Families with Dependent Children (AFDC) and the Food Stamp program for basic material needs. AFDC was a federal and state cash assistance program targeted at needy children and at certain others in these children’s households.¹¹ Among all children under age 6 in 1982, 21 percent were on AFDC for at least 1 year over the next 10 years (see Figure ES 2.1.A). As a result of major welfare reform enacted in August 1996, the AFDC program has now been replaced by the Temporary Assistance for Needy Families (TANF) program. TANF provides a block grant to states to design and administer their own welfare and work programs.

The Food Stamp program provides low-income households with vouchers that can be exchanged for food. The welfare reform law includes significant new restrictions on Food Stamp eligibility for immigrants who have not become U.S. citizens.

Children’s Receipt of AFDC and Other Welfare Benefits. Twelve percent of all children lived in families receiving AFDC or General Assistance in 1979, according to survey data (see Figure ES 2.1.B). The rate decreased slightly to 11 percent in 1989 but by 1993 had increased to 14 percent. However, by 1997, the recipiency rate had dropped to 9 percent.

Children’s Receipt of Food Stamps. Food Stamp receipt shows a similar pattern. The percentage of all children living in households receiving Food Stamps remained fairly constant at around 15 percent from 1979 to 1989 (see Figure ES 2.1.B). The proportion had increased to 20 percent by 1993. In that year 14.2 million children lived in households receiving Food Stamps (see Table ES 2.1.B). However, the recipiency rate had dropped back down to 15 percent by 1997.

Receipt of AFDC and Food Stamps by Race and Hispanic Origin. The percentage of children receiving AFDC and Food Stamps varies substantially by race/Hispanic origin. According to 1992 data from the Panel Study of Income Dynamics,¹² only 5 percent of white non-Hispanic children received AFDC and only 8 percent received Food Stamps (see Figure ES 2.1.C). In contrast, among black non-Hispanic children, 32 percent received AFDC and 42 percent received Food Stamps. Among Hispanic children, 18 percent received AFDC and 30 percent received Food Stamps.

There was also substantial variation among Hispanic children, depending on their descent. Among children of Cuban descent, only 8 percent received AFDC and 18 percent received Food Stamps. In contrast, among children of Puerto Rican descent, 28 percent received AFDC and 48 percent received Food Stamps. Among children of Mexican descent, 15 percent received AFDC and 30 percent received Food Stamps.

Figure ES 2.1.A Percentage of children under age 6 in the United States receiving any AFDC^a benefit, by number of years and by race:^b 1982

Figure ES 2.1.A Percentage of children under age 6 in the United States receiving any AFDCa benefit, by number of years and by race:b 1982

^aReceipt of AFDC by families of children who were under age 6 in 1982 was monitored for the decade beginning in 1982 and ending in 1991. The figure displays the percentage who participated in AFDC by number of years participating over the 10-year period (minimum is zero; maximum is 10 years).

^b Persons of Hispanic origin may be of any race. Estimates for blacks and nonblacks include persons of Hispanic origin. Source: Estimates supplied by Greg J. Duncan, Northwestern University, based on data from the Panel Study of Income Dynamics.

Table ES 2.1.A Percentage and number (in thousands) of children in the United States under age 18 in families receiving AFDC or General Assistance: Selected years, 1979-1997

	1979	1989	1993	1994	1995	1996	1997
Number (in thousands)	7,228	7,116	9,440	9,463	8,656	7,490	6,201
Percent	12	11	14	13	12	11	9

Sources: Estimates for 1979-1994 calculated by Child Trends based on analysis of the March 1980, 1990, 1994, and 1995 Current Population Surveys. Estimates for 1995-1997 provided by U.S. Bureau of the Census.

Figure ES 2.1.B Percentage of children in the United States under age 18 living in families receiving AFDC or General Assistance, and in households receiving Food Stamps: Selected years, 1979-1997

Table ES 2.1.B Percentage and number (in thousands) of children in the United States under age 18 in households receiving Food Stamps: Selected years, 1979-1997

	1979	1989	1993	1994	1995	1996	1997
Number (in thousands)	9,336	9,696	14,193	13,677	13,115	12,272	10,987
Percent	15	15	20	19	18	17	15

Figure ES 2.1.C Percentage of children in the United States under age 18 in households receiving AFDC and Food Stamps, by race/ethnicitya and by descent: 1992

^a Estimates for Hispanic children exclude those migrating to the United States after 1990.

Source: Estimates supplied by Sandra Hofferth, University of Michigan, based on data from the Panel Study of Income Dynamics.

¹⁰ Includes General Assistance.

¹¹ Needy children include those “who have been deprived of parental support or care because their father or mother is absent from the home continuously, is incapacitated, is deceased or is unemployed.” See Overview of Entitlement Programs: 1994 Green Book. U.S. House of Representatives, Committee on Ways and Means.

¹² The Panel Study of Income Dynamics excludes children who migrated to the United States after 1990. Consequently, it understates recent migrants’ share of the Hispanic population. This is likely to lead to a lower estimate of receipt of transfers for Hispanics than a more representative survey such as the Current Population Survey.

ES 2.2 Child Support Nonpayment

The issue of child support has gained in importance in recent years. As rates of divorce and nonmarital births have risen, an increasing proportion of children and their custodial parents depend on this source of income for financial support and suffer when it is not forthcoming. In addition, when noncustodial parents do not support their children financially, it is often left to the government to step in and provide support in the form of AFDC/TANF, Food Stamps, and other forms of assistance.

In many cases, and particularly where nonmarital births are concerned, families who should be receiving child support from the noncustodial parent lack a court order establishing how much is owed. In 1995, 42 percent of custodial parents lacked a court order. Among custodial parents with a court order who were owed child support, 39 percent received the full amount.¹³

Table ES 2.2.A shows the proportion of custodial mother families who had court orders for child support but received no support at all for selected years between 1978 and 1991. Table ES 2.2.B shows similar estimates for 1993 and 1995, though changes in child support questions render these estimates incomparable to estimates for earlier years. Rates of nonpayment decreased somewhat from 1978 to 1985, from 28 to 21 percent, then rose to about 24 percent by 1991. The estimates for 1993 and 1995, which are not comparable with earlier estimates, are 29 and 30 percent, respectively.

Differences by Marital Status. Women who were separated or never married were substantially less likely to have court orders for child support than those who were divorced or who had remarried.2 In 1995, rates of nonpayment for those who had court orders ranged from 24 percent among divorced women to 44 percent among never-married women.

Differences by Race and Hispanic Origin. In most years, eligible white custodial mother families experienced lower rates of nonpayment than either black or Hispanic families. For example, in 1995, the most recent year for which estimates are available, the percentage of eligible custodial mother families receiving no payment was 27 percent for whites, 41 percent for blacks, and 42 percent for Hispanics (see Table ES 2.2.B).

Differences by Poverty Status. Women who are poor are less likely to have received child support payments. In 1995, rates of nonpayment for eligible custodial mothers were 38 percent among poor mothers and 27 percent among nonpoor mothers (see Table ES 2.2.B).

Methods of Payment. Some custodial parents receive their child support payments directly from the noncustodial parent or that parent’s employer. Other parents use the Child Support Enforcement program, authorized under Title IV-D of the Social Security Act, to establish and enforce child support orders. Since fiscal year 1992, collections made by child support enforcement agencies have increased by nearly 80 percent, from $8 billion in fiscal year 1992 to $14.4 billion in fiscal year 1998.3 For the same period, paternity establishments increased more than 40 percent, and child support orders increased 16 percent.

Table ES 2.2.A Child support nonpayment: Percentage of eligible women^a in the United States who are not receiving child support, by marital status and by race and Hispanic origin:^b Selected years, 1978-1991

	1978	1981	1983	1985	1987	1989	1991^c
Total	28	23	24	21	24	25	24
Marital status
Married	32	25	28	24	27	28	24
Divorced	27	23	24	21	22	23	22
Separated	27	16	13	12	26	20	26
Never-married	19	27	24	20	17	27	26
Race and Hispanic origin^b
White	27	23	23	21	23	24	22
Black	37	23	31	22	27	30	30
Hispanic	35	29	38	26	25	30	31

^aEligible women are those with court orders for child support.

^b Persons of Hispanic origin may be of any race. Estimates for whites and blacks include persons of Hispanic origin.

^cEstimates for 1991 were produced using somewhat different assumptions than in previous years and should not be contrasted with earlier estimates.

Sources: 1978-1987 data from Child Support and Alimony, Series P-23, 112, 140, 141, 154, and 167 (Table 1 in each); and Current Population Reports, Series P-60, 173, Table C. Data for 1991 from Current Population Reports, Series P-60, 187, Table 1.

Table ES 2.2.B Child support nonpayment: Percentage of eligible women^a in the United States who are not receiving child support, by marital status, race and Hispanic origin, ^b and poverty status: 1993 and 1995^c

	1993	1995
Total	29	30
Marital status
Married	26	28
Divorced	24	24
Separated	34	31
Never-married	41	44
Race and Hispanic origin^b
White	25	27
Black	39	41
Hispanic	35	42
Poverty status
Poor	35	38
Nonpoor	26	27

^a Eligible women are those with court orders for child support.

^b Persons of Hispanic origin may be of any race. Estimates for whites and blacks include persons of Hispanic origin.

^c Starting with the April 1994 CPS questionnaire, revisions were made to the questions surrounding child support awards and the receipt of payments.

Sources: U.S. Bureau of the Census. Current Population Reports, Series P60, 196; data for 1993 and 1995 can be found at: www.census.gov/hhes/www/childsupport/chldsu94.html (Table 4) and www.census.gov/hhes/www/childsupport/chldsu96.html (Table 4).

¹³ Scoon-Rogers, L. 1999. Child Support for Custodial Mothers and Fathers; 1995. Current Population Reports, P-60, no. 196, Table 7 (Detailed Tables), at http://www.census.gov/hhes/www/childsupport/cs95.html.

¹⁴Scoon-Rogers, L. 1999. Child Support for Custodial Mothers and Fathers; 1995. Current Population Reports, P-60, no. 196, Table 9 (Detailed Tables), at http://www.census.gov/hhes/www/childsupport/cs95.html

¹⁵U.S. Department of Health and Human Services (HHS), Administration on Children and Families. 1998. Child Support Collections Reach New Records. HHS Press Release. Washington, DC: Author.

Parental and Youth Employment

ES 3.1 Parental Labor Force Participation: Percentage of Children with Both Parents or Only Resident Parent in the Labor Force

Over the last three decades, the proportion of single-parent families has increased, as has the proportion of mothers who work regardless of marital status.¹⁵ These factors have reduced the percentage of children who have a parent at home full-time. Figure ES 3.1.A presents data on the percentage of children who have at least one parent in the labor force by family structure, while Figure ES 3.1.B shows the percentage of children with no resident parent in the labor force.

Parents in the Labor Force by Family Structure. Between 1985 and 1998, the percentage of children who have both parents or only the resident parent in the labor force increased from 59 percent to 68 percent (see Table ES 3.1.A). Between 1990 and 1996, this percentage was similar for both married-couple families and single-mother families; however, the rate for single-mother families increased sharply from 66 percent in 1996 to 74 percent in 1998, while the rate for married-couple families was nearly unchanged (64 percent in 1996 and 65 percent in 1998). The rate for children in single-father families was much higher, at 91 percent in 1998. Between 1994 and 1998, there was a large and statistically significant decline in the proportion of children living in families in which no resident parent was attached to the labor force, as shown in Table ES 3.1.B.

Parents in the Labor Force by Age of Child. Children under age 6 have been less likely than older children to have both parents or only the resident parent in the labor force (see Table ES 3.1.A). In 1998, 62 percent of children under age 6 had both parents or only the resident parent in the labor force, compared with 71 percent for older children.

Parents in the Labor Force by Race and Hispanic Origin. Between 1985 and 1990, white children, black children, and Hispanic children all became more likely to have both parents or only the resident parent in the labor force (see Table ES 3.1.A). Between 1990 and 1996, the rates stayed virtually the same for blacks and Hispanics and increased modestly for whites. However, the rate for all three groups increased between 1996 and 1998, with especially large increases for blacks and Hispanics. Between 1996 and 1998, the rate for black children of all ages increased from 64 percent to 73 percent, and the rate for black children under age 6 increased from 58 percent to 71 percent. Between 1996 and 1998, the rate for Hispanic children of all ages increased from 50 percent to 58 percent. By 1998, 68 percent of white children, 73 percent of black children, and 58 percent of Hispanic children lived in families in which all resident parents were working.

Figure ES 3.1.A Percentage of children under age 18 in the United States with both parents or only resident parent in the labor force, by family structure: Selected years, 1985-1998

Sources: 1985, 1990, 1994, and 1995 statistics calculated by Child Trends based on the March 1985, 1990, 1994, and 1995 Current Population Surveys; 1996, 1997, and 1998 statistics calculated by the U.S. Bureau of the Census based on the 1996, 1997, and 1998 Current Population Surveys.

Figure ES 3.1.B Percentage of children under age 18 in the United States with no resident parent in the labor force, by family structure: Selected years, 1985-1998

Sources: 1985, 1990, 1994, and 1995 statistics calculated by Child Trends based on analyses of the March 1985, 1990, 1994, and 1995 Current Population Surveys; 1996, 1997, and 1998 statistics calculated by U.S. Bureau of the Census based on the March 1996, 1997, and 1998 Current Population Surveys.

Table ES 3.1.A Percentage of children in the United States with both parents or only resident parent in the labor force, by age, family structure, and race and Hispanic origin:^a Selected years, 1985-1998

	1985	1990	1994	1995	1996	1997	1998
All children	59	63	64	65	66	68	68
Under age 6	51	55	56	59	58	61	62
Ages 6-17	63	67	68	69	70	71	71
Family structure
Married-couple	57	61	63	65	64	65	65
Under age 6	51	54	57	59	58	58	58
Ages 6-17	61	65	67	68	67	69	68
Single-mother	61	63	62	64	66	72	74
Under age 6	49	51	52	54	56	65	67
Ages 6-17	67	70	68	69	72	76	77
Single-father	89	88	86	88	88	88	91
Under age 6	90	90	85	86	86	89	94
Ages 6-17	89	88	86	88	89	88	90
Race and Hispanic origin^a
White	59	63	64	66	66	68	68
Under age 6	51	55	57	59	58	61	61
Ages 6-17	63	67	68	70	70	71	71
Black	60	63	62	64	64	71	73
Under age 6	54	55	56	57	58	68	71
Ages 6-17	63	67	66	67	68	73	75
Hispanic	45	50	49	50	50	54	58
Under age 6	40	44	41	44	43	49	52
Ages 6-17	48	54	54	54	55	57	62

^a Persons of Hispanic origin may be of any race. Estimates for whites and blacks include persons of Hispanic origin. Sources: 1985, 1990, 1994, and 1995 statistics calculated by Child Trends based on the March 1985, 1990, 1994, and 1995 Current Population Surveys; 1996, 1997, and 1998 statistics calculated by the U.S. Bureau of the Census based on the 1996, 1997, and 1998 Current Population Surveys.

Table ES 3.1.B Percentage of children in the United States with no resident parent in the labor force, by age, family structure, and race and Hispanic origin:^a Selected years, 1985-1998

	1985	1990	1994	1995	1996	1997	1998
All children	11	10	12	11	11	9	8
Under age 6	12	13	14	14	13	10	9
Ages 6-17	10	9	11	10	9	8	8
Family structure
Married-couple	3	2	3	3	2	2	2
Under age 6	2	2	2	2	2	2	2
Ages 6-17	3	3	3	3	3	2	2
Single-mother	39	37	38	36	34	28	26
Under age 6	51	49	48	46	44	35	33
Ages 6-17	33	30	32	31	28	24	23
Single-father	11	12	14	12	12	12	9
Under age 6	10	10	15	14	14	11	6
Ages 6-17	11	12	14	12	11	12	10
Race and Hispanic origin^a
White	8	7	9	8	7	7	7
Under age 6	8	9	11	10	9	7	7
Ages 6-17	7	6	8	7	7	6	6
Black	27	26	27	27	25	20	17
Under age 6	33	34	33	33	32	23	20
Ages 6-17	24	21	24	23	21	18	15
Hispanic	19	17	19	19	17	14	13
Under age 6	20	19	22	21	20	15	14
Ages 6-17	19	16	18	17	15	12	13

^aPersons of Hispanic origin may be of any race. Estimates for whites and blacks include persons of Hispanic origin. Sources: 1985, 1990, 1994, and 1995 statistics calculated by Child Trends based on analyses of the March 1985, 1990, 1994, and 1995 Current Population Surveys; 1996, 1997, and 1998 statistics calculated by U.S. Bureau of the Census based on the March 1996, 1997, and 1998 Current Population Surveys.

ES 3.2 Maternal Employment: Percentage of Mothers with Children Under Age 18 Who Are Employed, Full-Time and Part-Time

Over the last several decades, the increasing proportion of mothers moving into employment has had substantial consequences for the everyday lives of families with children. Maternal employment adds to the financial resources available to families and is often the only source of income for families headed by single mothers—although if child-care services are purchased and unsubsidized, they may offset a substantial percentage of lowwage mothers’ earnings.

Maternal employment rates for all mothers with children under age 18 increased steadily from 53 percent to 63 percent between 1980 and 1990 (see Figure ES 3.2). From 1990 to 1997, rates increased at a slower pace from 63 percent to 68 percent. This pattern of increasing maternal employment was evident for all mothers, regardless of the age of their children.

Differences by Age of Child. The percentage of mothers who are employed increases with the age of the youngest child for all time periods presented in Table ES 3.2. In 1997, 57 percent of mothers with children under age 3 were employed, compared with 64 percent and 74 percent for mothers with youngest children ages 3-5 and 6-17, respectively.

Differences by Marital Status. Throughout the period between 1980 and 1997, divorced mothers had higher rates of employment than never-married or currently married mothers (see Table ES 3.2). However, the gap narrowed over the period as employment increased from 62 percent to 69 percent for married mothers and from 40 percent to 57 percent for never-married mothers. In contrast, there was only a slight increase from 75 percent to 77 percent for divorced mothers.

Differences by Race and Hispanic Origin. In 1997, 69 percent of white mothers, 65 percent of black mothers, and 53 percent of Hispanic mothers were employed (see Table ES 3.2). Black mothers were the most likely to be employed full-time (55 percent). All three groups substantially increased their rates of employment between 1980 and 1990 and have continued to increase their rates of employment during the 1990s.

Full-Time Versus Part-Time Employment. Among all employed mothers, 50 percent were working full-time in 1997 (see Table ES 3.2). Employed mothers with older children were more likely to work full-time than those with young children, with rates ranging from 57 percent for mothers with children under age 3, to 74 percent for mothers with a youngest child between the ages of 6 and 17. Divorced mothers were more likely to work full-time (77 percent) than never-married mothers (57 percent) and married mothers (69 percent). Black mothers who were employed were more likely to work full-time (55 percent) than white mothers (48 percent) or Hispanic mothers (41 percent).

Figure ES 3.2 Percentage of mothers in the United States with children under age 18 who were employed, by age of youngest child: Selected years, 1980-1997

Source: Unpublished tables, Bureau of Labor Statistics, based on analyses of March Current Population Surveys for 1980, 1988, 1990, and 1994-1996.

Table ES 3.2 Percentage of mothers in the United States with children under age 18 who were employed, full-time and part-time,a by age of youngest child, marital status, and race and Hispanic origin:^bSelected years, 1980-1997

	1980	1988	1990	1994	1995	1996	1997
Total employed	53	60	63	64	66	66	68
Working full-time	—	44	46	45	46	47	50
Working part-time	—	16	17	19	19	19	18
Age of youngest child
Under age 3	37	47	50	52	54	55	57
Working full-time	—	32	34	34	35	36	38
Working part-time	—	15	16	18	19	19	19
Ages 3-5	50	57	61	60	62	63	64
Working full-time	—	40	43	41	42	43	47
Working part-time	—	17	18	19	20	20	17
Ages 6-17	60	70	70	72	73	74	74
Working full-time	—	53	53	53	53	55	56
Working part-time	—	17	17	19	19	19	18
Marital status
Married, spouse present	62	63	66	67	67	68	69
Working full-time	—	43	44	45	45	46	48
Working part-time	—	19	19	21	22	21	20
Never married	40	45	46	48	48	49	57
Working full-time	—	32	36	34	35	35	42
Working part-time	—	8	9	12	13	14	14
Divorced	75	75	74	77	77	79	77
Working full-time	—	66	66	63	64	66	65
Working part-time	—	9	9	11	13	13	12
Race and Hispanic origin
White	52	62	63	65	67	67	69
Working full-time	—	44	44	45	46	47	48
Working part-time	—	18	19	20	21	21	20
Black	54	56	61	58	62	63	65
Working full-time	—	48	53	47	50	52	55
Working part-time	—	8	8	11	11	10	10
Hispanic	42	49	50	48	49	49	53
Working full-time	—	38	39	36	37	37	41
Working part-time	—	11	11	12	12	12	12

^a Percentages for 1980 are not presented separately by marital status and full-time versus part-time due to incompatibilities with definitions used in later years. Sums may not add to totals due to rounding.

^b Persons of Hispanic origin may be of any race. Estimates for whites and blacks include persons of Hispanic origin.

Source: Unpublished tables, Bureau of Labor Statistics, based on analyses of March Current Population Surveys for 1980, 1988, 1990, and 1994-1997.

ES 3.3 Child Care

The child care needs of American families have been increasing over the past several decades as mothers have moved into the labor force in ever greater numbers. Child care that is reliable and of high quality is especially important for infants and preschoolers because they are dependent on caregivers for their basic needs and safety.

Child-Care Centers and Preschools. Working mothers with preschool children have increasingly chosen care provided in day care centers and preschools. In 1965, only 8 percent of mothers working full-time chose day care centers and preschools for child care (see Table ES 3.3.A). By 1994, 34 percent did so. Similarly, for children whose mothers worked part-time, use of child care centers and preschools increased from 3 percent in 1965 to 22 percent in 1994.

Child Care in a Nonrelative’s Home. For children of full-time working mothers, care in a nonrelative’s home ranged from 25 to 27 percent between 1977 and 1988, then declined to 18 percent by 1994. Similarly, for children whose mothers worked part-time, care in a nonrelative’s home peaked at 21 percent in 1986 and has since declined to 10 percent.

Child Care at Home. The fraction of children of full-time working mothers cared for at their home by either relatives or nonrelatives was 26 percent in 1994, compared with 21 percent in 1988 and 47 percent in 1965. The fraction of children of part-time working mothers cared for at home was 45 percent in 1994, compared with 42 percent in 1984-1985 and 47 percent in 1965 (see Table ES 3.3.A).

Child Care Arrangements by Various Child and Family Characteristics. Table ES 3.3.B presents 1994 estimates of the distribution of child-care types used by all working mothers (regardless of hours worked) by child’s race and Hispanic origin and age, mother’s marital status and educational attainment, poverty status, monthly income, and AFDC program participation status. The information in this table indicates the following:

Relatives usually care for employed mothers’ children before their first birthday. In 1994, 56 percent of infants were cared for by relatives either inside or outside the child’s home (see Figure ES 3.3). Among toddlers (ages 1-2), about half (51 percent) were cared for by relatives, while the other half were split about evenly between day care centers and preschools (26 percent) and nonrelatives (22 percent). Among children of preschool age (ages 3-4), 44 percent were cared for by relatives, another 37 percent in day care centers and preschools, and 16 percent by nonrelatives.
Hispanic families were less likely than white and black non-Hispanics to use day care centers and preschools. In 1994, 19 percent of Hispanic children of working mothers were cared for in day care centers and preschools, compared with 31 percent of non-Hispanic white children and 34 percent of non-Hispanic black children.
Children of employed mothers with higher socioeconomic status were the most likely to be receiving care from a day care center or preschool. For example, 22 percent of poor children under age 5 received care from such sources, compared with 30 percent of nonpoor children.

Table ES 3.3.A Percentage distribution of child care arrangements of children under age 5 in the United States with employed mothers, by mother’s employment status: Selected years, 1965-1994

	1965^a,b	1977^b	1982^b	1984-85	1986	1987	1988	1991	1993	1994
Mother employed full-time
Day care center or preschool	8	15	20	30	26	28	31	28	34	34
Nonrelative care in provider's home	20	27	25	27	26	25	27	21	18	18
Grandparent/other relative in relative's home	18	21	21	16	18	14	14	14	17	17
Father in child's home	10	11	11	10	11	10	8	15	11	13
Other care in child's homec	37	18	16	13	15	15	13	15	15	13
Other care outside child's homed	7	8	7	4	5	8	7	7	5	5
Mother employed part-time
Day care center or preschool	3	9	8	17	16	18	17	15	23	22
Nonrelative care in provider's home	8	16	19	14	21	18	17	13	14	10
Grandparent/other relative in relative's home	9	13	16	16	14	13	11	11	13	13
Father in child's home	23	23	21	22	21	25	27	29	25	28
Other care in child's homec	24	20	20	18	14	15	14	17	15	17
Other care outside child's homed	33	19	26	13	13	13	14	15	10	10

^aData for 1965 are for children under 6 years old.

^b Data for 1982 and earlier are based on survey questions that asked about care arrangements for the youngest child in the family. Percentages for 1982 and earlier have been recalculated after removal of cases in “don’t know” category.

^c Includes care by relatives and nonrelatives.

^d Includes children who are cared for by their mother at work or in kindergarten or school-based activities.

Sources: U.S. Bureau of the Census, Current Population Reports, Series P-23, 117, Table A; U.S. Bureau of the Census, Current Population Reports, Series P-70, 9, 20, 30, 36, and 53 (Table 1 in each); Casper, 1997; Current Population Reports, PPL 81 (Tables B and 2).

Table ES 3.3.B Percentage distribution of child care arrangements of children under age 5 in the United States with employed mothers, by selected characteristics: 1994

	Day Care Center/ Preschoola	Father in Child's Home	Other Relative in Child's Home	Nonrelative in Child's Home	Relative in Another Home	Nonrelative in Another Home	Mother Cares for Childb	Other Care Arrange- mentsc
All preschoolers	29	18	9	5	16	15	5	1
Race and Hispanic origin
White, non-Hispanic	31	20	7	6	14	16	7	1
Black, non-Hispanic	34	11	13	2	23	13	3	2
Hispanic^d	19	17	15	6	24	15	2	2
Other	21	22	19	6	12	15	3	2
Age of child
Under 1 year	18	21	11	7	17	19	7	0
Ages 1-2	26	19	10	5	18	17	4	0
Ages 3-4	37	17	8	4	13	12	6	2
Marital status
Married, husband present	29	22	6	6	14	16	6	1
All other marital statuses^e	31	5	21	3	22	15	3	1
Educational attainment
Less than high school	20	24	15	4	20	12	5	1
High school, 4 years	26	17	11	3	19	16	5	1
College, 1-3 years	32	21	7	4	14	14	6	1
College, 4+ years	35	15	6	9	11	17	5	1
Poverty status^f
Below poverty	22	18	15	4	20	11	10	1
Above poverty	30	19	9	5	15	16	5	1
Monthly family income^f
Less than $1,200	24	17	11	4	22	15	6	1
$1,200 to $2,999	26	22	10	3	19	13	6	1
$3,000 to $4,499	27	19	10	4	15	18	6	2
$4,500 and over	36	15	7	9	12	16	5	1
Program participation
AFDC recipient	27	15	17	3	18	11	6	2
AFDC nonrecipient	29	19	9	5	16	16	5	1

^a Includes day care centers, nursery schools, and preschools.

^b Includes mothers working at home or away from home.

^c Includes preschoolers in kindergarten and school-based activities.

^d Persons of Hispanic origin may be of any race

^e Includes married, spouse absent, widowed, separated, divorced, and never married.

^fOmits preschoolers whose families did not report income.

Source: Casper, 1997, Tables B, 1, and 2.

Figure ES 3.3 Percentage distribution of child care arrangements of children under age 5 in the United States with employed mothers, by age of child: 1994

Source: Casper, 1997, Tables B and 2.

Consumption

ES 4.1 Housing Problems

Housing is a major expense for most families; however, spending more than 30 percent of income on housing may compromise the budget for other essential goods and services. A home’s physical condition, its safety, the level of crowding in a household, and the quality of the surrounding neighborhood can all affect children’s well-being.¹⁶ This section presents recent trends in both the cost burden and the physical quality of housing for all households with children under age 18 and for renter households with children and very low income.

Cost Burden. The share of all households (containing children) spending more than 30 percent of their incomes on housing increased from 15 percent in 1978 to 28 percent in 1997, while the share spending more than half their income on housing doubled from 6 percent in 1978 to 12 percent in 1997 (see Table ES 4.1). For renter households with children and very low income¹⁷ the trend was similar, but housing expenses were a much higher share of income. Between 1978 and 1997, the percentage of renter households (with children and very low income) paying more than 30 percent of their income on housing rose from 59 percent to 74 percent, while the percentage spending more than 50 percent rose from 31 percent to 41 percent.

Physical Problems. During this same period, the percentage of households (containing children) living in housing with moderate to severe physical problems18 declined from 9 percent in 1978 to 7 percent in 1997. For renter households (with children and very low income), the percentage living in housing with moderate to severe physical problems declined from ¹⁸percent in 1978 to 13 percent in 1995, before increasing to 15 percent in 1997.

Differences by Type of Family. Married-couple families with children are the least likely to experience housing with physical problems, followed by households with one or no adult and households with two or more adults who are not married. In 1997, for example, 6 percent of married-couple households with children, 11 percent of households with one or no adult, and 12 percent of households with two or more unmarried adults lived in housing with moderate to severe physical problems (see Figure ES 4.1.A). Similarly, among all households with children, married couples are the least likely to be paying over 30 percent of their income on housing. For example, in 1997, 20 percent of married-couple households paid over 30 percent, compared with 54 percent of households with one or no adult and 34 percent of households with two or more unmarried adults (see Figure ES 4.1.B).

Table ES 4.1 Percentage of households with children under age 18 in the United States having selected housing problems,^a all households and very low incomeb renter households: Selected years, 1978-1997

	1978	1983	1989	1993	1995	1997
All households with children
Number of households(in millions)	32.3	33.6	35.7	35.5	37.3	37.0
Percentage with
Any problems	30	33	33	34	36	36
Moderate or severe physical problems	9	8	9	7	7	7
Crowded housing	9	8	7	6	7	7
Cost burden greater than 30 percent	15	21	24	27	28	28
Cost burden greater than 50 percent	6	11	9	11	12	12
Severe problems	8	12	10	11	12	11
Renter households with children and very low income
Number of households (in millions)	4.2	5.1	5.9	6.7	6.5	6.2
Percentage with
Any problems	79	83	76	75	77	82
Moderate or severe physical problems	18	18	18	14	13	15
Crowded housing	22	18	17	14	17	17
Cost burden greater than 30 percent	59	68	67	67	68	74
Cost burden greater than 50 percent	31	38	36	38	38	41
Severe problems	33	42	33	34	32	28
Rental assistance	23	23	29	28	29	30

^a Housing problems include physical problems, excessive cost burden, and overcrowding . “Crowded” is defined as having more than one person per room. Physical problems include plumbing, heating, electricity, upkeep, and/or condition of apartment hallways. For detailed definitions of “moderate” and “severe” physical problems, see U.S. Bureau of the Census and U.S. Department of Housing and Urban Development (1997), Current Housing Reports H150/95RV, American Housing Survey for the United States in 1995, Washington, D.C., pp. A-13 and A-14. Cost burden is the ratio of housing costs to reported household income.

^b Very low income households are those with incomes at or below one-half the median income in a geographic area.

Source: U.S. Department of Housing and Urban Development, tabulations of data from the American Housing Survey for the United States as published in America's Children: Key National Indicators of Well-Being, 1998. Federal Interagency Forum on Child and Family Statistics, Washington, D.C.: U.S. Government Printing Office, Table ECON3.

Figure ES 4.1.A Percentage of households with children under age 18 in the United States living in housing with moderate to severe physical problems:^a 1997

a Physical problems include plumbing, heating, electricity, upkeep, and/or condition of apartment hallways. For detailed definitions of “moderate” and “severe” physical problems, see U.S. Bureau of the Census and U.S. Department of Housing and Urban Development (1999), Current Housing Reports H150/95RV, American Housing Survey for the United States in 1997, Washington, D.C., p. A-18.

Source: U.S. Department of Housing and Urban Development, unpublished tabulations of data from the American Housing Survey for the United States, 1995.

Figure ES 4.1.B Percentage of households containing children under age 18 and paying over 30 percent of their income on housing: 1997

Source: U.S. Department of Housing and Urban Development, unpublished tabulations of data from the American Housing Survey for the United States, 1995.

¹⁶Moore, K., Zaslow, M.J., Coiro, M., Miller, S.M., & Magenheim, E. 1996. The Jobs Evaluation: How Are They Faring? AFDC Families with Preschool-Aged Children in Atlanta at the Outset of the JOBS Evaluation. Washington, D.C.: U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation; Blackman, T., Evason, E., Melaugh, M., & Woods, R. 1989. Housing and Health: A Case Study of Two Areas in West Belfast. Journal of Social Policy, 18, (1): 1-26.

¹⁷ Very low income households are those with incomes at or below one-half the median income in a geographic area.

¹⁸ Physical problems include plumbing, heating, electricity, upkeep, and/or condition of apartment hallways. For detailed definitions of “moderate” and “severe” physical problems, see U.S. Bureau of the Census and U.S. Department of Housing and Urban Development, 1997, Current Housing Reports H150/95RV, American Housing Survey for the United States in 1995, Washington, D.C., pp. A-13 and A-14.

ES 4.2 Food Security

Children’s good health and development depend on a diet sufficient in nutrients and calories. Food security has been defined as access at all times to enough nourishment for an active, healthy life. At a minimum, food security includes the ready availability of sufficient, nutritionally adequate and safe food, and the assurance that families can obtain adequate food without relying on emergency feeding programs or resorting to scavenging, stealing, or other desperate efforts to secure food.¹⁹ A family’s ability to provide for children’s nutritional needs is linked to income or other resources and secure access to adequate, nutritious food.

Members of food-insecure households are at risk of hunger, that is, the uneasy or painful sensation caused by a lack of food. The following indicator measures food insecurity on a scale that indicates increasing levels of severity of food insecurity and accompanying hunger. Food-insecure households without hunger report having difficulty obtaining enough food, reduced quality of diets, anxiety about their food supply, and increased resort to emergency food sources and other coping behaviors, but do not report hunger to a significant degree. However, food-insecure households with moderate and severe hunger report increasing difficulty obtaining food and decreased food intakes.²⁰

In 1995, 12.8 percent of children lived in households experiencing food insecurity. This rose slightly to 15.0 percent in 1998 and then decreased to 13.1 percent in 1999. This trend is also evident for children in homes with incomes below the federal poverty level and for children in homes with incomes at or above the poverty level (see Table ES 4.2).
In 1999, 3.8 percent of children lived in households experiencing food insecurity with moderate or severe hunger; 3.3 percent experienced food insecurity with moderate hunger and 0.5 percent experienced severe hunger (see Figure ES 4.2 and Table ES 4.2).
Poor children are much more likely than others to live in households experiencing food insecurity with moderate to severe hunger. In 1999, 11.8 percent of children in homes with incomes below the federal poverty level lived in households experiencing food insecurity with moderate to severe hunger, compared to 1.9 percent of children in nonpoor households.
Most food-insecure households do not report actual hunger for household members. In 1999, 13.1 percent of all children and 32.2 percent of poor children lived in households experiencing food insecurity without hunger evident.
The number of children who actually experience hunger themselves, even though they may live in a food-insecure household where one or more family members experience hunger, is believed to be significantly smaller than the total number of children living in such households. This is because in most such households the adults go without food, if necessary, so that the children will have food.

Table ES 4.2 Percentage of children under age 18 in the United States living in households experiencing food insecurity,^a by severity and poverty status: 1995-1999

	1995	1996	1997	1998	1999
All children
Food insecure without hunger	12.8	13.0	11.3	15.0	13.1
Food insecure with moderate or severe hunger	6.2	6.2	4.2	4.7	3.8
Food insecure with moderate hunger	5.2	5.2	3.5	4.0	3.3
Food insecure with severe hunger	1.0	1.0	0.7	0.7	0.5
Children below poverty line
Food insecure without hunger	26.6	28.7	26.8	34.5	32.2
Food insecure with moderate or severe hunger	15.7	17.4	11.1	14.2	11.8
Food insecure with moderate hunger	12.8	13.9	9.2	11.8	10.2
Food insecure with severe hunger	2.9	3.5	1.9	2.4	1.6
Children at or above poverty line
Food insecure without hunger	7.9	8.5	6.7	10.3	8.7
Food insecure with moderate or severe hunger	3.0	3.1	2.1	2.3	1.9
Food insecure with moderate hunger	2.6	2.8	1.8	1.9	1.6
Food insecure with severe hunger	0.4	0.3	0.3	0.4	0.3

^a The food security scale provides a near-continuous measure of the level of food insecurity and hunger experienced within each household. A categorical measure based on the scale classifies households according to four designated levels of household food security: food-secure, food-insecure without hunger, food-insecure with moderate hunger, and food- insecure with severe hunger. Food-secure households are households that do not report a significant number of instances of difficulty obtaining enough quality food. Food-insecure households without hunger report having difficulty obtaining enough food, reduced quality of diets, anxiety about their food supply, and increasing resort to emergency food sources and other coping behaviors, but do not report hunger to a significant degree. Food-insecure households with moderate hunger report food insecurity and significant instances of hunger for one or more adults and, in some cases, for children. Food-insecure households with severe hunger report food insecurity and significant instances of hunger for adults and children. For a detailed explanation of the new USDA/DHHS Food Security Measurement scale, see Household Food Security in the United States in 1995 (USDA, Food and Nutrition Service, 1997).

Source: Food Security Supplement to the April 1995, September 1996, and April 1997 Current Population Survey, Table ECON4.A.

Figure ES 4.2 Percentage of children under age 18 in the United States living in households experiencing food insecurity, by severity and poverty status: 1999

Source: Food Security Supplement to the April 1997, Current Population Survey.

¹⁹Life Sciences Research Office and American Institute of Nutrition. 1990. Core Indicators of Nutritional State for Difficult to Sample Populations. Bethesda, MD: Author.

²⁰ See the note to Table ES 4.2 for a description of the Food Security Supplement to the Current Population Survey and for details on the food security scale.

Section 3: Health Conditions and Health Care (HC)

Mortality

HC 1.1 Infant Mortality

Infancy is defined as the first year of life and is commonly divided into two periods. The first is the neonatal period which is the first 27 days of life. The second is the postnatal period which is 28 days to 1 year. About two-thirds of infant deaths occur during the neonatal period (although advances in neonatology in recent decades have greatly improved the chances that infants will survive this period).

The three leading causes of death to infants, overall, are congenital anomalies, disorders relating to a short gestation period and low birthweight, and sudden infant death syndrome (SIDS).¹ In 1994, SIDS dropped from the second to the third leading cause of infant mortality. The SIDS decline accounted for nearly one-third of the total drop in infant mortality in 1995 and 1996.² Infant deaths due to SIDS have been declining since 1989,³ including nearly a 12 percent drop between 1996 and 1997.⁴

The U.S. infant mortality rate has decreased rapidly over the past three decades, largely due to medical developments over this time. Between 1960 and 1998, the rate fell from 26.0 to 7.2 infant deaths per 1,000 live births (see Figure HC 1.1.A). There was a steep decline in the rate of neonatal deaths (from 18.7 to 4.8 infant deaths per 1,000 live births) and a smaller, more gradual decline in the rate of postneonatal deaths (from 7.3 to 2.4 infant deaths per 1,000 live births).

International Comparisons. Despite declines in recent decades, the U.S. infant mortality rate ranks among the highest of industrialized nations. For example, in 1995, the rate of infant deaths per 1,000 live births was 3.9 in Finland, 4.3 in Japan, 5.3 in Germany, and 6.1 in England and Wales, compared with 7.6 deaths per 1,000 live births in the United States. The Russian Federation, in contrast, had an infant mortality rate of 18.2 deaths per 1,000 live births in 1995.⁵

Differences by Race and Hispanic Origin. While infant mortality rates have declined for all races and ethnic groups in the United States, there is, nevertheless, considerable variation by race and Hispanic origin (see Figure HC 1.1.B). Specifically:⁷

For white infants, the infant mortality rate declined by 74 percent between 1960 and 1998—from 22.9 to 6.0 deaths per 1,000 live births (see Table HC 1.1.A).
For black infants, the infant mortality rate declined by 69 percent between 1960 and 1998—from 44.3 to 13.8 deaths per 1,000 live births (see Table HC 1.1.A).
For Hispanic infants, the infant mortality rate declined by 33 percent between 1985 and 1998—from 8.6 to 5.8 deaths per 1,000 live births (see Table HC 1.1.A).
For Asian/Pacific Islander infants, the infant mortality rate declined by 34 percent from an average of 8.3 deaths per 1,000 live births during the period 1983-1985 to 5.5 deaths per 1,000 live births in 1998 (see Table HC 1.1.B).⁶
For American Indian/Alaska Native infants, the infant mortality rate declined by 33 percent from an average of 13.9 deaths per 1,000 live births during the period 1983-1985 to 9.3 deaths per 1,000 live births in 1998 (see Table HC 1.1.B).

Figure HC 1.1.A Infant, neonatal, and postneonatal mortality rates (deaths per 1,000 live births) in the United States: Selected years, 1960^a-1998

Figure HC 1.1.A Infant, neonatal, and postneonatal mortality rates (deaths per 1,000 live births) in the United States: Selected years, 1960a-1998

^a Includes births and deaths of persons who were not residents of the 50 states and the District of Columbia.

Sources: Anderson, Kochanek, & Murphy, 1997, Tables 25 and 26. Also previous issues of this annual report [Table 26 in 41 (7, Supp.), Table 25 in 42 (2, Supp.), Table 28 in 43 (6, Supp.), Table 32 in 44 (7, Supp.), and Table 25 in 45 (3, Supp.)]; 1970, data from the Center for Disease Control, National Center for Health Statistics, 1996, (Table 2-2); Center for Disease Control, National Center for Health Statistics, 1988, (Table 2-19); Ventura, et al., 1998, Births and Deaths, Table 14.

Figure HC 1.1.B Infant mortality rates (deaths per 1,000 live births) in the United States, by race and Hispanic origin:^a Selected years, 1960^b,c-1998

^a Estimates for whites and blacks include Hispanics of those races. Persons of Hispanic origin may be of any race. Hispanic rates not available prior to 1985. Infant mortality by Hispanic origin was reported by 17 states and the District of Columbia in 1985; 45 states, New York State (excluding New York City), and the District of Columbia in 1990; 47 states, New York State (excluding New York City), and the District of Columbia in 1991; 48 states and the District of Columbia in 1992; 49 states and the District of Columbia from 1993 to 1996; and all 50 states and the District of Columbia in 1997.

^b Includes births and deaths of persons who were not residents of the 50 states and the District of Columbia.

^c Data for 1960 are by race of child; all other years are by race of mother.

Sources: Anderson, Kochanek, & Murphy, 1997; Also previous issues of this annual report [Table 26 in 41 (7, Supp.), Table 25 in 42 (2, Supp.), Table 28 in 43 (6, Supp.), Table 32 in 44 (7, Supp.), and Table 25 in 45 (3, Supp.)]; 1970 data from the Center for Disease Control, National Center for Health Statistics, 1996; Peters, Kochanek, & Murphy, 1998; 1996 United States Deaths, Table 26.

Table HC 1.1.A Infant, neonatal, and postneonatal mortality rates (deaths per 1,000 live births) in the United States, by race and Hispanic origin:^a Selected years, 1960-1998

	1960^b,c	1970	1980	1985	1990	1991	1992	1993	1994	1995	1996	1997	1998
Infant^d total	26.0	20.0	12.6	10.6	9.2	8.9	8.5	8.4	8.0	7.6	7.3	7.2	7.2
White	22.9	17.6	10.9	9.2	7.6	7.3	6.9	6.8	6.6	6.3	6.1	6.0	6.0
Black	44.3	33.3	22.2	19.0	18.0	17.6	16.8	16.5	15.8	15.1	14.7	14.2	13.8
Hispanic	—	—	—	8.6	7.8	7.5	6.8	6.7	6.5	6.1	5.9	6.0	5.8
Neonatal^e total	18.7	15.1	8.5	7.0	5.8	5.6	5.4	5.3	5.1	4.9	4.8	4.8	4.8
White	17.2	13.7	7.4	6.0	4.8	4.5	4.3	4.3	4.2	4.1	4.0	4.0	4.0
Black	27.8	23.2	14.6	12.6	11.6	11.2	10.8	10.7	10.2	9.8	9.6	9.4	9.4
Hispanic	—	—	—	5.4	5.0	4.6	4.3	4.1	4.1	4.0	3.8	3.9	3.9
Postneonatal^ftotal	7.3	4.9	4.1	3.7	3.4	3.4	3.1	3.1	2.9	2.7	2.5	2.5	2.4
White	5.7	4.0	3.5	3.2	2.8	2.8	2.6	2.5	2.4	2.2	2.1	2.0	2.0
Black	16.5	10.1	7.6	6.4	6.4	6.3	6.0	5.8	5.6	5.3	5.1	4.8	4.4
Hispanic	—	—	—	3.2	2.8	2.8	2.5	2.6	2.5	2.1	2.1	2.0	1.9

^bIncludes births and deaths of persons who were not residents of the 50 states and the District of Columbia.

^c Data for 1960 are by race of child; all other years are by race of mother.

^d Under one year old.

^e Under 28 days old.

^fTwenty-eight days to one year old.

Sources: Anderson, Kochanek, & Murphy, 1997; Also previous issues of this annual report [Table 26 in 41 (7, Supp.), Table 25 in 42 (2, Supp.), Table 28 in 43 (6, Supp.), Table 32 in 44 (7, Supp.), and Table 25 in 45 (3, Supp.)]; 1970 data from the Center for Disease Control, National Center for Health Statistics, 1996; Peters, Kochanek, & Murphy, 1998; 1996 United States Deaths, Table 26; Kramorow, et al., 1999, Health.

Table HC 1.1.B Infant mortality rates (deaths per 1,000 live births) in the United States, by detailed race^a and Hispanic origin:^b Selected years, 1983-1998

	1983-1985	1986-1988	1989-1991	1995	1996	1997	1998
Infant (all races)	10.6	9.8	9.0	7.6	7.3	7.2	7.2
White	9.0	8.2	7.4	6.3	6.1	6.0	6.0
Black	18.7	17.9	17.1	14.6	14.1	13.7	13.8
American Indian/Alaska Native	13.9	13.2	12.6	9.0	10.0	8.7	9.3
Asian/Pacific Islander	8.3	7.3	6.6	5.3	5.2	5.0	5.5
Chinese	7.4	5.8	5.1	3.8	3.2	—	4.0
Japanese	6.0	6.9	5.3	5.3	4.2	—	3.5
Filipino	8.2	6.9	6.4	5.6	5.8	—	6.2
Hawaiian and part Hawaiian	11.3	11.1	9.0	6.6	5.6	—	10.0
Other Asian or Pacific Islander	8.6	7.6	7.0	5.5	5.7	—	5.7
Hispanic	9.2	8.3	7.6	6.3	6.1	6.0	5.8
Mexican American	8.8	7.9	7.2	6.0	5.8	5.8	5.6
Puerto Rican	12.3	11.1	10.4	8.9	8.6	7.9	7.8
Cuban	8.0	7.3	6.2	5.3	5.1	5.5	3.6
Central and South American	8.2	7.6	6.6	5.5	5.0	5.5	5.3
Other and unknown
Hispanic	9.9	9.0	8.2	7.4	7.7	6.2	6.5

^a Estimates are based on specified race or national origin of mother.

^bEstimates for separate race groups include Hispanics of those races. Persons of Hispanic origin may be of any race.

Sources: Data from the National Linked Files of Live Births and Infant Deaths. Health, United States, 1996-97, Table 20; MacDorman, & Atkinson, 1998, Tables A and C; MacDorman, & Atkinson, 1997, Tables A and C; MacDorman & Atkinson, 1999.

¹ Ventura, S.J., Anderson, R.N., Martin, J.A., & Smith, B.L. 1998. Births and Deaths: Preliminary Data for 1997. National Vital Statistics Report 47 (4). Hyattsville, MD: National Center for Health Statistics.

²Singh, G.K., Kochanek, K.D., & MacDorman, M.F. 1994. Advance Report of Final Mortality Statistics, 1994. Monthly Vital Statistics Report 45 (3 Supp.). Hyattsville, MD: National Center for Health Statistics.

³ Ibid.

⁴As reported in Ventura, S.J., Anderson, R.N., Martin, J.A., & Smith, B.L. 1998. Births and Deaths: Preliminary Data for 1997.

⁵ World Health Organization: World Health Statistics Annuals Vols. 1990-1996. Geneva; United Nations: Demographic Yearbook 1996. New York; Centers for Disease Control & Prevention, NCHS. Vital Statistics of the United States, 1995. Washington: Public Health Service.

⁶ Infant mortality data for Asians/Pacific Islanders and American Indians/Alaska Natives are presented from the National Linked Files of Live Births and Infant Deaths in Table HC 1.1.B. Rather than relying solely on death certificate data, which may underestimate mortality for infants of Hispanic origin or of races other than white and black, data from the National Linked Files of Live Births and Infant Deaths use race from birth certificates and, therefore, provide more accurate data for these populations. The National Linked Files of Live Births and Infant Deaths data are available for 1983- 1991, 1995-1996, and 1998.

HC 1.2 Child and Youth Deaths

Injuries are a common cause of death for children of all ages.⁷ Among children ages 1 to 4, unintentional injuries were the leading cause of death, followed by congenital anomalies, malignant neoplasms, homicide and legal intervention, and diseases of the heart.⁸ In 1996, all injuries, including homicides and suicides, accounted for 52 percent of deaths to children ages 5 through 14 and for 80 percent of deaths to youth ages 15 through 19.^9,10

Overall, child death rates have decreased substantially over the past several decades (see Figure HC 1.2.A). In 1998, death rates per 100,000 were 35.6 for 1- through 4-year-olds, 18.5 for 5- through 9-year-olds, 23.1 for 10- through 14-year-olds, and 73.3 for 15- through 19-year-olds.

Differences by Age. The most dramatic declines in death rates occurred among children under age 15, with decreases of 67 percent among children ages 1 to 4, 62 percent among children ages 5 to 9, and 48 percent among children ages 10 through 14 since 1960 (see Figure HC 1.2.A). Most of the decline in the death rate for these groups occurred between 1960 and 1990. In contrast, death rates for youth ages 15 through 19 have decreased by only 21 percent since 1960. Moreover, unlike the fairly steady declines among the younger age groups, the death rate for this age group has had a variable pattern over the last 30 years (see Figure HC 1.2.A).

Differences by Race and Hispanic Origin. Multi-year data from the National Center for Health Statistics are used to examine the differences in the death rate of children and youth for several racial and ethnic groups across three time periods spanning 1989 through 1998 (see Table HC 1.2). For children ages 1 to 14 and youth ages 15 to 24, black children and youth have the highest death rate, followed by American Indian/Alaska Native, Hispanic, and white children and youth. Asian children and youth consistently have the lowest death rates.

The death rate for children ages 1 to 14 decreased modestly for all racial and ethnic groups except American Indian/Alaska Native children. The death rate for American Indian/ Alaska Native children dropped sharply from its high of 40 in 1994-1996 to 33 in 1998. Trends in the death rate for youth ages 15 to 24 were similar with all racial groups. Overall, black and American Indian/Alaska Native youth experienced the largest decreases for the 15- to 24-year-old age group.

Differences by Race for Adolescents. The black-white disparity among adolescents ages 15 through 19 was substantial in 1970 but had declined by 1980 to the point where black youth registered lower death rates than white youth (see Figure HC 1.2.B). This reversal was short-lived, however. Black death rates surged from 85.2 per 100,000 in 1985 to 145.0 per 100,000 by 1994, while white death rates remained fairly stable. Much of this increase in black teen deaths reflected a substantial increase in black teen male homicide rates, which are reviewed in Section HC 1.4 of this report. Recently, the difference between the white and black adolescent death rates has narrowed, as the rate for blacks declined 27 percent between 1994 and 1997.

Differences by Gender. Male child death rates are higher than female rates for all age and racial/ethnic groups, but the differences are far more pronounced for the older age groups, for whom injury-related deaths disproportionately affect males (see Table HC 1.2).¹¹

Figure HC 1.2.A Child and youth death rates (per 100,000 population in each age group) in the United States, by age group: Selected years, 1960-1998

Source: Murphy, 1999.

Table HC 1.2 Child and youth death rates (per 100,000 population in each age group) in the United States, by age group, gender, and race and Hispanic origin: 1989-1998

	Combined Years 1989-1991			Combined Years 1992-1993			Combined Years 1994-1996			1998
	Total	Male	Female	Total	Male	Female	Total	Male	Female	Total	Male	Female
Ages 1-14
All races	31.4	36.2	26.3	29.3	33.7	24.6	27.6	31.7	23.3	24.0	27.3	20.5
White^a	28.4	32.8	23.8	26.1	30.3	21.7	24.5	28.3	20.6	21.5	24.4	18.5
Black^a	48.3	56.1	40.3	47.1	53.4	40.7	44.7	51.2	38.0	38.1	44.6	31.4
Asian/Pacific Islander^a	22.7	25.3	20.0	20.3	23.1	17.4	18.7	21.3	16.0	16.2	17.6	14.7
American Indian/Alaska Native^a	37.3	45.1	29.2	38.9	47.0	30.6	40.0	45.1	34.8	33.4	38.4	28.2
Hispanic^b	30.2	34.7	25.5	28.4	32.4	24.2	25.6	29.6	21.4	21.5	24.4	18.4
Ages 15 to 24
All races	99.1	146.1	50.0	97.0	144.0	47.9	94.3	139.0	47.5	82.3	119.3	43.5
White^a	89.3	129.5	47.0	84.2	122.3	44.1	83.0	120.2	43.8	75.4	107.6	41.2
Black^a	161.9	254.9	69.8	174.8	279.5	70.6	161.5	253.3	69.7	126.5	194.6	58.0
Asian/Pacific Islander^a	50.1	70.8	28.1	56.1	80.1	31.1	55.6	79.0	31.9	44.4	59.9	28.8
American Indian/Alaska Native^a	142.0	208.3	71.1	129.4	184.2	71.4	127.2	188.5	63.6	115.6	166.4	64.1
Hispanic^b	103.3	156.5	40.9	107.5	167.3	40.2	102.1	158.1	39.9	83.3	128.8	34.0

^a Includes persons of Hispanic origin

^b Persons of Hispanic origin may be of any race. Death figures for Hispanic persons are based on data from 44 states and the District of Columbia that reported Hispanic origin on the death certificate in 1989, 47 states and the District of Columbia in 1990, 48 states and the District of Columbia in 1991 and 1992, and 49 states and the District of Columbia in 1993-1996.

Note: Death rates reported for white and black persons are based on highly consistent information. However, persons identified as American Indian, Asian, or Hispanic origin in the data from the Census Bureau (denominator of death rates) are sometimes misreported as white or non-Hispanic on the death certificate (numerator), resulting in underestimates of about 22 percent to 30 percent for death rates of American Indians, about 12 percent for death rates of Asians, and about 7 percent for persons of Hispanic origin. (National Center for Health Statistics, Health, United States, 1993, Table 33; Sorlie, P.D., Rogot E., and Johnson, N.J. 1992. "Validity of Demographic Characteristics on the Death Certificate." Epidemiology 3 (2): 181-184.)

Sources: Murphy, 1999, Centers for Disease Control and Prevention, National Center for Health Statistics. Data Computed by the Division of Analysis from data compiled by the Division of Vital Statistics and from national population estimates for race groups. Also, data computed by Infant and Child Health Studies Branch, National Center for Health Statistics, from mortality data compiled by Division of Vital Statistics, Centers for Disease Control, National Center for Health Statistics, 1994, Health,Table 32.

Figure HC 1.2.B Youth death rates (per 100,000 population in age group) in the United States for ages 15 through 19, by race: Selected years, 1970-1998

Sources: Peters, Kochanek, & Murphy, 1998, 1996 United States Deaths; Anderson, Kochanek, & Murphy, 1997; Murphy, 1999, Table 2.

⁷ Injury-related deaths include deaths from motor vehicle crashes, fires and burns, drowning, suffocation, and accidents caused by firearms and other explosive materials, as well as homicides, suicides, and other external causes of death. See Fingerhut, L.A., Annest J.L., Baker, S.P., Kochanek, K.D., & McLoughlin, E. 1996. Injury Mortality among Children and Teenagers in the United States, 1993. Injury Prevention, 2: 93-94.

⁸Murphy, S.L. 1999. Deaths: Final Data for 1998. National Vital Statistics Report, 48, (11). Hyattsville, MD: National Center for Health Statistics.

⁹Percentages calculated by Child Trends based on data on the number of deaths from all causes and from injuries. Peters, Kochanek, & Murphy, 1998, Table 2; National Center for Injury Control and Prevention, Centers for Disease Control. 1996 United States Deaths and Rates per 100,000: All Injury, available online at http://www.cdc.gov/ncipc/osp/states/0001.htm, 10/15/98.

¹⁰ Discussion and data regarding motor vehicle crashes, the largest category of accident-related death for 15- to 19-yearolds, follows in the next section (HC 1.3).

HC 1.3 Youth Motor Vehicle Crash Deaths

Youth ages 15 to 24 had the highest fatality and injury rates of any age group in 1998 due to motor vehicle crashes.¹² Such crashes are among the major causes of injury-related deaths¹³ for 15- to 19-year-olds, accounting for 36 percent of injury deaths in 1996;¹⁴ however, as a fraction of all violent deaths to teens, motor vehicle crashes have declined. Data for 1998 show that motor vehicle crashes claimed 26.4 lives per 100,000 youth ages 15 through 19, compared with 43.6 per 100,000 youth in 1970 (see Figure HC 1.3). The rate of motor vehicle crash deaths among youth has been relatively constant since 1992.

Differences by Gender and Race. For persons under age 20, the decrease in the rate of youth motor vehicle deaths between 1970 and 1998 has been greatest among white males ages 15 through 19, falling from 67.1 to 36.2 deaths per 100,000 and among black males who declined from 43.4 to 26.0 deaths per 100,000 (see Table HC 1.3). Similar decreases in the rates of motor vehicle crash deaths have not been seen among females ages 15 through 19. Among white females, ages 15 through 19, the rate of deaths due to motor vehicle crashes has fluctuated between 20 and 26 per 100,000; by 1998 it was 20.9 deaths per 100,000, compared with 24.4 deaths per 100,000 in 1970. Black females have had lower motor vehicle crash death rates than whites. After a drop from 11.1 deaths per 100,000 in 1970 to 6.7 deaths per 100,000 in 1980, rates have generally increased for this group, to 8.5 deaths per 100,000 in 1998.

Differences by Age. Among youth ages 10 through 14, motor vehicle death rates are quite low in comparison to older youth and dropped from 9.6 to 5.4 per 100,000 between 1970 and 1998. This decline was evident for both white and black males and females, with most of the decline occurring before 1990.

Figure HC 1.3 Youth motor vehicle crash deaths (rate per 100,000) in the United States, by age: Selected years, 1970-1998

Source: National Center for Health Statistics, Table 291, p473-478, Mortality Statistics Branch, Division of Vital Statistics.

Table HC 1.3 Youth motor vehicle crash deaths (rate per 100,000) in the United States, by age, gender, and race: Selected years, 1970- 1998

	1970	1975	1980	1985	1990	1991	1992	1993	1994	1995	1996	1997	1998
All youth
Ages 10-14	9.6	8.4	8.1	7.4	6.4	6.1	5.5	5.9	6.0	6.1	5.8	5.9	5.4
Ages 15-19	43.6	38.4	43.0	33.5	33.1	31.2	28.2	28.6	29.3	28.6	28.6	27.3	26.4
White males
Ages 10-14	12.6	10.9	10.9	9.8	7.7	7.8	7.0	7.1	7.5	7.2	7.2	6.8	6.4
Ages 15-19	67.1	61.7	69.1	51.3	49.3	44.5	39.6	41.6	41.7	38.9	39.5	36.6	36.2
White females
Ages 10-14	6.6	5.8	5.7	5.6	5.3	4.4	4.1	4.4	4.8	5.0	4.8	4.9	4.3
Ages 15-19	24.4	20.6	25.6	22.6	22.2	23.0	21.0	20.2	21.3	22.1	21.2	21.4	20.9
Black males
Ages 10-14	11.9	9.6	7.9	8.9	7.9	8.8	7.8	8.3	7.6	7.7	6.8	7.4	7.8
Ages 15-19	43.4	24.6	24.4	22.1	28.7	29.5	26.2	26.7	29.0	29.0	28.2	28.7	26.0
Black females
Ages 10-14	6.4	4.2	4.0	3.0	3.8	3.3	3.6	4.8	4.8	4.2	3.0	4.8	3.1
Ages 15-19	11.1	7.1	6.7	7.5	9.7	9.0	9.1	8.2	10.4	10.7	12.4	10.4	8.5

Source: National Center for Health Statistics, Table 291, p473-478, Mortality Statistics Branch, Division of Vital Statistics.

¹² Murphy, S.L. 2000. National Vital Statistics Reports, 48, (11).

¹³ Injury-related deaths include deaths from motor vehicle crashes, fires and burns, drowning, suffocation, and unintentional injuries caused by firearms and other explosive materials, as well as homicides, suicides, and other external causes of death.

¹⁴ Percentages calculated by Child Trends based on data on the number of deaths from all causes and from injuries. Peters, K.D., Kochanek, K.D., & Murphy, S.L. 1998. National Vital Statistics Report, 47, (9), Table 2. National Center for Injury Control and Prevention, Centers for Disease Control. 1996 United States Deaths and Rates per 100,000: All Injury. Available online at http://www.cdc.gov/ncipc/osp/states/0001.htm, 10/15/98.

HC 1.4 Youth Homicides

After more than a decade of sharp increases, the youth homicide rate decreased between 1993 and 1997. The rate of death from homicide for youth ages 15 through 19 more than doubled between 1970 and 1993, increasing from 8.1 to 20.7 per 100,000 (see Table HC 1.4.A). Virtually all of this increase occurred after 1985. Since 1993, rates have decreased steadily to 11.8 deaths per 100,000 in 1999.

Male Youth Homicide Rates by Race. The trend in the death rate due to homicide for black males largely dominates the rate of youth homicides for ages 15 through 19. Since 1990, the rate of death due to homicide for black males ages 15 through 19 has been about eight to nine times higher than the rate for their white peers. The rate for this age group of black males actually declined nearly 30 percent from 1970 to 1985, but it increased dramatically from 46.7 per 100,000 in 1985 to 140.7 per 100,000 in 1993. Since 1993, this rate has decreased by over 50 percent, falling to 71 deaths per 100,000 by 1998 (see Table HC 1.4.A).

While the homicide rate for white males of the same age group (15 through 19) is substantially less than that of black males, similar fluctuations in this rate can be seen over time, with the largest increases occurring between 1985 and the early 1990s and decreases in recent years. Overall, this rate has almost doubled, going from 5.2 deaths per 100,000 in 1970 to 10.2 deaths per 100,000 in 1998.

Female Youth Homicide Rates by Race. Homicide rates for females ages 15 through 19 are considerably lower than among similarly aged males within the same race groups (rates for black females have actually been higher than rates for white males). For example, the rate for black females was 10.6 per 100,000 in 1997, 87 percent lower than the rate for black males. The gender disparity in homicide rates is also large for whites, although it is not as great as that between black males and females. In 1998, the homicide rate for white females ages 15 through 19 was 2.4 deaths per 100,000, just over a quarter of that for white males. As is the case for males, the youth homicide rate for black females is higher than the rate for white females—nearly four times higher in 1998 (see Table HC 1.4.A).

Homicide Rates for Younger Youth. The homicide rate for youth ages 10 through 14 was 1.5 per 100,000 in 1998—substantially lower than the rate for older youth (see Figure HC 1.4.B). The disparity between males and females is not as pronounced in this age group as the difference for older youth ages 15 through 19. However, the homicide rates for both white and black males ages 10 through 14 have been approximately twice those of females in recent years.

Homicides Involving Firearms. Firearms have been involved in the majority of youth homicides since 1980 (see Figure HC 1.4.C). Deaths to youth ages 15 through 19 involving firearms accounted for 66 percent of the total deaths due to homicide in 1980 (7.0 firearm deaths per 100,000 out of a total of 10.6 deaths per 100,000 due to homicide). The percentage of firearm-related homicides increased to 85 percent by 1997 for this same age group.

Homicides due to firearms are more likely among black youth than among white youth and most particularly among black males ages 15 through 19 (see Table HC 1.4.B). In 1997, 91 percent of homicides among older male black youth (ages 15 through 19) involved a firearm, compared with 84 percent among older white male youth. The rate of death due to firearms among black males ages 15 through 19 has decreased since 1993, serving as one explanation for the decline in the overall homicide rate among this group. Homicides among female youth involve a firearm less often, although firearms are still the means of the majority of female homicides.

Table HC 1.4.A Youth homicides^a (rate per 100,000) in the United States, by age, gender, and race: Selected years, 1970-1998

	1970	1975	1980	1985	1990	1991	1992	1993	1994	1995	1996	1997	1998
All youth
Ages 10-14	1.2	1.2	1.4	1.5	2.1	2.2	2.4	2.5	2.2	2.1	1.8	1.5	1.5
Ages 15-19	8.1	9.6	10.6	8.6	17.0	19.6	19.3	20.7	20.3	18.2	15.7	13.7	11.8
White males
Ages 10-14	0.6	1.0	1.1	1.4	1.7	1.8	2.0	1.9	1.8	2.0	1.5	1.4	1.3
Ages 15-19	5.2	8.1	10.9	7.2	12.5	14.4	15.2	15.2	15.4	14.7	12.2	11.1	10.2
White females
Ages 10-14	0.6	0.8	1.1	0.9	0.9	0.9	1.0	1.2	0.9	1.0	0.9	0.6	1.0
Ages 15-19	2.1	3.2	3.9	2.7	3.6	3.6	3.6	3.6	3.4	3.9	2.9	2.9	2.4
Black males
Ages 10-14	6.8	4.1	3.9	4.2	8.1	9.1	9.6	10.5	9.1	8.2	6.0	5.6	4.4
Ages 15-19	65.2	51.4	48.8	46.7	115.7	134.6	128.5	140.7	135.8	110.5	100.9	85.3	71.0
Black females
Ages 10-14	2.3	2.3	2.4	1.7	4.8	3.8	5.1	5.2	4.6	3.0	3.1	2.3	2.6
Ages 15-19	10.6	15.3	11.0	10.4	15.6	15.6	14.2	18.4	15.1	16.4	12.9	10.6	9.8

^a Homicide includes death by legal intervention.

Source: National Center for Health Statistics, Table 291, p491-496, Mortality Statistics Branch, Division of Vital Statistics.

Figure HC 1.4.A Youth homicides^a for males ages 15 through 19 (rate per 100,000) in the United States, by race: Selected years, 1970-1998

^a Homicide includes death by legal intervention.

Source: National Center for Health Statistics, Table 291, p473-478, Mortality Statistics Branch, Division of Vital Statistics.

Figure HC 1.4.B Youth homicides^a (rate per 100,000) in the United States, by age: Selected years, 1970-1998

^a Homicide includes death by legal intervention.

Source: National Center for Health Statistics, Table 291, p473-478, Mortality Statistics Branch, Division of Vital Statistics.

Table HC 1.4.B Youth homicides due to firearms^a (rate per 100,000) in the United States, by age, gender, and race: Selected years, 1980-1998

	1980	1985	1990	1991	1992	1993	1994	1995	1996	1997	1998
All youth
Ages 10-14	0.8	0.8	1.5	1.6	1.9	1.9	1.7	1.6	1.3	1.0	1.0
Ages 15-19	7.0	5.7	13.8	16.4	16.7	17.8	17.7	15.4	13.2	10.9	9.7
White males
Ages 10-14	0.7	0.9	1.3	1.4	1.6	1.5	1.5	1.6	1.2	1.1	1.0
Ages 15-19	7.2	4.9	9.4	11.7	12.9	12.6	12.9	12.3	10.0	8.3	8.0
White females
Ages 10-14	0.5	0.4	0.4	0.5	0.6	0.6	0.5	0.5	0.5	0.3	0.5
Ages 15-19	1.7	1.2	2.0	2.1	2.3	2.2	2.4	2.2	1.7	1.5	1.3
Black males
Ages 10-14	3.2	3.0	6.9	8.2	8.4	9.8	7.7	7.4	5.2	4.1	3.1
Ages 15-19	38.4	36.6	104.4	122.6	118.8	130.1	126.6	101.7	91.7	75.2	64.5
Black females
Ages 10-14	1.0	0.6	3.2	2.7	3.4	3.3	3.3	2.0	1.8	1.5	1.6
Ages 15-19	6.2	5.0	10.4	11.2	10.5	14.3	11.1	12.3	9.9	7.2	6.7

^aIncludes assault by handguns and all other and unspecified firearms.

Sources: National Center for Health Statistics, Table 291, p491-496, Mortality Statistics Branch, Division of Vital Statistics. Murphy, 1999.

Figure HC 1.4.C Percentage of youth homicides^a due to firearms^b in the United States, for youth ages 15 through 19: Selected years, 1980-1998

^a Homicide includes death by legal intervention

^b Includes assault by handguns and all other and unspecified firearms.

Sources: National Center for Health Statistics, Table 291, p491-496, Mortality Statistics Branch, Division of Vital Statistics; Murphy, 1999.

HC 1.5 Youth Suicides

Suicide, like homicide, has come to play a proportionately larger role in teen deaths over the past several decades. Between 1970 and 1990, the suicide rate for youth ages 15 through 19 nearly doubled, from 5.9 to 11.1 per 100,000 (see Figure HC 1.5). After remaining stable from 1990 to 1994 at approximately 11 deaths per 100,000 youth ages 15 through 19, the rate decreased slightly to 8.9 per 100,000 in 1998.

Differences by Gender. Male teens are more likely than females to commit suicide (see Table HC 1.5). The suicide rate for white males ages 15 through 19 was 15.3 per 100,000 in 1998, more than five times the rate of 3.0 per 100,000 for white females. Among blacks, males had a rate almost six times that of females for youth ages 15 through 19 in 1998 (10.7 and 1.8 per 100,000, respectively).

Differences by Race. White males ages 15 through 19 have long had a higher suicide rate than their black male peers (see Table HC 1.5). In 1970, white males ages 15 through 19 were twice as likely as black males to commit suicide (9.4 versus 4.7 per 100,000). However, the gap between white and black male suicide rates has narrowed in recent years, with suicide rates of 15.3 and 10.7 per 100,000, respectively, according to 1998 white and black males.¹⁵ Among females ages 15 through 19, whites and blacks were equally likely to commit suicide in 1970, with rates of 2.9 per 100,000. By 1975, white female suicide rates were more than twice that of their black peers ages 15 through 19. White female suicide rates have remained higher than black female rates since1975.

Suicide Rates for Younger Youth. While considerably lower, suicide rates for youth ages 10 through 14 have followed trends similar to those among older youth, with males having higher rates of suicide than females and whites having higher suicide rates than blacks (see Table HC 1.5). In this age group, suicide is infrequent for both sexes and races, making gender or racial differences small as well.

Figure HC 1.5 Youth suicides (rate per 100,000) in the United States, by age: Selected years, 1970-1998

Source: National Center for Health Statistics, Table 291, p485-490, Mortality Statistics Branch, Division of Vital Statistics.

Table HC 1.5 Youth suicides (rate per 100,000) in the United States, by age, gender, and race: Selected years, 1970-1998

	1970	1975	1980	1985	1990	1991	1992	1993	1994	1995	1996	1997	1998
All youth
Ages 10-14	0.6	0.8	0.8	1.6	1.5	1.5	1.7	1.7	1.7	1.7	1.6	1.6	1.6
Ages 15-19	5.9	7.5	8.5	9.9	11.1	11.0	10.8	10.9	11.1	10.5	9.7	9.5	8.9
White males
Ages 10-14	1.1	1.4	1.4	2.5	2.3	2.4	2.6	2.4	2.5	2.8	2.3	2.5	2.6
Ages 15-19	9.4	12.9	15.0	17.1	19.3	19.1	18.4	18.5	18.7	18.4	16.3	16.0	15.3
White females
Ages 10-14	0.3	0.4	0.3	0.9	0.9	0.8	1.1	1.0	1.0	0.9	0.9	0.8	0.9
Ages 15-19	2.9	3.1	3.3	4.1	4.0	4.2	3.7	4.2	3.5	3.3	3.8	3.5	3.0
Black males
Ages 10-14	0.3	0.2	0.5	—	1.6	2.0	2.0	2.3	2.1	1.6	1.9	1.9	1.4
Ages 15-19	4.7	6.1	5.6	8.2	11.5	12.2	14.8	14.4	16.6	13.8	11.5	11.4	10.7
Black females
Ages 10-14	0.4	0.3	0.1	—	—	—	—	—	—	—	—	—	—
Ages 15-19	2.9	1.5	1.6	1.5	1.9	—	1.9	—	2.4	2.3	1.8	2.7	1.8

— = Not calculated because of unreliability due to infrequency of the event.

Source: National Center for Health Statistics, Table 291, p485-490, Mortality Statistics Branch, Division of Vital Statistics.

¹⁵The race disparity in the suicide rate between all white youth ages 10 through 19 and all black youth ages 10 through 19 narrowed substantially between 1980 and 1995, largely due to the increase of suicide among black youth. In 1980, white youth (ages 10-19) had a suicide rate that was 157 percent greater than that of their black peers; by 1995, the rate among whites was 42 percent greater than the rate among blacks. [These data, not shown here, can be found in Centers for Disease Control and Prevention. March 20, 1998. Suicide among Black Youths—United States, 1980-1995. Morbidity and Mortality Weekly Report 47 (10).]

HC 1.6 Firearm-Related Deaths

Death due to injury by firearms includes deaths due to homicide, suicide, legal intervention, unintentional death by firearms, and firearm-related deaths of undetermined intent. Taken together, suicide and homicide have accounted for the vast majority of firearm-related deaths over the past 30 years—as high as 94 percent in 1994.¹⁶

Firearm-related death is a growing public health concern for all ages. It was a major contributor to death in 1994 and the fourth leading cause of years of potential life lost before age 65.¹⁷ However, the rate of firearm-related death among youth ages 15 through 19 is of particular concern, as homicide rates for this group rose dramatically in the late 1980s and early 1990s, particularly among black males. In addition, the rate of unintentional death due to firearms has historically been highest among youth ages 15 through 19. Overall, the rate of death due to injury by firearms doubled for youth ages 15 through 19 between 1980 and 1994, from 14.7 deaths to 28.2 deaths per 100,000. Since 1994, the firearm-related death rate has declined, and in 1998 it was at 16.3 deaths per 100,000 (see Table HC 1.6). The firearm-related death rate for youth ages 10 through 14, 2.3 per 100,000 in 1998, is considerably lower than the rate for older youth.¹⁸

Differences by Race. Among younger adolescents ages 10 through 14, and among females ages 15 through 19, the rate of death due to injury by firearms ranges from two to three times higher for blacks than for whites. In 1998, the rate of firearm-related death for black males ages 15 through 19 is almost four times the rate for their white peers, but it has decreased by 50 percent since 1993, when the rate was over five times higher than that of white males. Based on 1998 data, the rate for older black males decreased by 25 percent between 1996 and 1997, from 108.7 to 75.5 per 100,000. The high rate of deaths due to homicide among black males in this age group largely accounts for the high firearm-related death rate.¹⁹

Differences by Gender. Among blacks and whites in both age groups, firearm-related deaths are more prevalent among males; for example, the death rate for black females ages 15 through 19 was 8.0 per 100,000 in 1998, while the rate for their male peers was almost 10 times greater (75.5 per 100,000). Among whites ages 15 through 19, females experience firearm-related deaths at approximately one-sixth the rate of males.

Figure HC 1.6 Deaths due to injury by firearms (rate per 100,000) for youth ages 15 through 19 in the United States, by gender and race: 1990-1998^a

Source: Centers for Disease Control, National Center for Health Statistics, Mortality Statistics Branch, Division of Vital Statistics, 2000.

Table HC 1.6 Youth deaths due to injury by firearms (rate per 100,000) in the United States, by age, gender and race: Selected years, 1980- 1998

	1980	1985	1990	1991	1992	1993	1994	1995	1996	1997	1998
All youth
Ages 10-14	2.4	2.8	3.3	3.5	3.7	3.8	3.5	3.4	2.7	2.2	2.3
Ages 15-19	14.7	13.3	23.3	26.4	26.2	27.8	28.2	24.5	21.2	18.2	16.3
White males
Ages 10-14	3.6	4.5	4.2	4.6	4.5	4.4	4.3	4.4	3.6	3.1	3.1
Ages 15-19	20.9	18.4	26.2	29.1	28.8	28.8	30.2	27.9	23.1	20.8	19.4
White females
Ages 10-14	1.0	1.0	1.0	1.0	1.3	1.2	1.2	1.2	1.0	0.6	1.0
Ages 15-19	4.1	3.5	4.6	4.6	4.3	4.9	4.7	4.2	3.8	3.5	3.1
Black males
Ages 10-14	4.7	4.8	10.2	11.5	11.6	13.4	11.2	10.1	7.8	6.2	4.6
Ages 15-19	46.7	46.5	119.7	140.5	140.9	153.1	151.1	120.3	108.7	88.2	75.5
Black females
Ages 10-14	1.5	—	3.7	3.0	3.9	3.9	3.5	2.5	2.2	2.3	2.0
Ages 15-19	7.5	6.1	12.1	12.7	12.4	15.8	13.3	14.2	11.7	8.8	8.0

Source: Centers for Disease Control, National Center for Health Statistics, Mortality Statistics Branch, Division of Vital Statistics, 2000; Murphy, 1999.

¹⁶ Ikeda, R.M., Gorwitz, R., James, S.P., Powell, K.E., & Mercy, J.A. 1997. Fatal Firearm Injuries in the United States, 1962- 1994. Violence Surveillance Summary Series (3). Atlanta: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.

¹⁷ Ibid.

¹⁸ Data for 1997 are preliminary, based on a sample of 85 percent of all deaths.

¹⁹ Refer to section HC 1.4 for further discussion of youth homicide.

Health Conditions

HC 2.1 Healthy Births

A healthy birth is defined here as a birth with the following characteristics: a 5-minute Apgar score of 7 or more out of 10,²⁰ weight at birth of at least 2,500 grams (5 lbs. 8oz.), a gestational age of at least 37 weeks, and maternal receipt of prenatal care within the first trimester.

Table HC 2.1.A reports the percentage of all births qualifying as healthy births, by race and Hispanic origin, according to the above criteria in 1998. The table shows non-Hispanic black newborns scored lower on all four measures of healthiness than non-Hispanic white and Hispanic newborns. For example, 86.8 percent of non-Hispanic black infants were born weighing 2,500 grams or more, while the comparable numbers for Hispanic and nonHispanic white newborns were 93.6 and 93.4 percent respectively

Apgar Score. The Apgar score is a numerical expression of the physical condition of an infant shortly after delivery and is used to predict the newborn’s chance of survival. The score considers five characteristics of the baby—heart rate, respiratory effort, muscle tone, reflex irritability, and color. Each of these characteristics is assessed and assigned a value between 0 and 2. The total score is the sum of the scores of the five components and thus ranges between 1 and 10. Ninety-nine percent of all births were rated with an Apgar score at 5 minutes after birth of 7 or more in 1998 (See Table HC 2.1.A). These numbers were nearly the same for all racial/ethnic groups except non-Hispanic blacks. In 1998, 97.6 of all births to this group were rated as healthy according to the Apgar criteria.

Birthweight. The risks for infants born weighing less than 2,500 grams (5lb. 8oz.) is discussed in the following indicator, HC 2.2. As stated in that section, the percentage of infants born at low birthweight has increased steadily since 1985 to 7.6 percent in 1999 (See Table HC 2.2.A). In contrast, the percentage of children born weighing more than 2,500 in 1998 was 92.4. Hispanic and non-Hispanic whites had similarly high percentages with 93.6 and 93.4 percent respectively. The percentage of infants born to non-Hispanic black mothers weighing over 2,500 grams was much lower however, at 86.8 percent (See Table HC 2.1A).

Period of Gestation. Preterm birth, defined as infants that are born prior to 37 weeks of gestation, is a major cause of infant mortality and has been associated with long-term neurodevelopment and respiratory disorders. The percentage of births that are preterm has risen steadily over the past decade. In 1989, 10.6 of all births were preterm, and this percentage had risen to 11.6 in 1998 (See Table HC 2.1.B). It appears that the rising number of preterm infants born to white non-Hispanic mothers account for much of this increase. This percentage has risen from 8.4 in 1989 to 10.2 percent in 1998. In comparison, the percentage of preterm infants born to black non-Hispanic mothers has decreased (from 19 percent in 1989 to 17.6 percent in 1998), and the percentage of preterm Hispanic infants has increased only slightly, from 11.1 to 11.4 in the same time period.

Prenatal care. Early prenatal care (especially within the first trimester of pregnancy) can promote healthier births by detecting and managing preexisting medical conditions, and by providing health advice to the mother.²¹ In 1998, nearly 88 percent of all non-Hispanic white mothers received prenatal care sometime during their first trimester of pregnancy. The percentages for non-Hispanic blacks and Hispanic mothers were considerably lower at 73 and 74 percent respectively (See Table HC 2.1.A). This topic is discussed in greater detail in section HC 3.2.

Table HC 2.1.A Percentage of all births in the United States defined as healthy, by mother’s race: 1998

	Gestational age 37 weeks +	Birthweight 2,500 grams +	Apgar score 7 or above	Prenatal care 1st trimester
All	88.4	92.4	98.6	82.8
White	89.8	93.4	98.7	87.9
Black	82.4	86.8	97.6	73.3
Hispanic	88.6	93.6	98.8	74.3

Source: Special tabulations for 1998 birth data by Sally C. Curtin, National Center for Health Statistics.

Table HC 2.1.B Percentage of preterma live births by race and Hispanic origin of mother: 1989-1998

	1989^b	1990^c	1991^d	1992^d	1993	1994	1995	1996	1997	1998
All	10.6	10.6	10.8	10.7	11.0	11.0	11.0	11.0	11.4	11.6
White	8.4	8.5	8.7	8.7	9.1	9.3	9.4	9.5	9.9	10.2
Black	19.0	18.9	19.0	18.5	18.6	18.2	17.8	17.5	17.6	17.6
Hispanic	11.1	11.0	11.0	10.7	11.0	10.9	10.9	10.9	11.2	11.4

^aInfants born prior to 37 weeks of gestation.

^b Data by Hispanic origin exclude New Hampshire, Oklahoma, and Louisiana, which did not report Hispanic origin.

^cData by Hispanic origin exclude New Hampshire and Oklahoma, which did not report Hispanic origin.

^d Data by Hispanic origin exclude New Hampshire which did not report Hispanic origin.

Sources: Ventura, et al., 2000. Births.

²⁰ The Apgar score is a numerical expression of the physical condition of an infant shortly after delivery. The infant is rated 0, 1, or 2 on color, heart rate, reflex irritability, muscle tone, and breathing. The maximum score is 10, and a score of 4 or less indicates examination and treatment are warranted. As defined in Apgar, V., Holiday, D.A., James, L.S., Weisbrot, I.N., & Berrien, C. 1953. Evaluation of the Newborn Infant-2nd Report. Current Researchers in Anesthesia and Analgesia, 32: 260-267.

²¹ Ibid.

HC 2.2 Low and Very Low Birthweight

Low Birthweight

Babies born weighing less than 2,500 grams (5lb. 8oz.) face an increased risk of physical and developmental complications and death.²² These babies account for four-fifths of all neonatal deaths (deaths under 28 days of age) and are 24 times more likely to die during the first year than are heavier infants.²³

Although slight declines are seen in the early 1980s, overall the percentage of all infants born at low birthweight has increased steadily since 1985, when 6.8 percent of infants were born at low birthweight, compared with 7.6 percent in 1999 (see Table HC 2.2.A).

Smoking. Babies born to mothers who smoke during pregnancy are at greatly elevated risk of low birthweight, a finding documented in birth certificate data as well as in numerous other studies.²⁴ In 1998, 12 percent of infants born to smokers weighed less than 2,500 grams (5lb. 8oz.) compared with 7.2 percent of births to nonsmokers (See Figure HC 2.2.A). This substantial differential is found for every race and Hispanic origin group (See Figure HC 2.2.A). The low birthweight risk is heightened as the number of cigarettes increases, “although low birthweight is elevated even among babies born to the lightest smokers (one to five cigarettes daily).” “Advancing maternal age exacerbates the risk, probably a consequence of the much greater cigarette consumption among older women.”²⁵

Differences by Race and Ethnicity. Low birthweight rates are substantially higher among black infants than among other races and Hispanics. The percentages of low birthweight infants among whites, American Indians/Alaska Natives, Asians/Pacific Islanders, and Hispanics have remained within 1 percentage point of each other and have mostly hovered around 6 to 7 percent over the last two decades, compared to around 13 percent for blacks.

Among Asians/Pacific Islanders and Hispanics, there are important subgroup differences. Since 1970, Chinese women have consistently had the lowest percentage of low-weight births, and Filipino women have had the highest among Asian/Pacific Islander women. Among Hispanics, Mexican American women have generally had the lowest percentage of low birthweight infants, and Puerto Rican women have had the highest (see Table HC 2.2.A).

Differences by Age. For women in all age groups, there was a decline in the percentage of low-weight births between 1970 and 1985. Since 1985, however, that percentage increased slightly across nearly all age groups. The following trends, illustrated in Table HC 2.2.A, are particularly noteworthy:

Women under age 15 consistently have the highest rates of low-weight births of any age group (see Figure HC 2.2.B).
For women in all other age groups, rates of low-weight births have generally stayed within 1.5 percentage points of their 1970 rate.
Women between the ages of 25 and 29 consistently have the lowest rates of lowweight births.

Multiple births. Multiple births are more likely than singletons to be born either preterm or low birthweight (See Figure HC2.2.C). Multiples comprised only 3 percent of all births in 1998, but 21 percent of all low birthweight infants and 24 percent of very low birthweight. Multiple birth rates generally rise with increasing maternal age, with the rate peaking for mothers 45 to 54 years of age. The rising multiple birth rate and the accompanying high risk for these births has increasingly influenced measures of perinatal health at the national and State levels.²⁶

Very Low Birthweight

Babies born weighing less than 1,500 grams (3lb. 4oz.) are at particularly high risk of severe physical and developmental complications and death. Advances in medical technology in recent years have made it possible for increasing numbers of very low birthweight infants to survive; however, these babies are 96 times more likely to die during the first year of life than babies weighing at least 2,500 grams.²⁷

The percentage of infants born at very low birthweight has increased steadily since the early 1980s, by 25 percent overall since 1981 (see Table HC 2.2.C). Between 1970 and 1989 (not shown), 1.2 percent of all infants were classified as very low birthweight. The proportion then increased to 1.27 percent in 1990, and to 1.45 percent in 1998.

Differences by Race and Ethnicity. The percentage of babies born at very low birthweight varies by race and Hispanic origin (see Table HC 2.2.C). For white, Hispanic, American Indian/Alaska Native, and Asian/Pacific Islander infants, the percentage of very low-weight births was about 1 percent in 1998. However, the percentage of black infants born at very low birthweight is considerably higher. In 1970, 2.4 percent of all infants born to black mothers weighed 1,500 grams or less, a percentage that has increased to 3.1 in 1998. The percentage of very low birthweight has increased steadily for all groups since the early 1980’s.

Differences by Age. A woman’s age is an important factor in the likelihood of very low birthweight, particularly at the youngest ages. The percentage of very low birthweight infants born to women under age 15 was 3.3 percent in 1998. The percentage of very low birthweight births among women ages 15 through 19 is lower than the proportion of such births to their younger counterparts but remains slightly higher than the proportion observed for women ages 20 and older, (see Table HC 2.2C).

Table HC 2.2.A Low birthweight^a infants as a percentage of all infants born in the United States by mother’s race/ethnicity^b and by age: Selected years, 1970-1999

	1970	1975	1980	1985	1990	1995	1996	1997	1998	1999
Total	7.9	7.4	6.8	6.8	7.0	7.3	7.4	7.5	7.6	7.6
Race/ethnicity
White^c	6.9	6.3	5.7	5.7	5.6	6.2	6.4	6.5	6.6	6.6
Black^c	13.9	13.2	12.7	12.7	13.3	13.2	13.1	13.1	13.2	13.1
American Indian/Alaskan Native	8.0	6.4	6.4	5.9	6.1	6.6	6.5	6.8	6.8	—
Asian/Pacific Islander	—	—	6.7	6.2	6.5	6.9	7.1	7.2	7.4	—
Chinese	6.7	5.3	5.2	5.0	4.7	5.3	5.0	5.1	5.3	—
Japanese	9.0	7.5	6.6	6.2	6.2	7.3	7.3	6.8	7.5	—
Filipino	10.0	8.1	7.4	7.0	7.3	7.8	7.9	8.3	8.2	—
Hawaiian and part Hawaiian	—	—	7.2	6.5	7.2	6.8	6.8	7.2	7.2	—
Other Asian or Pacific Islander	—	—	6.8	6.2	6.7	7.1	7.4	7.5	7.8	—
Hispanic origin^{b, d}	—	—	6.1	6.2	6.1	6.3	6.3	6.4	6.4	6.4
Mexican American	—	—	5.6	5.8	5.6	5.8	5.9	6.0	6.0	—
Puerto Rican	—	—	9.0	8.7	9.0	9.4	9.2	9.4	9.7	—
Cuban	—	—	5.6	6.0	5.7	6.5	6.5	6.8	6.5	—
Central and South American	—	—	5.8	5.7	5.8	6.2	6.0	6.3	6.5	—
Other and unknown Hispanic	—	—	7.0	6.8	6.9	7.5	7.7	7.9	7.6	—
Age
Under age 15	16.6	14.1	14.6	12.9	13.3	13.5	12.8	13.6	13.1	12.8
15-19 years	10.5	10.0	9.4	9.3	9.3	9.3	9.3	9.5	9.5	9.6
20-24 years	7.4	7.1	6.9	6.9	7.1	7.3	7.4	7.4	7.5	7.6
25-29 years	6.9	6.1	5.8	5.9	6.2	6.4	6.5	6.6	6.7	6.7
30-34 years	7.5	6.8	5.9	6.1	6.4	6.7	6.8	6.9	7.0	7.0
35-49 years^e	8.8	8.4	7.2	7.1	7.4	8.3	8.3	8.6	8.7	8.7

^a Before 1979, low birthweight was defined as infants weighing 2,500 grams (5lb. 8oz.) or less. From 1979 and beyond, low birth weight defined as infants weighing less than 2,500 grams (5lb. 8oz.).

^b Birth figures for Hispanic infants are based on data from 22 states that reported Hispanic origin on the birth certificate in 1980, 23 states and the District of Columbia in 1985, 48 states and the District of Columbia in 1990, 49 states and the District of Columbia in 1992, and 50 states and the District of Columbia since 1993.

^c Excludes persons of Hispanic origin after 1990.

^dPersons of Hispanic origin may be of any race.

^e Data for 1997 and 1998 are for ages 35-54 years.

Sources: Curtin & Martin, 2000; Ventura, et al., 2000; Ventura, et al., 1999, Births, Tables 24, 25, and 45; Centers for Disease Control, National Center for Health Statistics, 1998, Health, United States, 1998, Table 11; and unpublished tabulations, Division of Vital Statistics, National Center for Health Statistics.

Table HC 2.2.B Percent low birthweight^a among singletons by race/Hispanic origin of mother: 1989-98

	1989^d	1990^c	1991^b	1992^b	1993	1994	1995	1996	1997	1998
Total	6.00	5.90	5.99	5.93	6.05	6.05	6.05	6.03	6.08	6.05
Non-Hispanic White	4.60	4.56	4.61	4.59	4.70	4.79	4.87	4.90	4.95	4.91
Non-Hispanic Black	12.22	11.92	12.15	11.91	11.90	11.79	11.66	11.55	11.46	11.44
Hispanic	5.35	5.23	5.29	5.22	5.34	5.37	5.36	5.34	5.43	5.40

^a Low birthweight is less than 2,500 grams or 5lb 8oz.

^b Excludes data for New Hampshire, which did not require reporting of Hispanic origin of mother.

^c Excludes data for New Hampshire and Oklahoma which did not require reporting of Hispanic origin of mother.

^d Excludes data for Louisiana, New Hampshire, and Oklahoma which did not require reporting of Hispanic origin of mother.

Sources: Martin & Park, Trends in twin and triplet births: 1980-1997; National Vital Statistics Reports 47(24). Hyattsville, MD: National Center for Health Statistics; Ventura, et al., 2000, Births; Ventura, et al., 1999, Births, Tables 24, 25 and 45

Figure HC 2.2.A Percentage of children born with low birthweight,^a by mother’s smoking status and age, race and Hispanic origin, 1998

Figure HC 2.2.A continued Percentage of children born with low birthweight,^a by mother’s smoking status and age, race and Hispanic origin, 1998

^a Low birthweight defined as infants weighing less than 2,500 grams (5lb. 8oz.).

^b Data for smokers under 15 years did not meet standards of reliability or precision; based on fewer than 20 births in numerator or denominator.

Sources: Ventura, et al., 2000, Births, Tables 24, 25, and 45.

Figure HC 2.2.B Low birthweighta infants as a percentage of all infants born in the United States, by age of mother: 1998

^aLow birthweight defined as infants weighing less than 2,500 grams (5lb. 8oz.).

Sources: Ventura, et al., 1999, Births, Table 45.

Figure HC 2.2.C Percentage of children born with low birthweight by plurality and age of mother: United States, 1998

Source: Unpublished tabulation, Division of Vital Statistics, National Center for Health Statistics, 2000.

Table HC 2.2.C Very low birthweight^a infants as a percentage of all infants born in the United States, by mother's race/ethnicity^b and by age. Selected years: 1970-1998

	1970	1975	1980	1985	1990	1995	1996	1997	1998
Total	1.17	1.16	1.15	1.21	1.27	1.35	1.37	1.42	1.45
Race/ethnicity^b
Whitec	0.95	0.92	0.90	0.94	0.93	1.04	1.08	1.12	1.15
Blackc	2.40	2.40	2.48	2.71	2.93	2.98	3.02	3.05	3.11
American Indian/Alaska Native^c	0.98	0.95	0.92	1.01	1.01	1.10	1.21	1.19	1.24
Asian/Pacific Islander^c	—	—	0.92	0.85	0.87	0.91	0.99	1.05	1.10
Chinese	0.80	0.52	0.66	0.57	0.51	0.67	0.64	0.74	0.75
Japanese	1.48	0.89	0.94	0.84	0.73	0.87	0.81	0.78	0.84
Filipino	1.08	0.93	0.99	0.86	1.05	1.13	1.20	1.29	1.35
Hawaiian and part Hawaiian	—	—	1.05	1.03	0.97	0.94	0.97	1.41	1.53
Other Asian or Pacific Islander	—	—	0.96	0.91	0.92	0.91	1.04	1.07	1.12
Hispanic origin^d	—	—	0.98	1.01	1.03	1.11	1.12	1.13	1.15
Mexican American	—	—	0.92	0.97	0.92	1.01	1.01	1.02	1.02
Puerto Rican	—	—	1.29	1.30	1.62	1.79	1.70	1.85	1.86
Cuban	—	—	1.02	1.18	1.20	1.19	1.35	1.36	1.33
Central and South American	—	—	0.99	1.01	1.05	1.13	1.14	1.17	1.23
Other and unknown Hispanic	—	—	1.01	0.96	1.09	1.28	1.48	1.35	1.38
Age
Under age 15	—	3.10	3.40	3.10	3.20	3.15	3.16	3.06	3.28
15-19 years	—	1.80	1.70	1.80	1.80	1.74	1.72	1.78	1.81
20-24 years	—	1.10	1.10	1.20	1.30	1.31	1.32	1.37	1.38
25-29 years	—	0.90	1.00	1.00	1.10	1.16	1.22	1.24	1.27
30-34 years	—	1.00	1.00	1.10	1.20	1.24	1.26	1.33	1.37
35-49 years^e	—	1.20	1.20	1.30	1.40	1.58	1.65	1.68	1.71

^a Before 1979, very low birthweight defined infants weighing 1,500 grams (3lb. 4oz.) or less. From 1979 and beyond, very low birthweight defined as infants weighing less than 1,500 grams (3lb. 4oz.).

^c Includes persons of Hispanic origin until 1990. Beginning in 1990, persons of Hispanic origin are not included.

^dPersons of Hispanic origin may be of any race.

^e Data for 1997 and 1998 are for ages 35-54 years.

Sources: Ventura, et al., 2000, Births; Ventura, et al., 1999; Natality 1996, Tables 24, 25, and 45; Centers for Disease Control, National Center for Health Statistics, 2000, Health, Table 12; and unpublished tabulations, Division of Vital Statistics, National Center for Health Statistics.

²⁶ Ibid.

²⁷ Mathews, Curtin, & MacDorman, 2000.

HC 2.3 General Health Conditions: Percentage of Children in Very Good or Excellent Health

Most children in the United States are reported by their parents to be in very good or excellent health. The percentage of all children under age 18 reported to be in very good or excellent health has remained at about 80 percent since 1984.

Differences by Race. Parents’ reports of their children’s health vary by race. Between 1984 and 1996, black parents were less likely than white parents to report that their children were in very good or excellent health. In 1996, 75 percent of black children under age 5 were reported in very good or excellent health, compared with 82 percent of white children. Seventy percent of black children ages 5 to 17 were reported in very good or excellent health, compared with 81 percent of white children in this age group (see Table HC 2.3).

Differences by Family Income. Parents’ reports of their children’s health also vary by family income, with higher-income families more likely to report that their children are in very good or excellent health. For example, in 1997, 68 percent of children under age 18 who fell below the poverty line were reported to be in very good or excellent health, compared with 86 percent for children at or above the poverty line. Sixty-seven percent of children under age 5 in families with annual incomes under $10,000 were reported to be in very good or excellent health, compared with 87 percent of children in families with annual incomes of $35,000 or more in 1996. A similar pattern exists for children ages 5 to 17 (see Figure HC 2.3.A).

Table HC 2.3 Percentage of children under age 18 in the United States who are reported by their parents to be in very good or excellent health, by age, race, gender, poverty status, and family income:^a Selected years, 1984–1997

	1984	1990	1992	1993	1994	1995	1996	1997^b
Ages 0-17
Total	78	81	80	79	79	81	80	81
Poverty status
Below poverty	62	66	65	64	64	65	64	68
At or above poverty	82	84	83	83	83	85	84	86
Under age 5
Total	79	81	80	80	81	81	81	62
Race
White	81	83	82	82	83	83	82	86
Black	67	72	70	71	72	72	75	77
Gender
Male	78	80	79	80	81	80	80	83
Female	79	82	81	80	81	82	81	84
Annual family income^a
Under $10,000	—	—	—	—	—	—	67	73
$10,000-$19,999	—	—	—	—	—	—	74	78
$20,000-$34,999	—	—	—	—	—	—	82	82
$35,000 or more	—	—	—	—	—	—	87	91
Poverty status
Below poverty	66	69	67	68	68	66	68	74
At or above poverty	82	84	84	84	84	86	85	88
Ages 5-17
Total	77	80	80	79	79	80	79	82
Race
White	80	83	82	81	81	82	81	84
Black	65	68	68	70	68	70	70	70
Gender
Male	78	81	80	79	79	80	79	81
Female	77	80	79	78	78	80	79	81
Annual family income^a
Under $10,000	—	—	—	—	—	—	59	64
$10,000-$19,999	—	—	—	—	—	—	68	69
$20,000-$34,999	—	—	—	—	—	—	77	76
$35,000 or more	—	—	—	—	—	—	88	89
Poverty status
Below poverty	60	64	64	63	62	64	62	65
At or above poverty	81	84	83	82	82	85	83	85

^a Family income is not adjusted in the National Health Interview Survey for comparison over time; therefore, family income is shown only for the most recent year. Income breaks are those provided by the National Center for Health Statistics.

^b In 1997, the National Health Interview Survey was redesigned. Data for 1997 are not strictly comparable with earlier data.

Sources: Data from the National Health Interview Survey, National Center for Health Statistics (unpublished tabulations provided by the Centers for Disease Control and Prevention and other estimates as published in America's Children: Key National Indicators of Well-Being, 2000, Federal Interagency Forum on Child and Family Statistics, Table HEALTH1, available online at http://childstats.gov/ac1998/xhealth1.htm); Benson, & Marono, 1996, Table 70; National Center for Health Statistics. Also previous issues of this report [Series 10, 156, 166, 181, 189, 190, and 199 (Table 70 in each)].

Figure HC 2.3.A Percentage of children under age 18 in the United States who are reported by their parents to be in very good or excellent health, by age and family income: 1996

Source: Unpublished data from the National Health Interview Survey, provided by the National Center for Health Statistics.

Figure HC 2.3.B Percentage of children under age 18 in the United States who are reported by their parents to be in very good or excellent health, by poverty status: 1984-1996

^aIn 1997, the National Health Interview Survey was redesigned. Data for 1997 are not strictly comparable with earlier data.

Sources: Data from the National Health Interview Survey, National Center for Health Statistics (unpublished tabulations provided by the Centers for Disease Control and other estimates as published in America's Children: Key National Indicators of Well-Being, 1998, Federal Interagency Forum on Child and Family Statistics, Table HEALTH1, available online at http://childstats.gov/ac1998/xhealth1.htm); Benson, & Marono, 1996, Table 70; Also previous issues of this report [Series 10, Nos. 156, 166, 181, 189, 190, and 199 (Table 70 in each)].

HC 2.4 Chronic Health Conditions

Chronic health problems can cause children to miss school and often require medical assistance and follow-up. Chronic conditions can also create stress for children and their parents, cause parents to miss work, and increase a family’s medical expenses.

Over the period from 1984 to 1996, respiratory conditions were the most prevalent chronic health problems experienced by children under age 17 (see Table HC 2.4). The incidence of asthma and chronic sinusitis increased between 1984 and 1995 but decreased in 1996. Chronic sinusitis affected 47 children per thousand in 1984, 76 per thousand in 1995, and 64 per thousand in 1996. Meanwhile, asthma affected 43 children per thousand in 1984, compared with 75 per thousand in 1995 and 62 per thousand in 1996. Asthma attacks, which involve episodes of wheezing, breathlessness, and coughing, can range from mild to life-threatening, and children with asthma miss an average of twice as many school days as children without asthma.²⁸ The prevalence rate for asthma increased between 1980 and 1994 for all race groups, both sexes, and all age groups, with the most substantial increase among children under age 4 (a 160 percent increase) and ages 5 to 14 (a 74 percent increase).²⁹

Between 1984 and 1996, the number of children suffering from chronic diseases of the tonsils or adenoids (34 and 20 per thousand in 1984 and 1996, respectively), hearing impairments (24 and 13), and anemia (11 and 5) decreased (see Table HC 2.4).

Table HC 2.4 Selected chronic health conditions^a for children under age 18 (rate per 1,000 children) in the United States: Selected years, 1984-1996

	Rate per 1,000
	1984	1987	1990	1992	1993	1994	1995	1996
Respiratory conditions
Hay fever, allergic rhinitis without asthma	61	64	57	71	57	61	66	59
Chronic bronchitis	50	62	53	54	59	55	54	57
Chronic sinusitis	47	58	57	69	80	65	76	64
Asthma	43	53	58	63	72	69	75	62
Chronic diseases of tonsils or adenoids	34	30	23	28	26	23	19	20
Skin conditions
Dermatitis	39	32	31	41	36	38	35	31
Serious acne	26	26	26	25	28	29	26	24
Impairments
Deformity or orthopedic impairment	35	36	29	33	29	28	30	26
Speech impairment	16	19	14	21	20	21	18	16
Hearing impairment	24	16	21	15	17	18	15	13
Visual impairment	9	10	9	10	7	9	7	6
Other conditions
Heart disease	23	22	19	19	20	18	19	24
Migraine headache	11	8	14	13	13	16	13	15
Anemia	11	8	10	11	9	12	7	5
Epilepsy	7	4	4	3	5	5	4	5

^a Chronic health conditions as defined in the National Health Interview Survey are conditions that either (a) were first noticed 3 months or more before the reference date of the interview; or (b) belong to a group of conditions (including heart diseases, diabetes, and others) that are considered chronic regardless of when they began. The prevalence estimates are based on reports by parents or other adult respondents in response to checklists administered in household interviews.

Sources: Unpublished data from the National Health Interview Survey, National Center for Health Statistics; Benson, & Marono, 1996, tables 57 and 62; also previous issues of this report [Series 10, 156, 166, 181, 189, 190, and 193 (Tables 57 and 62 in each)].

Figure HC 2.4 Selected chronic health conditions^a for children under age 18 (rate per 1,000 children) in the United States: 1996

Source: Unpublished data from the National Health Interview Survey, National Center for Health Statistics.

²⁸ U.S. Department of Health and Human Services Press Office. May 21, 1998. HHS Targets Efforts on Asthma. Fact Sheet. Available online at http://www.hhs.gov/news/press/1998.html.

²⁹ Mannino, D.M., Homa, D.M., Pertowski, C.A., Ashizawa, A, Nixon, L.L., Johnson, C.A., et al., 1998. Surveillance for Asthma: United States, 1960-1995. Morbidity and Mortality Weekly Report 47 (SS-1): 1-28.

HC 2.5 Overweight Prevalence Among Children and Adolescents

Persons who are overweight in adolescence are at greater risk of being overweight as adults, and adults who are overweight are at higher risk of numerous health problems, including hypertension, coronary heart disease, gallbladder disease, noninsulin-dependent diabetes, and some cancers.³⁰ Because being overweight in childhood and adolescence increases the risk of being overweight in adulthood, the trends in overweight prevalence among children and youth have become an important public health concern. Overall, the percentage of children ages 6 through 17 who are overweight has increased more than twofold since the 1960s, with the largest increases seen since 1980 (see Table HC 2.5).³¹

Differences by Age. In the earliest period shown in Table HC 2.5 (1963-1965), 5 percent of children ages 6 through 11 were overweight, with this percentage rising to 13.6 percent in the last period (1988-1994). Similar increases are shown among older children ages 12 through 17, although overweight prevalence has been about two percentage points lower for older children in the later time periods.

Differences by Gender. In the latest time period (1988-1994), 14.7 percent of males ages 6 through 11 were overweight, compared with 12.6 percent of females; 12.4 percent of males ages 12 through 17 were overweight, compared with 10.5 percent of females.

Differences by Race. In later years, overweight prevalence among male children (ages 6 through 11) and adolescents (ages 12 through 17) ranges within one percentage point between black and white males. The percentage of overweight black female children and adolescents is nearly six percentage points above that of their white peers (see Figure HC 2.5).

Table HC 2.5 Percentage of overweight^a children and adolescents in the United States, by age, gender, and race:^b Selected years, 1963-1994

	1963-1965	1966-1970	1971-1974	1976-1980	1988-1994
Ages 6-11
Total	5.0	—	5.5	7.6	13.6
Male	4.9	—	6.5	8.1	14.7
White	5.4	—	6.6	8.1	14.6
Black	1.7	—	5.6	8.6	15.1
Female	5.2	—	4.4	7.1	12.6
White	5.1	—	4.4	6.5	11.7
Black	5.3	—	4.5	11.5	17.4
Ages 12-17
Total	—	5.0	6.2	5.6	11.4
Male	—	5.0	5.3	5.3	12.4
White	—	5.2	5.5	5.3	13.1
Black	—	3.6	4.4	6.0	12.1
Female	—	5.0	7.2	6.0	10.5
White	—	4.8	6.6	5.4	10.0
Black	—	6.4	10.5	10.2	16.1

^a Overweight is defined as body mass index (BMI) at or above the sex- and age-specific 95th percentile BMI cutoff points calculated at 6-month age intervals for children ages 6 through 11 [from the 1963-1965 National Health Examination Survey (NHES)] and for adolescents ages 12 through 17 (from the 1966-70 NHES). Age is at time of examination at mobile examination center. This definition differs from that reported in earlier versions of this report, which was based on children at or above the 85th percentile of BMI.

^bTotals for male and female children and adolescents include data for race groups not shown separately. Sources: Centers for Disease Control, National Center for Health Statistics, 1998, Health, United States, 1998, With Socioeconomic Status and Health Chartbook, Table 71; Estimates were calculated from the National Health Examination Survey (1963-1965 for ages 6 through 11, and 1966-1970 for ages 12 through 17) and from the National Health and Nutrition Examination Survey (NHANES; 1971-1974 for NHANES I, 1976-1980 for NHANES II, and 1988-1994 for NHANES III).

Figure HC 2.5 Percentage of overweight^a adolescents (ages 12 through 17) in the United States, by gender and race: 1976-1980 and 1988-1994

Figure HC 2.5 Percentage of overweighta adolescents (ages 12 through 17) in the United States, by gender and race: 1976-1980 and 1988-1994

^aOverweight is defined as body mass index (BMI) at or above the sex- and age-specific 95th percentile BMI cutoff points calculated at 6-month age intervals for children ages 6 through 11 [from the 1963-1965 National Health Examination Survey (NHES)] and for adolescents ages 12 through 17 (from the 1966-70 NHES). Age is at time of examination at mobile examination center. This definition differs from that reported in earlier versions of this report, which was based on children at or above the 85th percentile of BMI.

Source: Centers for Disease Control, National Center for Health Statistics, 1998, Health, United States, 1998.

³⁰ Troiano, R.P., Flegal, K.M., Kuczmarski, R.J., Campbell, S.M., & Johnson, C.L. 1995. Overweight Prevalence and Trends for Children and Adolescents: The National Health and Nutrition Examination Surveys, 1963-1991. Archives of Pediatrics and Adolescent Medicine 149 (October).

³¹Overweight is defined as body mass index (BMI) at or above the sex- and age-specific 95th percentile BMI cutoff points calculated at 6-month age intervals for children ages 6 through 11 [from the 1963-65 National Health Examination Survey (NHES)] and for adolescents ages 12 through 17 (from the 1966-70 NHES). Age is at time of examination at mobile examination center. This definition differs from that reported in earlier versions of this report, which was based on children at or above the 85th percentile of BMI.

HC 2.6 Abuse and Neglect

Abuse and neglect cause physical and/or emotional harm to children. They can produce short-term psychological consequences that range from poor peer relations to violent behavior, as well as untold long-term psychological and economic consequences when children reach adulthood.³² They can result in serious injury or, in extreme cases, death.

According to data from the most comprehensive annual data collection efforts undertaken to date, there were an estimated 903,395 child victims of maltreatment in 1998 (see Table HC 2.6). Of these cases, 23 percent were classified as physical abuse, 12 percent as sexual abuse, 54 percent as neglect, 2 percent as medical neglect, 6 percent as emotional maltreatment, and 26 percent as “other” or “unknown” types of maltreatment.³³

Between 1990 and 1994, the total estimated number of victims increased by 20 percent from 860,577 to 1,029,118 in 1994. However, between 1994 and 1998, the total estimated number of victims fell by 12 percent from 1,209,118 to 903,395.

The number of victims shown in Table HC 2.6 may substantially understate the actual number of victims of maltreatment. In order for a child to be included in these counts, a report must first be made to child welfare authorities, an investigation undertaken, and a determination made that maltreatment occurred.

\Another data source, the third National Incidence Study of Child Abuse and Neglect, yields a much higher estimate of the total number of cases of child maltreatment—possibly as high as 2.8 million children in 1993. This study includes (1) all cases determined to be substantiated or indicated by child protective services³⁴ and (2) cases known to community professionals but not necessarily reported to child protective services (in a representative sample of counties).

Differences by Race. Black children, who account for about 15 percent of the child population, constituted 25 percent of all child abuse and neglect victims in 1998. Whites accounted for 55 percent of all victims and Hispanics 12 percent of all victims (see Table HC 2.6).

Differences by Age. No age group accounts for an obviously disproportionate share of abuse and neglect victims. In 1998, infants age 1 and under accounted for 14 percent of all victims; children ages 2 to 5 accounted for 24 percent; children ages 6 to 9 accounted for 25 percent; children ages 10 to 13 accounted for 20 percent, and children ages 14 to 17 accounted for 15 percent (see Table HC 2.6).

Table HC 2.6 Victims of child maltreatment in the United States. Substantiated incidences by type of maltreatment, race/ethnicity, gender and age: 1990-1998

	1990	1991	1992	1993	1994	1995	1996	1997	1998
Number of victims, per 1,000 children^a	860,577	911,690	994,655	1,026,331	1,029,118	1,005,511	1,011,973	956,711	903,395
Type of sustantiated maltreatment^b
Neglect	49	46	50	49	52	52	52	55	54
Physical Abuse	27	26	23	24	24	24	24	24	23
Sexual Abuse	17	16	14	14	14	13	12	12	12
Psychological or Emotional	7	6	5	5	5	4	6	6	6
Abuse or Neglect^c	0	2	3	2	2	3	3	2	2
Other and Unknown	10	13	21	17	16	17	19	12	26
Gender
Male	44	45	45	41	41	40	39	40	47
Female	50	52	51	47	46	45	43	44	51
Unknown	7	3	4	11	14	15	17	16	2
Age of victim^d
1 year and younger	13	14	13	12	12	11	11	11	14
2 to 5 years old	24	25	25	23	23	23	22	21	24
6 to 9 years old	22	23	23	21	20	21	21	21	25
10 to 13 years old	19	20	19	18	17	17	16	17	20
14-17 years old	14	15	15	14	13	13	13	12	15
18 and over	1	1	1	1	1	1	1	0	1
Unknown	8	4	5	12	14	15	18	18	2
Race/ethnicity of victim^e
White	5	56	53	51	48	47	50	49	55
African American	25	27	27	25	25	24	22	22	25
American Indian/Alaska Native	1	1	1	1	1	1	2	2	2
Asian/Pacific Islander	1	1	1	1	1	1	1	1	1
Other races	1	2	2	1	1	2	3	3	2
Hispanic origin	10	10	10	9	9	9	9	9	12
Unknown race	9	5	6	13	15	16	14	25	14

^a For the 50 states and the District of Columbia. The number of reporting states on which these estimates are based varies from year to year.

^b More than one type of maltreatment may be substantiated per child. Therefore, the percentage total may add up to more than 100.

^c Medical neglect was not reported in 1990.

^dSome states have included persons ages 18 and older in their statistics on child abuse and neglect. Because these persons are considered victims of child maltreatment under the laws of their state, statistics in this table include these persons. Such individuals accounted for fewer than 1 percent of all victims.

Note: All data presented are from the National Child Abuse and Neglect Data System (NCANDS), which annually collects information from state child protective agencies. Because state agencies may modify or correct data submitted in a previous year, some findings differ from previously published data. Also, subgroup percentages may be based on data from fewer states than the number of states contributing to the total because all states do not provide demographic information. Source: U.S. Department of Health and Human Services, Children's Bureau, 2000.

³² Many studies have demonstrated a correlation between child abuse and neglect and serious adult problems, including violence, incarceration, and mental illness. However, these studies have not been able to separate the effects of child abuse and neglect from other factors that are correlated with it, including poverty, education, parenting skills, etc.

³³ These percentages add up to over 100 because individual cases may include more than one type of maltreatment.

³⁴According to the National Incidence Study, in 1993, only 28 percent of maltreatment cases identified by the study were investigated—a significant decrease from the 44 percent investigated in 1986. The cause of this drop is not clear.

HC 2.7 Suicidal Teens: Youth Who Have Thought Seriously About or Attempted Suicide

Suicide is a major cause of death among youth (see Section HC 1.5). Attempted suicide has been related to mental health problems including depression and adjustment or stress reactions, as well as to substance abuse.³⁵

In 1999, 19 percent of youth in grades 9 through 12 report having seriously considered suicide during the previous 12 months (see Table HC 2.7.A). During the same time period, 8 percent report having actually attempted suicide during the previous year (see Table HC 2.8.B). These rates are considerably higher than the proportion of youth who actually commit suicide (see Section HC 1.5).

Differences by Race and Hispanic Origin.³⁶ In 1999, black youth report the lowest rates of considering suicide at 15 percent. Eighteen percent of whites report having seriously considered suicide in the previous year. Hispanic youth report the highest rates of considering suicide, at 20 percent. (See Table HC 2.7.A.) Rates of reported attempted suicide range from 7 percent for whites and blacks to 13 percent for Hispanics (see Table HC 2.7.B).

Differences by Gender. In 1999, female youth were more likely than male youth to report having thought seriously about suicide (25 percent versus 14 percent) and having attempted suicide (11 percent versus 6 percent) during the previous year (see Figure HC 2.7). However, the rate of actual suicides, particularly among teens ages 15 to 19, is considerably higher for males than for females, as discussed in Section HC 1.5.

Table HC 2.7.A Percentage of teens in the United States in grades 9 through 12 who report having seriously considered suicide in the previous 12 months, by gender, grade, and race and Hispanic origin:^a Selected years, 1990-1999

	1990	1991	1993	1995	1997	1999
Total	27	29	24	24	21	19
Male	21	21	19	18	15	14
Female	34	37	30	30	27	25
Grade
Ninth	30	29	24	26	22	18
Tenth	26	29	25	25	22	22
Eleventh	29	32	25	26	21	18
Twelfth	23	26	23	20	18	18
Race and Hispanic origin^a
White	28	30	24	25	20	18
Black	20	22	20	20	16	15
Hispanic	30	27	26	25	23	20

^aEstimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.

Sources: Centers for Disease Control and Prevention, 1990-1991 Youth Risk Behavior Surveillance System, Table 1, p. 9; table 1, p. 66; Kann, et al., 1995: Table 10, p. 32; Kann, et al., 1996: Table 10, p. 41; Kann, et al., 1998, Table 10, p. 47.

Table HC 2.7.B Percentage of teens in the United States in grades 9 through 12 who report having attempted suicide in the previous 12 months, by gender, grade, and race and Hispanic origin:^a Selected years, 1990-1999

	1990	1991	1993	1995	1997	1999
Total	8	7	9	9	8	8
Male	6	4	5	6	5	6
Female	10	11	13	12	12	11
Grade
Ninth	9	9	10	11	11	10
Tenth	9	8	9	10	9	11
Eleventh	8	6	8	9	8	6
Twelfth	7	6	7	6	5	6
Race and Hispanic origin^a
White	8	7	8	8	6	7
Black	7	7	8	10	7	7
Hispanic	12	8	14	13	11	13

^aEstimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.

Sources: Centers for Disease Control and Prevention, 1990-1991 Youth Risk Behavior Surveillance System, Table 1, p. 9; Table 1, p. 66; Kann, 1995, Table 10, p. 32; Kann, 1996, Table 10, p. 41; Kann, L., 1998, Table 10, p. 47.

Figure HC 2.7 Percentage of teens in the United States in grades 9 through 12 who report having seriously considered suicide or attempted suicide in the previous 12 months, by gender: 1999

Sources: Centers for Disease Control and Prevention. Kann, 1998: Table 10, p. 47.

³⁵ Alcohol, Drug Abuse, and Mental Health Administration. 1989. Report of the Secretary’s Task Force on Youth Suicide. Publication No. (ADM)899-1621. Washington, D.C.: U.S. Department of Health and Human Services, 1989. Cited in Healthy People 2000: National Health Promotion and Disease Prevention Objectives, Conference Edition. U.S. Department of Health and Human Services.

³⁶ Estimates for white and black youth exclude Hispanics of those races.

HC 2.8 Activity Limitations

Activity limitations refer to long-term reductions in activities resulting from a chronic disease or impairment.³⁷ Two types of activity limitations are examined here: limitations in major activities and limitations in any activity. A person is classified as having an activity limitation if he or she reports (1) an inability to perform the major activity for a person in his or her age group, (2) being able to perform the major activity but being limited in the kind or amount of this activity, or (3) not being limited in the major activity but being limited in the kind or amount of other activities. For children under age 5, the major activity consists of ordinary play. For children ages 5 to 17, the major activity is attending school. Children are classified as being limited in a major activity if they are unable to engage in the major activity or are limited in the kind or amount of this activity (classifications (1) and (2) above).

In 1996, 6.1 percent of all children under age 18 had a chronic condition that limited their activity (see Table HC 2.8.A), while 4.4 percent were limited in a major activity due to a chronic condition (see Table HC 2.8.B).

Differences by Age. Children ages 5 through 17 are more likely to experience an activity limitation due to a chronic condition than are younger children. In 1997, 3.4 percent of children under age 5 had an activity limitation due to a chronic condition, compared with 6.4 percent of older children. These differences by age can be seen across family income, gender, race, and Hispanic origin categories (see Table HC 2.8.A).

Differences by Gender. Males have consistently accounted for a greater percentage of children under 18 with an activity limitation due to a chronic condition. In 1997, 8.3 percent of males, compared with 4.7 percent of females, had activity limitations that were caused by a chronic condition (see Table HC 2.8.A). Looking only at limitations in major activities in 1996, 5.5 percent of males under age 18 had such limitations, compared with 3.2 percent of females (see Figure HC 2.8.B).

Differences by Race and Hispanic Origin.³⁸ In 1996, 8.4 percent of black children under age 18 had any activity limitation, compared with 5.7 percent of white children and 6.3 percent of Hispanic children (see Table HC 2.9.A). Black children also suffered from restrictions in their major activities more frequently than white children (see Figure HC 2.8.B).

Differences by Income. Children under age 18 who were below the poverty line were much more likely to have an activity limitation than nonpoor children in 1997: 8.8 versus 6.4 percent (see Figure HC 2.8 A). Even for children under age 5, who in general have fewer limitations than older children, the disparity between the poor and nonpoor incidence of activity limitation is striking: 3.2 percent of nonpoor children and 4.5 percent of poor children were limited in some activity.

Table HC 2.8.A Percentage of children under age 18 in the United States with any activity limitation^a due to a chronic condition,^b by family income, age, gender, poverty status, and race and Hispanic origin:^c Selected years 1984-1997

	1984	1990	1991	1992	1993	1994	1995	1996	1997
Under 18 total	5.0	4.9	5.8	6.1	6.6	6.7	6.0	6.1	6.5
Gender
Male	5.9	5.6	6.8	7.1	7.8	7.9	7.4	7.4	8.3
Female	4.0	4.2	4.7	5.0	5.3	5.6	4.6	4.7	4.7
Race and Hispanic origin^c
White, non-Hispanic	4.9	5.0	5.8	6.0	6.7	6.6	6.0	5.7	7.0
Black, non-Hispanic	5.6	5.5	6.7	7.5	7.7	8.9	7.3	8.4	7.3
Hispanic	4.7	4.1	5.5	5.3	5.6	5.7	5.8	6.3	4.8
Poverty status
Below poverty	7.1	6.7	8.8	9.2	9.5	9.7	9.2	9.7	8.8
At or above poverty	4.4	4.6	5.1	5.3	5.9	6.0	5.4	5.3	6.4
Under 5 total	2.5	2.2	2.4	2.8	2.8	3.1	2.7	2.6	3.4
Gender
Male	2.7	2.6	2.7	3.3	3.1	3.4	3.3	3.3	4.2
Female	2.3	1.7	2.1	2.2	2.5	2.7	2.0	1.7	2.7
Race and Hispanic origin^c
White, non-Hispanic	2.3	2.1	2.4	2.5	2.4	2.7	2.7	1.8	3.6
Black, non-Hispanic	3.3	2.9	3.2	4.2	4.7	5.0	3.5	4.8	4.5
Hispanic	2.5	2.0	1.8	2.5	2.7	3.1	2.5	3.5	2.4
Poverty status
Below poverty	4.0	3.0	4.3	4.5	4.3	5.2	3.9	4.9	4.5
At or above poverty	2.0	2.0	2.0	2.3	2.4	2.5	2.4	1.7	3.2
Ages 5-17 total	6.1	6.1	7.2	7.5	8.1	8.2	7.4	7.5	6.4
Gender
Male	7.3	6.9	8.5	8.7	9.8	9.7	9.0	9.0	9.9
Female	4.8	5.2	5.9	6.2	6.4	6.7	5.6	5.9	5.5
Race and Hispanic origin^c
White, non-Hispanic	6.0	6.2	7.1	7.4	8.4	8.1	7.2	7.1	8.2
Black, non-Hispanic	6.7	6.7	8.2	9.0	9.0	10.6	8.9	9.8	8.3
Hispanic	5.8	5.1	7.2	6.7	7.1	7.0	7.5	7.7	5.9
Poverty status
Below poverty	8.7	8.5	11.0	11.7	12.2	11.9	11.8	12.1	10.7
At or above poverty	5.5	5.6	6.4	6.6	7.2	7.4	6.5	6.6	7.5

^a Persons are classified in terms of the major activity usually associated with their particular age group. The major activities for children are ordinary play for children under 5 years of age and attending school for those 5-17 years of age. A person is classified as having an activity limitation if he or she is unable to perform the major activity, is able to perform the major activity but is limited in the kind or amount of this activity, or is not limited in the major activity but is limited in the kind or amount of other activities.

^b A condition is considered chronic if the respondent indicates it was first noticed more than 3 months before the reference date of the interview, or it is a type of condition that ordinarily has a duration of more than 3 months.

^cEstimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.

Sources: Data from the National Health Interview Survey, National Center for Health Statistics (provided by the Centers for Disease Control and Prevention and as published in America's Children: Key National Indicators of Well-Being, 1998, Federal Interagency Forum on Child and Family Statistics, Table HEALTH2, available online at http://childstats.gov/ac1998/xhealth2.htm); Benson, & Marono, 1995. Previous issues of this report [Series 10, 181, 184, 189, and 193)].

Table HC 2.8.B Percentage of children under age 18 in the United States with any activity limitation in a major activity^a due to a chronic condition,^b by gender and race: Selected years, 1983-1996

	1983	1985	1990	1991	1992	1993	1994	1995	1996
Total	3.5	3.7	3.6	4.2	4.4	4.6	4.9	4.3	4.4
Gender
Male	4.2	4.4	4.2	5.0	5.2	5.6	6.0	5.5	5.5
Female	2.8	2.9	3.0	3.3	3.7	3.5	3.8	3.1	3.2
Race
White	3.4	3.5	3.5	4.1	4.3	4.5	4.7	4.2	4.1
Black	4.5	4.6	4.2	5.2	6.0	5.7	6.7	5.5	6.2

^a Persons are classified in terms of the major activity usually associated with their particular age group. The major activities for children are ordinary play for children under 5 years of age and attending school for those 5-17 years of age. A person is classified as having an activity limitation in a major activity if he or she is unable to perform the major activity or is able to perform the major activity but is limited in the kind or amount of this activity.

Sources: Unpublished data from the National Health Interview Survey, National Center for Health Statistics; Benson, & Marono, 1996, Table 67; Previous issues of this report. [Series 10, 154, 163, 181, 184, 189, 190, and 193 (Table 67 in each)].

Figure HC 2.8.A Percentage of children under age 18 in the United States with any activity limitation^a due to a chronic condition,^b by poverty status: 1984-1997

a Persons are classified in terms of the major activity usually associated with their particular age group. The major activities for children are ordinary play for children under 5 years of age and attending school for those 5-17 years of age. A person is classified as having an activity limitation if he or she is unable to perform the major activity, is able to perform the major activity but is limited in the kind or amount of this activity, or is not limited in the major activity but is limited in the kind or amount of other activities.

b A condition is considered chronic if the respondent indicates it was first noticed more than 3 months before the reference date of the interview, or it is a type of condition that ordinarily has a duration of more than 3 months.

Figure HC 2.8.B Percentage of children under age 18 in the United States with an activity limitation in a major activity^a due to a chronic condition,^b by gender and by race: 1996

^a Persons are classified in terms of the major activity usually associated with their particular age group. The major activities for children are ordinary play for children under 5 years of age and attending school for those 5-17 years of age. A person is classified as having an activity limitation in a major activity if he or she is unable to perform the major activity or is able to perform the major activity but is limited in the kind or amount of this activity.

Source: Unpublished data from the National Health Interview Survey, National Center for Health Statistics.

³⁷A disease or impairment is classified as chronic if it has been apparent for at least 3 months or is a new condition that will ordinarily last for more than 3 months.

³⁸ Estimates for white and black children exclude Hispanics of those races.

HC 2.9 Serious Violent Victimization of Teens

Serious violent crimes include aggravated assaults,³⁹ rape, and robbery (stealing by force or threat of violence). In order to keep track of the incidence of these and other crimes, the Bureau of Justice Statistics has been administering the National Crime Victimization Survey on an annual basis since 1972.

Among youth ages 12 to 17, rates of victimization for violent crimes remained relatively constant from 1980 to 1994, ranging from 34.3 to 43.8 per thousand.⁴⁰ Between 1994 and 1998, the rate dropped from 41.3 to 24.6 per 1,000 (see Table HC 2.9).

Differences by Gender. Male youth are considerably more likely than female youth to be victims of violent crimes. In 1998, 32.2 per 1,000 males ages 12 through 17 were victims of violent crimes, compared with 16.5 per 1,000 females (see Figure HC 2.9).

Differences by Race. The rate of violent victimization of white teens ranged from 25.5 to 40.1 per 1,000 between 1980 and 1998, in comparison to 30.4 to 77.0 per 1,000 for black youth. Black youth have consistently been more likely than white youth to be victims of violent crimes. In 1998, 31.0 black youths per 1,000 were victims of violent crime, compared with 24.2 per 1,000 among white youth ages 12 through 17 (see Table HC 2.9).

Table HC 2.9 Serious violent victimization^a of youth ages 12 through 17 in the United States (rates per 1,000), by age, race, and gender: Selected years, 1980-1998

	1980	1985	1990	1991	1992	1993	1994	1995	1996	1997	1998
Age
12-17 years	37.6	34.3	43.2	40.7	38.8	43.8	41.3	28.3	30.3	27.1	24.6
12-14 years	33.4	28.1	41.2	37.8	37.6	38.0	34.5	26.7	24.9	23.5	20.4
15-17 years	41.4	40.3	45.2	43.6	40.1	49.9	48.5	30.0	35.8	30.7	28.6
Race
White	34.1	34.4	37.0	40.1	35.2	40.0	38.0	25.5	27.7	27.6	24.2
Black	60.2	35.2	77.0	48.0	54.3	71.5	63.0	44.5	43.4	30.4	31.0
Other	21.7	28.8	37.3	25.0	48.7	17.6	27.5	23.7	31.2	9.7	11.7
Gender
Male	54.8	49.8	60.5	60.7	49.8	53.9	51.5	39.0	40.4	33.1	32.2
Female	19.7	18.2	24.9	19.6	27.2	33.1	30.6	17.0	19.7	20.8	16.5

^a Serious violent victimization is defined as being a victim of a violent crime, including aggravated assaults, rape, and robbery (stealing by force or threat of violence).

Notes: Because of changes made in the victimization survey, data prior to 1992 are adjusted to make them comparable with data collected under the redesigned methodology. Victimization rates were calculated using population estimates from the U.S. Bureau of the Census, Current Population Reports. Such population estimates normally differ somewhat from population estimates derived from survey data. The rates may therefore differ marginally from rates based upon survey-derived population estimates.

Source: U.S. Bureau of Justice Statistics, National Crime Victimization Survey, 1980-1997, Table BEH4.A.

Figure HC 2.9 Serious violent victimization^a of youth ages 12 through 17 in the United States (rates per 1,000), by gender: 1980-1998

^a Serious violent victimization is defined as being a victim of a violent crime, including aggravated assaults, rape, and robbery (stealing by force or threat of violence).

Source: Source: U.S. Bureau of Justice Statistics, National Crime Victimization Survey, 1980-1997, and unpublished tables.

³⁹ Previous editions of this report have included simple assaults in the rates of violent victimization.

⁴⁰ The estimate of 34.1, for 1984, is not shown in Table HC 2.10 but does appear in Figure HC 2.10.

HC 2.10 Dental Caries

“Dental caries” refers to decay in one or more teeth. Proper preventive care reduces the incidence of dental caries. The presence of dental caries may indicate a lack of access to preventive care or a lack of information about preventive techniques.⁴¹ Additionally, children who do not receive restorative treatment for existing dental caries may experience much pain and suffering and may frequently miss school, and the functioning of their teeth may be permanently harmed.⁴²

Differences by Race/Ethnicity.⁴³ Mexican American children ages 2 through 5 had the highest prevalence of dental caries in their primary teeth (see Figure HC 2.10). From 1988 to 1994, one-third of Mexican American children had dental caries, compared with 24.2 percent of non-Hispanic black children and 13.6 percent of non-Hispanic white children. Mexican American and non-Hispanic black children ages 6 through 14 were about twice as likely as non-Hispanic white children to have dental caries in their permanent teeth (see Figure HC 2.10).

Differences by Poverty Status. The prevalence of dental caries is disproportionately concentrated among children from low-income families. Among children ages 2 to 5, 29.7 percent of poor children had caries in their primary teeth, compared to 14.4 percent of nonpoor children. Among older children, 19.5 percent of poor children had caries in their permanent teeth, while 8.6 of non-poor children did (see Table HC 2.10). Additionally, poor children, who are less likely than other children to receive dental services, are at a higher risk of suffering from untreated dental caries.^44,45

Figure HC 2.10 Percentage of children ages 2 through 14 in the United States with untreated dental caries, by age and race/ethnicity:^a 1988-1994

Figure HC 2.10 Percentage of children ages 2 through 14 in the United States with untreated dental caries, by age and race/ethnicity:a 1988-1994

^a Estimates for whites and blacks exclude Hispanics of those races.

Sources: Unpublished estimates from the Third National Health and Nutrition Survey (conducted between 1988 and 1994) calculated by the Division of Epidemiology, Office of Analysis, Epidemiology and Health Promotion, National Center for Health Statistics, Centers for Disease Control. Vargas, Crall, and Schneider, 1998, 1229-1238 (Tables 2 and 5).

Table HC 2.10 Percentage of children ages 2 through 14 in the United States with untreated dental caries, by age, race/ethnicity, and poverty status:^a 1988-1994

	Total	Above poverty level	At or below poverty level
Ages 2-5 (caries in primary teeth)
All children	18.7	14.4	29.7
White, non-Hispanic	13.6	11.3	25.6
Black, non-Hispanic	24.2	21.8	26.4
Mexican American	33.9	30.2	37.7
Ages 6-14 (caries inpermanent teeth)
All children	11.3	8.6	19.5
White, non-Hispanic	8.5	7.2	15.8
Black, non-Hispanic	18.0	16.7	19.8
Mexican American	16.9	12.0	22.2

^a Estimates for whites and blacks exclude Hispanics of those races.

⁴¹ Kaste, L.M., Selwitz, R.H., Oldakowski, R.J., Brunelle, J.A., Winn, D.M., & Brown, L.J. 1996. Coronal Caries in the Primary and Permanent Dentition of Children and Adolescents 1-17 Years of Age: United States 1988-1991. Journal of Dental Research 75 (Spec Iss): 631-641.

⁴² Lewit, E.M., & Kerrebrock, N. 1998. Child Indicators: Dental Health. The Future of Children 8 (1): 133-142.

⁴³ Estimates for whites and blacks exclude Hispanics of those races.

⁴⁴ Vargas, C.M., Crall, J.J., & Schneider, D.A. 1998. Sociodemographic Distribution of Pediatric Dental Caries: NHANES III, 1988-1994. Journal of the American Dental Association 129: 1229-1238 (Tables 2 and 5).

⁴⁵ Lewit, 1998.

HC 2.11 Children and Adolescents with HIV/AIDS

Pediatric AIDS. Through December 1999, 8,718 case of AIDS among children younger than 13 years of age have been reported in the United States. Of those, 5,084 have died. Pediatric AIDS cases represent 1.2 percent of all the cumulative cases (733,374) reported to the Centers for Disease Control and Prevention (CDC). The vast majority of children with AIDS (91 percent) resulted from transmission of HIV before or during birth, or what is known as perinatal transmission.

The steep decline in perinatally acquired AIDS (Figure HC 2.11A) has been one of the dramatic changes of the 1990s. The number of perinatally acquired AIDS cases peaked in 1992 and has decreased 75 percent in recent years. Studies and surveillance data suggest that the implementation of Public Health Service guidelines for universal counseling and voluntary HIV testing of pregnant women and the use of zidovudine by pregnant women and administered to newborn infants account primarily for the decline. The rate of perinatal transmission is expected to continue to decline as a result of more aggressive courses of treatment (e.g., combination therapy) and more use of obstetric procedures, such as elective cesarean section, that reduce transmission.

Differences by Race and Hispanic Origin. Decreases in perinatally acquired AIDS have occurred in all racial and ethnic groups. However, in 1999, the highest rates of AIDS continue to be reported among children who are black, non- Hispanic, and Hispanics (Figure HC2.11B). The rate of AIDS among black children in 1999, 2.3 per 100,000 children, was 23 times higher than among white children (0.1 per 100,000) and nearly four times higher than among Hispanic children (0.6 per 100,000). Because the majority of pediatric cases of AIDS are attributed to perinatal HIV transmission, these rates also reflect the disproportionate racial/ethnic distribution of HIV and AIDS among black and Hispanic women.

Adolescent HIV/AIDS. As of the end of 1999, 3,725 adolescents (ages 13-19) have been reported with AIDS. Adolescent AIDS cases represent less than 1 percent of all cumulative cases (733,374) reported to the CDC. The number of adolescents reported with AIDS peaked in 1993 when the surveillance case definition was changed (Figure HC2.11C). In the earlier years, the vast majority of reported cases in adolescents were among males; however, the ratio of male to female cases has decreased over time. In 1999, 312 persons, 13-19 years old, were reported with AIDS; more females (180) than males (132) were reported with AIDS in this age group, in part, because the proportion of male cases who acquired HIV through receipt of blood products has diminished.

Data from HIV infection case surveillance present a more current view of the HIV/AIDS epidemic than AIDS case surveillance data alone. Currently, 31 states and the Virgin Islands conducted name-based confidential HIV infection surveillance of adults and adolescents. In 1999, these 32 areas reported 3,209 cases of HIV infection in adolescents and young adults ages 13-24, compared to 1,813 reported with AIDS. The HIV data are underestimates of the population of infected adolescents, as some states do not report HIVinfected persons to the CDC, and only persons who have been tested are reported. However, the number of adolescents reported with HIV is greater than those reported with AIDS because of the long period of time between infection and development of disease. Young adults with AIDS probably became infected as adolescents but did not develop AIDS or get reported as having AIDS until they were adults. This indicates the importance of targeting HIV prevention messages to youth even though the total numbers of AIDS cases reported in this age group is relatively small.

Black and Hispanic adolescents have been disproportionately affected by the HIV/AIDS epidemic. Although only 15 percent of the adolescent population in the United States is black, 60 percent of AIDS cases reported in 1999 among 13- to 19-year-olds were black. Hispanics compromise 14 percent of the population, 20 percent of all reported AIDS cases and 24 percent of reported adolescent AIDS cases in 1999.⁴⁶ These patterns are likely to continue since HIV infection also disproportionately affects young black and Hispanic persons.

Figure HC 2.11.A Reported perinatally acquired AIDS cases among children under age 13 in the United States: 1985–1998

Figure HC 2.11.A Reported perinatally acquired AIDS cases among children under age 13 in the United States: 1985–1998

Note: Data are adjusted for reporting delays and unreported risk.

Source: Pediatric AIDS Surveillance, L262 slide series (through 1997). Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention. The slide series is available online at: http://www.cdc.gov/nchstp/hiv_aids/graphics/pediatri.htm.

Figure HC 2.11.B Reported AIDS rate (per 100,000) among children under age 13 in the United States, by race and Hispanic origin:^a1999

a Persons of Hispanic origin may be of any race

Figure HC 2.11.C AIDS cases in adolescents ages 13 through 19, by gender in the United States: 1985–1999

Figure HC 2.11.C AIDS cases in adolescents ages 13 through 19, by gender in the United States: 1985–1999

Source: Adolescent AIDS Surveillance, L265 slide series (through 1998). Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention. The slide series is available online at: http://www.cdc.gov/hiv

⁴⁶ Pediatric AIDS Surveillance, L262 slide series (through 1997). Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention. The slide series is available online at: http://www.cdc.gov/nchstp/hiv_aids/graphics/pediatri.htm.b

HC 2.12 Sexually Transmitted Diseases Among Adolescents

Sexually Transmitted Diseases (STDs) have potentially severe consequences. Gonorrhea infections are a major cause of pelvic inflammatory disease, which in turn may lead to adverse reproductive consequences such as infertility, ectopic pregnancy, or the birth of children with physical and mental developmental disabilities. Syphilis facilitates the transmission of HIV and may be particularly important to contributing to HIV transmission in areas with high rates of both infections.⁴⁷ The increase in sexual activity among teenagers described in Section SD 4.1 has exposed a growing number of young people to the risk of STDs. Despite this increased risk, the reported rate of incidence has declined among adolescents for both gonorrhea and syphilis.

Decline in Gonorrhea Rates. Gonorrhea rates have declined for all youth since 1975 (see Table HC 2.12.A). Among youth ages 15 through 19, rates decreased by more than half, from 1,275.1 cases of gonorrhea per 100,000 youth in 1975 to 560.6 cases per 100,000 youth in 1998. Gonorrhea rates also decreased among youth ages 10 through 14, but the decline started in more recent years and has not been as dramatic as among older youth. The rate for this age group was 46.7 per 100,000 in 1975, peaked at 68.9 cases in 1990, and, by 1998, had declined to 32.6 cases per 100,000.

Differences in Gonorrhea Rates by Gender. For youth ages 15 through 19 and ages 10 through 14, females have had consistently higher reported rates of gonorrhea than males (see Figure HC 2.12.A). In 1998, rates for females ages 15 through 19 were 779.7 per 100,000, versus 354.9 per 100,000 males of the same age.

Differences in Gonorrhea Rates by Race and Hispanic Origin.⁴⁸ Blacks have consistently had the highest reported rates of gonorrhea, frequently more than 10 times the rate of any other racial or ethnic group. Rates for blacks have been falling since 1990 for both age groups (for ages 15 through 19, the rate dropped from 6,316.2 in 1990 to 2,950.8 per 100,000 in 1998). By contrast, in 1998 gonorrhea rates per 100,000 for 15- through 19-yearolds of other groups were 404.4 for American Indians/Alaska Natives, 233.2 for Hispanics, 127.3 for whites, and 71.4 for Asians (see Table HC 2.12.A).

Decline in Syphilis Rates. Table HC 2.12.B shows that reported rates for primary and secondary syphilis have decreased for youth ages 10 through 14 and 15 through 19 since their peak in 1990. The rate for teens ages 15 through 19 is substantially higher than the rate for youth ages 10 through 14. The reported rate for syphilis in 1998 for ages 15 through 19 was 3.2 cases per 100,000, compared with less than one case per 100,000 for ages 10 through 14.

Higher Syphilis Rates Among Females. Females from both age groups have reported more cases of syphilis than their male counterparts (see Figure HC 2.12.B). In 1998, females ages 15 through 19 had a rate of 4.5 cases per 100,000, more than double the male rate of 1.9 cases per 100,000.

Differences in Syphilis Rates by Race and Hispanic Origin.⁴⁹ Black youth ages 15 through 19 have rates of syphilis more than 10 times higher than all other racial and ethnic groups throughout the period 1990 through 1998. Rates have been falling for all groups except American Indians/Alaska Natives, whose reported syphilis rates have fluctuated since 1990 (see Table HC 2.12.B).

Figure HC 2.12.A Reported rates of gonorrhea^a for youth ages 15 through 19 in the United States, by gender (per 100,000 population ages 15 through 19): Selected years, 1975-1998

^a Although most areas generally adhere to the case definitions for STDs found in Case Definitions for Public Health Surveillance (Morbidity and Mortality Weekly Report 1990; 39: 1-43), there are significant differences between individual areas in case definitions as well as in the policies and systems for collecting surveillance data. In many areas, reporting from publicly supported institutions (e.g., STD clinics) was more complete than from other sources (e.g., private practitioners).

Sources: Data for 1975 from Centers for Disease Control and Prevention, Division of STD Prevention, 1996, Table 7; data for 1980 and 1985 from Centers for Disease Control and Prevention, Division of STD Prevention, 1987, Table 3; data for 1990-1992 from Division of STD/HIV Prevention, December 1994, Table 9.B; data for 1993 from Division of STD Prevention, 1997, Table 12.B; data for 1994-1997 from Division of STD Prevention, 1999, Table 12B.

Table HC 2.12.A Reported rates of youth gonorrhea^a in the United States, by age, gender, and race and Hispanic origin (per 100,000 population): Selected years, 1975–1998

	1975	1980	1985	1990	1995	1996	1997	1998
Ages 10-14
Total	46.7	48.7	47.7	68.9	41.3	33.2	30.7	32.6
Gender
Male	20.9	23.6	23.8	32.1	12.4	9.1	8.5	8.5
Female	73.6	74.8	72.9	107.5	71.7	58.6	54.1	58.0
Race and Hispanic originb,c
White	—	—	—	14.3	8.9	7.5	7.2	6.8
Black	—	—	—	386.8	237.0	179.8	162.2	175.9
Hispanic	—	—	—	15.3	19.3	15.8	15.0	14.0
Asian/Pacific	—	—	—	4.5	5.6	3.3	3.5	3.5
Islander American Indian/Alaska Native	—	—	—	22.7	19.0	21.7	23.7	25.1
Ages 15-19
Total	1,275.1	1,187.3	1,189.9	1,114.4	671.0	543.6	521.6	560.6
Gender
Male	1,103.9	953.4	930.5	993.7	503.2	373.6	348.1	354.6
Female	1,446.4	1,424.6	1,455.1	1,241.6	847.8	724.5	706.2	779.7
Race and Hispanic origin^b,c
White	—	—	—	230.3	145.1	125.8	117.4	127.3
Black	—	—	—	6,316.2	3,815.3	2,904.8	2,780.0	2,950.8
Hispanic	—	—	—	268.7	270.3	222.7	223.5	233.2
Asian/Pacific Islander	—	—	—	70.0	81.0	64.1	68.6	71.4
American
Indian/Alaska Native	—	—	—	414.6	296.2	329.0	342.9	404.4

^a Although most areas generally adhere to the case definitions for STDs found in "Case Definitions for Public Health Surveillance" (Morbidity and Mortality Weekly Report 1990; 39: 1-43), there are significant differences between individual areas in case definitions.

^b For the following years, the states/areas listed did not report race/ethnicity for most cases: 1990 (Baltimore, New Jersey, New York City, New York State, and Kentucky); 1991 (Baltimore, New York City, New York State, and Kentucky); 1992 (New York City and New York State); 1993 (New York City, New York State, and Georgia); 1994 (New York City, New York State, and Georgia); 1995 (Georgia, New Jersey, New York City, and New York State); and 1996 (New Jersey, New York City, and New York State); 1997 (Idaho, New Jersey, New York City, and New York State), and 1998 (Idaho and New Jersey). Massachusetts did not report age for most cases in 1990. Cases and population denominators have been excluded for these states/areas for the appropriate years.

^c Estimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.

Sources: Data for 1975 from Centers for Disease Control and Prevention, 1996, Table 7; data for 1980 and 1985 from Centers for Disease Control and Prevention, 1987; Table 3; data for 1990-1992 from Division of STD/HIV Prevention, 1994; Table 9.B; data for 1993 from Division of STD Prevention, 1997; Table 12.B; data for 1994-1998 from Division of STD Prevention, 1999. Table 12B.

Table HC 2.12.B Reported rates of youth primary and secondary syphillis^a in the United States, by age, gender, and race and Hispanic origin (per 100,000 population): Selected years, 1975-1998

	1975	1980	1985	1990	1991^b	1992	1993^b	1994	1995	1996^b	1997^b	1998
Ages 10-14
Total	1.1	0.9	0.9	1.8	1.4	1.3	0.9	0.6	0.6	0.3	0.2	0.2
Gender
Male	0.7	0.5	0.5	0.5	0.4	0.3	0.3	0.1	0.1	0.1	0.0	0.1
Female	1.5	1.3	1.4	3.2	2.5	2.3	1.6	1.2	1.0	0.5	0.4	0.4
Race and Hispanic origin^c
White	—	—	—	0.1	0.1	0.1	0.1	0.1	0.0	0.0	0.0	0.0
Black	—	—	—	10.6	8.6	8.1	5.9	3.8	3.5	1.6	1.3	1.2
Hispanic	—	—	—	1.1	0.4	0.4	0.1	0.1	0.1	0.1	0.1	0.0
Asian/Pacific Islander	—	—	—	0.2	0.3	0.0	0.2	0.0	0.0	0.0	0.0	0.0
American Indian/Alaska Native	—	—	—	0.5	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0
Ages 15-19
Total	17.8	17.2	17.0	29.8	27.8	22.5	17.0	12.7	10.1	6.1	4.1	3.2
Gender
Male	18.0	19.2	16.3	20.9	19.1	15.5	10.8	8.3	6.6	4.1	2.6	1.9
Female	17.5	15.1	17.7	39.2	37.0	29.9	23.5	17.3	13.8	8.2	5.8	4.5
Race and Hispanic origin^c
White	—	—	—	2.9	2.6	2.0	1.6	1.4	1.1	0.9	0.5	0.4
Black	—	—	—	174.6	164.8	136.7	103.5	76.5	60.9	35.1	23.0	17.8
Hispanic	—	—	—	15.2	12.5	8.5	5.6	2.8	2.4	1.7	2.1	1.5
Asian/Pacific Islander	—	—	—	1.7	1.9	1.4	1.0	0.8	0.5	0.8	0.4	0.4
American Indian/Alaska Native	—	—	—	2.8	7.0	2.7	0.6	2.4	4.2	1.1	0.5	3.8

^b For the indicated states/areas, cases and population denominators have been excluded for the years indicated: 1991 (Kentucky, as race/ethnicity was not reported for most cases); 1993 (Baltimore, because age was not reported for most cases); and 1996 (Rhode Island, because race/ethnicity was not reported for most cases).

^c Estimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.

Sources: Data for 1975 from Centers for Disease Control and Prevention,1986, Table 8; data for 1980 and 1985 from Centers for Disease Control and Prevention, Division of STD Prevention, 1987, Table 2; data for 1990-1992 from Division of STD/HIV Prevention. December, 1994; Table 21.B; data for 1993 from Division of STD Prevention, 1997, Table 24.B; data for 1994-1998 from Division of STD Prevention, 1999, Table 24B.

Figure HC 2.12.B Reported rates of primary and secondary syphilis^a for youth ages 15 through 19 in the United States, by gender (per 100,000 population ages 15 through 19): Selected years, 1975-1998

Sources: Data for 1975 from Centers for Disease Control and Prevention, Division of STD Prevention, 1996, Table 7; data for 1980 and 1985 from Centers for Disease Control and Prevention, Division of STD Prevention, 1987, Table 3; data for 1990-1992 from Division of STD/HIV Prevention, 1994, Table 9.B; data for 1993 from Division of STD Prevention, 1997, Table 12.B; data for 1994-1998 from Division of STD Prevention, 1999, Table 12B.

⁴⁷ Centers for Disease Control and Prevention, Division of STD Prevention. September 1999. Sexually Transmitted Disease Surveillance, 1998. U.S. Department of Health and Human Services, Public Health Service. Atlanta: Centers for Disease Control and Prevention, p. 21.

⁴⁸ Estimates for whites and blacks exclude Hispanics of those races.

⁴⁹ Estimates for whites and blacks exclude Hispanics of those races

Health Care

HC 3.1 Health Insurance Coverage

Children who are covered by health insurance are considerably more likely to have a regular source of health care. Among children covered by private health insurance, 97 percent had a regular source of medical care in 1993, and of those covered by government health insurance, 94 percent had a regular source of medical care. In contrast, 79 percent of children with no health insurance had a regular source of medical care.⁵⁰ Regular care increases the continuity of care, which is important to the maintenance of good health.

Since 1987, the percentage of children who are covered by health insurance has remained stable, ranging from 85 to 87 percent (see Table HC 3.1.A). Rates of coverage vary little by age of child, though older children appear slightly less likely to be covered.

Differences by Race and Hispanic Origin.⁵¹Hispanic children are less likely to be covered than either white or black children. In 1998, 70 percent of Hispanic children were covered by health insurance, compared with 86 percent of white, 83 percent of Asian and Pacific Islander, and 80 percent of black children (see Table HC 3.1.A).

Differences by Poverty Status. Poor children have lower rates of health insurance coverage at 75 percent compared to 85 percent for all children in 1998 (see Tables HC 3.1.A and HC 3.1.B). They are also much less likely to be covered by private health insurance at 23 percent compared to 68 percent for all children.

Differences by Type of Health Care Coverage. Government health insurance coverage for children increased from 19 percent in 1987 to a high of 27 percent in 1993, before declining to 23 percent by 1998 (see Figure HC 3.1).⁵² Younger children are considerably more likely to be covered by government health insurance. In 1998, 27 percent of children under age 6 were covered, compared with 19 percent of children ages 12 through 17 (see Table HC 3.1.A). Finally, a large proportion of black and Hispanic children rely on government health insurance for their medical coverage. In 1998, 42 percent of black and 31 percent of Hispanic children were covered by government health insurance, compared with 19 percent of white children. These percentages are down from highs of 50 and 41 percent, respectively, in 1993. The vast majority of children covered by government health insurance are covered by Medicaid (see Table 3.1.C).

Table HC 3.1.A Percentage of children under age 18 in the United States who are covered by health insurance, by type of insurance, age, and race and Hispanic origin:^a 1987-1998

	1987	1988	1989	1990	1991	1992	1993	1994	1995	1996	1997	1998
All health insurance
All children	87	87	87	87	87	87	86	86	86	85	85	85
Under age 6	88	87	87	89	89	89	88	86	87	86	86	84
Ages 6-11	87	87	87	87	88	88	87	87	87	85	86	85
Ages 12-17	86	86	86	85	85	85	83	85	86	84	83	84
Race and Hispanic origin^a
White	88	88	88	87	88	88	87	87	87	86	86	86
Blacka	83	84	84	85	85	86	84	83	85	81	81	80
Hispanic	72	71	70	72	73	75	74	72	73	71	71	70
Asian/Pacific Islander	—	—	—	—	—	—	—	—	—	—	85	83
Private health insurance
All children	74	74	74	71	70	69	67	66	66	66	67	68
Age
Under age 6	72	71	71	68	66	65	63	60	60	62	63	64
Ages 6-11	74	74	75	73	71	71	70	67	67	67	68	68
Ages 12-17	75	76	76	73	72	71	69	70	71	70	70	70
Race and Hispanic origin^a
White	79	79	78	76	75	74	72	71	71	71	71	72
Black^a	49	50	52	49	45	46	46	43	44	45	48	47
Hispanic	48	48	48	45	43	42	42	38	38	40	42	43
Asian/Pacific Islander	—	—	—	—	—	—	—	—	—	—	70	67
Government health insurance^b
All children	19	19	19	22	24	25	27	26	26	25	23	23
Age
Under age 6	22	23	24	28	30	33	35	33	33	31	29	27
Ages 6-11	19	18	18	20	22	23	25	25	26	25	23	23
Ages 12-17	16	16	15	18	19	19	20	20	21	19	19	19
Race and Hispanic origin^a
White	14	14	15	17	19	20	22	21	21	21	20	19
Black^a	42	42	41	45	48	49	50	48	49	45	40	42
Hispanic	28	27	27	32	37	38	41	38	39	35	34	31

^a Estimates for blacks and whites include Hispanics of those races. Persons of Hispanic origin may be of any race.

^b Government health insurance for children consists primarily of Medicaid but also includes Medicare and CHAMPUS

Sources: Housing and Household Economic Statistics Division, U.S. Census Bureau, analyses from the March Current Population Surveys. Health Insurance Coverage: 1998, Table 7, available online at http://www.census.gov/hhes/hlthins/hlthin98/hi98t7.html, 10/4/99, and unpublished Table 1: Health Insurance Coverage Status—People by Age, Gender, and Race: 1997. Estimates for 1987-1998 as published in Federal Interagency Forum on Child and Family Statistics, 2000 Table ECON5.A.

Table HC 3.1.B Percentage of poor children under age 18 in the United States who are covered by health insurance, by type of insurance, age, and race and Hispanic origin:^a 1998

	All health insurance	Private health insurance	Government health insurance
All poor children	75	23	59
Age
Under age 6	76	20	64
Ages 6-11	77	25	60
Ages 12-17	70	24	52
Race and Hispanic origin^a
White	72	25	55
Black	79	18	66
Hispanic	67	16	55
Asian/Pacific Islander	83	30	62

^a Estimates for whites and blacks include Hispanics of those races. Persons of Hispanic origin may be of any race.

^b Government health insurance for children consists primarily of Medicaid but also includes Medicare and CHAMPUS.

Source: Housing and Household Economic Statistics Division, U.S. Census Bureau, analyses from the March Current Population Surveys. Health Insurance Coverage: 1998, Table 7.

Figure HC 3.1 Percentage of children under age 18 in the United States who are covered by health insurance, by type of insurance:^a1987-1998

^a Government health insurance for children consists primarily of Medicaid but also includes Medicare and CHAMPUS.

Sources: Housing and Household Economic Statistics Division, U.S. Bureau of the Census, analyses from the March Current Population Surveys. Health Insurance Coverage: 1998, Table 7, available online at http://www.census.gov/hhes/hlthins/hlthin98/hi98t7.html, 10/4/99. Estimates for 1987-1996 as published in America’s Children: Key National Indicators of Well-Being, 1998, Table ECON5.A.

Table HC 3.1.C Percentage of children under age 18 in the United States who are covered by Medicaid, by age and by race and Hispanic origin:^a 1987-1998

	1987	1988	1989	1990	1991	1992	1993	1994	1995	1996	1997	1998
Total all children	15	16	16	19	20	22	24	23	23	22	21	20
Age
Under age 6	18	19	20	24	27	30	32	30	30	28	26	24
Ages 6-11	15	15	15	17	19	20	22	22	23	22	20	20
Ages 12-17	12	12	11	14	15	15	17	16	17	16	16	16
Race and Hispanic origin^a
White	11	11	11	14	16	17	19	18	18	18	17	16
Black	38	38	37	42	44	46	47	44	45	41	37	39
Hispanic	26	25	25	30	34	37	39	37	37	34	32	30
Asian/Pacific Islander	—	—	—	—	—	—	—	—	—	—	18	19
Poor children	56	57	57	62	66	66	67	64	65	63	61	58
Age
Under age 6	61	63	63	71	75	74	76	72	73	71	67	63
Ages 6-11	56	57	56	59	64	64	66	65	65	63	62	59
Ages 12-17	48	48	47	52	54	55	54	52	53	51	52	51
Race and Hispanic origin^a
White	49	49	49	56	59	60	62	59	59	59	57	54
Black	67	69	69	73	77	76	77	74	76	70	68	65
Hispanic	53	48	50	58	61	63	62	62	64	60	60	54
Asian/Pacific Islander	—	—	—	—	—	—	—	—	—	—	63	61

^a Estimates for whites and blacks include Hispanics of those races. Persons of Hispanic origin may be of any race.

Source: Housing and Household Economic Statistics Division, U.S. Bureau of the Census, analyses from the March Current Population Surveys, Table 7.

⁵⁰Simpson G., Bloom B., Cohen R.A., & Parsons P.E. 1997. Access to Health Care. Part 1: Children. Vital and Health Statistics 10 (196). National Center for Health Statistics.

⁵¹ Estimates for whites, blacks, and Asians and Pacific Islanders include Hispanics of those races. Hispanic children may be of any race.

⁵²Government health insurance for children consists primarily of Medicaid but also includes Medicare and CHAMPUS.

HC 3.2 Prenatal Care

Early Prenatal Care

Early prenatal care (i.e., care in the first trimester of a pregnancy) allows women and their health care providers to identify and, when possible, treat or correct health problems and health-compromising behaviors that can be particularly damaging during the initial stages of fetal development. Increasing the percentage of women who receive prenatal care, and who do so early in their pregnancies, can improve birth outcomes and lower health care costs by reducing the likelihood of complications during pregnancy and childbirth.⁵³

The percentage of women receiving prenatal care in the first trimester has increased from 68.0 percent in 1970 to 83.2 percent in 1999 (see Table HC 3.2.A).⁵⁴ Following a decade of essentially no change, the proportion of women receiving early prenatal care has improved incrementally throughout the 1990s.

Differences by Race and Ethnicity. The percentage of women receiving prenatal care during the first 3 months of pregnancy has increased over the past two decades for women of all races and those of Hispanic origin. While the gains have been greatest for women with lower levels of timely care, white, Chinese, Japanese, and Cuban women are most likely to receive prenatal care in their first trimester (see Table HC 3.2.A).

American Indian/Alaska Native and Mexican women have consistently had the lowest percentage of women receiving early prenatal care; however, this percentage has increased to 68.8 for American Indian women and 72.8 percent for Mexican women in 1998.
The percentage of black women receiving prenatal care in the first trimester increased from 44.2 percent in 1970 to 62.4 percent in 1980. Rates declined slightly during the 1980s but then increased in subsequent years, reaching 74 percent by 1999.
The percentage of all Hispanic women who receive early prenatal care has increased from 60.2 percent in 1980 to 74.3 percent by 1998. Among Hispanics, there are important subgroup disparities. In 1998, 91.8 percent of Cuban women received early prenatal care, compared with 72.8 percent of Mexican American women.
Since 1980, early prenatal care receipt has improved among Asian/Pacific Islander women as a group—from 73.7 percent in 1980 to 83.1 percent in 1998. Chinese, Japanese, and Filipino women tend to have higher rates of prenatal care than Hawaiian and other Asian women.
The percentage of white women receiving early prenatal care increased from 72.3 percent to 79.2 percent between 1970 and 1980, was stable through the 1980s, then increased during the 1990s to 88.4 percent by 1999.

Late or No Prenatal Care

Receiving prenatal care late in a pregnancy, or receiving no prenatal care at all, can lead to negative health outcomes for mother and child. Women who receive care late in their pregnancy, or who do not receive care at all, are at increased risk of bearing infants who are of low birthweight, who are stillborn, or who die within the first year of life.⁵⁵ Between 1970 and 1999, the percentage of women receiving late or no prenatal care declined from 7.9 percent to 3.8 percent (see Table HC 3.2.B).

Differences by Race and Ethnicity. The percentage of women who receive late or no prenatal care has declined substantially for women in all racial and ethnic groups (see Table HC 3.2.B).

American Indian/Alaska Native women and black women have seen the most dramatic improvements, with the percentages receiving late or no prenatal care dropping by more than two-thirds for American Indian women and by more than half for black women since 1970. In 1998, 8.5 percent of American Indian/Alaska Native women received late or no prenatal care, and 7.0 percent of black women received late or no prenatal care.
The percentage of Hispanic women receiving late or no prenatal care has decreased every year during the 1990s and at 6.3 percent in 1998 was lower than the rate for black women at 7.0.
White women and Asian women as a group have consistently been least likely to receive late or no prenatal care. In 1998, 2.4 percent of white women received late or no prenatal care, compared to 3.6 percent of Asian women.

Adequacy of Prenatal Care

Receiving early and consistent prenatal care increases the likelihood of a healthy birth outcome. Adequate prenatal care is determined by both the early receipt of prenatal care (within the first trimester) and the receipt of an appropriate number of prenatal care visits for each stage of a pregnancy. Women whose prenatal care fails to meet these standards are at a greater risk for pregnancy complications and negative birth outcomes.

There has been a sharp decline in the percentage of women receiving inadequate prenatal care from 18 percent in 1989 to 11.9 percent in 1998 (see Table HC 3.2.C). According to the Adequacy of Prenatal Care Utilization Index, the proportion of women with at least adequate care rose from 66.1 percent to 74.3 percent between 1989 and 1998. The proportion of women with intensive use of care (women for whom the number of visits exceeded the American College of Obstetricians and Gynecologists’ recommendations by a ratio of observed to expected visits of at least 110 percent) rose from 24.1 to 31 percent during the same time period.

Table HC 3.2.A Percentage of women^a in the United States receiving prenatal care in the first trimester, by race/ethnicity of mother: Selected years, 1970-1999

	1970	1980	1985	1990^b	1991	1992	1993	1994	1995	1996	1997	1998	1999
Total	68.0	76.3	76.2	75.8	76.2	77.7	78.9	80.2	81.3	81.9	82.5	82.8	83.2
Race/ethnicity
White^b	72.3	79.2	79.3	83.3	83.7	84.9	85.6	86.5	87.1	87.4	87.9	87.9	88.4
Black^b	44.2	62.4	61.5	60.7	61.9	64.0	66.1	68.3	70.4	71.5	72.3	73.3	74.0
American Indian/Alaska Native	38.2	55.8	57.5	57.9	59.9	62.1	63.4	65.2	66.7	67.7	68.1	68.8	—
Asian/Pacific Islander	67.3	73.7	74.1	75.1	75.3	76.6	77.6	79.7	79.9	81.2	82.1	83.1	—
Chinese	71.8	82.6	82.0	81.3	82.3	83.8	84.6	86.2	85.7	86.8	87.4	88.5	—
Japanese	78.1	86.1	84.7	87.0	87.7	88.2	87.2	89.2	89.7	89.3	89.3	90.2	—
Filipino	60.6	77.3	76.5	77.1	77.1	78.7	79.3	81.3	80.9	82.5	83.3	84.2	—
Hawaiian	—	—	—	65.8	68.1	69.9	70.6	77.0	75.9	78.5	78.0	78.8	—
Other Asian or Pacific Islander	54.9	67.6	69.7	71.9	71.9	72.8	74.4	76.2	77.0	78.4	79.7	80.9	—
Hispanic originc,^d	—	60.2	61.2	60.2	61.0	64.2	66.6	68.9	70.8	72.2	73.7	74.3	74.5
Mexican American	—	59.6	60.0	57.8	58.7	62.1	64.8	67.3	69.1	70.7	72.1	72.8	—
Puerto Rican	—	55.1	58.3	63.5	65.0	67.8	70.0	71.7	74.0	75.0	76.5	76.9	—
Cuban	—	82.7	82.5	84.8	85.4	86.8	88.9	90.1	89.2	89.2	90.4	91.8	—
Central and South	—	58.8	60.6	61.5	63.4	66.8	68.7	71.2	73.2	75.0	76.9	78.0	—
American Unknown Hispanic	—	66.4	65.8	66.4	65.6	68.0	70.0	72.1	74.3	74.6	76.0	74.8	—

^a The data refer to those women who had live births.

^b Includes persons of Hispanic origin until 1990. After 1990 persons of Hispanic origin are not included.

^c Persons of Hispanic origin may be of any race.

^d Figures for Hispanic women are based on data from 22 states that reported Hispanic origin on the birth certificate in 1980; 23 states and the District of Columbia in 1985, 48 states and the District of Columbia in 1990, 49 states and the District of Columbia in 1992, and 50 states and the District of Columbia since 1993.

Sources: Curtin & Martin, 2000; Data computed by the Division of Health and Utilization Analysis from data compiled by the Division of Vital Statistics; National Center for Health Statistics, 1998, Table 6; Ventura, et al., 2000, Births, Tables 24, 25 and 33; Ventura, et al., 1999, Births, Tables 24, 25, and 33.

Table HC 3.2.B Percentage of womena in the United States receiving late or no prenatal care,^b by race/ethnicity of mother and by age: selected years, 1970-1999

	1970	1980	1985	1990	1991	1992	1993c	1994	1995	1996	1997	1998	1999
Total	7.9	5.1	5.7	6.1	5.8	5.2	4.8	4.4	4.2	4.0	3.9	3.9	3.8
Race/ethnicity
White^c	6.3	4.3	4.8	4.9	4.7	4.2	2.7	2.5	2.5	2.4	2.4	2.4	2.3
Black^c	16.6	8.9	10.2	11.3	10.7	9.9	9.0	8.2	7.6	7.3	7.3	7.0	6.7
American Indian/Alaska Native	28.9	15.2	12.9	12.9	12.2	11.0	10.3	9.8	9.5	8.6	8.6	8.5	—
Asian/Pacific Islander	6.8	6.5	6.5	5.8	5.7	4.9	4.6	4.1	4.3	3.9	3.8	3.6	—
Chinese	6.5	3.7	4.4	3.4	3.4	2.9	2.9	2.7	3.0	2.5	2.4	2.2	—
Japanese	4.1	2.1	3.1	2.9	2.5	2.4	2.8	1.9	2.3	2.2	2.7	2.1	—
Filipino	7.2	4.0	4.8	4.5	5.0	4.3	4.0	3.6	4.1	3.3	3.3	3.1	—
Hawaiian	—	—	—	8.7	7.5	7.0	6.7	4.7	5.1	5.0	5.4	4.7	—
Other Asian or Pacific Islander	—	9.0	8.1	7.1	6.8	5.9	5.4	4.8	5.0	4.6	4.4	4.2	—
Hispanic originc, ^d	—	12.0	12.4	12.0	11.0	9.5	8.8	7.6	7.4	6.7	6.2	6.3	6.3
Mexican American	—	11.8	12.9	13.2	12.2	10.5	9.7	8.3	8.1	7.2	6.7	6.8	—
Puerto Rican	—	16.2	15.5	10.6	9.1	8.0	7.1	6.5	5.5	5.7	5.4	5.1	—
Cuban	—	3.9	3.7	2.8	2.4	2.1	1.8	1.6	2.1	1.6	1.5	1.2	—
Central and South American	—	13.1	12.5	10.9	9.5	7.9	7.3	6.5	6.1	5.5	5.0	4.9	—
Unknown Hispanic	—	9.2	9.4	8.5	8.2	7.5	7.0	6.2	6.0	5.9	5.3	6.0	—

^aThe data refer to those women who had live births.

^b Late prenatal care is defined as seventh month or later.

^c Includes persons of Hispanic origin until 1993. After 1993, persons of Hispanic origin are not included. Persons of Hispanic origin may be of any race.

^dFigures for Hispanic women are based on data from 22 states that reported Hispanic origin on the birth certificate in 1980; 23 states and the District of Columbia in 1985, 48 states and the District of Columbia in 1990, 49 states and the District of Columbia in 1992, and 50 states and the District of Columbia since 1993.

Sources: Curtin, & Mathews, 2000, Table 6; Ventura, et al.,2000, Births, Tables 24, 25, and 33.

Table HC 3.2.C Adequacy of Prenatal Care Utilization Indexa: United States, 1989, 1990, and 1995-1998

	1989	1990^a	1995^a	1996	1997	1998
Intensive use	24.1	24.6	28.8	29.3	30.7	31.0
Adequate	42.0	42.3	43.7	43.6	43.3	43.3
Intermediate	15.9	15.7	14.7	14.7	14.0	13.8
Inadequate	18.0	17.4	12.8	12.4	12.0	11.9

^a Kotelchuck M. An evaluation of the Kessner adequacy of prenatal care index and a proposed adequacy of prenatal care utilization index. Am J Public Health 84(9):1414–20. 1994 Kogan MD, Martin JA, Alexander GR, et al. The changing pattern of prenatal care utilization in the United States, 1981–1985, using different prenatal care indices. JAMA 279(20):1623–28. 1998.

Sources: Ventura, et al., 2000, Births, Table F.

⁵³ U.S. Public Health Service. 1989. Caring for Our Future: The Content of Prenatal Care. Washington, D.C.: U.S. Department of Health and Human Services.

⁵⁴ These data include only those women who gave birth, not all women who were pregnant.

⁵⁵ U.S. Public Health Service, 1989.

HC 3.3 Immunization: Percentage of Children ages 19 Months to 35 Months Who Are Fully Immunized

Childhood vaccinations can prevent diseases that killed or permanently impaired many children in past decades. The Centers for Disease Control and Prevention recommends that 80 percent of all routine childhood vaccinations be administered within the first 2 years of life. Vaccination coverage is particularly important before children enter preschool to prevent the spread of disease. Today, at least 95 percent of children are adequately vaccinated by the time they enter kindergarten.⁵⁶

There were substantial increases in the proportion of children vaccinated between 1991 and 1994 for each of the recommended vaccines (data not shown).⁵⁷ Coverage has continued to increase during the period from 1994 to 1998. For example, the percentage of preschool children receiving the combined series 4:3:1:3 vaccine was 69 percent in 1994 and reached 79 percent by 1998 (see Table HC 3.3).⁵⁸ Even with the increases of recent years, more than 1 million preschool children remain unvaccinated for serious preventable diseases.⁵⁹ In particular, there are differences in immunization rates by poverty status and race and Hispanic origin.

Differences by Race and Hispanic Origin.⁶⁰ Non-Hispanic white infants ages 19 months to 35 months have higher percentages of vaccination receipt than do non-Hispanic black children or children of Hispanic origin (see Table HC 3.3). This disparity in vaccination levels has narrowed somewhat from 1994 to 1997, as the vaccination levels of black and Hispanic children have improved. By preschool, the vaccination levels of children across racial and ethnic groups are nearly the same, narrowing a gap that once was as wide as 26 percentage points for specific vaccinations.⁶¹ Differences in vaccination rates among racial and ethnic groups are partly accounted for by poverty level.⁶²

Differences by Poverty Status. Although vaccination levels have increased substantially between 1995 and 1998 among children in households at or above the poverty level, poor children are still less likely to have received recommended vaccinations.⁶³ In 1998, 82 percent of children in families at or above the poverty level received the combined series 4:3:1:3, compared with 74 percent of poor children (see Table HC 3.3).

Figure HC 3.3 Percentage of children^a ages 19 months to 35 months in the United States who have received vaccinations for routinely recommended vaccines:^b 1997

^a Data are based on telephone interviews of a sample of the civilian, noninstitutionalized population, with households selected via a random digit dial (RDD) procedure. Refusals and unknowns were excluded. Exclusions included unknown vaccine type.

^b The combined series 4:3:1:3 consists of four doses of diphtheria-tetanus-pertussis (DTP) vaccine, three doses of polio vaccine, one dose of a measles-containing vaccine, and three doses of Haemophilus influenzae type b (HiB) vaccine. The combined series 4:3:1 consists of four doses of DTP vaccine, three doses of polio vaccine, and one dose of a measles-containing vaccine.

Source: Centers for Disease Control and Prevention. National Center for Health Statistics and National Immunization Program, 2000, Table 73.

Table HC 3.3 Percentage of children ages 19 months to 35 months in the United States who have received routinely recommended vaccinations, by poverty status^a and race and Hispanic origin:^b1994c -1998

	All races			White, non-Hispanic			Black, non-Hispanic			Hispanic
Vaccination type	Total	Below poverty	At or above poverty	Total	Below poverty	At or above poverty	Total	Below poverty	At or above poverty	Total	Below poverty	At or above poverty
Combined series (4:3:1:3)^d
1994	69	61	72	72	—	—	67	—	—	62	—	—
1995	74	67	77	77	68	79	70	66	75	69	65	72
1996	77	69	80	79	68	81	74	70	78	71	68	74
1997	76	71	79	79	72	80	73	71	77	72	70	76
1998	79	74	82	82	77	83	73	72	74	75	73	79
Combined series (4:3:1)^e
1994	75	66	78	78	—	—	69	—	—	68	—	—
1995	76	68	79	79	—	—	72	—	—	71	—	—
1996	78	71	81	80	70	82	76	73	80	73	70	75
1997	78	73	80	80	73	82	74	72	78	74	72	77
1998	—	—	—	—	—	—	—	—	—	—	—	—
DTP (3 doses or more)^f
1994	93	89	96	95	—	—	91	—	—	90	—	—
1995	95	91	96	96	—	—	92	—	—	93	—	—
1996	95	92	96	96	92	97	93	91	95	93	92	94
1997	95	93	97	97	93	97	95	95	96	93	92	94
1998	—	—	—	—	—	—	—	—	—	—	—	—
DTP (4 doses or more)^f
1994	76	69	79	80	—	—	72	—	—	70	—	—
1995	79	71	81	81	—	—	74	—	—	75	—	—
1996	81	73	84	83	72	85	79	75	82	77	73	79
1997	81	76	84	84	76	85	78	76	80	77	75	80
1998	84	80	86	87	—	—	77	—	—	81	—	—
Polio (3 doses or more)
1994	83	78	85	85	—	—	79	—	—	81	—	—
1995	88	84	89	89	—	—	84	—	—	87	—	—
1996	91	88	92	92	88	93	90	88	92	89	88	90
1997	91	90	92	92	90	92	90	90	91	90	89	90
1998	91	90	92	92	—	—	88	—	—	89	—	—
Measles-containing^g
1994	89	87	90	90	—	—	86	—	—	88	—	—
1995	90	85	91	91	—	—	86	—	—	88	—	—
1996	91	87	92	92	86	93	89	88	91	88	88	89
1997	91	86	92	92	85	93	90	88	92	88	86	89
1998	92	90	93	93	—	—	89	—	—	91	—	—

Table HC 3.3 continued. Percentage of children ages 19 months to 35 months in the United States who have received routinely recommended vaccinations, by poverty statusa and race and Hispanic origin:^b1994^c -1998

	All races			White, non-Hispanic			Black, non-Hispanic			Hispanic
Vaccination type	Total	Below poverty	At or above poverty	Total	Below poverty	At or above poverty	Total	Below poverty	At or above poverty	Total	Below poverty	At or above poverty
HiB (3 doses or more)^h
1994	86	81	88	87	—	—	85	—	—	84	—	—
1995	92	88	93	93	—	—	89	—	—	90	—	—
1996	92	88	93	93	87	94	90	87	92	89	88	90
1997	93	90	94	94	90	95	92	92	94	90	89	92
1998	93	91	95	95	—	—	90	—	—	92	—
Hepatitis B (3 doses or more)ⁱ
1994	37	25	41	40	—	—	29	—	—	33	—	—
1995	68	64	69	68	—	—	65	—	—	69	—	—
1996	82	78	83	82	75	83	82	79	86	80	79	82
1997	84	80	85	85	80	85	83	82	84	81	79	84
1998	87	85	88	88	—	—	84	—	—	86	—	—

^aPoverty status is based on family income and family size using U.S. Bureau of the Census poverty thresholds.

^b Estimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.

^c Estimates are based on interviews conducted from April 1994 through December 1994.

^d The combined series 4:3:1:3 consists of four doses of diphtheria-tetanus-pertussis (DTP) vaccine, three doses of polio vaccine, one dose of a measles-containing vaccine, and three doses of Haemophilus influenzae type b (HiB) vaccine.

^e The combined series 4:3:1 consists of four doses of DTP vaccine, three doses of polio vaccine, and one dose of a measles-containing vaccine.

^fDiphtheria-tetanus-pertussis vaccine.

^gAny vaccination containing measles vaccine.

^h Haemophilus influenzae type b vaccine.

ⁱThe percentage of children 19-35 months of age who received three or more doses of hepatitis B vaccine was artificially low in 1994 because universal infant vaccination with a three-dose series was not recommended until November 1991.

Sources: Unpublished data from the National Immunization Survey, National Center for Health Statistics and National Immunization Program, Centers for Disease Control and Prevention; Centers for Disease Control and Prevention. 1998; Table 1; Centers for Disease Control and Prevention, 1998, Table 1 and text; National Center for Health Statistics, 1997, Table 55; Centers for Disease Control and Prevention, 1997, Tables 1 and 2; National Center for Health Statistics, 1998. Table 52.

Section 4: Social Development, Behavioral Health, and Teen Fertility (SD)

Social Development

SD 1.1 Life Goals: The Percentage of High School Seniors who Rated Selected Personal and Social Goals as Extremely Important

The personal and social life goals of high school students reflect their priorities for the future and provide insights into the positive and negative influences in their lives as they make the transition to adulthood. The percentages of high school seniors who rated selected personal and social life goals as extremely important for selected years between 1976 and 1999 are presented in Tables SD 1.1.A and SD 1.1.B. Personal goals include being successful in their line of work, having a good marriage and family life, and having lots of money. Social goals include making a contribution to society, working to correct social and economic inequalities, and being a leader in their community. From 1976 through 1999, high school seniors have been fairly consistent in the relative importance they assign to various life goals. Specifically:

Being Successful in My Line of Work and Having a Good Marriage and Family Life have been cited more often than other values by high school seniors as being extremely important. Since 1992, more than three out of four high school seniors have felt it extremely important to have a good marriage and family life, and nearly two out of three have felt it extremely important to be successful at work (see Table SD 1.1.A).
Having Lots of Money and Making a Contribution to Society were the next most likely goals to be considered extremely important by high school seniors. Between 20 and 30 percent of seniors have found these goals extremely important in recent years (see Figures SD 1.1.A and SD 1.1.B).
Working to Correct Social and Economic Inequalities and Being a Leader in My Community are extremely important goals in 1999 for only small percentages of high school seniors: 10 percent and 15 percent, respectively (see Figure SD 1.1.B).

Differences by Race. In 1999, black students were more likely than whites to view as extremely important goals such as being successful at work (76 percent versus 60 percent), having lots of money (47 percent versus 21 percent), and correcting social and economic inequalities (16 percent versus 8 percent). The two groups appeared equally likely to attach extreme importance to having a good marriage and family life, a rate that has hovered around 75 percent for both races over the time period examined.

Differences by Gender. Across the six goals, rates vary little between male students and female students, with several exceptions. In 1997, females were more likely to indicate that having a good marriage and family life was extremely important (83 percent versus 74 percent) and were less likely to report that having lots of money was an extremely important goal (17 percent versus 34 percent).

Table SD 1.1.A Percentage of high school seniors in the United States who rate selected personal life goals as being "extremely important," by gender and race: Selected years, 1976-1999

	1976	1981	1986	1991	1992	1993	1994	1995	1996	1997	1998	1999
Being successful in my line of work
Total	53	57	61	62	66	65	63	62	65	64	64	63
Gender
Male	53	58	62	60	63	63	61	62	62	65	61	63
Female	52	57	60	64	69	67	66	62	68	64	68	64
Race
White	50	55	58	59	65	62	60	59	63	60	61	60
Black	67	71	73	75	80	74	79	72	74	81	80	76
Having a good marriage and family life
Total	73	76	75	76	78	79	76	78	78	76	77	78
Gender
Male	66	71	69	71	72	74	70	73	74	72	72	74
Female	80	82	82	83	84	85	81	83	81	81	82	83
Race
White	72	77	76	76	79	79	76	78	78	77	77	79
Black	75	73	76	78	75	76	72	76	75	76	77	76
Having lots of money
Total	15	18	27	28	29	26	26	25	25	28	29	26
Gender
Male	20	24	34	37	35	32	32	30	33	33	35	34
Female	11	13	18	19	22	18	19	19	16	20	20	17
Race
White	12	15	24	25	24	20	22	21	21	22	22	21
Black	33	32	38	39	46	45	47	41	43	45	46	47

Note: 1976–1988 data based on one of five forms, with a resulting sample one-fifth of the total sample size for each year.
1989–1999 data based on one of six forms, with a resulting sample one-sixth of the total sample size for each year.
Sources: Johnston, Bachman, & O’Malley, 1976, 1981, 1986, 1991, 1992, 1993, 1994, 1995, 1996–1999 unpublished tables.
Questionnaire Form 1, items A007A, A007B, and A007C.

Table SD 1.1.B Percentage of high school seniors in the United States who rate selected social life goals as being "extremely important," by gender and race: Selected years, 1976-1999

	1976	1981	1986	1991	1992	1993	1994	1995	1996	1997	1998	1999
Making a contribution to society
Total	18	18	17	21	22	24	24	20	24	22	23	22
Gender
Male	16	19	18	20	22	25	23	19	23	19	21	22
Female	20	17	16	22	23	25	25	21	26	25	24	22
Race
White	18	18	16	20	22	24	23	19	23	22	23	21
Black	23	21	20	27	27	25	29	25	29	24	30	26
Working to correct social and economic inequalities
Total	10	10	9	12	15	15	14	10	12	12	11	10
Gender
Male	8	9	7	11	14	14	12	9	11	10	10	9
Female	13	10	11	13	17	16	16	10	12	12	11	10
Race
White	8	7	7	10	13	12	11	8	9	9	8	8
Black	20	21	19	21	26	21	25	18	19	18	20	16
Being a leader in my community
Total	7	8	9	11	13	13	14	12	15	15	14	15
Gender
Male	8	8	11	12	14	17	14	14	16	16	14	17
Female	6	7	6	10	11	10	13	10	13	13	15	13
Race
White	6	7	8	9	11	12	12	10	14	12	12	13
Black	14	14	12	17	21	19	21	22	23	24	30	25

Note: 1976–1988 data based on one of five forms, with a resulting sample one-fifth of the total sample size for each year.
1989–1999 data based on one of six forms, with a resulting sample one-sixth of the total sample size for each year.
Sources: Johnston, Bachman, & O’Malley, 1976, 1981, 1986, 1991, 1992, 1993, 1994, 1995. 1996–1999 unpublished tables.
Questionnaire Form 1, items A007G, A007H, and A007L.

Figure SD 1.1.A Percentage of high school seniors in the United States who rate selected personal life goals as being “extremely important”: 1976 and 1999

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Figure SD 1.1.B Percentage of high school seniors in the United States who rate selected social life goals as being “extremely important”: 1976 and 1999

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SD 1.2 Peer Approval

As children grow older, peer relationships come to play an increasingly important role in determining their own behaviors and attitudes.¹ For example, teenagers reporting that a large proportion of their friends are (or would like to be) sexually active are more likely to become sexually active themselves.²

Two measures of potential peer influence are offered here: the percentage of youth reporting that getting good grades has great or very great importance to their peers, and the percentage reporting that peers would disapprove of intentionally angering a teacher in school. Between 1980 and 1999, the percentage of 12th-graders reporting that their peers value good grades stayed fairly constant, varying between 44 percent and 49 percent³ (see Figure SD 1.2.A). During that same time period, the percentage reporting peer disapproval of angering a teacher in school decreased from 41 percent in 1980 to 34 percent in 1999 (see Table SD 1.2.B).

Differences by Age. Eighth-grade students were more likely in 1999 than either 10th- or 12th-graders to report that their peers consider good grades to be of great or very great importance (50 percent versus 42 percent and 47 percent, respectively). In that same year, on the other hand, more 12th-grade students (34 percent) than 8th- or 10th-graders (22 and 26 percent, respectively) were likely to report peer disapproval of intentionally angering a teacher in school (see Tables SD 1.2.A and SD 1.2.B).

Differences by Gender. Female students were slightly more likely than males to report that their peers value good grades and that they would disapprove of intentionally angering teachers; for example, among 12th-grade youth in 1999, 49 percent of females and 44 percent of males reported that peers hold good grades to be of great or very great importance (see Table SD 1.2.A). In that same year, 37 percent of 12th-grade females and 30 percent of 12th-grade males reported peer disapproval of intentionally angering a teacher in school (see Table SD 1.2.B).

Differences by Race. For all years for which data are presented, black students in all grades were considerably more likely than their white counterparts to report strong peer support for good grades (see Figure SD 1.2.A); for example, in 1999, 39 percent of white and 77 percent of black 12th-graders reported that their peers believed that good grades were of great or very great importance. Black students are slightly less likely to report peer disapproval of intentionally angering teachers in the 8th, 10th, and 12th grades. The difference by race is largest among high school seniors, in a trend that has been consistent since 1980 (see Figure SD 1.2.B).

¹ Hayes, C.D. Risking the Future, p. 105; Newcomer, S.F., Gilbert, M., & Udry, J.R. Perceived and Actual Same-Sex Behavior as Determinants of Adolescent Sexual Behavior. Paper presented at the Annual Meeting of the American Psychological Association, Montréal, Canada, 1980. Cited in National Commission on Children. 1991. Beyond Rhetoric: A New American Agenda for Children and Families, Final Report of the National Commission on Children, p. 351. Washington, D.C.: U.S. Government Printing Office.
²Hayes, C.D. Risking the Future, p. 105; Cvetkovitch, G., & Grote, B. Psychological Development and the Social Problem of Teenage Illegitimacy. In Adolescent Pregnancy and Childbearing: Findings from Research (C. Chilman, ed). Washington, D.C.: U.S. Department of Health and Human Services, 1980. Cited in National Commission on Children. 1991. Beyond Rhetoric: A New American Agenda for Children and Families, Final Report of the National Commission on Children, p. 351. Washington, D.C.: U.S. Government Printing Office.
³The 53 percent estimate occurred in 1982, not shown in Table SD 1.2.A.

Table SD 1.2.A Percentage of 8th-, 10th-, and 12th-grade students in the United States reporting that good grades have great or very great importance to peers, by gender and race: Selected years, 1980-1999

	1976	1981	1986	1991	1992	1993	1994	1995	1996	1997	1998	1999
8th Grade
Total	—	—	—	51	52	54	54	55	55	52	51	50
Gender
Male	—	—	—	50	50	54	52	52	54	51	52	49
Female	—	—	—	53	53	54	55	56	55	53	50	51
Race
White	—	—	—	47	47	49	49	48	48	46	46	45
Black	—	—	—	72	72	70	70	72	77	71	69	68
10th Grade
Total	—	—	—	44	43	39	42	44	45	43	44	42
Gender
Male	—	—	—	42	42	36	39	43	42	40	43	40
Female	—	—	—	46	44	42	45	45	47	45	46	44
Race
White	—	—	—	38	38	35	38	39	40	38	37	36
Black	—	—	—	67	66	59	64	67	65	62	69	66
12th Grade
Total	48	49	48	44	45	46	45	46	46	45	45	47
Gender
Male	48	50	46	41	42	43	44	41	44	41	42	44
Female	48	48	51	47	48	48	46	50	49	49	48	49
Race
White	43	43	43	37	39	40	39	40	42	41	40	39
Black	78	77	76	71	70	61	67	67	69	59	63	77

Note: Data for 8th- and 10th-grade students are based on one of two questionnaire forms for 1991–1996, and based on two of four forms for 1997–1999, with a resulting sample size one-half of the total sample size for each grade in each year. Data for 12th-grade students are based on one of six questionnaire forms for 1989–1999 and one of five for 1980–1988, resulting in one-sixth, and one-fifth, respectively, of the total sample size for each year . Data for 8th and 10th grades have been available since 1991.
Sources: Bachman, Johnston, & O‘Malley, 1980, Questionnaire Form 5, item E06D; Bachman, Johnston, & O‘Malley, Questionnaire Form 3, item E06D; Bachman, Johnston, & O‘Malley, 1997 unpublished, Questionnaire Form 3, item E04D. Data for 8th and 10th grades are from unpublished questionnaire responses, Form 1, item E10D, for 1991-1996 and from unpublished questionnaire responses, Forms 1 & 3, item E08D, for 1997.

Table SD 1.2.B Percentage of 8th-, 10th-, and 12th-grade students in the United States reporting peer disapproval of intentionally angering a teacher in school, by gender and race: Selected years, 1980-1999

	1976	1981	1986	1991	1992	1993	1994	1995	1996	1997	1998	1999
8th Grade
Total	—	—	—	26	24	24	21	22	23	23	24	22
Gender
Male	—	—	—	22	20	20	18	19	20	21	20	20
Female	—	—	—	30	27	26	23	24	26	26	27	24
Race
White	—	—	—	26	24	24	22	22	23	24	24	23
Black	—	—	—	23	24	23	22	22	22	20	23	20
10th Grade
Total	—	—	—	26	24	24	26	24	23	23	25	26
Gender
Male	—	—	—	21	19	19	22	21	19	20	23	22
Female	—	—	—	31	28	28	30	28	26	27	28	30
Race
White	—	—	—	27	25	25	26	25	23	24	26	27
Black	—	—	—	22	21	20	23	19	20	19	24	26
12th Grade
Total	41	42	33	33	34	34	33	36	35	34	33	34
Gender
Male	37	35	29	31	28	30	25	32	29	31	28	30
Female	46	48	38	37	39	37	40	41	40	38	38	37
Race
White	44	43	35	34	35	34	34	36	36	36	35	36
Black	29	33	30	29	30	27	25	33	28	30	24	23

Note: Data for 8th- and 10th-grade students are based on one of two questionnaire forms for 1991–1996, and based on two of four forms for 1997–1999, with a resulting sample size one-half of the total sample size for each grade in each year. Data for 12th-grade students are based on one of six questionnaire forms for 1989–1999 and one of five for 1980–1988, resulting in one-sixth, and one-fifth, respectively, of the total sample size for each year. Data for 8th and 10th grades have been available since 1991.
Sources: Bachman, Johnston, & O‘Malley, Questionnaire Form 1, item D007; data for 8th and 10th grades are from unpublished questionnaire responses, Form 1, item E08, for 1991-1996 and from unpublished questionnaire responses, Forms 1 & 3, item E06.

Figure SD 1.2.A Percentage of high school seniors in the United States reporting that good grades have great or very great importance to peers, by race: 1980-1999 ^a

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^a This question was not asked in 1981.
Sources: Bachman,Johnston, & O‘Malley, 1980, Questionnaire Form 5, item E06D; Bachman, Johnston, & O‘Malley, 1982-1995, Questionnaire Form 3, item E06D; Bachman, Johnston, & O‘Malley, 1997, Questionnaire Form 3, item E04D.

Figure SD 1.2.B Percentage of high school seniors in the United States reporting peer disapproval of intentionally angering a teacher in school, by race: 1980-1999

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Source: Bachman, Johnston, & O‘Malley, 1980-1997, Questionnaire Form 1, item D007.

SD 1.3 Religious Attendance and Religiosity

Research relating religion to children’s day-to-day conduct suggests that teens who are religious are more likely to avoid high-risk behaviors.⁴

The number of 12th-grade students who report weekly religious attendance has declined from two out of every five students (41 percent) in 1976 to one out of every three students (31-33 percent) since 1987. During that same period, the percentage of 12th-grade students who report that religion plays a very important role in their lives stayed fairly constant, varying between 25 percent and 33 percent (see Figure SD 1.3).

Differences by Age. Data for students in the 8th and 10th grades, available since 1991, indicate that younger adolescents are more likely to report weekly religious attendance but are not more likely to report that religion plays a very important role in their lives (see Tables SD 1.3.A and SD 1.3.B). In 1999, 43 percent of 8th-graders reported weekly religious attendance, versus 38 percent of 10th-grade and 33 percent of 12th-grade students. During that same year, the percentage reporting that religion played an important role in their lives was between 32 percent and 33 percent for all three grades.

Differences by Gender. Females in all grades are somewhat more likely than males to report weekly religious attendance and that religion plays a very important role in their lives (see Tables SD 1.3.A and SD 1.3.B).

Differences by Race. Black students across grades have consistently been nearly twice as likely as their white counterparts to report that religion plays a very important role in their lives; for example, in 1999, 55 percent of black 12th-graders reported that religion played such a role, compared with 29 percent of white 12th-grade students.

⁴ National Commission on Children. 1991. Beyond Rhetoric: A New American Agenda for Children and Families. Final Report
of the National Commission on Children, p. 352. Washington, D.C.: U.S. Government Printing Office.

Figure SD 1.3 Percentage of high school seniors in the United States reporting weekly religious attendance and reporting religion is important in their lives: 1976-1999

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Sources: Johnston, Bachman, & O’Malley, 1976-1997, 12th grade 1976-1988 Questionnaire Forms 1-5; 12th grade 1989-1996 Questionnaire Forms 1-6, items C13B and C13C; 12th grade 1997 Questionnaire, Core Questions, items C13B and C13C; and 12th grade 1998 Questionnaire, Core Questions, items C12B, C13, C13B, and C13C.

Table SD 1.3.A Percentage of 8th-, 10th-, and 12th-grade students in the United States who report weekly religious attendance, by gender and race: Selected years, 1976-1999

	1976	1981	1986	1991	1992	1993	1994	1995	1996	1997	1998^a	1999^a
8th Grade
Total	—	—	—	46	43	42	42	42	43	44	45	43
Gender
Male	—	—	—	44	41	39	40	40	40	42	42	41
Female	—	—	—	49	46	45	45	45	46	47	47	46
Race
White	—	—	—	48	44	44	44	43	44	46	45	45
Black	—	—	—	47	46	42	42	46	45	46	49	46
10th Grade
Total	—	—	—	38	39	40	37	37	38	38	38	38
Gender
Male	—	—	—	35	37	37	35	35	35	36	35	36
Female	—	—	—	42	41	43	39	40	40	41	40	40
Race
White	—	—	—	39	39	41	37	37	38	39	37	37
Black	—	—	—	44	45	44	41	44	38	43	45	43
12th Grade
Total	41	40	34	31	32	32	32	32	33	31	32	33
Gender
Male	36	36	31	28	31	29	30	30	30	28	29	33
Female	46	44	38	34	34	34	35	35	35	33	34	34
Race
White	42	41	35	31	32	31	32	32	32	29	31	33
Black	37	40	36	38	35	35	39	40	38	40	41	40

^a California schools omitted.
Note: Data for 8th and 10th grades available since 1991.
Sources: Johnston, Bachman, & O’Malley, 8th and 10th grade 1991-1996 Questionnaire Forms 1 and 2, item C12B, and 8th and 10th grade 1997 Questionnaire Core Questions, item C12B. 12th grade 1976-1988 Questionnaire Forms 1-5; 12th grade 1988-1996 Questionnaire Forms 1-6, item C13B; 12th grade 1997 Questionnaire Core Questions, item C13B; and 12th grade 1998 Questionnaire, Core Questions, items C12B, C13, C13B, and C13C.

Table SD 1.3.B Percentage of 8th-, 10th-, and 12th-grade students in the United States who report that religion plays a very important role in their lives, by gender and race: Selected years, 1976-1999

	1976	1981	1986	1991	1992	1993	1994	1995	1996	1997	1998^a	1999^a
8th Grade
Total	—	—	—	29	27	30	30	30	32	32	34	33
Gender
Male	—	—	—	27	26	27	29	28	29	30	32	31
Female	—	—	—	31	28	32	32	32	34	34	36	36
Race
White	—	—	—	26	23	26	26	26	27	28	30	29
Black	—	—	—	46	46	42	47	45	47	48	52	51
10th Grade
Total	—	—	—	29	28	29	28	29	29	30	31	32
Gender
Male	—	—	—	26	26	26	24	26	26	28	29	28
Female	—	—	—	31	29	31	32	31	31	33	34	34
Race
White	—	—	—	24	24	26	24	25	26	27	26	27
Black	—	—	—	52	50	50	48	49	47	48	52	55
12th Grade
Total	29	31	26	28	29	29	30	30	31	30	32	33
Gender
Male	24	25	23	24	26	26	27	27	27	26	28	30
Female	34	36	30	31	33	33	32	33	35	34	36	35
Race
White	26	27	23	24	25	24	26	26	27	24	27	29
Black	51	51	51	50	51	51	49	52	55	55	57	55

^a California schools were omitted.
Note: Data for 8th and 10th grades available since 1991.
Sources: Johnston, Bachman, & O’Malley, 1976-1999, 8th and 10th grade 1991-1996 Questionnaire Forms 1 and 2, item C13 and 8th and 10th grade 1997 Questionnaire Core Questions, item C13; 12th grade 1976-1988 Questionnaire Forms 1-5; 12th grade 1989-1996 Questionnaire Forms 1-6, item C13C; 12th grade 1997 Questionnaire Core Questions, item C13C; and 12th grade 1998 Questionnaire, Core Questions, items C12B, C13, C13B, and C13C.

SD 1.4 Voting Behavior of Young Adults

Voting is a critical exercise of citizenship in a democracy. Measures of the voting behavior of young adults may be seen as indicators of the level of youth commitment to the democratic process.

Rates of reported voter registration and voting among 18- through 24-year-olds during presidential election years declined between 1972 and 1976 and have stayed rather flat through 1996 (see Table SD 1.4.A). In 1972, 59 percent of young adults ages 18 through 24 reported that they had registered to vote, and 50 percent reported that they had voted. By 1996, 46 percent reported that they had registered, and 31 percent reported that they had voted (see Figure SD 1.4.A).

Differences by Gender. Reported rates of voter registration and voting are modestly higher among women both over time and within racial and ethnic groups, particularly during presidential election years; for example, in 1996, 51 percent of females and 47 percent of males ages 18 through 24 reported that they had registered to vote (see Table SD 1.4.A).

Differences by Race and Hispanic Origin. Hispanic young adults are the least likely to report that they register and vote. In 1996, 28 percent of Hispanic young adults reported that they had registered, and 15 percent reported that they had voted. Comparable numbers for blacks are 49 percent registered and 32 percent voted. Whites were the most likely to report that they had registered (50 percent) and voted (32 percent) in 1996 (see Figure SD 1.4.B). Since 1972, the percentage of Hispanic young adults who reported that they had voted in presidential election years has declined by almost one-half, from 31 percent to 15 percent (see Table SD 1.4.A).

Differences by Electoral Cycle. The percentage of young adults who reported that they had voted in nonpresidential election years since 1974 is substantially lower than the percentage who reported that they had voted during presidential election years (see Table SD 1.4.B). Rates of reported registration and voting have been remarkably stable during such years, across nonpresidential election years, with overall rates varying by only a few percentage points across the years.

Table SD 1.4. A Percentage of persons ages 18 through 24 in the United States who reported that they had registered to vote and percentage who reported that they had voted in presidential election years, by race and Hispanic origin and by gender: Selected years, 1972-1996

		1972	1976	1980	1984	1988	1992	1996
Percentage who reported registering
All races^a
	Total	59	51	49	51	48	53	49
	Male	58	51	48	50	46	50	47
	Female	59	52	50	53	51	54	51
White
	Total	61	54	51	52	49	75	50
	Male	60	53	50	51	46	53	48
	Female	61	54	52	53	51	57	52
Black
	Total	48	39	41	54	50	49	49
	Male	45	38	40	49	47	46	45
	Female	50	40	43	58	53	52	53
Hispanic
	Total	39	29	23	30	25	25	28
	Male	38	30	20	27	21	20	25
	Female	39	28	25	32	30	30	31
Percentage who reported voting
All races^a
	Total	50	42	40	41	36	43	32
	Male	49	41	39	39	34	41	30
	Female	50	43	41	43	38	45	35
White
	Total	52	45	42	42	37	45	33
	Male	51	43	40	40	35	43	31
	Female	53	46	60	43	39	47	35
Black
	Total	35	28	30	41	35	37	32
	Male	32	27	29	36	32	32	26
	Female	37	29	31	45	37	41	38
Hispanic
	Total	31	22	16	22	17	18	15
	Male	30	22	13	20	14	14	12
	Female	32	22	19	24	20	22	19

Figure SD 1.4.A Percentage of persons ages 18 through 24 in the United States who reported that they had registered to vote and percentage who reported that they had voted in presidential election years: Selected years, 1972-1996

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Note: Current Population Survey figures routinely overestimate voter registration and turnout when compared to the official rates.
Sources: U.S. Bureau of the Census, Current Population Reports, Series P-20, 253, 293, 322, 344, 370, 405, 414, 453, 466, and PPL24-RV.

Table SD 1.4.B Percentage of persons ages 18 through 24 in the United States who reported that they had registered to vote and percentage who reported that they had voted in nonpresidential election years, by race and Hispanic origin and by gender: Selected years, 1974-1998

		1974	1978	1982	1986	1990	1994	1998
Percentage who reported registering
All races^a
	Total	41	41	42	42	40	42	39
	Male	42	40	42	41	40	41	36
	Female	41	42	43	43	40	44	42
White
	Total	43	41	43	42	41	44	41
	Male	44	41	44	42	40	—	38
	Female	42	42	43	43	41	—	43
Black
	Total	34	37	57	46	40	42	38
	Male	31	35	38	43	41	—	33
	Female	36	40	45	49	40	—	42
Hispanic
	Total	23	21	24	22	19	20	22
	Male	24	22	24	20	18	—	18
	Female	23	20	25	24	21	—	27
Percentage who reported voting
All races^a
	Total	24	24	25	22	20	20	17
	Male	25	23	25	21	20	19	16
	Female	23	24	25	23	21	22	18
White
	Total	25	24	25	22	21	21	17
	Male	29	24	26	21	20	—	17
	Female	24	25	24	22	22	—	18
Black
	Total	16	20	26	25	20	17	16
	Male	16	19	24	24	20	—	13
	Female	17	21	27	26	21	—	18
Hispanic
	Total	13	12	14	12	9	10	9
	Male	14	13	14	10	7	—	6
	Female	13	10	14	13	16	—	12

^a Estimates for whites and blacks include Hispanics of those races. Persons of Hispanic origin may be of any race.
Note: Current Population Survey figures routinely overestimate voter registration and turnout when compared to the official rates.
Sources: U.S. Bureau of the Census, Current Population Reports, Series P-20, 253, 293, 322, 344, 370, 405, 414, 453, 466, and PPL24-RV; Reported voting and registration for the United States, 1998, table 2, available online at www.census.gov/population/socdemo/voting/cps1998/tab02.txt

Figure SD 1.4.B Percentage of persons ages 18 through 24 in the United States who registered to vote and percentage who voted in nonpresidential election year 1998, by race and Hispanic origin ^a

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SD 1.5 Television Viewing Habits

Some studies indicate that excessive television watching is negatively related to the academic attainment of children and youth; for example, children and adolescents in grades 4, 8, and 11 who watch 5 or more hours of television per day have substantially lower test scores than other children on average.⁵ Yet, as depicted in Figure SD 1.5, substantial percentages of students report watching large amounts of television on a daily basis. The content of the television programs the students watched was not reported.

Differences by Age. The percentage of children who report watching 6 or more hours of television declines with age, as indicated in Figure SD 1.5. Among 9-year-olds, 18 percent reported watching 6 or more hours of television each day in 1996. Among 13-year-old students, 13 percent watched 6 or more hours of television. Among 17-year-olds, only 7 percent watched this amount of television each day. For all three age groups, the percentage of students spending 6 or more hours a day watching television increased between 1982 and 1986 and then declined through 1996.

Differences by Gender. Larger proportions of boys than girls at ages 9 and 13 are watching television for long periods of time (see Table SD 1.5.A). In 1996, 20 percent of 9-year-old boys watched television for 6 or more hours per day, compared with 15 percent of girls in that age group. A similar pattern is evident for 13-year-olds (see Table SD 1.5.B), while for 17-year-olds, the percentages of boys and girls watching television for long periods is the same, at 7 percent (see Table SD 1.5.C).

Differences by Race and Hispanic Origin.⁶ For each age group and for each time point of assessment, larger proportions of black students watch television for 6 or more hours per day than do either white or Hispanic students; for example, among 9-year-old students, 39 percent of black students, compared with 13 percent of white students and 21 percent of Hispanic students, reported watching television 6 or more hours per day in 1996 (see Table SD 1.5.A).

Differences by Type of School. In general, smaller percentages of children and adolescents who attend private school spend 6 or more hours per day watching television than do students who attend public school. The differences between public and private school pupil television viewing habits are more pronounced among 9- and 13-year-old students (see Tables SD 1.5.A, SD 1.5.B, and SD 1.5.C).

Differences by Parents’ Educational Level. Children’s television viewing habits also vary by parents’ educational level. In general, as parents’ educational levels increase, the percentages of children watching 6 or more hours of television decline. In 1996, 18 percent of 13-year-olds whose parents had less than a high school education were watching 6 or more hours of television per day, compared with 13 percent of students with parents who graduated from high school and 10 percent of students whose parents graduated from college (see Table SD 1.5.B). A similar pattern is evident for 17-year-olds (see Table SD 1.5.C).

⁵ U.S. Department of Education, National Center for Education Statistics. 1994. Youth Indicators 1993: Trends in the Well-Being of American Youth. Washington, D.C.: U.S. Government Printing Office.
⁶ Estimates for whites and blacks exclude Hispanics of those races.

Figure SD 1.5 Percentage of students in the United States who watch 6 or more hours of television per day, by age: selected years, 1982-1996

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Sources: Unpublished tables, National Assessment of Educational Progress (NAEP), 1992, 1994, and 1996 Long- Term Trend Results, Math Assessment data; and unpublished Almanacs, 1978-1990.

Table SD 1.5.A Percentage of 9-year-old students in the United States who watch 6 or more hours of television per day, by gender, race and Hispanic origin, and type of school: Selected years, 1982-1996

	1982	1986	1990	1992	1994	1996
Total	26	31	23	19	19	18
Gender
Male	30	34	27	22	23	20
Female	23	27	20	17	16	15
Race and Hispanic origin^a
White non-Hispanic	23	26	18	14	14	13
Black non-Hispanic	43	53	47	41	40	39
Hispanic	28	33	26	25	22	21
Type of school
Public	27	32	24	21	19	19
Private	21	24	18	5	11	7

^aEstimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Note: Parents’ education is not reported for 9-years-olds because approximately one-third of these students did not know their parents’ education level.
Sources: Unpublished tables, National Assessment of Educational Progress (NAEP), 1992, 1994, and 1996 Long-Term Trend Results, Math Assessment data; and unpublished Almanacs, 1978-1990.

Table SD 1.5.B Percentage of 13-year-old students in the United States who watch 6 or more hours of television per day, by gender, race and Hispanic origin, type of school, and parents’ highest level of education: Selected years, 1982-1996

	1982	1986	1990	1992	1994	1996
Total	16	20	17	13	13	13
Gender
Male	18	21	18	14	15	15
Female	15	19	15	11	12	11
Race and Hispanic origin^a
White non-Hispanic	13	17	12	8	8	7
Black non-Hispanic	32	40	35	31	35	35
Hispanic	19	21	18	19	19	17
Type of school
Public	17	20	17	14	14	13
Private	13	—	11	6	4	3
Parents’ highest level of education
Less than high school	23	32	24	21	23	18
Graduated high school	18	22	19	16	17	13
More than high school	13	18	12	9	13	13
Graduated college	12	15	13	9	9	10

— =Too few observations for a reliable estimate.
^a Estimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Sources: Unpublished tables, National Assessment of Educational Progress (NAEP), 1992, 1994, and 1996 Long-Term Trend Results, Math Assessment data; and unpublished Almanacs, 1978-1990.

Table SD 1.5.C Percentage of 17-year-old students in the United States who watch 6 or more hours of television per day, by gender, race and Hispanic origin, type of school, and parents’ highest level of education: Selected years, 1978-1996

	1978	1982	1986	1990	1992	1994	1996
Total	5	6	9	9	7	8	7
Gender
Male	5	7	10	9	7	10	7
Female	5	6	8	8	7	7	7
Race and Hispanic origin^a
White non-Hispanic	4	5	6	6	4	5	4
Black non-Hispanic	13	14	22	23	21	24	21
Hispanic	7	6	12	8	6	9	9
Type of school
Public	5	7	9	9	7	8	7
Private	3	3	—	—	3	3	6
Parents’ highest level of education
Less than high school	8	10	17	11	10	14	15
Graduated high school	5	8	10	11	10	12	9
More than high school	4	4	9	8	5	8	6
Graduated college	3	4	4	5	5	5	6

SD 1.6 Detached Youth: Percentage of 16- Through 19-Year- Olds Not in School and Not Working

“Detached youth” refers to young people ages 16 through 19 who are neither enrolled in school nor working. This detachment, particularly if it lasts for several years, increases the risk that a young person, over time, will have lower earnings and a less stable employment history than his or her peers who stayed in school and/or secured jobs.⁷

Since 1985, the percentage of detached youth has fluctuated between 8 and 11 percent (see Table SD 1.6). In 1999, 8 percent of all youth ages 16 through 19 were detached.

Differences by Sex. Young women are slightly more likely than young men to be detached from both school and employment. In 1999, 9 percent of young women, while 7 percent of young men experienced detachment.

Differences by Race and Hispanic Origin. Black and Hispanic youth are more likely than white youth to be detached from school and employment. In 1999, 13 percent of black youth and 14 percent of Hispanic youth experienced detachment. The corresponding rate for white youth was 6 percent.

Differences by Age. Youth ages 16 or 17 are more likely than 18- or 19-year-olds to be in school or working. In 1999, 13 percent of 18- and 19-year-olds were detached, while only 4 percent of their younger peers were detached.

⁷Brown, B. 1996. Who Are America’s Disconnected Youth? Report prepared for the American Enterprise Institute.

Table SD 1.6 Percentage of 16- through 19-year-olds in the United States who are neither enrolled in school nor working,^a by gender and by race and Hispanic origin^b and by age: Selected years, 1985-1999

	1985	1990	1991	1992	1993	1994^c	1995^c	1996^c	1997^c	1998^c	1999
All youth	11	10	10	10	9	10	9	9	9	8	8
Gender
Male	9	8	9	8	8	8	8	8	8	8	7
Female	13	12	13	12	11	11	11	11	10	9	9
Race and Hispanic origin^b
White	9	8	8	8	7	7	7	7	7	6	6
Black	18	15	17	17	15	14	14	15	13	13	13
Hispanic	17	17	16	17	16	16	16	14	14	14	14
Age group
Ages 16-17	5	5	5	4	4	4	4	4	4	4	4
Ages 18-19	17	15	16	16	15	15	15	15	14	13	13

^aThe figures represent a yearly average based on responses for the 9 months youth typically are in school (September through May). Youth are asked about their activities for the week prior to the survey. Results are based on uncomposited estimates and are not comparable to data from published tables.
^bPersons of Hispanic origin may be of any race. Estimates for whites and blacks do not include persons of Hispanic origin.
^cData for 1994 and subsequent years are not strictly comparable with data for prior years, because of major revisions in the Current Population Survey questionnaire and data collection methodology, and because of the inclusion of the 1990 census-based population controls in the estimation process.
Source: Special tabulations of the Current Population Survey prepared by the Bureau of Labor Statistics, as published in America's Children: Key National Indicators of Well-Being, 2000. Federal Interagency Forum on Child and Family Statistics, Table ED5.

SD 1.7 Youth Violent Crime Arrest Rates (8)

The Federal Bureau of Investigation’s Violent Crime Index includes murder, forcible rape, robbery, and aggravated assault.9 The rate of youth arrests for these Index crimes increased substantially between 1980 and 1994, from 334 to 527 per 100,000 persons ages 10 through 17, and has been declining since to where it stood in 1998 at 370 per 100,000 persons ages 10 through 17 (see Table SD 1.7).

Differences by Age and Gender. Arrest rates for Violent Index crimes have consistently been much higher among males than among females over time and across all ages (see Figure SD 1.7). Rates for both males and females increased considerably between 1980 and 1994 for males and 1995 for females, with declines in the past several years for both genders. In 1998, rates for males and females age 10–17 were 597 and 130 per 100,000, respectively (see Table SD 1.7).

Youth Violent Crime Index arrest rates climb quickly and steadily with age for males, from 124 per 100,000 for 10- through 12-year-olds to 1,356 per 100,000 among 17-year-olds in 1998 (see Table SD 1.7). The rates for young women in 1998 also increase with age, with 234 arrests per 100,000, for females age 17. Girls ages 10 through 12 are the least likely to be arrested for violent crimes, with only 26 per 100,000 arrested in 1998.

⁸ Arrests for violent crimes were chosen in preference to other arrest measures as an indicator both because of the particular hazards that violent crime represents to our society and because arrests for violent crimes are less likely to be affected over time by changes in police practice and policy than other types of crime.
⁹ Violent crimes in addition to the four included in the FBI's Violent Crime Index, including kidnapping, extortion, and forcible sodomy, are not included in this indicator.

Table SD 1.7 Violent crime^a arrest rates for youth ages 10 through 17^b in the United States, by gender and age (per 100,000): Selected years, 1980-1998

	1980	1985	1990	1991	1992	1993	1994	1995	1996	1997	1998
Total
Ages 10-17	334	303	428	461	482	504	527	518	460	443	370
Ages 10-12	46	56	71	79	85	86	92	91	80	83	76
Ages 13-14	261	252	368	405	444	460	493	469	405	398	329
Age 15	504	446	670	732	768	826	855	823	723	667	547
Age 16	639	566	876	935	993	1,026	1,053	1,031	896	869	696
Age 17	740	651	983	1,066	1,056	1,109	1,111	1,113	1,013	944	814
Male
Ages 10-17	587	528	736	792	819	851	881	859	760	726	597
Ages 10-12	81	99	119	134	144	144	153	149	132	137	124
Ages 13-14	445	425	601	664	720	739	787	744	640	622	507
Age 15	876	769	1,136	1,241	1,280	1,373	1,406	1,337	1,173	1,072	865
Age 16	1,131	994	1,521	1,620	1,711	1,755	1,785	1,730	1,500	1,440	1,135
Age 17	1,322	1,159	1,740	1,888	1,853	1,930	1,922	1,914	1,722	1,600	1,356
Female
Ages 10-17	70	67	105	112	127	140	153	158	144	144	130
Ages 10-12	10	12	19	21	23	25	27	29	26	26	26
Ages 13-14	70	71	123	132	153	167	183	181	159	163	143
Age 15	117	108	177	195	228	248	272	279	248	239	211
Age 16	125	117	192	207	230	252	274	287	254	261	229
Age 17	130	116	178	191	205	232	246	257	254	242	234

^a Violent crimes include murder, forcible rape, robbery, and aggravated assault.
^b Rates were calculated assuming the age profile of the FBI's reporting sample was consistent with the profile of the U.S. resident population in that year.
Note: Estimates in this table may not be comparable to estimates provided in previous issues of Trends in the Well-Being of America’s Children and Youth due to changes in the population estimates provided by the U.S. Bureau of the Census.
Source: Snyder, 2000.

Figure SD 1.7 Violent crime a arrest rates for youth ages 10 through 17 in the United States, by gender (rate per 100,000): 1980-1998

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^aViolent crimes include murder, forcible rape, robbery, and aggravated assault.
Note: Estimates in this figure may not be comparable to estimates provided in previous issues of Trends in the Well-Being of America’s Children and Youth due to changes in the population estimates provided by the U.S. Bureau of the Census.
Sources: Special analysis by Howard N. Snyder, National Center for Juvenile Justice, 1999, using published and unpublished arrest data from the FBI Uniform Crime Reporting Program and population data from the U.S. Bureau of the Census. A portion of these data was originally published in Snyder, 1998.

SD 1.8 Low-Risk Teen Cumulative Risk Index (10)

Statistics often show rates of individual problem behaviors among adolescents, such as drug or alcohol use, school dropout, or early sexual activity. Yet youth engaged in one problem behavior are often engaged in others as well; their risk of immediate and long-term harm increases as the number of risky behaviors increases.¹¹

The Low-Risk Teen Cumulative Risk Index is designed to identify the degree to which adolescents avoid a set of key problem behaviors simultaneously. This measure is created from 1995 youth-report data for five behaviors, where a youth is defined as having no risks if he or she:

Has not been suspended or expelled from school,
Has never had sexual intercourse,
Has never used illegal drugs (including marijuana, cocaine, inhalants, heroin, PCP,
ecstasy, amphetamines, LSD, mushrooms, and pills),
Has never drunk alcohol unsupervised by adults, and
Has never smoked cigarettes regularly (at least once a day for 30 days).

Differences by Age. The proportion of young people who report avoiding all of these risk behaviors decreases with age (see Figure SD 1.8). By age 15 (by the 15th birthday), slightly more than half of responding young people (53 percent) have avoided all five risk behaviors, and 32 percent have experienced two or more risks. By age 17 (by the 17th birthday), an age at which most young people are still in high school, the proportion with no risks drops to 29 percent, and nearly half (45 percent) have now experienced two or more risk behaviors. Once youth reach their 18th birthday, only 22 percent report having engaged in no risk behaviors, while 48 percent report two or more such behaviors. Table SD 1.8 presents additional data on the percentage who report only one, and two or more, risk behaviors.

No Risk Behaviors by Gender, Family Structure, and Family Income. Across the adolescent years, more girls than boys report being free of any of the five risk behaviors. Similarly, children from two-parent families are more likely than children in single-mother families to avoid risky behaviors. Family income is another mitigating factor, with children in mid- to high-income families somewhat more likely than others to report that they avoid risk behaviors (see Table SD 1.8).

¹⁰ This measure uses different source data than a similar risk index presented in previous editions of this publication and should not be compared.
¹¹ Moore, K.A., & Glei, D.A. 1994. Taking the Plunge: An Examination of Positive Youth Development. Journal of Adolescent Research 10 (11): 15-40.

Figure SD 1.8 Percentage of youth by their 12th through 18th birthdays in the United States with no risks ^a on cumulative risk measure, by age ^b and gender: 1995

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Table SD 1.8 Percentage of youth by their 12th through 18th birthdays in the United States who have engaged in selected risk^a behaviors, by age,^b gender, family structure, and family income: 1995

		By age 12	By age 13	By age 14	By age 15	By age 16	By age 17	By age 18
All Respondents
	No risks	87	79	66	53	40	29	22
	Only one risk	3	5	10	15	21	26	30
	Two or more risks	10	16	24	32	39	45	48
Respondents with no risks
Gender
	Male	84	75	62	49	37	27	21
	Female	92	84	71	57	44	32	23
Family Structure^c
	Two parents	91	85	73	61	48	36	28
	Single-mother	84	73	58	43	32	23	16
	Other	82	72	57	42	31	20	15
Family Income
	$15,000 and under	85	76	63	48	37	27	20
	$15,001-$35,000	85	76	62	52	39	28	22
	$35,001-$50,000	90	82	70	57	43	31	26
	$50,001 and over	92	85	72	58	45	33	23

^a Risks are drawn from youth reports of selected behaviors in the 1995 National Longitudinal Study of Adolescent Health. The behaviors examined for this cumulative index are suspension or expulsion from school, engaging in sexual intercourse, use of illegal drugs, unsupervised consumption of alcohol, and regular smoking of tobacco cigarettes. A status of “no risks” indicates that a youth reported involvement in none of the five tracked behaviors for each of the age periods specified.
^b Age breaks for this indicator represent percentages of youth who have engaged (or not engaged) in the specified behaviors by the indicated birthdays.
^c“Two parents” includes biological and adoptive parents only. The “other” category includes all family types that are not households with two biological or adoptive parents from birth, or female single-parent households. Stepfamilies, single-father families, and children living with their grandparents are included as “other” families in Table SD 1.8.
Source: The National Longitudinal Study of Adolescent Health Wave 1, 1995, tabulations by Child Trends.

SD 1.9 Closeness With Parents

The quality of relationships that youth have with parents is important for several aspects of their development; for example, a positive parent-child relationship can promote an adolescent’s ability to handle stress.¹² Recent research suggests that closeness with parents serves as a protective factor against emotional distress, substance use, early sexual activity, and suicide thoughts or attempts.¹³

Differences by Age. More young adolescents report feeling very close to parents than do older adolescents; for example, more youth ages 12 through 14 (78 percent) report a very close relationship with their resident biological mother than do youth ages 15 through 17 (66 percent). Similar patterns are found for reports of closeness to resident and nonresident biological fathers, as well as resident nonbiological parents (see Figure SD 1.9).

Differences by Gender. Males report feeling closer to their parents than do females; for example, 74 percent of adolescent males compared with 65 percent of adolescent females report feeling very close to their resident biological mothers. Similarly, 64 percent of adolescent males report feeling very close to their resident biological fathers, compared with 51 percent of female youth.

Differences by Race and Hispanic Origin.¹⁴ More black and Hispanic youth than white youth report feeling very close to their mothers or mother figures; for example, 78 percent of black adolescents and 74 percent of Hispanic adolescents report feeling very close to their resident biological mother, while 68 percent of white adolescents report a similar relationship with their resident biological mother. Feelings of closeness with fathers followed the same pattern, with black and Hispanic youth reporting closer relationships than white youth. However, the variations by race or Hispanic origin were not as pronounced for fathers as for mothers (see Table SD 1.9).

Differences by Socioeconomic Status. Generally speaking, youth from low-income families were more likely to report being very close to their resident parents (biological and nonbiological); for example, youth whose parents earned between $5,000 and $9,999 per year were more likely to report very close relationships with their resident biological mother (78 percent) than were youth whose parents earned $25,000 to $34,999 per year (68 percent). (see Table SD 1.9).

Differences by Status of Parent. More adolescents report feelings of closeness with resident than with nonresident biological parents. Furthermore, adolescents report feeling closer to nonbiological resident parents than nonresident biological parents. For example, 70 percent of youth report feeling very close to their resident biological mother, compared with 61 percent who report feeling very close to their resident nonbiological mother and 37 percent who report feeling very close to their nonresident biological mother. Similar patterns exist for fathers and father figures.

¹² Hawes, D. 1996. Who Knows Who Best: A Program to Stimulate Parent-Teen Interaction. School Counselor 44 (2): 115-121.
¹³ Resnick, M.D., et al. 1997. Protecting Adolescents from Harm: Findings from the National Longitudinal Study on Adolescent Health. Journal of the American Medical Association 278 (10): 823-832.
¹⁴ Estimates of whites and blacks exclude Hispanics of those races.

Table SD 1.9 Percentage of youth ages 12 through 17 in the United States who report feeling very close to their parents, by parent type and by age, gender, race and Hispanic origin, parents’ education, and socioeconomic status: 1995

	Resident Biological Mother	Resident Non-Biological Mother	Resident Biological Mother	Resident Biological Father	Resident Non-Biological Father	Resident Biological Father
Total	70	61	37	58	34	21
Age
12-14	78	71	38	68	44	29
15-17	66	58	37	53	29	18
Gender
Male	74	64	41	64	40	25
Female	65	57	32	51	29	17
Race and Hispanic origin ^a
White, non-Hispanic	68	58	31	58	34	20
Black, non-Hispanic	78	65	55	61	33	22
Hispanic	74	67	41	59	35	24
Other ^b	64	63	29	53	43	20
Education of most educated parent
Less than high school	75	68	38	60	47	19
High school graduate	72	63	42	59	36	20
Some college or postsecondary	67	59	27	54	24	18
College graduate or more	67	56	37	57	34	24
Annual household income
Less than $5,000	78	74	48	77	72	31
$5,000 - $9,999	78	57	36	66	54	23
$10,000 - $14,999	75	71	44	56	36	15
$15,000 - $24,999	73	72	38	60	43	20
$25,000 - $34,999	68	49	42	59	32	17
$35,000 - $49,999	72	51	33	62	34	24
$50,000 - $74,999	67	53	47	57	28	23
$75,000 - $99,999	65	61	36	56	33	20
$100,000 +	64	56	20	53	33	27

^a Estimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
^b “Other” race category includes respondents who chose Asian, American Indian, or other race and also did not identify themselves (in a separate question) as Hispanic.
Source: The National Longitudinal Study of Adolescent Health Wave 1, 1995, tabulations by Child Trends.

Figure SD 1.9 Percentage of youth ages 12 through 17 in the United States who report feeling very close to their parents, by age and parent type: 1995

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Source: The National Longitudinal Study of Adolescent Health Wave 1, 1995, tabulations by Child Trends.

SD 1.10 Parents’ Activities With Children

Mothers and fathers are active in children’s lives in a variety of ways. In addition to providing for children’s basic care and protection, parents also serve as important teachers, mentors, role models, playmates, companions, and confidantes. The common theme of these additional roles is the direct interaction that takes place between parent and child in various contexts. Recent research indicates that positive interactions between parents and children foster positive developmental outcomes for children.¹⁵ Furthermore, there is a growing interest in identifying ways that fathers’ involvement in children’s lives uniquely contributes to child well-being.¹⁶

Data from the first and second waves of the National Survey of Families and Households (NSFH 1988 and 1995) were used to examine mothers’ and fathers’ interactions with their children (ages 5 through 17) in daily activities. Activities included eating meals together, spending time in activities away from home, working on a project together, having private talks, and helping with reading or homework.

As shown in Table SD 1.10.A, findings from the 1995 data include the following:

Over half of mothers (55 percent) and two-fifths of fathers (42 percent) eat dinner with their child every day of the week.
A similar percentage of mothers and fathers report going on outings with their childseveral times a week (17 percent and 18 percent for mothers and fathers, respectively) as well as almost every day (7 percent and 5 percent, respectively).
Twenty percent of mothers and 12 percent of fathers worked on a project at home with their child almost every day. An additional 32 percent of mothers and 28 percent of fathers worked on a project with their child several times a week.
The majority of mothers often engage their children in private conversations, with 22 percent reporting having private talks almost every day and another 31 percent reporting private talks several times a week. Among fathers, 21 percent reported having private talks with their children at least several times a week.
Mothers are also frequently helping their children with homework and reading. Forty percent report this type of interaction on an almost daily basis, with an additional 29 percent reporting helping their child with homework several times a week. One-third (33 percent) of fathers also report helping with homework several times a week, with a smaller group (13 percent) reporting helping almost every day.

Trends in Parental Activities. There was a significant drop in high levels of parent-child activity between 1988 and 1995 in most activities (see Table SD 1.10.A); for example, 62 percent of mothers reported eating dinner with their child on a daily basis in 1988, but in 1995 only 55 percent reported doing so. Similarly, 50 percent of fathers ate a daily dinner with their child in 1988, but in 1995 this rate dropped to 42 percent. Another example involves the rate at which parents engage their children in private talks. There was a 7 percentage point drop (from 29 to 22 percent) between 1988 and 1995 in the proportion of mothers who had private talks with their children almost every day. Similarly, there was a 5 percentage point drop (from 11 to 6 percent) in the proportion of fathers who had almost daily private talks with their children. Decreases in the amount of time parents spend in activities outside the home and working on projects inside the home were also found.

Differences by Race and Hispanic Origin.¹⁷ In 1995, white (55 percent) and Hispanic mothers (65 percent) were more likely than black mothers (49 percent) to report eating dinner with their child every day (see Table SD 1.10.B). Other racial/ethnic differences were also evident; for example, Hispanic mothers (17 percent) were more likely than white mothers (6 percent) to go on outings with their children almost every day in 1995 (see Table SD 1.10.B). On the other hand, black mothers (50 percent) were more likely than white mothers (38 percent) to help their children with homework or reading almost every day (see Figure SD 1.10). In general, father involvement in 1995 did not appear to vary by race and Hispanic origin; however, black fathers (11 percent) were more likely than white fathers (4 percent) to take their children on outings almost every day (see Table SD 1.10.B).

¹⁵ Hawes, D., 1996.
¹⁶ Lamb, M.E. 1997. Fathers and Child Development: An Introductory Overview and Guide. In M.E. Lamb (Ed.), The Role of the Father in Child Development, pp. 1-18. New York: John Wiley & Sons, Inc.
¹⁷ Estimates of whites and blacks exclude Hispanics of those races.

Table SD 1.10.A Percentage of parents in the United States who engage in selected activities with their children ages 5 through 17, by parent and type of activity: 1988 and 1995

	Mothers		Fathers
	1988	1995	1988	1995
Days per week eat dinner with at least one child
0 days	2	2	4	3
1-3 days	9	10	13	15
4-6 days	27	33	33	39
Every day	62	55	50	42
Time spent with children in activities away from home
Never or rarely	6	5	6	5
Once a month or less	15	20	18	24
Several times a month	25	29	25	29
About once a week	23	22	26	20
Several times a week	18	17	15	18
Almost every day	13	7	9	5
Time spent with children at home working on a project
Never or rarely	4	4	5	3
Once a month or less	9	9	10	13
Several times a month	14	17	17	27
About once a week	14	18	17	17
Several times a week	28	32	33	28
Almost every day	31	20	18	12
Time spent with children having private talks
Never or rarely	2	2	8	7
Once a month or less	7	7	17	19
Several times a month	14	17	20	23
About once a week	18	22	22	24
Several times a week	29	31	21	21
Almost every day	29	22	11	6
Time spent with children helping with reading or homework
Never or rarely	9	7	15	10
Once a month or less	6	6	13	13
Several times a month	9	8	17	16
About once a week	11	11	16	16
Several times a week	27	29	26	33
Almost every day	38	40	14	13

Source: The National Survey of Families and Households (NSFH), Wave 1, 1988, and Wave 2, 1995, tabulations by Dr. Randal Day, Washington State University.

Table SD 1.10.B Percentage of parents in the United States who engage in selected activities with their children ages 5 through 17, by parent, race and Hispanic origin,a and type of activity: 1995

	Mothers			Fathers
	White	Black	Hispanic^a	White	Black	Hispanic^a
Days per week eat dinner with at least one child
0 days	1	5	1	3	9	2
1-3 days	9	15	9	14	23	19
4-6 days	34	32	24	40	35	37
Every day	55	49	65	43	34	43
Time spent with children in activities away from home
Never or rarely	4	9	11	4	11	8
Once a month or less	19	22	19	22	26	28
Several times a month	30	27	20	31	26	22
About once a week	23	21	21	21	12	24
Several times a week	19	12	12	19	15	12
Almost every day	6	9	17	4	11	5
Time spent with children at home working on a project
Never or rarely	3	5	7	2	7	2
Once a month or less	9	8	8	11	23	12
Several times a month	17	21	14	29	18	27
About once a week	18	22	17	18	13	18
Several times a week	34	24	25	28	25	32
Almost every day	19	20	29	12	14	8
Time spent with children having private talks
Never or rarely	2	2	5	6	10	7
Once a month or less	7	9	7	20	17	17
Several times a month	17	15	18	23	19	23
About once a week	22	22	18	24	26	23
Several times a week	31	30	29	21	22	23
Almost every day	21	22	23	6	7	7
Time spent with children helping with reading or homework
Never or rarely	7	6	7	9	19	9
Once a month or less	6	5	6	14	9	9
Several times a month	9	7	9	16	14	16
About once a week	11	9	16	15	13	21
Several times a week	31	23	20	33	31	32
Almost every day	38	50	42	13	15	13

^aEstimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Source: The National Survey of Families and Households (NSFH), Wave 2, 1995, tabulations by Dr. Randal Day,
Washington State University.

Figure SD 1.10 Percentage of parents in the United States with children ages 5 through 17 who help their child with homework almost ever y day, by gender of parent and race and Hispanic origin: ^a 1995

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^a Estimates for whites and blacks include Hispanics of those races. Persons of Hispanic origin may be of any race.
Source: The National Survey of Families and Households (NSFH), Wave 2, 1995, tabulations by Dr. Randal Day, Washington State University.

Behavioral Health: Physical Health And Safety

SD 2.1 Physical Fighting by Youth

Physical violence is a major cause of injury and homicide among adolescents.¹⁸ In 1999, almost half of all male students and one-quarter of female students in grades 9 through 12 reported having been involved in a physical fight during the previous year. However, the percentage of all students who reported involvement in a fight decreased significantly between 1991 and 1999, from 43 percent to 36 percent. For males, the percentage decreased from 50 percent in 1991 to 44 percent in 1999 (see Figure SD 2.1).

Differences by Age. For all the years included in Table SD 2.1, the percentage of students who reported being involved in fights decreased with age. In 1997, 45 percent of 9th-grade students and 29 percent of 12th-grade students reported being involved in a fight. It is unclear, however, whether this pattern reflects the effects of increasing maturity, a change in the propensity to report having been in a fight, or a tendency for violence-prone youth to drop out of school, leaving a less violent pool of students in the higher grades.

Differences by Race.¹⁹ In 1999, 33 percent of white students reported involvement in a physical fight within the past year, compared with 41 percent of black students and 40 percent of Hispanic students (see Table SD 2.1).

¹⁸ Injuries were the leading cause of death for 15- to 19-year-olds in 1995 and 1996, accounting for 80 percent of all deaths. Injury-related mortality includes death from motor vehicle crashes, fires and burns, drowning, suffocation, and accidents caused by firearms and other explosive materials, among others. The rate of death from homicide for youth ages 15 through 19 more than doubled between 1970 and 1994 but decreased 37 percent between 1994 and 1997. (See, for injury-related and homicide mortality, the report section “Health Conditions and Health Care,” indicators HC 1.2 and HC 1.4, this report). See also: University of California at Los Angeles, CDC (Centers for Disease Control and Prevention). “The Epidemiology of Homicide in Los Angeles, 1970-79.” Atlanta: U.S. Department of Health and Human Services, Public Health Service, CDC, 1985. Cited in Chronic Disease and Health Promotion, Reprints from the Morbidity and Mortality Weekly Report: 1990-1991 Youth Risk Behavior Surveillance System. Atlanta: U.S. Department of Health and Human Services, Public Health Service, CDC, 1992, p. 37.
¹⁹ Estimates for whites and blacks exclude Hispanics of those races.

Figure SD 2.1 Percentage of students in grades 9 through 12 in the United States reporting that they have been in a physical fight within the past year, by gender: 1991, 1993, 1995, 1997, and 1999

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Sources: Unpublished tabulations of the Youth Risk Behavior Surveillance System (YRBSS) provided by the Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control, Kann et al., 1995, Table 6, p. 26; Kann et al., 1996, Table 6, p. 35; Kann et al., 1998, Table 6, p. 41.

Table SD 2.1 Percentage of students in grades 9 through 12 in the United States reporting that they have been in a physical fighta within the past year, by gender, grade, and race and Hispanic origin: 1991, 1993, 1995, 1997, and 1999

	1991			1993			1995			1997			1999
	Total	Male	Female	Total	Male	Female	Total	Male	Female	Total	Male	Female	Total	Male	Female
Total	43	50	34	42	51	32	39	46	31	37	46	26	36	44	27
Grade
Ninth	51	58	43	50	59	41	47	55	37	45	56	32	41	50	33
Tenth	43	50	35	42	52	32	40	46	34	40	48	30	38	46	29
Eleventh	43	51	35	41	52	28	37	46	28	34	44	23	31	39	23
Twelfth	34	42	25	35	43	27	31	38	24	29	37	19	30	39	22
Race and Hispanic origin^b
White	41	49	32	40	50	30	36	44	27	34	43	21	33	43	22
Black	51	58	44	50	58	42	42	49	35	43	49	38	41	44	39
Hispanic	41	49	35	43	52	34	48	56	40	41	50	30	40	51	30

^a One or more times.
^b Estimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Sources: Unpublished tabulations of the Youth Risk Behavior Surveillance System (YRBSS) provided by the Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control. Kann et al.; 1995, Table 6, p. 26; Kann et al.; 1996, Table 6, p. 35; Kann et al.; 1998, Table 6, p. 41.

SD 2.2 Weapon Carrying Among High School Youth

Weapon carrying is associated with the most serious injuries resulting from violence. Carrying a weapon significantly increases the risk that a violent argument will result in death, disability, or other serious injury.²⁰

Since 1991, the percentage of students who report carrying a weapon such as a gun, knife, or club at least once in the past month has declined; for example, in 1999, 17 percent of students in grades 9 through 12 reported carrying a weapon, compared with 26 percent in 1991 (see Table SD 2.2A).

Differences by Age. In general, students in the lower grades are more likely than students in the upper grades to carry a weapon. In 1999, 18 percent of 9th graders reported having carried a weapon in the past 30 days, compared with 16 percent of 12th graders.

Differences by Gender. High school males are much more likely than females to carry a weapon. This is true across all grades and for all racial and ethnic groups (see Figure SD 2.2.A); for example, in 1999, 29 percent of males in grades 9 through 12 reported carrying a weapon, compared with 7 percent of females.

Differences by Race and Hispanic Origin.²¹ In 1999, 16 percent of white, 17 percent of black, and 19 percent of Hispanic students reported having carried a weapon. For white and black students, these represent reductions from 1991 rates of 25 and 33 percent, respectively.

Youth Who Report Carrying a Gun. The number of students who reported carrying a gun at some time in the past 30 days declined significantly between 1993 and 1999. In 1999, 5 percent of high school students reported having carried a gun, including 12 percent of black students, 8 percent of Hispanic students, and 4 percent of white students (see Table SD 2.2.B).

²⁰ Public Health Service. 1993. Measuring the Health Behavior of Adolescents: The Youth Risk Behavior Surveillance System and Recent Public Health Reports on High-Risk Adolescents. Public Health Reports 108 (Supp. 1). Rockville, MD.
²¹ Estimates for whites and blacks exclude Hispanics of those races.

Table SD 2.2.A Percentage of students in grades 9 through 12 in the United States who reported having carried a weapon^a at least once within the past 30 days, by gender, grade, and race and Hispanic origin: 1991, 1993, 1995, 1997, and 1999

	1991			1993			1995			1997			1999
	Total	Male	Female	Total	Male	Female	Total	Male	Female	Total	Male	Female	Total	Male	Female
Total	26	41	11	22	34	9	20	31	8	18	28	7	17	29	6
Grade
Ninth	28	44	10	26	39	11	23	34	9	23	33	11	18	29	7
Tenth	27	42	11	21	33	10	21	32	9	17	27	6	19	31	5
Eleventh	29	44	13	22	33	9	20	32	8	18	29	6	16	27	5
Twelfth	21	33	10	20	33	7	16	26	6	15	23	5	16	27	5
Race and Hispanic origin^b
White	25	41	8	21	33	7	19	31	6	17	27	4	16	29	4
Black	33	43	24	29	38	19	22	30	16	22	29	15	17	23	12
Hispanic	26	40	13	24	37	12	25	37	13	23	35	10	19	30	8

^a Students were asked whether they carried a weapon “such as a gun, knife, or club” on at least one of the 30 days preceding the survey.
^b Estimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Sources: Centers for Disease Control and Prevention. 1990-1991 Youth Risk Behavior Surveillance System (YRBSS), Table 2, p. 68; Kann et al., 44 (SS-1), 45 (SS-4), 47 (SS-3), Table 4 in each.

Figure SD 2.2.A Percentage of students in grades 9 through 12 in the United States who reported having carried a weapon a at least once within the past 30 days, by gender and by race^b and Hispanic origin: 1999

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Table SD 2.2.B Percentage of students in grades 9 through 12 in the United States who reported having carried a gun at least once within the past 30 days, by gender, grade, and race and Hispanic origin: 1993, 1995, 1997, and 1999

	1993			1995			1997			1999
	Total	Male	Female	Total	Male	Female	Total	Male	Female	Total	Male	Female
Total	8	14	2	8	12	3	6	10	2	5	9	1
Grade
Ninth	9	16	2	9	14	3	8	13	3	5	10	1
Tenth	9	15	2	8	13	3	6	10	1	5	10	1
Eleventh	7	13	1	7	12	1	6	9	1	4	7	1
Twelfth	7	12	1	6	11	2	5	8	1	5	8	1
Race and Hispanic origin^a
White	7	12	1	6	10	2	4	7	1	4	8	1
Black	12	21	4	11	19	4	9	16	3	8	15	2
Hispanic	10	17	3	11	17	5	10	17	2	5	8	2

^aEstimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Source: Kann et al., 1995, 44 (SS-1), Table 4, p. 23; Kann et al., 1996 45 (SS-4), Table 4, p. 32; Kann et al., 1998, 47 (SS-3), Table 4, p. 38.

Figure SD 2.2.B Percentage of students in grades 9 through 12 in the United States who reported having carried a gun at least once within the past 30 days, by gender and by race and Hispanic origin^a: 1999

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^a Estimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Source: Kann et al., 1998, Table 4, p. 38.

SD 2.3 Seat Belt Use

Motor vehicle crashes are among the leading causes of death for children and youth.²² Consistent use of seat belts and child safety seats dramatically lessens the risk of injury or death in a motor vehicle crash. The National Highway Traffic Safety Administration estimates that in 1998, 51 percent of all children under age 5 who were killed while occupants of a motor vehicle were not protected by seat belts or child safety seats.²³

Table SD 2.3 presents data from the National Occupant Protection Use Survey (NOPUS), which gathers data through observation at intersections.²⁴ Between 1996 and 1998, seat belt use among toddlers ages 1 to 4 increased dramatically from 60 percent to 91 percent. Use among infants under 1 year old increased from 85 percent to 97 percent during the same time period. While these are promising trends, recent research indicates as many as 85 percent of parents and caregivers who do use car seats continue to install and use car seats incorrectly.²⁵

Between 1996 and 1998 rates of seat belt use increased modestly for persons ages 5 to 15 and 16 to 24, from 65 to 69 percent and 50 to 55 percent, respectively.

Differences by Age. The use of child safety seats or seat belts is substantially higher at younger ages. In 1998, rates were 97 percent for infants, 87 percent for children ages 1 to 4, 69 percent for children ages 5 to 15, and 55 percent for ages 16 to 24 (see Figure SD 2.3).

²² Hoyert, D.L., Kochanek. K.D., & Murphy, S.L. Deaths: Final Data for 1997. National Vital Statistics Reports 47 (19), Table 8. Hyattsville, MD: National Center for Health Statistics.
²³ National Highway Traffic Safety Administration. 1997. Traffic Safety Facts 1998. DOT HS 808 765. Washington, D.C.: U.S. Department of Transportation.
²⁴ Previous editions of Trends in the Well-Being of America’s Children and Youth presented seat belt data based on parent report rather than observation. Estimates based on parent report are higher than those based on observation.
²⁵ The study identified several frequent misuses of rear-facing, forward-facing, and booster seats for observed children, including 63 percent in seats not held tightly by safety belts, 33 percent with loose harness straps, and 20 percent with harness straps incorrectly routed through the seats. National SAFE KIDS Campaign. 1999. Child Passengers at Risk in America: A National Study of Car Seat Misuse. Washington, D.C.: National SAFE KIDS Campaign. Summary results online at: http://www.safekids.org/buckleup/study.html.

Figure SD 2.3 Percentage of children and youth in the United States who are obser ved to have worn a seat belt or been placed in a child safety seat, by age: a 1998

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^a Age group is based on the best judgment of the observers in the National Occupant Protection Use Survey (NOPUS) Controlled Intersection Study. Source: Transportation Secretary Slater Hails Increased Seat Belt Use, NHTSA 21-99, May 24, 1999. 1994 and 1996 estimates from National Occupant Protection Use Survey—1996: Controlled Intersection Study. Research Note. National Highway Traffic Safety Administration, U.S. Department of Transportation, August 1997.

Table SD 2.3 Percentage of children and youth in the United States who are observed to have worn a seat belt or been placed in a child safety seat, by age:^a 1994, 1996, and 1998

	1994	1996	1998
Infants (under age 1)^b	88	85	97
Toddlers (1-4 years)^c	61	60	91
Youths (5-15 years)	58	65	69
Young adults (16-24 years)	53	50	55

^a Age group is based on the best judgment of the observers in the National Occupant Protection Use Survey (NOPUS) Controlled Intersection Study.
^b Use of restraints for infants refers to child safety seats.
^cUse of restraints for toddlers refers to safety belts or child safety seats.
Source: 1998 Estimates from U.S. Department of Transportation, National Highway Traffic Safety Administration, 1999, Seat Belt Use; 1994 and 1996 estimates from National Occupant Protection Use Survey—1996: Controlled Intersection Study. Research Note. National Highway Traffic Safety Administration, U.S. Department of Transportation, August 1997.

SD 2.4 Regular Physical Exercise

Sixty percent of Americans do not exercise regularly, according to a 1996 report by the surgeon general, despite the many health benefits associated with physical activity.²⁶ People of all ages, both male and female, benefit from regular physical activity. Significant health benefits can be obtained by including a moderate amount of physical activity (e.g., 30 minutes of brisk walking or raking leaves, 15 minutes of running, or 45 minutes of playing volleyball) on most, if not all, days of the week.

The percentage of 12th-grade students who report actively participating in sports or exercise “almost every day” has remained fairly stable since 1976, varying between 44 and 48 percent. Rates have also been stable for 8th- and 10th-grade students since 1991, the first year in which data were collected for those grades (see Table SD 2.4.A).

Differences by Age. The percentages of students who report that they actively participate in sports or exercise “almost every day” decreased with age. In 1999, for example, 53 percent of 8th graders, 52 percent of 10th graders, and 45 percent of 12th graders reported daily or almost daily exercise (see Figure SD 2.4). A similar pattern emerged in a survey that asked teens whether they had exercised vigorously three or more times in the past week (see Table SD 2.4.B).

Differences by Gender. Males consistently report exercising or participating in sports more often than females. In 1999, for each age group, male rates were 14 to 17 percentage points higher than female rates, a trend that exists for nearly every year that data are available (see Table SD 2.4.A).

Differences by Race. Black and white students in the 8th grade are about equally likely to exercise regularly (see Table SD 2.4.A). Among 10th- and 12th-grade students, blacks appeared to be less likely than whites to exercise regularly in 1999. Other survey data, reported in Table SD 2.4.B, show larger differences by race and Hispanic origin. In 1999, 67 percent of white teens reported exercising vigorously at least three times a week, compared with 56 percent of non-Hispanic black teens and 61 percent of Hispanic teens.

²⁶ U.S. Department of Health and Human Services. 1996. Physical Activity and Health: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion.

Table SD 2.4.A Percentage of 8th-, 10th-, and 12th-grade students in the United States who report that they actively participate in sports or exercise "almost every day," by gender and race: Selected years, 1976-1999

	1976	1981	1986	1991	1992	1993	1994	1995	1996	1997	1998	1999
8th Grade
Total	—	—	—	57	55	55	53	56	54	55	53	53
Gender
Male	—	—	—	65	65	65	63	66	63	63	61	60
Female	—	—	—	49	45	46	44	47	47	48	45	46
Race
White	—	—	—	58	56	58	56	59	57	58	56	55
Black	—	—	—	61	57	54	52	55	56	56	54	55
10th Grade
Total	—	—	—	54	54	53	53	53	52	52	50	52
Gender
Male	—	—	—	63	64	62	62	62	60	60	58	60
Female	—	—	—	45	45	45	44	45	44	45	42	44
Race
White	—	—	—	55	55	54	54	55	53	54	52	54
Black	—	—	—	54	52	56	50	52	53	52	47	47
12th Grade
Total	44	48	44	46	46	44	45	45	45	45	44	45
Gender
Male	52	56	54	55	59	55	56	55	58	56	53	54
Female	36	39	36	36	33	33	36	37	32	36	35	37
Race
White	43	47	46	48	48	46	49	46	48	46	46	48
Black	49	53	43	43	41	39	39	48	40	38	38	40

Sources: Bachman, Johnston, & O’Malley, 1976, 1981, 1986, 1991, 1992, 1993, 1994, 1995, 1996, 1997, 1998, and 1999 (prepublication tables). 8th and 10th grade 1991 Questionnaire Forms 1 and 2, item A04E; 1992-1996 Questionnaire Forms 1 and 2, item A03E; and 1997 Questionnaire Forms 1-6, item A03E. 12th grade 1976, 1981, 1986, and 1991-1997 Questionnaire Form 2, item A02H.

Figure SD 2.4 Percentage of 8th-, 10th-, and 12th-grade students who report that they actively participate in sports or exercise “almost every day,” by gender: 1999

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Source: Bachman, Johnston, & O’Malley, 1999 (prepublication tables), items A03E and A02H.

Table SD 2.4.B Percentage of students in grades 9 through 12 in the United States who report having exercised vigorously three or more times in the past 7 days, by gender, grade, and race and Hispanic origin: 1993, 1995, 1997, and 1999

	1993			1995			1997			1999
	Total	Male	Female	Total	Male	Female	Total	Male	Female	Total	Male	Female
Total	66	75	56	64	74	52	64	72	54	65	72	57
Grade
Ninth	75	81	68	72	80	62	73	79	66	73	77	68
Tenth	70	77	61	69	79	59	66	74	56	65	73	56
Eleventh	63	71	53	60	72	47	60	69	49	58	67	49
Twelfth	58	70	45	55	67	42	58	68	44	61	71	52
Race and Hispanic origin^a
White	68	76	59	67	76	57	67	73	58	67	75	60
Black	60	71	49	53	68	41	54	67	41	56	65	47
Hispanic	59	69	50	57	70	45	60	69	50	61	72	50

^a Estimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race. Note: Vigorous physical exercise is defined as activities that cause sweating and hard breathing for at least 20 minutes.
Sources: Kann et al., 1995, Table 24, p. 53; Kann et al., 1996, Table 36, p. 78; Kann et al., 1998, Table 36, p. 84.

SD 2.5 Sufficient Hours of Sleep

Getting sufficient hours of sleep on a regular basis is important for optimum functioning throughout the day. Getting enough sleep is also linked to physical health. Individuals who are chronically sleep-deprived may be more susceptible to physical illness and more prone to accidents due to lack of concentration or inattention. Research indicates that sleep loss has a negative effect on motor performance, cognitive function, and mood.²⁷ For adolescents, not getting enough sleep may translate into lower performance in school or may affect socialization.

The number of hours that prove to be sufficient may differ between ages and individuals. A recent survey indicates that males ages 12 through 17 average 65.8 hours of sleep per week and females of the same age average 66.8 hours per week (approximately 9.5 hours of sleep a night for both sexes).²⁸ Analyses based on data from the 1995 National Longitudinal Study of Adolescent Health allow for an examination of youth perceptions of whether they obtain the sleep they need. In 1995, 74.1 percent of youth ages 12 through 17 reported that they got enough sleep (see Table SD 2.5).

Differences by Gender. Adolescent males are more likely to report getting enough sleep than their female peers. In 1995, 76.4 percent of males ages 12 through 17 reported getting enough sleep, compared with 71.8 percent of females.

Differences by Age and Grade. In 1995, approximately four out of every five (82.2 percent) youth ages 12 through 14 reported getting enough sleep, compared with 70.5 percent of youth ages 15 through 17. Similarly, in grades 7 and 8, 83.3 percent of students reported getting enough sleep, compared with 72.5 percent of students in grades 9 and 10 and 66.5 percent of students in grades 11 and 12.

Differences by Family Structure. Lower percentages of adolescents who live with a single father reported getting enough sleep (65.6 percent), compared with adolescents in other living arrangements (see Table SD 2.5).

²⁷Pilcher, J., & Huffcut, A. 1996. Effects of Sleep Deprivation on Performance: A Meta-analysis. Sleep 19 (4): 318-326.
²⁸Results from the Americans’ Use of Time Project, University of Maryland, as reported in Robinson, J.P., & Bianchi, S. 1997. The Children's Hours. American Demographics 12.

Table SD 2.5 Percentage of adolescents ages 12 through 17 in the United States who report that they get enough sleep, by gender, age, grade, race and Hispanic origin,^a and family structure: 1995

	1995
Total	74.1
Gender
Male	76.4
Female	71.8
Age
12-14	82.2
15-17	70.5
Grade
7-8	83.3
9-10	72.5
11-12	66.5
Race and Hispanic Origin^a
White	75.3
Black	72.8
Hispanic	73.5
Family Structure
Biological/Adoptive Mother & Father	75.6
Mother & Spouse/Partner	76.2
Father & Spouse/Partner	76.5
Single Mother	72.0
Single Father	65.6

^a Estimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Source: The National Longitudinal Study of Adolescent Health Wave 1, 1995, tabulations by Child Trends.

Behavioral Health: Smoking, Alcohol, And Substance Abuse

SD 3.1 Cigarette Smoking Among Youth

Cigarette smoking is the single most preventable cause of death in the United States. The Centers for Disease Control and Prevention estimates that one in five deaths is caused by tobacco use.²⁹ Youthful smoking can have severe, lifelong consequences because a large proportion of those who initiate smoking in adolescence will continue to smoke as adults.³⁰ In addition, youth who smoke are also more likely to use illicit drugs and to drink more heavily than their nonsmoking peers.³¹ Youth tobacco use varies within and among racial and ethnic minority groups, and it has been the focus of federal attention in recent years.³²

There are an estimated 3 million underage smokers in the United States. In a 1990 study, it was estimated that each year underage smokers purchase 947 million packs of cigarettes and 26 million cans of smokeless tobacco, resulting in $1.26 billion in tobacco sales.³³ A 1992 study by the CDC concluded that more than half of underage smokers buy their own cigarettes.³⁴ Although studies also show that only 23 percent of smoking youth now use vending machines often or occasionally, anticipated changes in state enforcement of minors’ access laws may increase the number of underage smokers who use tobacco vending machines.

Daily smoking among 12th-grade students decreased sharply in the late 1970s, and increased throughout most of the 1990s before declining modestly in 1998. Between 1992 and 1997, the percentage of 12th graders who reported smoking daily increased from 17.2
percent to 24.6 percent. In 1999, however, the percentage of 12th graders reporting daily smoking decreased to 23.1 (see Figure SD 3.1).

Data for 8th- and 10th-grade students, available from 1991 through 1999, also show increases throughout the 1990s in the percentage of students who reported smoking daily and a decrease in the last several years of the survey. Among 8th-grade students, the rate increased from 7.2 percent to 10.4 percent between 1991 and 1996 and decreased to 8.1 percent in 1999. Among 10th-grade students, the rate increased from 12.6 percent to 18.3 between 1991 and 1996 and decreased to 15.9 percent in 1999 (see Table SD 3.1.A).

Increases in the prevalence of current smoking among youth are also reflected in the results from the Youth Risk Behavior Survey, which examines “current smoking,” or smoking on one or more of the previous 30 days (see Table SD 3.1.B).

Differences by Age. In general, as age and/or grade increases, so does the prevalence of smoking. In 1999, the percentage of students who report daily smoking was 8.1 percent among 8th graders, 15.9 percent among 10th graders, and 23.1 percent among 12th-grade students (see Figure SD 3.1).

Differences by Race and Hispanic Origin.³⁵ White students consistently have the highest rates of smoking, while black students consistently have the lowest (see Tables SD 3.1.A and SD 3.1.B). The prevalence of current³⁶ smoking among white students is about twice that of black students. White students are twice as likely as Hispanic students and three times as likely as black students to be frequent³⁷ smokers (see Table SD 3.1.B).

Differences by Gender.³⁸ There is little to no difference in the prevalence of smoking between males and females, with the exception of black youth. Among black youth in grades 9 through 12, males were more likely than females in 1995 and in 1997 to report current and frequent smoking (see Table SD 3.1.B).

Prevalence of Smoking by Frequency. Two to three times the percentage of students report current smoking (smoking on 1 or more of the previous 30 days) than report frequent smoking (smoking on 20 or more of the previous 30 days) (see Table SD 3.1.B). This is apparent across all grades and for all the racial and ethnic groups shown.

²⁹ Centers for Disease Control and Prevention. 1993. Cigarette Smoking—Attributable Mortality and Years of Potential Life Lost-United States, 1990. Morbidity and Mortality Weekly Report 42 (33): 645-649.
³⁰ The Monitoring the Future Study, The University of Michigan. Cigarette Smoking Rates May Have Peaked among Younger Teens. Press release of December 18, 1997.
³¹ Substance Abuse and Mental Health Services Administration. 1996. Preliminary Estimates from the 1995 National Household Survey on Drug Abuse. Rockville, MD: Public Health Service. 1995 results indicate that youth ages 12 through 17 who smoked were about 8 times as likely to use illicit drugs and 11 times as likely to drink heavily as nonsmoking youths.
³² Centers for Disease Control and Prevention. 1998. Tobacco Use among U.S. Racial/Ethnic Minority Groups, African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, Hispanics: A Report of the Surgeon General (Executive Summary). Morbidity and Mortality Weekly Report 47 (RR-18): 4.
³³ Difranza, J.R., & Tye, J.B. 1990. Who Profits from Tobacco Sales to Children? JAMA 263 (20): 2784-2787.
³⁴ Allen, K., et al. 1993. Teenage Tobacco Use: Data Estimates from the Teenage Attitudes and Practices Survey, United States, 1989. Advance Data 224: 1-20.
³⁵ Estimates reported from the Youth Risk Behavior System for whites and blacks exclude Hispanics of those races.
³⁶ Current smoking is smoking on 1 or more of the previous 30 days.
³⁷ Frequent smoking is smoking one or more cigarettes per day in the previous 30 days.
³⁸The 1997 National Household Survey on Drug Abuse reports similar rates of cigarette smoking for males and females ages 12 through 17. 1997 responses to questions about use of cigarettes include: 39 percent of males and 38.3 percent of females "ever used," 25.7 percent of males and 27.2 percent of females "used in the past year," and 19 percent of males and 20.7 percent of females "used in the past month." Substance Abuse and Mental Health Services Administration, Office of Applied Studies. "National Household Survey on Drug Abuse: Population Estimates 1997," August 1998, Table 14A, accessed at http://www.samhsa.gov/oas/nhsda/pe1997/popes105.htm#E10E107 on 4/29/99.

Figure SD 3.1 Percentage of 8th-, 10th-, and 12th-grade students in the United States who reported smoking cigarettes daily over the previous 30 days: Selected years, 1975-1999

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Sources: Johnston, O’Malley & Bachman, 2000. 8th- and 10th-grade, Table D-48; 12th-grade Table D-49. 1998 prepublication detail tables provided by Monitoring the Future Study staff.

Table SD 3.1.A Percentage of 8th-, 10th-, and 12th-grade students who reported smoking cigarettes daily over the previous 30 days, by gender and by race and Hispanic origin: Selected years, 1975-1999

	1975	1980	1985	1990	1991	1992	1993	1994	1995	1996	1997	1998	1999
8th Grade
Total	—	—	—	—	7.2	7.0	8.3	8.8	9.3	10.4	9.0	8.8	8.1
Gender
Male	—	—	—	—	8.1	6.9	8.8	9.5	9.2	10.5	9.0	8.1	7.4
Female	—	—	—	—	6.2	7.2	7.8	8.0	9.2	10.1	8.7	9.0	8.4
Race and Hispanic origin^{a, b}
White	—	—	—	—	—	7.7	8.8	9.7	10.5	11.7	11.4	10.4	9.7
Black	—	—	—	—	—	1.4	1.8	2.6	2.8	3.2	3.7	3.8	3.8
Hispanic	—	—	—	—	—	7.3	7.2	9.0	9.2	8.0	8.1	8.4	8.5
10th Grade
Total	—	—	—	—	12.6	12.3	14.2	14.6	16.3	18.3	18.0	15.8	15.9
Gender
Male	—	—	—	—	12.4	12.1	13.8	15.2	16.3	18.1	17.2	14.7	15.6
Female	—	—	—	—	12.5	12.4	14.3	13.7	16.1	18.6	18.5	16.8	15.9
Race and Hispanic origin^{a, b}
White	—	—	—	—	—	14.5	15.3	16.5	17.6	20.0	21.4	20.3	19.1
Black	—	—	—	—	—	2.8	3.1	3.8	4.7	5.1	5.6	5.8	5.3
Hispanic	—	—	—	—	—	8.4	8.9	8.1	9.9	11.6	10.8	9.4	9.1
12th Grade
Total	26.9	21.3	19.5	19.1	18.5	17.2	19.0	19.4	21.6	22.2	24.6	22.4	23.1
Gender
Male	26.9	18.5	17.8	18.6	18.8	17.2	19.4	20.4	21.7	22.2	24.8	22.7	23.6
Female	26.4	23.5	20.6	19.3	17.9	16.7	18.2	18.1	20.8	21.8	23.6	21.5	22.2
Race and Hispanic origin^{a, b}
White	—	23.9	20.4	21.8	21.5	20.5	21.4	22.9	23.9	25.4	27.8	28.3	26.9
Black	—	17.4	9.9	5.8	5.1	4.2	4.1	4.9	6.1	7.0	7.2	7.4	7.7
Hispanic	—	12.8	11.8	10.9	11.5	12.5	11.8	10.6	11.6	12.9	14.0	13.6	14.0

Table SD 3.1.B Percentage of students in grades 9 through 12 in the United States who reported current and frequent smoking, by gender, race and Hispanic origin, and grade: 1991, 1993, 1995, 1997, and 1999

	Current Smoking^a					Frequent Smoking^b
	1991	1993	1995	1997	1999	1991	1993	1995	1997	1999
Total	28	31	35	36	35	13	14	16	17	17
Male	28	30	35	38	35	13	14	16	18	18
Female	27	31	34	35	35	12	14	16	16	16
Race and Hispanic origin^a
White	31	34	38	40	39	15	16	20	20	20
Male	30	32	37	40	38	15	16	18	20	21
Female	32	35	40	40	39	16	16	21	20	19
Black	13	15	19	23	20	3	5	5	7	7
Male	14	16	28	28	22	5	5	9	10	9
Female	11	14	12	17	18	2	4	1	4	5
Hispanic	25	29	34	34	33	7	8	10	11	10
Male	28	30	35	36	34	8	9	11	13	13
Female	23	27	33	32	32	6	7	9	8	9
Grade
Ninth	23	28	31	33	28	8	9	10	13	11
Tenth	25	28	33	35	35	11	13	13	15	15
Eleventh	32	31	36	37	36	16	15	19	19	19
Twelfth	30	35	38	40	43	16	18	21	19	23

^aCurrent smoking is smoking on 1 or more of the previous 30 days.
^bFrequent smoking is smoking on 20 or more of the previous 30 days.
^cEstimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Sources: Centers for Disease Control and Prevention. 1990-1991 Youth Risk Behavior Surveillance System, Table 1, p. 60 (current smoking); Table 1, p. 50, and unpublished data results Q28 (frequent smoking); Kann et al., 1995, Table 12, p. 35; Kann et al., 1996, Table 12, p. 44; Kann et al., 1998, Table 12, p. 50.

SD 3.2 Smokeless Tobacco Use Among Youth

The use of smokeless tobacco— snuff and chewing tobacco—is associated with a substantially higher risk of developing oral cancer.³⁹ Data from the Monitoring the Future Study indicate that smokeless tobacco use among youth has generally decreased in recent years. Data from the Youth Risk Behavior Survey provide additional information about smokeless tobacco use by males and females within racial and Hispanic groups.

Differences by Age.⁴⁰ In general, as age and/or grade increases, so does the prevalence of smokeless tobacco use. In 1999, the percentage of students who reported using smokeless tobacco over the previous 30 days was 4.5 percent among 8th graders, 6.5 percent among 10th graders, and 8.4 percent among 12th-grade students (see Table SD 3.2.A). The rate for 12th-grade students decreased from 12.2 percent in 1995 to 8.4 percent in 1999.

Differences by Gender. While rates of youth cigarette smoking are similar among males and females (see section SD 3.1), male students in the 8th, 10th, and 12th grades are more likely to use smokeless tobacco than are female students (see Figure 3.2.A). In 1999, among 12th-grade students, 15.5 percent of males and 1.3 percent of females reported smokeless tobacco use (see Table 3.2.A).

Differences by Race and Grade.⁴¹ The use of smokeless tobacco is most prevalent among white youth. In 1999, 11 percent of white 12th graders reported having used smokeless tobacco one or more times in the 30 days preceding the survey, compared with 3.9 percent of Hispanic 12th graders and 1.5 percent of black 12th graders (see Table SD 3.2.A).
The rate of smokeless tobacco use increases for white students as grade level increases. In 1999 among white students, the prevalence of smokeless tobacco use was 5.4 percent among 8th graders, 8.7 percent among 10th graders, and 11 percent among 12th graders (see Table 3.2.A).

The Youth Risk Behavior Survey provides additional subgroup information for 9th- through 12th-grade students combined. According to this survey’s most recent administration in 1999, the use of smokeless tobacco is most prevalent among white, non-Hispanic male high school students, with 19 percent reporting having used smokeless tobacco one or more times in the 30 days preceding the survey, compared with 6 percent of Hispanic male youth and 3 percent of black male youth (see Figure SD 3.2.B).

³⁹ U.S. Department of Health and Human Services, Centers for Disease Control. 1999. Targeting Tobacco Use: The Nation’s Leading Cause of Death: At-a-Glance. Atlanta, GA.: Centers for Disease Control. See also Tomar, S.L., & Henningfield, J.E. 1995. Additional Evidence Implicating Moist Snuff as a Potent Carcinogen. Journal of the National Cancer Institute 87 (24): 1822-1823.
⁴⁰According to Sherry Everett Jones at the Center for Disease Control, differences by grade are not statistically significant.
⁴¹In Table SD 3.2.B and Figure SD 3.2.B, estimates for whites and blacks exclude Hispanics of those races.

Table SD 3.2.A Percentage of 8th-, 10th-, and 12th-grade students in the United States who reported using smokeless tobacco over the previous 30 days, by grade, gender, and race and Hispanic origin: Selected years, 1992-1999

	1992	1993	1994	1995	1996	1997	1998	1999
8th Grade
Total	7.0	6.6	7.7	7.1	7.1	5.5	4.8	4.5
Gender
Male	12.5	10.9	12.8	11.8	11.4	9.9	8.1	6.9
Female	2.0	2.7	2.4	2.9	2.9	1.5	1.5	2.1
Race and Hispanic origin^a (2-year average)^b
White	8.3	8.0	8.1	8.9	8.8	7.6	6.1	5.4
Black	1.8	2.7	3.2	2.6	2.2	2.6	2.3	2.3
Hispanic	4.2	4.0	5.0	5.7	5.2	4.6	4.5	4.6
10th Grade
Total	9.6	10.4	10.5	9.7	8.6	8.9	7.5	6.5
Gender
Male	18.1	19.3	19.2	17.2	15.0	14.9	13.8	12.2
Female	1.8	2.0	2.1	2.1	2.3	2.7	1.7	1.3
Race and Hispanic origin^a (2-year average)^b
White	11.4	12.0	12.5	12.0	11.0	10.4	10.0	8.7
Black	2.9	2.3	2.3	2.5	2.5	2.8	2.3	1.6
Hispanic	6.2	6.1	4.3	3.6	4.0	4.6	4.8	4.8
12th Grade
Total	11.4	10.7	11.1	12.2	9.8	9.7	8.8	8.4
Gender
Male	20.8	19.7	20.3	23.6	19.5	18.7	15.6	15.5
Female	2.0	2.3	2.6	1.8	1.1	1.2	1.5	1.3
Race and Hispanic origin^a (2-year average)^b
White	—	13.8	13.8	13.8	13.0	12.2	11.8	11.0
Black	—	2.0	1.9	2.1	2.7	2.2	1.4	1.5
Hispanic	—	6.0	5.4	7.6	8.1	5.3	4.3	3.9

^aEstimates for whites and blacks include Hispanics of those races. Persons of Hispanic origin may be of any race.
^bEstimates for race and Hispanic origin represent the mean of the specified year and the previous year. Data have been combined to increase subgroup sample sizes, thus providing more stable estimates.
Note: Prevalence of smokeless tobacco was not asked of 12th graders in 1990 and 1991. Prior to 1990, the prevalence question on smokeless tobacco was located near the end of one 12th-grade questionnaire form, whereas after 1991, the question was placed in a different and earlier form in the questionnaire. This shift could explain the discontinuities between the corresponding data in later years. Data for 8th and 10th grades have been available since 1991.
Sources: Johnston, O’Malley, & Bachman, 2000, 8th and 10th grade Table D-33; 12th grade Table D-34. Data for 1999: prepublication detail tables provided by Monitoring the Future Study staff: 8th and 10th grade Table D-52; 12th grade Table D-53.

Figure SD 3.2.A Percentage of 8th-, 10th-, and 12th-grade students in the United States who reported using smokeless tobacco during the previous 30 days, by gender: 1999

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Source: The Monitoring the Future Study, The University of Michigan. Prepublication detail tables provided by the Monitoring the Future Study staff: 8th and 10th grade Table D-52; 12th grade Table D-53.

Figure SD 3.2.B Percentage of youth in grades 9 through 12 in the United States who reported having used smokeless tobacco during the previous 30 days, by gender and by race and Hispanic origin:^a 1999

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^aEstimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Source: Kan, et al. 1998, Table 12, p. 50.

Table SD 3.2.B Percentage of youth in grades 9 through 12 in the United States who reported having used smokeless tobacco during the previous 30 days,^a by gender and by race and Hispanic origin:^b 1991, 1993, 1995, 1997, and 1999

	1991			1993			1995			1997			1999
	Total	Male	Female	Total	Male	Female	Total	Male	Female	Total	Male	Female	Total	Male	Female
Total	11	19	1	12	20	2	11	20	2	9	16	2	8	14	1
Race and Hispanic origin^b
White	13	24	1	15	26	2	15	25	3	12	21	2	10	19	2
Black	2	4	1	3	5	1	2	4	1	2	3	1	1	3	0
Hispanic	6	11	1	5	8	2	4	6	3	5	8	1	4	6	2

^aIn 1991 and 1993, students were asked whether they had “used chewing tobacco or snuff during the 30 days preceding the survey;” in 1995 1997, and 1999, students were asked how many days they had “used chewing tobacco or snuff on 1 or more of the 30 days preceding the survey.”
^bEstimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Sources: Centers for Disease Control and Prevention. 1990-1991, Table 1, p. 50; Kann, et al., 1995, Table 12, p. 35; Kann, et al., 1996, Table 12, p. 44; Kann, et al., Table 12, p. 50.

SD 3.3 Alcohol Use Among Youth

Alcohol use among adolescents is linked to a host of problems, including motor vehicle crashes and deaths, difficulties in school and the workplace, fighting, and breaking the law.⁴² The National Institute on Alcohol Abuse and Alcoholism finds that the younger the age of drinking onset, the greater the chance that an individual at some point in life will develop a clinically defined alcohol disorder.⁴³ In addition, binge drinking by youth at some point in the previous 2 weeks is associated with higher levels of illicit drug use.⁴⁴

Among 12th-grade students, rates of binge drinking fell from a high of 41.4 percent in 1981 to 27.5 percent in 1993 (see Figure SD 3.3.A). Between 1993 and 1999, rates have edged up modestly to 30.8 percent (see Table SD 3.3.A).45 Having an alcoholic beverage on one or
more occasion in the previous 30 days was reported by 52 percent of 12th-grade students in 1998 but dropped slightly to 51 percent in 1999 (see Table SD 3.3.B).

Differences by Age. Binge drinking increases as students move into the upper grade levels (see Figure SD 3.3.A). In 1999, 15.2 percent of 8th-grade students reported binge drinking, while more than twice this percentage (30.8 percent) reported binge drinking in the 12th grade. A larger increase in binge drinking appears to occur between the 8th and 10th grades than in the period between the 10th and 12th grades (see Table SD 3.3.A).

Differences by Gender. Male students report higher rates of binge drinking than do female students. The disparity in binge drinking rates between males and females is greater in the upper grades, with 38.1 percent of males and 23.6 percent of females in the 12th grade reporting binge drinking in 1999 (see Table SD 3.3.A). Similar disparities exist for regular drinking (see Table 3.3.B).

Differences by Race and Hispanic Origin. Hispanic youth in the 8th grade are more likely than their white and black peers to engage in binge drinking. By the 12th grade, however, white students report a higher prevalence of binge drinking than do either Hispanic or black students. Black students consistently report the lowest prevalence of binge drinking for all grades and across all years (see Table SD 3.3.A).

⁴² Petraitis, J., & Flay, B.R. 1995. Reviewing Theories of Adolescent Substance Use: Organizing Pieces in the Puzzle. Psychological Bulletin 117 (1): 67-86; Hawkins, J.D., Catalano, R.F., & Miller, J.Y. 1992. Risk and Protective Factors for Alcohol and Other Drug Problems in Adolescence and Early Adulthood: Implications for Substance Abuse Prevention. Psychological Bulletin 112 (1): 64-105; National Institute on Drug Abuse. 1987. National Trends in Drug Use and Related Factors among American High School Students and Young Adults, 1976-1986. DHHS Pub. No. (ADM) 87-1535. Washington, D.C.: U.S. Department of Health and Human Services.
⁴³ Grant, B.R., & Dawson, D.A. Age at Onset of Alcohol Use and Its Association with DSM-IV Alcohol Abuse and Dependence: Results from the National Longitudinal Alcohol Epidemiologic Survey. Journal of Substance Abuse 9: 103-110. Also, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism. "Age of Drinking Onset Predicts Future Alcohol Abuse and Dependence." Press release of January 14, 1998.
⁴⁴ Substance Abuse and Mental Health Services Administration. 1996. Preliminary Estimates from the 1995 National Household Survey on Drug Abuse. Rockville, Md.: Public Health Service. Results from 1995 indicate that among binge drinkers, 18 percent were illicit drug users. In this survey, binge drinking is defined as having five or more drinks on the same occa-sion at least once in the past month. See also: Gruber, E., Diciemente, R.J., Anderson, M.M., & Lodico, M. 1996. Early Drinking Onset and Its Association with Alcohol Use and Problem Behavior in Late Adolescence. Preventive Medicine 25: 293-300.
⁴⁵ These percentages underestimate the rate of binge drinking among all youth, because school-age youth who are not in school are somewhat more likely to binge drink than those in school. (Based on unpublished analyses of the National Health Interview Survey 1992 by Child Trends, and unpublished prevalence rates of past-month alcohol use among youth ages 12 through 17 by school status, enrolled or not enrolled, from the 1994-95 National Household Surveys on Drug Abuse.)

Figure SD 3.3.A Percentage of 8th-, 10th-, and 12th-grade students who reported binge drinking:^a Selected years, 1975-1999

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^aBinge drinking means having five or more drinks in a row in the previous 2 weeks.
Sources: Johnston, O’Malley, & Bachman, 1998, 8th and 10th grade Table D-27; 12th grade Table D-28. Data for 1998: prepublication detail tables provided by Monitoring the Future Study staff: 8th and 10th grade Table D-31; 12th grade Table D-32.

Table SD 3.3.A Percentage of 8th-, 10th-, and 12th-grade students in the United States who reported binge drinking,a by gender and by race and Hispanic origin: Selected years, 1975-1999

	1975	1980	1985	1990	1991	1992	1993	1994	1995	1996	1997	1998	1999
8th Grade
Total	—	—	—	—	12.9	13.4	13.5	14.5	14.5	15.6	14.5	13.7	15.2
Gender
Male	—	—	—	—	14.3	13.9	14.8	16.0	15.1	16.5	15.3	14.4	16.4
Female	—	—	—	—	11.4	12.8	12.3	13.0	13.9	14.5	13.5	12.7	13.9
Race and Hispanic origin^{a, b}
White	—	—	—	—	—	12.7	12.6	12.9	13.9	15.1	15.1	14.1	14.3
Black	—	—	—	—	—	9.6	10.7	11.8	10.8	10.4	9.8	9.0	9.9
Hispanic	—	—	—	—	—	20.4	21.4	22.3	22.0	21.0	20.7	20.4	20.9
10th Grade
Total	—	—	—	—	22.9	21.1	23.0	23.6	24.0	24.8	25.1	24.3	25.6
Gender
Male	—	—	—	—	26.4	23.7	26.5	28.5	26.3	27.2	28.6	26.7	29.7
Female	—	—	—	—	19.5	18.6	19.3	18.7	21.5	22.3	21.7	22.2	21.8
Race and Hispanic origin^{a, b}
White	—	—	—	—	—	23.2	23.0	24.5	25.4	26.2	26.9	27.0	27.2
Black	—	—	—	—	—	15.0	14.8	14.0	13.3	12.2	12.7	12.8	12.7
Hispanic	—	—	—	—	—	22.9	23.8	24.2	26.8	29.6	27.5	26.3	27.5
12th Grade
Total	36.8	41.2	36.7	32.2	29.8	27.9	27.5	28.2	29.8	30.2	31.3	31.5	30.8
Gender
Male	49.0	52.1	45.3	39.1	37.8	35.6	34.6	37.0	36.9	37.0	37.9	39.2	38.1
Female	26.4	30.5	28.2	24.4	21.2	20.3	20.7	20.2	23.0	23.5	24.4	24.0	23.6
Race and Hispanic origin^{a, b}
White	—	44.3	41.5	36.6	34.6	32.1	31.3	31.5	32.3	33.4	35.1	36.4	35.7
Black	—	17.7	15.7	14.4	11.7	11.3	12.6	14.4	14.9	15.3	13.4	12.3	12.3
Hispanic	—	33.1	31.7	25.6	27.9	31.1	27.2	24.3	26.6	27.1	27.6	28.1	29.3

^aBinge drinking means having five or more drinks in a row in the previous 2 weeks.
^bEstimates for whites and blacks include Hispanics of those races. Persons of Hispanic origin may be of any race.
^cEstimates for race and Hispanic origin represent the mean of the specified year and the previous year. Data have been combined to increase subgroup sample sizes, thus providing more stable estimates.
Note: Data for 8th and 10th grades available since 1991. Sources: Johnston, O’Malley, & Bachman, 1998, 8th and 10th grade Table D-27; 12th-grade Table D-28. Data for 1998: prepublication detail tables provided by Monitoring the Future Study staff.

Table SD 3.3.B Percentage of 8th-, 10th-, and 12th-grade students in the United States who reported drinking alcohol on one or more occasions,a by gender: Selected years, 1998-1999

	1998	1999
8th Grade
Total	23.0	24.0
Male	24.0	24.8
Female	21.9	23.3
10th Grade
Total	38.8	40.0
Male	40.0	42.3
Female	37.7	38.1
12th Grade
Total	52.0	51.0
Male	57.3	55.3
Female	46.9	46.8

^aQuestion indicated that a “drink” of alcohol is more than a few sips within the last 30 days.
Note: The form of this question changed in 1993 so the data in this report are not comparable to previous editions of this report.
Sources: Bachman, Johnston, & O’Malley, 8th and 10th grade 1991-1996 Questionnaire Forms 1 and 2, item B05C; 12th grade 1980-1988 Questionnaire Forms 1-5, item B04B, and 1989-1997 Questionnaire Forms 1-6, item B04C.

SD 3.4 Exposure to Drunk Driving

Motor vehicle crashes are a major cause of death in the United States for youth ages 15 through 19.⁴⁶ Among young Americans of driving age, the issue of alcohol-impaired driving has particular significance. In all states, the purchase of alcohol by persons under age 21
is illegal; however, in 1994, 29 percent of the 2,610 traffic fatalities involving persons ages 15 through 17 were alcohol-related. For traffic deaths involving persons ages 18 through 20, the percentage of alcohol involvement was 44 percent.⁴⁷

In 1999, 36 percent of adolescents in grades 9 through 12 reported that within the month prior to the survey, they had either driven after drinking alcohol or had ridden with a driver who had been drinking alcohol (see Table SD 3.4). Since 1991, about two in five high school students have reported this level of exposure to drunk driving.

Differences by Age. Rates of exposure to drunk driving differed modestly by age. In 1999, 41 percent of 12th-grade students reported taking this risk, compared with 32 percent of 9th-grade students (see Figure SD 3.4).

Differences by Gender. In 1999, 38 percent of males and 34 percent of females reported driving after drinking alcohol or riding with someone who had been drinking (see Table SD 3.4).

Differences by Race and Hispanic Origin.⁴⁸ In 1999, 42 percent of Hispanic, 36 percent of white, and 36 percent of black teens reported having been exposed to drunk driving within the past month (see Table SD 3.4).

⁴⁶Injury-related mortality (including motor vehicle crashes, fires and burns, drowning, suffocation, and accidents caused by firearms and other explosive materials, among others) accounted for 80 percent of all deaths of youth ages 15 through 19 in 1995. However, the rate of motor vehicle crash deaths among youth has been relatively constant since 1992 and has declined as a fraction of all violent deaths to teens. Preliminary data for 1996 show that motor vehicle crashes claimed 28.9 lives per 100,000 youth ages 15 through 19, compared with 43.6 per 100,000 youth in 1970. Data for 1996 are preliminary based on 85 percent of all reported deaths in 1996.
⁴⁷Update: Alcohol-Related Traffic Crashes and Fatalities among Youth and Young Adults—United States, 1982-1994. Morbidity and Mortality Weekly Report 44: 869-874.
⁴⁸Estimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.

Table SD 3.4 Percentage of students in grades 9 through 12 in the United States who reported driving after drinking alcohol, or riding with a driver who had been drinking alcohol,^a by gender, grade, and race and Hispanic origin: 1991, 1993, 1995, 1997, and 1999

	1991	1993	1995	1997	1999
Total	42	38	42	40	36
Gender
Male	44	40	43	42	38
Female	41	36	40	37	34
Grade
Ninth	36	32	39	35	32
Tenth	39	37	40	36	36
Eleventh	45	39	41	42	35
Twelfth	49	44	46	45	41
Race and Hispanic origin^b
White	43	37	41	40	36
Black	38	41	39	36	36
Hispanic	49	45	52	47	42

^aWithin the last 30 days.
^bEstimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Sources: Youth Risk Behavior Survey results, 1991, 1993, 1995, 1997, and 1999. Unpublished tabulations by Laura Kann, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services.

Figure SD 3.4 Percentage of students in grades 9 through 12 in the United States who reported driving after drinking alcohol or riding with a driver who had been drinking alcohol within the past 30 days, by grade: 1999

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^aWithin the last 30 days.
Source: Youth Risk Behavior Survey results, 1999. Unpublished tabulations by Laura Kann, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services.

SD 3.5 Drug Use Among Youth: Marijuana, Inhalants, Hallucinogens, and Cocaine

Drug use by youth has serious and often long-term individual, social, and economic consequences. Drug use contributes to crime, decreases economic productivity, and requires a disproportionate share of health care services for those affected. Use of drugs is a preventable behavior that, when established during adolescence, can extend into adulthood.⁴⁹

The effects of drug use on individual health and well-being have been well documented: for example, the use of cocaine has been linked with numerous health problems ranging from eating disorders to disability and even death from heart attack and stroke.⁵⁰ Marijuana use holds both health and cognitive risks, particularly for damage to pulmonary functions as a result of chronic use.⁵¹ Hallucinogens can affect brain chemistry and result in problems both in learning new information and retaining knowledge.⁵² And chronic use of some inhalants may result in injury to the liver and kidneys as well as cause neurological damage, although it is not yet determined whether such damage is long term.⁵³

Marijuana Use.⁵⁴ From a high of 37.1 percent in 1978, large and steady declines in the percentage of 12th graders reporting marijuana use were evident through 1992. Since 1992, however, marijuana use in the past 30 days among 12th-grade students has increased from 11.9 percent to 23.1 percent in 1999 (see Figure SD 3.5.A). The rise in marijuana use is also evident among 8th-grade students, increasing from 3.2 percent in 1991 to 9.7 percent in 1999. Marijuana use by 10th graders rose from 8.7 percent in 1991 to 19.4 percent in 1999.

Tenth and 12th graders have consistently been more likely to use marijuana than inhalants, hallucinogens, or cocaine. As of 1994, marijuana use among 8th-grade students had surpassed prevalence rates of other drugs shown (see Table SD 3.5.A). This increase in the use of marijuana corresponds with a decline in its perceived harmfulness by students across all grade levels from 1991 to 1998.⁵⁵

Differences by Age. As seen with cigarette and alcohol use (see Sections SD 3.1 and SD 3.3), use of both marijuana and hallucinogens increases with grade level. This increase is relatively small for hallucinogen use but is substantial for marijuana use. In 1999, 9.7 percent of 8th-grade students reported using marijuana in the past 30 days (see Table SD 3.5.A). More than twice that percentage of 12th graders (23.1 percent) reported using marijuana within the past 30 days in the same year. In contrast, inhalant use is more prevalent in the 8th grade than in either the 10th or the 12th grade. The rate of inhalant use among 8th graders was 5.0 percent, compared with 2.6 percent for 10th graders and 2.0 percent for high school seniors in 1999. The prevalence of cocaine use is lowest among 8th graders in 1999 (1.3 percent), but similarly small rates are reflected in other grades as well (1.8 percent for 10th grade and 2.6 percent for 12th grade) (see Table SD 3.5.A).

Use of Other Specified Drugs. Increases have also been shown in the use of cocaine and hallucinogens since 1991 across all grade levels. In recent years, cocaine use has been least prevalent among the four drugs types examined in this section among all grade levels, with a high of 2.6 percent of 12th-grade students reporting use within a 30-day period in 1999 (see Figure SD 3.5.B). Hallucinogens have low prevalence rates among 8th graders in 1999 (1.3 percent), although use increases with grade, eventually surpassing the use of inhalants for the upper grade levels. The use of inhalants is highest among 8th-grade students at 5.0 percent in 1999 (see Table SD 3.5.A).

One-quarter (25.9 percent) of America’s 12th graders report use of “any illicit drug” in the
past 30 days in 1999, with 22.1 percent of 10th graders and 12.2 percent of 8th graders
reporting similar recent use (see Table SD 3.5.C).

Differences by Gender. Male high school students appear somewhat more likely than females to report use of marijuana, inhalants, hallucinogens, and cocaine. The largest gender difference is seen in marijuana use and is most apparent in the upper grade levels. Among 8th-grade students, 10.5 percent of males and 8.8 percent of females reported marijuana use within the preceding 30 days of the survey in 1999. In the 10th grade in that year, males reported marijuana use at about 5 percentage points higher than that of females (21.8 versus 17 percent). This gender gap is about 7 percentage points among high school seniors in 1999 (26.3 versus 19.7) (see Table SD 3.5.A).

Differences by Race. For each category of drug use shown, as well as for use of any illicit drugs, black students consistently report the lowest rates of use across all grades (see Tables SD 3.5.B and SD 3.5.C).

⁴⁹Johnson, R.A., Hoffmann, J.P., & Gerstein, D.R. July 1996. The Relationship between Family Structure and Adolescent Substance Use. Rockville, Md.: Substance Abuse and Mental Health Services Administration, Office of Applied Studies.
⁵⁰Blanken, A.J. 1993. Measuring Use of Alcohol and Other Drugs among Adolescents. Public Health Reports (Journal of the U.S. Public Health Service) 108 (Supp. 1).
⁵¹See, for example, Marijuana: Facts Parents Need to Know, National Institute on Drug Abuse, U.S. Department of Health and Human Services, NCADI Pub. No. PHD712, 1995; and Pope, H., & Yurgelun-Todd, D., 1996, The Residual Cognitive Effects of Heavy Marijuana Use in College Students, Journal of the American Medical Association 275 (7).
⁵²"Measuring the Health Behavior of Adolescents: The Youth Risk Behavior Surveillance System and Recent Reports on High-Risk Adolescents." 1993. Public Health Reports 108 (Supp. 1). Rockville, Md.: Public Health Service.
⁵³Public Health Service, 1993.
⁵⁴These percentages likely underestimate the rate of drug use among all youth, because school-age youth who are not in school are somewhat more likely to use drugs than those in school. (Based on unpublished prevalence rates of past-month marijuana use, past-year cocaine use, and past-year inhalant use among youth ages 12 to 17, by school status, enrolled or not enrolled, from the 1994-95 National Household Surveys on Drug Abuse.)
⁵⁵The data on perceived harmfulness of specified drugs are not shown here but can also be obtained from the Monitoring the Future Study. The percentage of students who think that smoking marijuana occasionally or regularly is physically or otherwise harmful has dropped from 1991 to 1998 across all grade levels. In 1999, 23.9 percent of 12th-grade students perceived smoking marijuana occasionally to be harmful (down from 40.6 percent in 1991), and 57.4 percent perceived smoking marijuana regularly to be harmful (down from 78.6 percent in 1991).

Figure SD 3.5.A Percentage of 8th-, 10th-, and 12th-grade students in the United States who report having used marijuana within the previous 30 days: Selected years, 1975-1999

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Sources: Johnston, O’Malley, and Bachman, 2000, Table 4-7; also, prior years of this publication. Additional historical data tables provided by Monitoring the Future Study staff.

Table SD 3.5.A Percentage of 8th-, 10th-, and 12th-grade students in the United States who report having used specified drugs within the previous 30 days, by grade and gender: Selected years, 1975-1999

	1975	1980	1985	1990	1991	1992	1993	1994	1995	1996	1997	1998	1999
Marijuana
8th grade	---	---	---	---	3.2	3.7	5.1	7.8	9.1	11.3	10.2	9.7	9.7
Male	---	---	---	---	3.8	3.8	6.1	9.5	9.8	12.1	11.4	10.3	10.5
Female	---	---	---	---	2.6	3.5	4.1	6.0	8.2	10.2	8.9	8.8	8.8
10th grade	---	---	---	---	8.7	8.1	10.9	15.8	17.2	20.4	20.5	18.7	19.4
Male	---	---	---	---	10.1	9.0	13.1	18.6	19.1	22.3	23.0	20.3	21.8
Female	---	---	---	---	7.3	7.1	8.6	12.8	15.0	18.6	17.9	17.2	17.0
12th grade	27.1	33.7	25.7	14.0	13.8	11.9	15.5	19.0	21.2	21.9	23.7	22.8	23.1
Male	32.3	37.8	28.7	16.1	16.1	13.4	18.2	23.0	24.6	25.1	26.4	26.5	26.3
Female	22.5	29.1	22.4	11.5	11.2	10.2	12.5	15.1	17.2	18.3	20.3	18.8	19.7
Inhalants^a
8th grade	---	---	---	---	4.4	4.7	5.4	5.6	6.1	5.8	5.6	4.8	5.0
Male	---	---	---	---	4.0	4.4	4.9	5.4	5.6	4.8	5.1	4.8	4.6
Female	---	---	---	---	4.7	4.9	6.0	5.8	6.6	6.6	5.8	4.7	5.3
10th grade	---	---	---	---	2.7	2.7	3.3	3.6	3.5	3.3	3.0	2.9	2.6
Male	---	---	---	---	2.9	2.9	3.7	3.9	3.8	3.4	3.0	3.2	2.9
Female	---	---	---	---	2.6	2.6	2.9	3.3	3.2	3.2	2.9	2.6	2.2
12th grade	---	1.4	2.2	2.7	2.4	2.3	2.5	2.7	3.2	2.5	2.5	2.3	2.0
Male	---	1.8	2.8	3.5	3.3	3.0	3.2	3.6	3.9	3.1	3.3	2.9	2.5
Female	---	1.0	1.7	2.0	1.6	1.6	1.7	1.9	2.5	2.0	1.8	1.7	1.5
Hallucinogens^b
8th grade	---	---	---	---	0.8	1.1	1.2	1.3	1.7	1.9	1.8	1.4	1.3
Male	---	---	---	---	0.9	1.1	1.3	1.5	1.8	2.0	2.2	1.7	1.6
Female	---	---	---	---	0.7	1.0	1.1	1.0	1.5	1.6	1.3	1.1	1.0
10th grade	---	---	---	---	1.6	1.8	1.9	2.4	3.3	2.8	3.3	3.2	2.9
Male	---	---	---	---	1.8	2.1	2.5	3.0	3.9	3.3	4.0	3.5	3.6
Female	---	---	---	---	1.4	1.4	1.3	1.7	2.7	2.3	2.5	2.9	2.2
12th grade	4.7	3.7	2.5	2.2	2.2	2.1	2.7	3.1	4.4	3.5	3.9	3.8	3.5
Male	6.0	4.8	3.4	3.2	3.1	2.9	3.6	4.3	5.8	4.7	5.1	5.1	4.5
Female	3.6	2.5	1.4	1.0	1.1	1.4	1.7	1.7	2.7	2.3	2.7	2.3	2.3
Cocaine
8th grade	---	---	---	---	0.5	0.7	0.7	1.0	1.2	1.3	1.1	1.4	1.3
Male	---	---	---	---	0.7	0.6	0.9	1.2	1.1	1.2	1.2	1.5	1.4
Female	---	---	---	---	0.4	0.8	0.6	0.9	1.2	1.4	1.0	1.2	1.2
10th grade	---	---	---	---	0.7	0.7	0.9	1.2	1.7	1.7	2.0	2.1	1.8
Male	---	---	---	---	0.7	0.8	1.2	1.4	1.8	1.8	1.9	2.4	2.2
Female	---	---	---	---	0.6	0.6	0.5	0.9	1.5	1.6	1.8	1.8	1.6
12th grade	1.9	5.2	6.7	1.9	1.4	1.3	1.3	1.5	1.8	2.0	2.3	2.4	2.6
Male	2.5	6.0	7.7	2.3	1.7	1.5	1.7	1.9	2.2	2.6	2.8	3.0	3.3
Female	1.2	4.3	5.6	1.3	0.9	0.9	0.9	1.1	1.3	1.4	1.6	1.7	1.8

^a All data are unadjusted for underreporting of nitrites. Data for 12th grade only, based on three of six questionnaire forms, with sample size one-half of total sample size.
^bAll data are unadjusted for underreporting of PCP. Note: Data for 8th and 10th grades available since 1991.
Sources: Johnston, O’Malley, & Bachman, 2000. Table 4-7, pre-publication Table 4-7 for 1998, and prior years of this publication. Additional historical data tables provided by Monitoring the Future Study staff.

Table SD 3.5.B Percentage of 8th-, 10th-, and 12th-grade students in the United States who report having used specified drugs within the previous 30 days, by race and Hispanic origin^a: 1992-1999

	1992	1993	1994	1995	1996	1997	1998	1999
8th Grade
Marijuana^a
White	3.3	4.1	5.6	7.8	10.0	10.6	9.5	8.7
Black	2.0	2.9	5.0	6.6	8.0	9.0	9.1	9.7
Hispanic	6.4	8.3	12.1	12.9	12.5	13.1	13.5	14.3
Inhalants ^a,b
White	4.7	5.4	6.0	6.6	6.8	6.5	5.9	5.5
Black	2.4	2.7	2.8	2.5	2.0	1.9	2.2	2.2
Hispanic	5.5	5.6	6.1	6.5	6.4	5.5	5.2	6.0
Hallucinogens^a,c
White	0.8	1.1	1.3	1.6	2.0	2.0	1.5	1.2
Black	0.4	0.4	0.4	0.4	0.5	0.4	0.4	0.4
Hispanic	1.9	1.9	1.8	1.9	2.2	2.3	2.5	2.3
Cocaine ^a
White	0.5	0.5	0.7	0.9	1.2	1.2	1.0	1.1
Black	0.4	0.4	0.3	0.4	0.4	0.3	0.4	0.4
Hispanic	1.7	1.8	2.2	2.5	2.3	2.1	2.5	3.2
10th Grade
Marijuana^a
White	9.0	9.8	13.4	16.8	19.3	21.1	20.3	19.8
Black	3.6	4.9	9.8	13.8	15.9	16.5	15.3	14.6
Hispanic	10.4	12.4	15.6	17.7	19.1	21.3	21.4	20.6
Inhalants ^a,b
White	2.9	3.2	3.7	3.9	3.9	3.5	3.3	3.1
Black	2.0	2.0	1.6	1.3	1.2	1.2	1.1	1.0
Hispanic	3.0	3.0	3.4	3.4	2.9	2.9	2.9	2.6
Hallucinogens^a,c
White	2.0	2.1	2.3	3.1	3.5	3.4	3.5	3.5
Black	0.2	0.3	0.7	0.8	0.5	0.6	0.7	0.6
Hispanic	1.4	1.8	2.2	2.7	3.1	3.3	3.8	3.0
Cocaine ^a
White	0.7	0.8	0.9	1.4	1.6	1.7	1.9	2.0
Black	0.1	0.2	0.6	0.6	0.4	0.4	0.6	0.5
Hispanic	1.1	1.2	1.8	2.4	2.9	3.6	3.9	3.6
12th Grade
Marijuana^a
White	14.1	14.9	18.4	20.8	22.0	23.6	24.4	23.8
Black	6.1	8.1	13.1	16.8	18.3	18.5	18.3	19.3
Hispanic	12.7	12.5	14.9	17.9	19.1	21.2	21.6	22.0
Inhalants ^a,b
White	2.4	2.6	2.8	3.3	3.3	3.0	2.8	2.4
Black	1.5	1.4	1.5	1.4	1.0	0.9	0.9	0.8
Hispanic	2.5	2.1	2.3	2.3	2.1	1.7	1.8	2.3
Hallucinogens^a,c
White	2.5	2.9	3.3	4.1	4.4	4.3	4.5	4.1
Black	0.3	0.5	0.8	0.7	0.6	0.9	0.7	0.6
Hispanic	1.5	1.7	2.0	3.4	4.0	2.9	2.8	3.1
Cocaine ^a
White	1.5	1.2	1.3	1.6	1.9	2.2	2.5	2.7
Black	0.7	0.4	0.5	0.5	0.4	0.5	0.6	0.4
Hispanic	1.9	2.4	2.3	2.3	3.2	3.3	2.7	2.8

^aEstimates for whites and blacks include Hispanics of those races. Persons of Hispanic origin may be of any race.
^bInhalants include substances such as glues and aerosols. Data for 12th-grade students based on five of six forms. Data are unadjusted for known underreporting of nitrites.
^cHallucinogens include substances such as LSD. Data are unadjusted for known underreporting of PCP.Note: Estimates represent the mean of the specified year and the previous year. Data have been combined to increase subgroup sample sizes, thus providing more stable estimates.
Sources: Johnston, O’Malley, & Bachman, 1998, Table 4-9. Also, prior years of this publication (Table 10 for 1992-1995, Table 4-9 thereafter). Prepublication Table 4-9 for 1998 provided by Monitoring the Future Study staff.

Figure SD 3.5.B Percentage of 12th-grade students in the United States who report having used specified drugs within the previous 30 days: 1975-1999

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^aAll data on inhalants are unadjusted for underreporting of nitrites.
^bAll data on hallucinogens are unadjusted for underreporting of PCP.
Sources: Johnston, O’Malley, & Bachman, 2000, Table 4-7. Also, prior years of this publication. Additional historical data tables provided by Monitoring the Future Study staff.

Table SD 3.5.C Percentage of 8th-, 10th-, and 12th-grade students in the United States who report having used any illicit drugsa in the previous 30 days, and 12th-grade reports of illicit drug use by gender and by race and Hispanic origin: Selected years, 1985-1999

	1985	1990	1991	1992	1993	1994	1995	1996	1997	1998	1999
Grade
Eighth	—	—	5.7	6.8	8.4	10.9	12.4	14.6	12.9	12.1	12.2
Tenth	—	—	11.6	11.0	14.0	18.5	20.2	23.2	23.0	21.5	22.1
Twelfth	29.7	17.2	16.4	14.4	18.3	21.9	23.8	24.6	26.2	25.6	25.9
12th Graders
Gender
Male	32.1	18.9	18.4	15.9	20.4	25.5	26.8	27.5	28.7	29.1	28.6
Female	26.7	15.2	14.1	12.7	15.9	18.3	20.4	21.2	23.2	21.6	22.7
Race and Hispanic origin^{a, b}
White	30.2	20.5	18.6	16.8	17.8	21.4	23.8	24.8	26.4	27.5	27.0
Black	22.9	9.0	7.2	7.3	9.1	14.3	18.3	19.7	20.0	19.4	20.2
Hispanic	27.2	13.9	14.7	14.6	15.6	18.3	21.4	22.6	23.9	24.1	24.4

^aFor 12th graders only: Use of “any illicit drug” includes any use of marijuana, LSD, other hallucinogens, crack, other cocaine, or heroin, or any use of other opiates, stimulants, barbiturates, or tranquilizers not under a doctor’s orders. For 8th and 10th graders only: The use of other opiates and barbiturates has been excluded, because these younger respondents appear to overreport use (perhaps because they include the use of nonprescription drugs in their answers).
^bEstimates for whites and blacks include Hispanics of those races. Persons of Hispanic origin may be of any race.
^cEstimates for race and Hispanic origin represent the mean of the specified year and the previous year. Data have been combined to increase subgroup sample sizes, thus providing more stable estimates. Note: Data for 8th and 10th grades available since 1991.
Sources: Johnston, O’Malley, & Bachman, 2000, Table 2-1b. Some data for 1998: The Monitoring the Future Study, The University of Michigan. Drug Use among American Young People Begins to Turn Downward. Press release of December 18, 1998, Table 1b. 1119: pre-publication tables 4-7 and 4-9 provided by Monitoring the Future Study staff.

SD 3.6 Peer Attitudes Toward Alcohol, Marijuana, Cocaine, and Smoking

Drug use is correlated with attitudes and beliefs about drugs, both in terms of perceived health risks and the level of peer disapproval.⁵⁶ As children reach adolescence, peer influences on personal behavior can take on increasing importance in determining the use of drugs, alcohol, and cigarettes.

The majority of high school seniors have long reported peer disapproval of drug and alcohol use and cigarette smoking, as reflected in their responses to questions of the level of disapproval they would receive from their peers for (1) taking one to two drinks nearly every day, (2) smoking marijuana even occasionally (as opposed to trying it once), (3) taking cocaine even occasionally (as opposed to trying it once), and (4) smoking one or more packs of cigarettes per day (see Table SD 3.6).⁵⁷

Among 12th graders, peer disapproval of drinking (one to two drinks nearly every day) and smoking marijuana (even occasionally) reached highs of 78 and 79 percent, respectively, in 1992, before declining to 72 and 62 percent by 1999 (see Figure SD 3.6). Peer disapproval of smoking cigarettes (one or more packs per day) has declined since 1992, although disapproval levels had been relatively stable prior to that time. In 1999, 71 percent of 12th graders reported peer disapproval of smoking a pack or more of cigarettes per day. Peer disapproval of cocaine use (even occasionally) increased from 87 percent in 1986 to 95 percent in 1991 and has remained at about this level. Cocaine use commands the highest level of peer disapproval for every year shown (see Table SD 3.6 and Figure SD 3.6).

Differences by Gender. Male high school seniors have consistently reported lower levels of peer disapproval of drinking than have their female peers. In 1999, 64 percent of males reported peer disapproval of drinking, compared with 79 percent of females. Male students also report somewhat lower peer disapproval of smoking cigarettes and marijuana.

Differences by Race. For 1999, rates of disapproval for drug use were generally similar for black and white 12th graders for marijuana and for cocaine use. Group differences are apparent for disapproval of smoking (81 percent disapproval among black compared with 69 percent among white students) and disapproval of drinking (79 percent disapproval among black compared with 70 percent among white students).

⁵⁶ Substance Abuse and Mental Health Services Administration. 1996. Preliminary Estimates from the 1995 National Household Survey on Drug Abuse. Rockville, Md.: Public Health Service. Also see U.S. Department of Education, Office of Educational Research and Improvement, National Center for Education, 1993, Student Reports of Availability, Peer Approval, and Use of Alcohol, Marijuana, and Other Drugs at School: Statistics in Brief, June 1997.
⁵⁷ All references to drinking, marijuana and cocaine use, and smoking cigarettes throughout this text use the parameters for these activities as defined by the Monitoring the Future questionnaire.

Table SD 3.6 Percentage of 12th-grade students in the United States who report that peers would not approve of their using alcohol, marijuana, cocaine, or cigarettes: Selected years, 1980-1999

	1980	1985	1990	1991	1992	1993	1994	1995	1996	1997	1998	1999
Disapprove of taking one to two drinks nearly every day
Total	71	75	79	77	78	77	76	73	73	72	72	72
Gender
Male	61	69	71	68	69	68	67	65	63	63	63	64
Female	79	81	87	85	85	85	83	80	83	79	82	79
Race
White	70	75	77	77	77	76	76	72	71	71	71	70
Black	76	82	85	80	81	80	78	74	77	74	75	79
Disapprove of smoking marijuana even occasionally
Total	51	64	76	76	79	74	69	65	63	60	60	62
Gender
Male	49	64	73	73	78	72	63	62	59	57	56	58
Female	52	65	80	78	80	75	74	69	67	63	66	65
Race
White	50	63	74	75	78	73	68	64	62	58	60	61
Black	59	72	89	86	84	76	70	69	66	67	67	63
Disapprove of taking cocaine even occasionally^a
Total	—	—	94	95	94	94	94	94	93	91	92	92
Gender
Male	—	—	92	93	93	92	91	92	90	89	90	90
Female	—	—	96	96	96	96	96	95	96	93	95	94
Race
White	—	—	95	96	96	95	94	95	93	91	92	93
Black	—	—	92	97	91	89	94	92	93	95	94	91
Disapprove of smoking one or more packs of cigarettes per day
Total	74	74	75	74	76	72	72	69	69	69	69	71
Gender
Male	73	72	73	72	76	68	67	65	65	65	66	67
Female	76	76	77	77	77	75	77	74	73	71	73	76
Race
White	75	73	73	72	75	71	69	67	66	64	65	69
Black	74	81	87	88	82	80	83	81	82	83	81	81

^aThe question regarding cocaine use was not included prior to 1986.
Sources: Johnston, Bachman, & O’Malley, 1980, 1985, 1990-1999 (prepublication tables), Questionnaire Form 4. 1980-1985: items E08A, E08C, E08G. 1986-1987: items E08A, E08C, E08H, E08I. 1988-1999: items E07A, E07C, E07H, E07I. Data based on one of six questionnaire forms, with a resulting sample size one-sixth of the total sample size for each year.

Figure SD 3.6 Percentage of 12th-grade students in the United States who report that peers would not approve of their using alcohol, marijuana, cocaine, or cigarettes: 1980-1999

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Note: Figure reports students’ perceived peer nonapproval rates of use of various drugs: alcohol (taking one to two drinks nearly every day), marijuana (smoking even occasionally), cocaine (using even occasionally), and smoking (one or more packs of cigarettes every day).
Sources: Johnston, Bachman, & O’Malley, Questionnaire Form 4. 1980-1999: items E08A, E08C, E08G. 1986-1987: items E08A, E08C, E08H, E08I. 1988-1997: items E07A, E07C, E07H, E07I. Data based on one of six questionnaire forms, with a resulting sample size one-sixth of the total sample size for each year.

SD 3.7 Abuse of Alcohol or Other Controlled Substances

The use of alcohol and other illicit drugs by teens⁵⁸ has been related to numerous social problems, such as delinquency, fighting, and early sexual activity⁵⁹ and to a variety of short- and long-term health problems.⁶⁰ For many reasons, then, it is important that youth stay free of all such substances.

In 1998, 13 percent of 12- through 17-year-olds reported binge drinking and/or any use of an illicit drug during the previous month (see Table SD 3.7).

Differences by Gender. Rates of reported use vary little by gender. In 1998, 14 percent of males and 12 percent of females ages 12 through 17 reported illicit drug use or binge drinking in the previous month.

Differences by Race and Hispanic Origin.⁶¹ Rates of reported use differed little among whites, blacks, and Hispanics, ranging from 12 percent to 14 percent in 1998.

⁵⁸A note on methodology. Throughout this report, we present data from two major federally sponsored surveys of adolescent substance use: the Monitoring the Future Study, a school-based survey, and the National Household Survey on Drug Abuse, a household survey of the population ages 12 and older. A recent report finds that rates of drug use obtained were larger in the school survey than in the household survey, possibly because of greater underreporting in the household setting than in the classroom and the different questionnaires used in the two surveys. Gfroerer, J., Wright, D., & Kopstein, A. 1997. Prevalence of Youth Substance Use: The Impact of Methodological Differences between Two National Surveys. Drug and Alcohol Dependence 47: 19-30.
⁵⁹National Institute on Drug Abuse. National Trends in Drug Use and Related Factors among American High School Students and Young Adults, 1976-1986. 1987. DHHS Pub. No. (ADM) 87-1535. Washington, D.C.: U.S. Department of Health and Human Services. See also: Grant, B.R., & Dawson, D.A. Age at Onset of Alcohol Use and Its Association with DSM-IV Alcohol Abuse and Dependence: Results from the National Longitudinal Alcohol Epidemiologic Survey. Journal of Substance Abuse 9: 103-110, which reports decreasing odds of alcohol dependence with each increasing year of age at onset of use, as well as decreasing odds of alcohol abuse.
⁶⁰Public Health Service, 1993.
⁶¹Estimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.

Table SD 3.7 Percentage of youth ages 12 through 17 in the United States reporting illicit drug^a use and/or binge drinking^b in the past month, by gender and by race and Hispanic origin: 1994-1998

	1994	1995	1996	1997	1998
Total	13	15	13	14	13
Gender
Male	14	17	14	16	14
Female	12	13	11	13	12
Race and Hispanic origin^c
White	15	16	13	15	14
Black	10	12	10	12	11
Hispanic	10	13	13	13	12
Other	4	14	8	13	8

^aIllicit drugs include marijuana, cocaine (including crack), heroin, hallucinogens (including PCP), inhalants, and nonmedical use of psychotherapeutics.
^bBinge drinking includes drinking five or more drinks on the same occasion on one or more days in the past 30 days.
^cEstimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race. Source: Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies, Prevalence Branch. Unpublished analyses, National Household Survey on Drug Abuse, 1994-1998.

Behavioral Health: Sexual Activity And Fertility

SD 4.1 Sexually Experienced Teens

Sexual experience and, particularly, age at first intercourse represent critical indicators of the risk of pregnancy and sexually transmitted diseases. Youth who begin having sex at a younger age are exposed to these risks over a longer period of time. Because sexual intercourse during the teen years, especially first intercourse, is often unplanned,⁶² it is also often unprotected by contraception.⁶³ In addition, research has shown that youth who have an early sexual experience are more likely at later ages to have more sexual partners and more frequent intercourse.⁶⁴

Trends over the past several decades show that increasing proportions of teens are sexually experienced—defined as ever having had sexual intercourse (see Figure SD 4.1). However, recent data show a decline between 1995 and 1997 in the percentage of teens who have ever had sexual intercourse (see Table SD 4.1.B).

Differences by Age. Age is the most important correlate of teen sexual experience. For the 1985 through 1987 cohort (cohorts are defined as those individuals who turned 20 in the specific time period presented), just under 1 in 10 13-year-old males and only 1 in 50 13-year-old females were sexually experienced by age 13. The proportion of teen females who were sexually experienced by age 15 increased from 3 percent for the 1958-1960 cohort to 11 percent for the 1990 to 1994 cohort. By age 20 for that same age cohort, three in four females were sexually experienced. And, for the 1985-1987 cohort, four in five males were sexually experienced by age 20 (see Table SD 4.1.A). By the late teen years, most teens are sexually experienced; however, it is important to note that not all teens are sexually experienced. Among the 1990-1994 cohort of females, 45 percent had not had intercourse by age 18. Among the 1985-1987 cohort of adolescent males, more than one-third had not had intercourse by age 18 (see Table SD 4.1.A). In addition, data from the Youth Risk Behavior Survey, a survey of 9th- through 12th-grade students show that, for 9th-grade students in 1999, 39 percent reported having had sexual intercourse. This percentage rises with each grade, reaching 65 percent by the 12th grade (see Table SD 4.1.B).⁶⁵

Differences by Gender. More teen males than females reported having had intercourse by a given age. Data from the 1985-1987 cohort suggest that the proportion of teen males at each year of age who report having sex was roughly equal to the rate of sexually experienced teen females who are one year older (see Table SD 4.1.A).

Among female adolescents of all ages, the percentage who were sexually experienced has increased over time (see Table SD 4.1.A). For example, the percentage of 18-year-old females who were sexually experienced increased from 27 percent for the 1958-1960 cohort to 35
percent for the 1970-1972 cohort and to 52 percent for the 1985-1987 cohort. The proportion continued to increase to 55 percent for the 1990-1994 cohort. The percentage of male teens who were sexually experienced increased from 55 percent for the 1970-1972 cohort to
64 percent for the 1985-1987 cohort (see Table SD 4.1.A). Caution should be exercised in interpreting these differences, however, since the data for males and females come from different surveys.

Data for students from the Youth Risk Behavior Survey indicate that in 1999, males reported having had sex by the 9th grade at a rate 12 percentage points higher than females (45 versus 33 percent). By the 12th grade, females were as likely as males to report ever having sex (see Table SD 4.1.B). Additional survey research indicates that the percentage of teen males who have ever had sex has declined since 1988, while the use of contraception among teen males increased (1995 National Survey of Adolescent Males).⁶⁶ The 1995 National Survey of Family Growth found that 50 percent of women 15 through 19 years of age had ever had intercourse, the first decline ever recorded by the periodic survey.⁶⁷

Differences by Race.⁶⁸ Black students in grades 9 through 12 are more likely than white and Hispanic students to have had their first sexual experience while still in high school (see Table SD 4.1.B). Specifically, in 1999,

45 percent of both male and female white students reported having had sexual intercourse,
63 percent of Hispanic male students and 46 percent of Hispanic female students reported having had sexual intercourse, and
76 percent of black male students and 67 percent of black female students reported having had sexual intercourse.

⁶²Lowenstein, G., & Furstenberg, F.F. 1991. Is Teenage Sexual Behavior Rational? Journal of Applied Social Psychology 21 (12): 957-986. Abma, J., Driscoll, A., & Moore, K. 1998. Young Women's Degree of Control over First Intercourse: An Exploratory Analysis. Family Planning Perspectives 30 (1): 12-18.
⁶³Forrest, J.D., & Singh, S. 1990. The Sexual and Reproductive Behavior of American Women, 1982-1988. Family Planning Perspectives 22 (5): 206-214.
⁶⁴Koyle, P., Jensen, L., Olsen, J., & Cundick, B. 1989. Comparison of Sexual Behaviors among Adolescents Having an Early, Middle, and Late First Intercourse Experience. Youth and Society 20 (4): 461-475.
⁶⁵Direct comparison with other years is not possible, as grade in school does not accurately reflect age, and data from the Youth Risk Behavior Surveillance Survey include only teens in school.
⁶⁶The Urban Institute. New Data on Sexual Behaviors of Teenage Males. Fact Sheet, May 1, 1997. Washington, D.C.: The Urban Institute.
⁶⁷U.S. Department of Health and Human Services, HHS News. Teen Sex Down, New Study Shows. Secretary Shalala Announces New Teen Pregnancy Prevention Grant Programs. Press release, May 1, 1997. Washington, D.C.: HHS, National Center for Health Statistics.
⁶⁸Estimates for whites and blacks exclude Hispanics of those races.

Table SD 4.1.A Percentage of youth in the United States who have ever had intercourse by each age, by gender: Cohorts^a age 20 in 1958-1960, 1970-1972,1985-1987, and 1990-1994

Age at first intercourse	Females who turned age 20 in:^b
Age at first intercourse	1958-1960	1970-1972	1985-1987	1990-1994
13	1	0	2	—
14	2	1	5	—
15	3	4	10	11
16	8	9	21	—
17	16	20	36	—
18	27	35	52	55
19	46	53	66	—
20	61	68	76	75

Age at first intercourse	Males who turned age 20 in:^b
Age at first intercourse	1958-1960	1970-1972	1985-1987	1990-1994
13	—	11	9	—
14	—	15	13	—
15	—	20	27	—
16	—	30	41	—
17	—	41	52	—
18	—	55	64	—
19	—	67	75	—
20	—	74	80	—

^aCohorts are defined as those individuals who turned 20 years old within the specified time period.
^bData are based on females ages 30-32 and 42-44 in the 1982 National Survey of Family Growth (NSFG), ages 21-23 and 36-38 in the 1988 NSFG, and ages 25-29 in the 1995 NSFG and males ages 21-23 and 36-38 in the 1991 Survey of Men.
Source: Alan Guttmacher Institute, 1994, Figures 11 and 12, pages 22-23; Abma, et al., 1997, Table 20.

Figure SD 4.1 Percentage of youth in the United States who have had intercourse, by age and gender: Cohort a
age 20 in 1985-1987

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^aCohorts are defined as those individuals who turned 20 years old within the specified time period.
Source: Alan Guttmacher Institute, 1994.

Table SD 4.1.B Percentage of students grades 9 through 12 in the United States who reported ever having sexual intercourse, by gender, grade, and race and Hispanic origin: 1995,1997, and 1999

	1995			1997			1999
	Total	Male	Female	Total	Male	Female	Total	Male	Female
Total	53	54	52	48	49	48	50	52	48
Grade
Ninth	37	41	32	38	42	34	39	45	33
Tenth	48	50	46	43	42	44	47	51	43
Eleventh	59	57	60	50	49	50	53	51	54
Twelfth	66	67	66	61	60	62	65	64	66
Race and Hispanic origin^a
White	49	49	49	44	43	44	45	45	45
Black	73	81	67	73	80	66	71	76	67
Hispanic	58	62	53	52	58	46	54	63	46

^a Estimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Sources: Kann et al., 1998, Table 26; Kann et al., 1996, Table 26.

SD 4.2 Sexually Active Teens

Having become sexually experienced does not necessarily mean teenagers will be sexually active from that point on. They may still abstain from intercourse out of concern for the risk of pregnancy or sexually transmitted diseases or a preference for abstinence, or they may experience periods in which they do not have a sexual partner; nevertheless, research indicates that once a person has had sex, he or she is likely to continue to be sexually active. Among young adults ages 18 through 22 who had ever had intercourse, over 70 percent had a second experience of intercourse within 6 months of first intercourse.⁶⁹

The percentage of teens in grades 9 through 12 who are sexually active—defined as having had sexual intercourse in the previous 3 months—has remained steady, with little variation, from 1991 to 1996 (see Table SD 4.2).

Differences by Gender. There is no difference between the percentages of male and female students who are sexually active. In 1999, 36 percent of males and 36 percent of females reported being sexually active.

Differences by Race and Hispanic Origin.⁷⁰ In 1999, black students were, at 53 percent, more likely than either white (33 percent) or Hispanic (36 percent) students to be sexually active (see Figure SD 4.2).

Differences by Grade. The percentage of teens who are sexually active rises as grade increases. Twelfth-grade students are nearly twice as likely to be sexually active as are 9th-grade students (see Table SD 4.2).

⁶⁹Moore, K.A., & Peterson, J.L. August 1989. The Consequences of Teenage Pregnancy. Final Report to NICHD and ASPE/HHS, Grant No. HD 21537.
⁷⁰Estimates for whites and blacks exclude Hispanics of those races.

Table SD 4.2 Percentage of students grades 9 through 12 in the United States who reported having had sexual intercourse in the previous 3 months, by gender, race and Hispanic origin, grade, and age: 1991, 1993, 1995, 1997, and 1999

	1991	1993	1995	1997	1999
Total	38	38	38	35	36
Gender
Male	37	38	36	33	36
Female	38	38	40	37	36
Race and Hispanic origin^a
White	34	34	35	32	33
Black	59	59	54	54	53
Hispanic	37	39	39	35	36
Grade
Ninth	22	25	24	24	27
Tenth	33	30	34	29	33
Eleventh	43	40	42	38	38
Twelfth	51	53	50	46	51
Age
15	24	25	28	26	27
16	38	35	37	32	35
15 or 16	31	31	32	29	32

^aEstimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Sources: Data for 1991: Centers for Disease Control and Prevention. 1990-1991 Youth Risk Behavior Surveillance System, Table 1, p. 78; data for 1993: Kann, et al., 1995. Morbidity and Mortality Weekly Report 44 (SS-1): Table 20; data for 1995: Kann, et al., 1996, Table 26; data for 1997: Kann, et al., 1998, Table 26; and unpublished data from the Centers for Disease Control.

Figure SD 4.2 Percentage of youth in grades 9 through 12 in the United States who reported having had sexual intercourse in the previous 3 months, by race and Hispanic origin:^a 1999

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^aEstimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Source: Kann, et al., 1998, Table 26.

SD 4.3 Contraceptive Use by Teens

Sexual intercourse without contraception puts a teen at risk of unintended pregnancy and of contracting sexually transmitted diseases such as HIV/AIDS. The vast majority of teens do not want to become pregnant. Data from a national survey show that among teens who
had first intercourse at age 17 or younger, fewer than 1 in 100 wanted a pregnancy to occur at that time. This was true for both males and females and for both blacks and whites.⁷¹ Even among adolescents who give birth as a teenager, only 34 percent of the births are
intended.⁷²

Condoms and birth control pills are the most common forms of contraception used by sexually active teenagers.⁷³ In 1999, over half (58 percent) of sexually experienced students in grades 9 through 12 reported use of a condom during their last sexual intercourse, while only 16 percent reported use of the birth control pill (see Tables SD 4.3.A and SD 4.3.B).

Condom use among sexually experienced students increased between 1991 and 1999 from 46 percent to 58 percent (see Table SD 4.3.A). Use of birth control pills has remained relatively steady from 1993 to 1999 at 16 to 18 percent, with some subgroup differences that are discussed below (see Table SD 4.3.B).

Differences by Gender. Female students are less likely than male students to report having used a condom during their last intercourse (51 percent of females versus 66 percent of males in 1999).

Differences by Grade. Condom use among 12th-grade students is lower than among students in the earlier grades. The decrease is largest among young women, dropping from 50 percent to 41 percent between the 11th and 12th grades for 1999. In contrast, in 1999, only 12 percent of sexually experienced 9th graders reported use of the pill, while 25 percent of 12th graders reported its use (see Figure SD 4.3).

Differences by Race.⁷⁴ Black students report the highest use of condoms, while white students report the highest use of the pill. In 1999, white students were more likely to have used the pill during their last sexual intercourse (21 percent) than were either black students (8 percent) or Hispanic students (8 percent) (see Tables SD 4.3.A and SD 4.3.B). It is important to note that the data presented here include only those teens who are in school. Teens out of school are likely to have lower rates of contraceptive use because their access to education regarding the risks associated with unprotected sex, as well as guidance on how to obtain protection, is more limited.

⁷¹ Moore & Peterson, August 1989. See also preliminary results of research from the 1995 National Survey of Adolescent Males and the 1995 National Survey of Family Growth, The Urban Institute Fact Sheet (May 1, 1997), New Data on Sexual Behaviors of Teenage Males.
⁷² In the 1995 National Survey of Family Growth, the percentage of births intended at the time of conception to women ages 15 through 44 that occurred 5 years prior to the survey interview were as follows: 69 percent to all mothers, 34 percent to mothers under 20, 61 percent to mothers ages 20 through 24, 78 percent to mothers ages 25 through 29, and 80 percent to mothers ages 30 through 44. Abma, J.C., Chandra, A., Mosher, W.D., Peterson, L., & Piccinino, L. 1997. Fertility, Family Planning, and Women's Health: New Data from the 1995 National Survey of Family Growth. National Center for Health Statistics, Vital Health Statistics 23 (19), Table 14.
⁷³Peterson, L.S., 1995, Contraceptive Use in the United States: 1982-90. Advance Data, No. 260, Division of Vital Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention. Data from the National Survey of Family Growth.
⁷⁴Estimates for whites and blacks exclude Hispanics of those races.

Table SD 4.3.A Percentage of currently sexually activea high school students in the United States who reported using a condom during last sexual intercourse, by gender, grade, and race and Hispanic origin: 1991, 1993, 1995, 1997, and 1999

	1991			1993			1995			1997			1999
	Total	Male	Female	Total	Male	Female	Total	Male	Female	Total	Male	Female	Total	Male	Female
Total	46	55	38	53	59	46	54	61	49	57	63	51	58	66	51
Grade
Ninth	53	56	50	62	63	59	63	66	59	59	59	58	67	70	63
Tenth	46	57	36	55	63	46	60	68	52	59	65	53	63	70	55
Eleventh	49	57	41	55	65	46	52	57	49	60	65	55	59	69	50
Twelfth	41	51	33	47	52	41	50	57	43	52	61	43	48	56	41
Race and Hispanic origin^b
White	47	55	38	52	59	46	53	58	48	56	62	49	55	63	48
Black	48	57	39	57	64	48	66	72	61	64	68	59	70	75	65
Hispanic	37	47	27	46	55	37	44	56	33	48	55	40	55	66	43

^a“Currently sexually active” is defined as having had sexual intercourse during the 3 months preceding the survey.
^bEstimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Sources: Data for 1990: Centers for Disease Control and Prevention, 1990-1991 Youth Risk Behavior Surveillance System, Table 2, p. 47; data for 1993: Kann, et al., 1995, Table 20; data for 1995: Kann, et al., 1996, Table 28; also, unpublished tabulations from L. Kann, Centers for Disease Control and Prevention; data for 1997: Kann, 1998, Table 28.

Table SD 4.3.B Percentage of currently sexually activea high school students in the United States who reported birth control pill use during last sexual intercourse, by gender, grade, and race and Hispanic origin: 1993, 1995, 1997, and 1999

	1993			1995			1997			1999
	Total	Male	Female	Total	Male	Female	Total	Male	Female	Total	Male	Female
Total	18	15	22	17	14	20	17	13	21	16	12	20
Grade
Ninth	9	8	11	11	10	13	8	8	8	12	11	13
Tenth	14	10	17	12	9	16	12	8	17	9	6	13
Eleventh	17	12	22	15	13	17	16	12	19	15	12	18
Twelfth	26	23	29	25	21	29	24	19	30	25	17	31
Race and Hispanic origin^b
White	20	17	24	21	17	25	21	17	25	21	16	26
Black	15	11	21	10	8	12	12	9	15	8	3	12
Hispanic	12	10	15	11	14	9	10	7	13	8	5	11

Figure SD 4.3 Percentage of currently sexually active ^a high school students in the United States who reported using a contraceptive during their last sexual intercourse, by grade and method: 1999

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^a“Currently sexually active” is defined as having had sexual intercourse during the 3 months preceding the survey.
Source: Kann et al., 1998, Table 28.

SD 4.4 Number of Sexual Partners

The greater the number of sexual partners a person has, the greater the risk of contracting sexually transmitted diseases such as HIV/AIDS. While trend data on the sexual behavior of teens are limited, one study indicates that the proportion of sexually active females living in metropolitan areas who have had six or more sexual partners doubled from 1971 to 1988.⁷⁵

Differences by Gender. Male youth generally report a higher number of sexual partners than do female youth. In 1995, 6 percent of sexually active males and 3 percent of sexually active females ages 15 through 19 reported having five or more sexual partners in a year. The number of sexual partners per year among sexually active females is concentrated at the lower end of the scale, with either zero or one partners most likely to be reported (see Table SD 4.4.A). Among high school students surveyed in 1999, 19 percent of males reported having had four or more sexual partners in their lifetime, compared with 13 percent of female students (see Table SD 4.4.B).

Differences by Race.⁷⁶ Black high school students are more likely to report having had four or more sexual partners in their lifetime than their white or Hispanic peers: 34 percent versus 12 and 16 percent, respectively, in 1999 (see Table SD 4.4.B).

Differences by Age at First Intercourse. Age at first intercourse has a strong association with the number of sexual partners a person has over a lifetime (see Table SD 4.4.C). Among teens who were age 20 in 1992, 74 percent of males who had sexual intercourse at age 14 or younger had six or more partners during their lifetime, compared with 48 percent of those who initiated sex at age 15 or 16, and 10 percent of those who did not have intercourse until age 17 or older. A similar pattern exists for females (see Figure SD 4.4).

⁷⁵Kost, K., Forrest, J.D. 1992. American Women's Sexual Behavior and Exposure to Risk of Sexually Transmitted Disease. Family Planning Perspectives 24 (6): 244-254. Based on data from the National Surveys of Young Women (1971, 1976, and 1979) and the 1988 National Survey of Family Growth.
⁷⁶ Estimates for whites and blacks exclude Hispanics of those races.

Table SD 4.4.A Percentage distribution of number of sexual partners in a year among sexually active teens ages 15 through 19 in the United States, by gender: 1995

	0 Partners	1 Partner	2 Partners	3-4 Partners	5 or more Partners
Males	10	44	26	14	6
Females	8	62	17	10	3

Source: Analyses of the 1995 National Survey of Family Growth, Cycle 5, by Child Trends; also Sonenstein, et al., 1997, pp. 16 and 17.

Table SD 4.4.B Percentage of students in grades 9 through 12 in the United States who reported having four or more sex partners during lifetime, by gender, grade, and race and Hispanic origin: 1993, 1995, 1997, and 1999

	1993			1995			1997			1999
	Total	Male	Female	Total	Male	Female	Total	Male	Female	Total	Male	Female
Total	19	22	15	18	21	14	16	18	14	16	19	13
Grade
Ninth	11	15	6	13	18	7	12	16	8	12	16	8
Tenth	16	19	13	16	20	11	14	16	12	16	21	10
Eleventh	20	23	16	19	21	17	17	17	16	17	19	15
Twelfth	27	31	23	23	25	21	21	21	21	21	21	21
Race and Hispanic origin^b
White	14	15	13	14	15	13	12	11	12	12	12	13
Black	43	59	27	36	52	22	39	53	25	34	48	21
Hispanic	19	26	11	18	24	12	16	20	10	17	23	11

^a Estimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Sources: Data for 1993: Kann, et al., 1995, Table 20; data for 1995: Kann, et al., 1996, Table 26; data for 1997: Kann, et al., 1998, Table 26.

Table SD 4.4.C Percentage distribution of number of lifetime sexual partners among sexually active 20-year-olds by age at first intercourse and by gender: 1992

	First intercourse at age 14 or Younger	First intercourse at age 15 or 16	First intercourse at age 17 or older
Males
1 partner	2	9	42
2 or 3 partners	10	27	30
4 or 5 partners	15	16	19
6 or more partners	74	48	10
Females
1 partner	2	10	45
2 or 3 partners	26	28	33
4 or 5 partners	16	28	13
6 or more partners	57	34	10

Note: Percents may not sum to 100 due to rounding.
Source: National Center for Health Statistics, Centers for Disease Control and Prevention. 1992 National Health Interview Survey—Youth Risk Behavior Supplement. Tabulations by Child Trends.

Figure SD 4.4 Percentage of sexually active 20-year-olds in the United States with six or more lifetime sexual partners, by age at first intercourse: 1992

src=

Source: National Center for Health Statistics, Centers for Disease Control and Prevention. 1992 National Health Interview Survey—Youth Risk Behavior Supplement. Tabulations by Child Trends.

SD 4.5 Teen Pregnancy and Abortion

The United States has the highest teen pregnancy, birth, and legal abortion rates among western nations. The teen pregnancy rate in the United States is twice as high as that in England, Wales, and Canada; three times as high as that in Sweden; and seven times as high as that in the Netherlands.⁷⁷ The Society for Adolescent Medicine cites a multitude of factors, including the lack of sex education, inadequate access to reliable contraception, poverty, and substance abuse, as some of the reasons for the U.S.’s high teen pregnancy, birth, and abortion rates.

Pregnancy

Teenage pregnancy rates⁷⁸ have declined considerably in the 1990s. The overall pregnancy rate was 98.7 per 1,000 women ages 15-19 years in 1996, down 15 percent from its high point of 116.5 in 1991 (See Table SD 4.5). Among the factors accounting for the overall decrease in teenage pregnancy rates are 1) a decrease in sexual activity, 2) increased condom use, and 3) the adoption of Depo-Provera and Norplant contraception methods.⁷⁹ Furthermore, societal influences may have also combined to reduce the pregnancy rate among teens. One is changing attitudes towards premarital sex. Many public and private initiatives have focused attention on the importance of pregnancy prevention through abstinence. Furthermore, the long economic expansion of the 1990s has increased the economic opportunities for teenagers. The sexual activity of teens is closely associated with simple measures of economic prosperity. As a result of the economic boom, teenagers’ educational and occupational goals may have changed during the 1990s, with more value placed on school completion and entering the work force.⁸⁰

Differences by Age. Pregnancy is more prevalent among older teens. For teenagers ages 15 to 17 years, the pregnancy rate was 67.8 in 1996, while the pregnancy rate for older teens (18 or 19 years) was more than twice that, at 146.4 (See Table SD 4.5.A). This gap has been apparent throughout the 1990s. This trend reflects the fact that older teens are more sexually active than younger ones. In 1995, over two-thirds of teens ages 18 to 19 years had been sexually active in the last 12 months, compared to approximately one-third of all teenagers ages 15 to 17.⁸¹

Differences by Race and Hispanic Origin. The pregnancy rates for non-Hispanic black and Hispanic teenagers are about twice as high as the rate for non-Hispanic white teenagers. The lower rate for non-Hispanic white teenagers is due to both the smaller proportion of sexually active teens and lower pregnancy rates for those who are sexually active. In 1996 non-Hispanic black and Hispanic teens ages 15-19 were more than twice as likely as non-Hispanic whites to become pregnant (rates of 177.8 and 157.1, respectively versus 68.1). (See Table SD 4.5.A).

Abortion

The proportion of females ages 15 through 19 who obtained an abortion during the previous year increased from 2.3 percent to 4.4 percent between 1973 and 1985, presumably influenced both by the legalization of abortion and increasing levels of sexual activity and
pregnancy (see Section SD 4.2 and Table SD 4.5.B). By 1992, the proportion obtaining abortions had dropped to 3.6 percent, and it continued to decline, reaching 2.9 percent in 1996 (the most recent year for which data are available). Similar patterns occurred among both younger teens (ages 15 through 17) and older teens (ages 18 or 19).

There has not been a steady trend in the propensity of pregnant teens to give birth versus obtain an abortion over the past 20 years (see Figure SD 4.5.C). In 1972, the proportion of pregnancies (excluding miscarriages) to females ages 15 through 19 that ended in birth was
76 percent. During the rest of the 1970s, this proportion declined as abortion increased. Throughout most of the 1980s, however, the proportion of teen pregnancies ending in birth remained fairly stable at around 48 percent. By 1995, there was an increase to 55 percent in the proportion of teen pregnancies ending in birth, indicating a trend toward fewer abortions among pregnant teens.

Differences by Age. Older teens ages 18 or 19 have higher abortion rates than younger teens ages 15 through 17. In 1996, 1.9 percent of younger teens and 4.5 percent of older teens obtained an abortion (see Table SD 4.5.B).

Differences by Race and Hispanic Origin.⁸² Non-Hispanic black teens are more likely to have had an abortion than are their non-Hispanic white and Hispanic peers. Among non-Hispanic black females ages 15 through 19, 6.6 percent obtained an abortion in 1995, compared with 1.9 percent of non-Hispanic white and 3.9 percent of Hispanic females (see Table SD 4.5.C).

Sexually Experienced Teens. The percentage of teens who are sexually experienced has increased during the past several decades; therefore, it is reasonable to consider abortion in light of this trend. When abortion rates are calculated among females ages 15 through 19 who have ever had intercourse, the data indicate that the proportion obtaining abortions increased from 5.9 percent in 1973 to 9.1 percent in 1980, then declined to 6.8 percent in 1991 (see Table SD 4.5.B). Although a larger proportion of teen females were sexually experienced in 1990 than in 1980 (see Section SD 4.2), a smaller proportion of these sexually experienced teens obtained abortions.

⁷⁷Singh & Darroch. 2000. Adolescent Pregnancy and Childbearing: Levels and Trends in Developed Countries. Family Planning Perspectives 32 (1): 14-23. Society for Adolescent Medicine. Position Paper on Reproductive Health Care for Adolescents. Journal of Adolescent Health: 1991 12:649-661.
⁷⁸Pregnancy rates are based on the sum of live births, induced abortions, and fetal losses.
⁷⁹Ventura, Mosher, Curtin, Abma, & Henshaw. 2000. Trends in Pregnancies and Pregnancy Rates by Outcome: Estimates for the United States, 1976-96. Vital and Health Statistics 21(56) Hyattsville MD.
⁸⁰Ibid.
⁸¹Ibid.
⁸²Estimates for whites and blacks exclude Hispanics of those races.

Table SD 4.5.A Rate of females ages 15 through 19 experiencing pregnancy by age and by race and Hispanic origin: 1990-1996

	1990	1991	1992	1993	1994	1995	1996
Females 15-19 years
Total	116.3	116.5	112.8	110.4	107.6	102.7	98.7
Race and Hispanic origin^a
White	87.4	84.7	79.3	76.9	74.5	71.6	68.1
Black	221.3	221.7	217.3	211.7	201.2	184.4	177.8
Hispanic	155.8	164.6	167.8	166.1	167.2	162.8	157.1
Females 15-17 years
Total	80.3	79.8	77.3	76.8	75.5	71.7	67.8
Race and Hispanic origin^a
White	56.3	54.1	50.4	49.9	48.7	46.7	43.9
Black	165.0	164.6	160.4	158.0	149.8	137.0	128.1
Hispanic	101.0	107.0	110.9	110.2	113.9	110.0	105.0
Females 18 or 19 years
Total	162.4	167.2	165.1	160.6	156.7	150.8	146.4
Race and Hispanic origin^a
White	126.4	126.9	121.8	117.3	114.0	110.2	105.6
Black	295.3	299.8	300.5	292.4	280.9	258.3	254.4
Hispanic	231.4	247.6	251.6	249.3	246.5	242.7	235.4

^aEstimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Sources: Ventura, et al., 2000, Vital and Health Statistics Series 21, Tables 3-5.

Figure SD 4.5.A Pregnancy, birth, and abortion rates for teenagers 15-17 years: 1976-1996

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Source: Ventura, et al., 1999, National Vital Statistics Reports 47, Table 2.

Figure SD 4.5.B Pregnancy, birth, and abortion rates for teenagers 18-19 years: 1976-1996

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Source: Ventura, et al., 1999, National Vital Statistics Reports 47, Table 2.

Table SD 4.5.B Percentage of females ages 15 through 19 in the United States obtaining an abortion during the year, by age and by race and Hispanic origin: 1990-1996

	1990	1991	1992	1993	1994	1995	1996
Females ages 15-17
Total	2.7	2.4	2.3	2.3	2.1	2.0	1.9
Race and Hispanic origin^a
White	2.1	1.8	1.6	1.5	1.4	1.3	1.3
Black	5.8	5.5	5.4	5.4	5.0	4.6	4.4
Hispanic	2.4	2.5	2.8	2.7	2.8	2.5	2.5
Females ages 18 or 19
Total	5.8	5.6	5.4	5.2	4.9	4.6	4.5
Race and Hispanic origin^a
White	4.7	4.3	3.9	3.7	3.3	3.1	2.9
Black	11.7	11.6	11.7	11.5	10.8	9.8	10.0
Hispanic	6.0	6.3	6.6	6.4	6.3	5.9	6.0
Females ages 15-19
Total	4.0	3.8	3.6	3.4	3.2	3.0	2.9
Race and Hispanic origin^a
White	3.2	2.8	2.5	2.4	2.2	2.0	1.9
Black	8.4	8.1	8.0	7.8	7.3	6.6	6.6
Hispanic	3.9	4.0	4.3	4.2	4.2	3.9	3.9

^aEstimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.
Sources: Ventura, et al., 2000.

Table SD 4.5.C Percentage of females under age 20 in the United States obtaining an abortion, by all females and sexually experienced females: Selected years, 1973-1996

	1973	1975	1980	1985	1990	1991	1992	1993	1994	1995	1996
All females ages 14 or youngera	0.6	0.7	0.8	0.9	0.8	0.7	0.8	—	—	—	—
All females ages 15-17	1.9	2.4	3.0	3.1	2.7	2.4	2.3	2.3	2.1	2.0	1.9
All females ages 18 or 19	2.9	4.2	6.1	6.2	5.8	5.6	5.4	5.2	4.9	4.6	4.5
All females ages 15-19	2.3	3.1	4.3	4.4	4.0	3.8	3.6	3.4	3.2	3.0	2.9
Sexually experienced females ages 15-19b	5.9	7.5	9.1	8.5	7.3	6.8	—	—	—	—	—

^aDenominator is 14-year-old females.
^bData for sexually experienced females for 1985 were interpolated from 1980 and 1988 data. Data for sexually experienced females are not available for 1992-1995. Data for females ages 14 or younger are not available for 1993-1995.
Sources: Henshaw, 1998; Alan Guttmacher Institute, Table 2; Alan Guttmacher Institute. 1994, Figure 36. Both are based on data from abortion providers and sexual experience data from the National Survey of Family Growth; also, unpublished data from Ventura, Mosher, and Henshaw, National Center for Health Statistics and published and unpublished data from the Alan Guttmacher Institute.

SD 4.6 Teen Births

Research indicates that giving birth as a teen can have negative consequences on both mothers and their children. Giving birth at an early age can limit a young woman’s options regarding education and employment opportunities, increases the likelihood that she will need public assistance, and can have negative effects on the development of her children.⁸³

Between 1960 and 1985, birth rates for teens ages 15 through 19 dropped from 89.1 to 51.0 per 1,000 teen women. This trend reversed between 1986 and 1991, and the teen birth rate increased to 62.1 per 1,000 teen women. Since 1991, the teen birth rate has again turned
downward, declining to 49.6 births per 1,000 teen women by 1999, a record low for the U.S. (see Figure SD 4.6).

Differences by Race and Hispanic Origin.⁸⁴ The trends described in the previous paragraph are evident for white, black, and American Indian/Alaska Native⁸⁵ women ages 15 through 19.

The birth rate for black teens has remained about twice that of white teens since 1960. In 1999, the birth rate for white teens was 34.1 per 1,000 teen women, and for black teens it was 81.1 per 1,000 teen women. Black teens had the highest birth rate until 1994, when the rate for Hispanic teens surpassed that of blacks; the Hispanic rate has remained at a higher level through 1999. Black teens experienced a 30 percent drop in birth rates between 1991 and 1999, from 115.5 to 81.1 per 1,000 women ages 15 through 19. The birth rate for black teens is now at its lowest point in the more than 30 years for which detailed statistics for black teens have been available (see Table SD 4.6).

Differences by Age. Teen birth rates increase with age. In 1999, the birth rate for all teens ages 15 through 17 was 28.7 per 1,000 teen women; for those ages 18 or 19, it was 80.2 per 1,000. Rates for teen females ages 10 through 14 were considerably lower at 0.9 per 1,000. For black and Hispanic teens, the birth rate among 18- and 19-year-olds was more than twice that of the 15- through 17-year-old teen females. The birth rate of white, American Indian/Alaska Native, and Asian/Pacific Islander teen females ages 18 or 19 are over two and a half times that of younger teens ages 15 through 17.

⁸³Moore, K.A. 1993. Teenage Childbearing: A Pragmatic Perspective. Washington, D.C.: Child Trends, Inc.; Maynard, R.A. (ed.). 1996. Kids Having Kids: A Robin Hood Foundation Special Report on the Costs of Adolescent Childbearing. New York: The Robin Hood Foundation.
⁸⁴Estimates for white and black teens do not include those of Hispanic origin in the text. Teens of Hispanic origin may be of any race.
⁸⁵Data for American Indians/Alaska Natives available since 1980.

Table SD 4.6 Teen birth rates in the United States by age of mother and by race and Hispanic origin (births per 1,000 females in each age group) Selected years: 1960-1999

	1960	1965	1970	1975	1980^a	1985	1990	1995	1996	1997	1998	1999
All races
Ages 10-14	—	—	1.2	1.3	1.1	1.2	1.4	1.3	1.2	1.1	1.0	0.9
Ages 15-17	43.9	36.6	38.8	36.1	32.5	31.0	37.5	36.0	33.8	32.1	30.4	28.7
Ages 18 or 19	166.7	124.5	114.7	85.0	82.1	79.6	88.6	89.1	86.0	83.6	82.0	80.2
Ages 15-19	89.1	70.5	68.3	55.6	53.0	51.0	59.9	56.8	54.4	52.3	51.1	49.6
White ^b
Ages 10-14	—	—	0.5	0.6	0.6	0.6	0.7	0.8	0.8	0.7	0.6	0.6
Ages 15-17	35.5	27.8	29.2	28.0	25.5	24.4	29.5	30.0	28.4	27.1	25.9	24.8
Ages 18 or 19	154.6	111.9	101.5	74.0	73.2	70.4	78.0	81.2	78.4	75.9	74.6	73.4
Ages 15-19	79.4	60.6	57.4	46.4	45.4	43.3	50.8	50.1	48.1	46.3	45.4	44.5
White, non-Hispanic
Ages 10-14	—	—	—	—	0.4	—	0.5	0.4	0.4	0.4	0.3	0.3
Ages 15-17	—	—	—	—	22.4	—	23.2	22.0	20.6	19.4	18.4	17.1
Ages 18 or 19	—	—	—	—	67.7	—	66.6	66.1	63.7	61.9	60.6	59.0
Ages 15-19	—	—	—	—	41.2	—	42.5	39.3	37.6	36.0	35.2	34.1
Black ^b
Ages 10-14	—	—	5.2	5.1	4.3	4.5	4.9	4.2	3.6	3.3	2.9	2.6
Ages 15-17	—	99.3	101.4	85.6	72.5	69.3	82.3	69.7	64.7	60.8	56.8	52.1
Ages 18 or 19	—	227.6	204.9	152.4	135.1	132.4	152.9	137.1	132.5	130.1	126.9	122.9
Ages 15-19	156.1	144.6	140.7	111.8	97.8	95.4	112.8	96.1	91.4	88.2	85.4	81.1
Hispanic^c,d
Ages 10-14	—	—	—	—	1.7	—	2.4	2.7	2.6	2.3	2.1	2.0
Ages 15-17	—	—	—	—	52.1	—	65.9	72.9	69.0	66.3	62.3	61.2
Ages 18 or 19	—	—	—	—	126.9	—	147.7	157.9	151.1	144.3	140.1	139.0
Ages 15-19	—	—	—	—	82.2	—	100.3	106.7	101.8	97.4	93.6	93.1
American Indian/Alaska Native^b
Ages 10-14	—	—	—	—	1.9	1.7	1.6	1.8	1.7	1.7	1.6	1.7
Ages 15-17	—	—	—	—	51.5	47.7	48.5	47.8	46.4	45.3	44.4	41.3
Ages 18 or 19	—	—	—	—	129.5	124.1	129.3	130.7	122.3	117.6	118.4	110.4
Ages 15-19	—	—	—	—	82.2	79.2	81.1	78.0	73.9	71.8	72.1	67.7
Asian/Pacific Islander^b
Ages 10-14	—	—	—	—	0.3	0.4	0.7	0.7	0.6	0.5	0.4	0.4
Ages 15-17	—	—	—	—	12.0	12.5	16.0	15.4	14.9	14.3	13.8	12.6
Ages 18 or 19	—	—	—	—	46.2	40.8	40.2	43.4	40.4	39.3	38.3	38.8
Ages 15-19	—	—	—	—	26.2	23.8	26.4	26.1	24.6	23.7	23.1	22.8

^aBeginning in 1980, births have been tabulated by race and ethnicity of the mother. Prior to 1980, births were tabulated by race of child, assigning a child to the race of the nonwhite parent, if any, or to the race of the father, if both are nonwhite.
^bIncludes persons of Hispanic origin.
^cPersons of Hispanic origin may be of any race.
^d Data for Hispanics have been available only since 1980, with 22 states reporting in 1980, representing 90 percent of the Hispanic population. Hispanic birth data were reported by 23 states and the District of Columbia in 1985; 48 states and the District of Columbia in 1990; 49 states and the District of Columbia in 1991 and 1992; and all 50 states and the District of Columbia since 1993. Rates in 1985 were not calculated for Hispanics because estimates for populations were not available.
Sources: Curtin & Martin. 2000. Births. Ventura, et al., 1999, Births, Tables 4 and 9; Ventura, Mathews, & Curtin, 1998, Births, Tables 1 and 2; Ventura, et al., 1998, Table 4; Centers for Disease Control, National Center for Health Statistics. Vital Statistics of the United States, Volume 1, Natality. Annual Issues, Table: Birth Rates by Age of Mother and Race and Hispanic Origin: United States, 1940-97; and Mathews, et al., 1998, Table 1.

SD 4.7 Second- and Higher-Order Births to Teens

Bearing a child during adolescence is associated with poor outcomes for young women and their children.⁸⁶ Giving birth to a second child while still a teen further increases these risks.⁸⁷ Yet, analyses of nationally representative data indicate that in the 2 years following the first birth, teen mothers have a second birth at about the same rate as older mothers.⁸⁸

In 1999, more than one in every five births to teen mothers was a birth of second order or higher. The proportion of teen births that were second or higher order increased from 22 percent in 1980 to peak at 25 percent in 1991 but has since declined to 22 percent in 1999. This pattern is evident across racial, ethnic, and marital status groups (see Table SD 4.9). The rate of second births to teens who have had a first birth fell 21 percent between 1991 and 1996 and has changed little since (data not shown).⁸⁹

The increased use of contraceptives by teenage mothers may account for this drop in second births. Teenage mothers are increasingly using Depo-Provera and Norplant implants as their primary method of birth control. These contraceptives last longer and are more reliable than birth control pills or condoms, whose effectiveness is contingent upon proper and consistent use. In fact, one in four teenagers who already have a child used one of these two longer-lasting methods, compared to 5 percent of teenage females without children.⁹⁰

Differences by Race and Hispanic Origin. Births to black and Hispanic teens are more likely to be subsequent births than births to white teens. In 1999, 26 percent of births to black teens, 23 percent of births to Hispanic teens, and 18 percent of births to non-Hispanic white teens were second- or higher-order births.

Differences by Marital Status. A higher proportion of births among married teens are second or higher order than births to unmarried teens. In 1998, 29 percent of births to married teens were second or higher order, compared with 20 percent among unmarried teens.

⁸⁶Moore, K.A., Myers, D.E., Morrison, D.R., Nord, C.W., Brown, B.V., & Edmonston, B. 1993. Age at First Childbirth and Later Poverty. Journal of Research on Adolescence 3 (4): 393-422; Maynard, 1996.
⁸⁷Kalmuss, D., & Namerow, P.B. 1992. The Mediators of Educational Attainment among Early Childbearers. Unpublished manuscript. Columbia University, Center for Population and Family Health.
⁸⁸ Moore, K.A., Morrison, D.R., Nord, C.W., & Blumenthal, C. 1993. The Consequences of Early Childbearing in the 1980s. Unpublished tables. Washington, D.C.: Child Trends.
⁸⁹ Ventura, S.J., Martin, J.A., Curtin, S.C., Park, M.M., & Mathews, T.J. “Births: Final Data for 1998” National Vital Statistics Report 48 (3). Hyattsville, MD: National Center for Health Statistics.
⁹⁰ Ventura, Mosher, Curtin, Abma, & Henshaw. 2000. “Trends in Pregnancies and Pregnancy Rates by Outcome: Estimates for the United States 1976–1996”. Vital and Health Statistics Series 21 (56). Hyattsville, MD: National Center for Health Statistics.

Table SD 4.7 Percentage of all births to women under age 20 in the United States that are second or higher order, by marital status and by race and Hispanic origin of mother: Selected years, 1980-1999

	1980	1985	1991^a	1994	1995	1996	1997	1998	1999
All births	22	23	25	22	21	21	22	22	22
Race and Hispanic origin
White^a	19	20	19	17	17	17	18	18	18
Black^a	27	28	33	28	27	27	27	27	26
Hispanic^b	20	25	25	23	23	24	24	24	23
Marital Status
Married	24	26	28	26	26	27	28	29	—
Single	19	20	23	20	19	20	20	20	—

^aIncludes persons of Hispanic origin before 1990. Beginning 1990 persons of Hispanic origin are not included; figures for black women for 1999 include Hispanic women.
^bPersons of Hispanic origin may be of any race.
Sources: Ventura, et al., 2000. Births: Final Data for 1998. Curtin & Martin. 2000. Births: Preliminary Data for 1999. Ventura, et al., 1999, Births Tables 2 and 7; Ventura, et al., 1998, Natality 1996, Tables 2 and 7; also previous issues of this annual report (vol. 45, no. 11, supp., tables 2 and 6; vol. 44, no. 11, supp., tables 2 and 6; vol. 42, no. 3, supp.; vol. 36, no. 4, supp.; vol. 31, no. 8, supp., table 2 in each); also unpublished tabulations, Division of Vital Statistics, National Center for Health Statistics.

Figure SD 4.7 Rate of second births to teenagers who have had a first birth, 1985-1998

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Sources: Ventura, et al., 2000; Vital and Health Statistics 21, Table A.

Section 5: Education and Achievement (EA)

Enrollment/Attendance

EA 1.1 Early Childhood Program Enrollment

Enrollment in an early childhood program is one indicator of readiness to learn in elementary school that may be especially relevant for children from disadvantaged backgrounds. One of the National Education Goals for the year 2000, adopted by Congress, is that “all children will have access to high-quality and developmentally appropriate preschool programs that help prepare children for school.”¹

In 1998, 48 percent of children ages 3 to 4 who had not yet entered kindergarten attended a nursery school program (see Figure EA 1.1.A). This represents a substantial increase from the 30 percent who attended nursery school in 1980.

When a broader set of center-based programs is considered, the increase in early childhood program enrollment is even more substantial. Table EA 1.1 presents the percentage of children, ages 3 and 4, enrolled in day care centers, Head Start programs, preschools, prekindergartens, and other early childhood programs.² In 1999, 57 percent of all 3- to 4-year-old children were enrolled in a center-based program. This reflects a modest increase from 51 percent in 1991 and 1993 (see Table EA 1.1).

Differences by Race and Hispanic Origin.³ There are notable differences in center-based early childhood program enrollment rates among racial and ethnic groups; for example, in 1999, only 43 percent of Hispanic children were enrolled in a center-based program, compared with 57 percent of whites and 70 percent of blacks. Throughout the 1990s, black 3- to 4-year-olds have had the highest enrollments in center-based programs, followed closely by whites, with much lower enrollments among Hispanics (see Figure EA 1.1.B).

Differences by Socioeconomic Status. There are substantial differences in center-based enrollment rates by socioeconomic status, including poverty status and maternal education (see Table EA 1.1).

In 1999, enrollment rates were much higher among families that were at or above the poverty threshold (60 percent) than those who were below the poverty threshold (50 percent).
Enrollment rates also differ by maternal education, with the highest enrollment (72 percent) among children whose mothers were college graduates and the lowest (38 percent) among children whose mothers lacked a high school diploma. These differences by socioeconomic status were apparent for all years reported (see Table EA 1.1).

Differences by Mother’s Employment Status. There are also differences in enrollment rates by maternal employment status (see Figure EA 1.1.C); for example, in 1999, children whose mothers were working either full-time (35 hours or more per week) or part-time (less than 35 hours per week) had substantially higher enrollment rates than children whose mothers were not in the labor force.

¹National Education Goals Panel. 1999. The National Education Goals Report: Building a Nation of Learners, 1999 (Goal 1, p. xiv). Washington, D.C.: U.S. Government Printing Office.
²Estimates are based on children who have yet to enter kindergarten.
³Estimates for whites and blacks exclude Hispanics of those races.

Figure EA 1.1.A Percentage of 3- and 4-year-olds a in the United States enrolled in nurser y school: 1980-1998

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^aEstimates are based on children who have not yet entered kindergarten.
Note: Data for 1990 and 1994-96 may not be comparable with other years because of changes in survey procedures.
Source: U.S. Bureau of the Census, October Current Population Surveys. Tabulated by the National Center for Education
Statistics. As published in Federal Interagency Forum on Child and Family Statistics, 2000, Table ED2.A.

Table EA 1.1 Percentage of 3- and 4-year-olds^a in the United States enrolled in center-based programs,^b by child and family characteristics: 1991, 1993, 1995, 1996, and 1999

	1991	1993	1995	1996	1999
Total	51	51	53	53	57
Gender
Male	51	50	52	52	58
Female	52	52	53	53	56
Race and Hispanic origin^c
White, non-Hispanic	53	52	55	54	57
Black, non-Hispanic	56	56	57	63	70
Hispanic	38	42	34	37	43
Poverty Status
At or above poverty	54	55	58	58	60
Below poverty	42	42	41	41	50
Family structure^d
Two parents	52	51	53	51	56
One or no parent	47	52	53	56	60
Mother’s education^e
Less than high school	30	31	31	37	38
High school/GED	44	41	45	46	49
Vocational/technical or some college	59	58	55	55	61
College graduate	72	72	73	71	72
Mother’s employment status^e
35 hours or more per week	58	59	58	62	63
Less than 35 hours per week	57	55	60	62	60
Not in labor force	43	43	43	41	50

^aEstimates are based on children who have not yet entered kindergarten.
^bCenter-based programs include day care centers, Head Start programs, preschools, prekindergartens, and other early childhood programs.
^cPersons of Hispanic origin may be of any race.
^dParents include any combination of a biological, adoptive, step-, and foster mother and/or father. No parents in the household indicates that the child is living with non-parent guardians (e.g., grandparents).
^eChildren without mothers in the home are not included in estimates dealing with mother’s education or mother’s employment status. A mother is defined as a biological mother, adoptive mother, stepmother, foster mother, or female guardian (e.g., grandmother) who resides in the home with the child.
Source: U.S. Department of Education, National Center for Education Statistics, 1991, 1993, 1995, 1996, and 1999 National Household Education Survey. As published in Federal Interagency Forum on Child and Family Statistics, 2000, Table ED2.B.

Figure EA 1.1.B Percentage of 3- and 4-year-olds^a in the United States enrolled in center-based programs,^b by race and Hispanic origin:^c 1980-1999

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^aEstimates are based on children who have not yet entered kindergarten.
^bCenter-based programs include day care centers, Head Start programs, preschools, nursery schools, prekindergartens, and other early childhood programs.
^c Persons of Hispanic origin may be of any race.
Source: U.S. Department of Education, National Center for Education Statistics, 1991, 1993, 1995, and 1996 National
Household Education Survey.

Figure EA 1.1.C Percentage of 3- and 4-year-olds^a in the United States enrolled in center-based programs,^b by poverty status, mother’s education,^c and mother’s employment status:^c 1999

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^aEstimates are based on children who have not yet entered kindergarten.
^bCenter-based programs include day care centers, Head Start programs, preschools, nursery schools, prekindergartens, and other early childhood programs.
^cChildren without mothers in the home are not included in estimates dealing with mother’s education or mother’s employment status.
Source: U.S. Department of Education, National Center for Education Statistics, 1991, 1993, 1995, and 1996 National Household Education Survey.

EA 1.2 Grade Retention: Percentage of Current 2nd Graders Who Were Retained in Kindergarten and/or 1st Grade

Children’s early primary school experiences are associated with their adjustment to school and their later school success. Grade retention (repeating a grade) at an early age may indicate that a child has started school without adequate preparation and may continue to experience school problems in subsequent years. It may also measure the degree to which schools are able to respond to children from a variety of backgrounds.⁴

Table EA 1.2 presents data on the percentage of 2nd grade students who were retained in kindergarten and/or 1st grade as reported by their parents. Estimates are presented for 1991, 1993, 1995, 1996, and 1999.⁵

Trends in Grade Retention. Data in Table EA 1.2 indicate a decline in the proportion of 2nd graders retained in kindergarten and/or 1st grade, from 11 percent in 1991 to 8 percent in 1999 (see Figure EA 1.2).

Differences by Gender. A higher percentage of boys repeat kindergarten and/or 1st grade in 1991 and 1999 compared to girls (see Table EA 1.2). For example, in 1999, 10 percent of boys were retained, compared with 6 percent of girls.

Differences by Socioeconomic Status. Grade repetition differs by family poverty status and maternal education levels. In 1999, 16 percent of 2nd graders in poor families had repeated a grade, in comparison with 5 percent of 2nd graders living in nonpoor families (see Table EA 1.2). Grade repetition varies by maternal education, with the highest percentage of grade repetition in 1999 among children whose mothers did not complete high school (16 percent) and the lowest reported percentage among children whose mothers had attended some college or a vocational/technical school (6 percent) (see Table EA 1.2).

⁴Alexander, K.L., Entwisle, D.R., & Dauber, S.L. 1994. On the Success of Failure: A Reassessment of the Effects of Retention in the Primary Grades. New York: Cambridge University Press.
⁵Estimates are not presented when based on less than 30 cases in a subgroup.

Table EA 1.2 Percentage of 2nd graders in the United States who were retained in kindergarten and/or 1st grade, by child and family characteristics: 1991, 1993, 1995, 1996, and 1999

	1991	1993	1995	1996	1999
Total	11	8	8	7	8
Gender
Male	13	10	11	8	10
Female	9	—	5	—	6
Race and Hispanic origin^a
White, non-Hispanic	9	7	7	6	8
Black, non-Hispanic	15	—	—	—	8
Hispanic	18	—	—	—	8
Poverty Status^b
At or above poverty	9	8	7	5	5
Below poverty	18	—	10	—	16
Family structure^c
Two parents	10	7	8	5	7
One or no parent	14	11	9	—	10
Mother’s education^d
Less than high school	21	—	—	—	16
High school/GED	12	9	9	—	8
Vocational/technical or some college	9	—	7	—	6
College graduate	—	—	—	—	6
Mother’s employment status^d
35 hours or more per week	12	8	9	—	8
Less than 35 hours per week	8	—	—	—	8
Not in labor force	11	—	8	—	7

— = sample size is insufficient to permit a reliable estimate.
^aPersons of Hispanic origin may be of any race.
^bThe poverty threshold for 1995 and 1996 data was calculated using the total number of household members and estimates of household income to the nearest $1,000 either alone or in combination with exact income information. The 1995 and 1996 poverty calculations differ from calculations in other years (1991 and 1993), which were based on total number of household members and estimates of household income (in increments of $5,000 or $1,000) only. Calculations for all years do not account for the number of children in the household.
^cParents include any combination of a biological, adoptive, step-, and foster mothers and/or fathers. No parents in the household indicates that the child is living with non-parent guardians (e.g., grandparents).
^dChildren without mothers in the home are not included in estimates dealing with mother’s education or mother’s employment status. A mother is defined as a biological mother, adoptive mother, stepmother, foster mother, or female guardian (e.g., grandmother) who resides in the home with the child.
Source: U.S. Department of Education, National Center for Education Statistics, 1991, 1993, 1995, and 1996 National Household Education Surveys. Tabulations of data performed by U.S. Department of Education, National Center for Education Statistics (unpublished).

Figure EA 1.2 Percentage of 2nd graders in the United States who were retained in kindergarten and/or 1st grade: Selected years, 1991-1999

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Source: U.S. Department of Education, National Center for Education Statistics, 1991, 1993, 1995, 1996, and 1999 National Household Education Surveys. Tabulations performed by National Center for Education Statistics.

EA 1.3 School Absenteeism

Student absenteeism is associated with poor achievement in school, among other outcomes; for example, absenteeism is one of five personal and family background factors that accounted for 91 percent of the variation in states’ mathematics scores in a recent national report.⁶

Differences across Grade Levels. The percentage of 8th-grade students who were absent from school 3 or more days in the preceding month has remained relatively constant between 21 and 23 percent from 1990 to 1998 (see Table EA 1.3). During the same time period, a slightly larger percentage of 12th-grade students were absent from school for that length of time, with percentages ranging between 26 and 31 percent.

Differences by Race and Hispanic Origin.⁷ Among 8th graders in 1998, American Indian/Alaska Native and Hispanic students, at 34 percent and 25 percent respectively, were the most likely to have been absent 3 or more days in the preceding month. White and Asian students had the lowest absentee rates at 21 and 17 percent, respectively, followed by black students at 23 percent. The patterns are similar for 12th-grade students, though the differences range from lows of 26 to 28 percent for white, Asian, and black students, to a high of 41 percent for American Indian/Alaska Native Students.

Differences by Parents’ Education Level.⁸ Absences from school were highest for students whose better-educated parent had less than a high school education (see Figure EA 1.3). In 1998, for example, 33 percent of 8th graders whose better-educated parent lacked a high school diploma were absent from school 3 or more days in the preceding month, compared with 17 percent of their peers who had at least one parent with a college degree. Similar differences were reported for 12th-grade students.

Differences by Type of School. Students who attended private or Catholic schools experienced fewer school absences than did students from public schools, across all grades and years (see Table EA 1.3).

⁶National Education Goals Panel. 1994.
⁷Estimates for whites and blacks exclude Hispanics of those races.
⁸Parents’ education level refers to the highest level of education completed by either parent.

Table EA 1.3 Percentage of 8th- and 12th-grade students in the United States who were absent from school 3 or more days in the preceding month, by gender, race and Hispanic origin,a parents’ education level,b and type of school: 1990, 1992, 1994, 1996, and 1998

	8th Grade					12th Grade
	1990	1992	1994	1996	1998	1985	1990	1995	1996	1997
Total	23	22	22	23	21	31	26	28	26	26
Gender
Male	21	21	22	22	21	29	24	27	25	26
Female	24	24	22	23	22	32	27	28	28	28
Race and Hispanic origin^a
White, non-Hispanic	22	21	20	21	21	31	24	26	26	26
Black, non-Hispanic	23	22	27	25	23	30	29	32	28	28
Hispanic	26	31	28	29	25	34	32	32	29	32
Asian/Pacific Islander	9	12	21	18	17	32	19	28	26	26
American Indian/Alaska Native	37	38	39	29	34	—	—	53	30	41
Parents’ education level^b
Less than high school	38	31	33	32	33	41	30	36	35	32
Graduated high school	27	23	26	26	25	34	28	30	30	30
Some education after high school	22	21	22	23	23	31	26	27	30	27
Graduated college	15	19	18	18	17	27	23	25	21	24
Type of school
Public	23	23	23	23	22	31	27	28	28	28
Nonpublic	13	14	15	16	15	24	17	21	18	19

— = sample size is insufficient to permit a reliable estimate.
^aPersons of Hispanic origin may be of any race.
^bParents’ education level refers to the highest level of education completed by either parent.
Note: The sample for this table is based on the 1990, 1992, 1996, and 1998 National Mathematics Assessments and the 1994 National Reading Assessment.
Sources: U.S. Department of Education, National Center for Education Statistics, National Assessment of Educational Progress (NAEP), 1990, 1992, 1994, and 1996 Data Almanacs. National Mathematics Assessment data may be found at http://nces.ed.gov/naep/tables96/index.html (Question #15, S004001). National Reading Assessment data (1994) are from unpublished data almanacs.

Figure EA 1.3 Percentage of 8th- and 12th-grade students in the United States who were absent from school 3 or more days in the preceding month, by parents’ education level: a 1998

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^aParents’ education level refers to the highest level of education completed by either parent.
Sources: U.S. Department of Education, National Center for Education Statistics, National Assessment of Educational Progress (NAEP), 1990, 1992, 1994, and 1996 Data Almanacs. National Mathematics Assessment data may be found at http://nces.ed.gov/naep/tables96/index.html (Question #15, S004001). National Reading Assessment data (1994) are from unpublished data almanacs.

EA 1.4 High School Dropouts: Event Dropout Rate 9 for Grades 10 Through 12

High school dropouts have lower earnings, experience more unemployment, and are more likely to end up on welfare than their peers who complete high school or college.¹⁰ Women who drop out of high school are more likely to become pregnant and give birth at a young age and are more likely to become single parents.¹¹

Table EA 1.4 shows the event dropout rate (percentage) for students in grades 10 through 12, ages 15 through 24. Event dropout rates are measured by the proportion of students enrolled in grades 10 through 12 1 year earlier who were not enrolled and who had not completed high school in the year the data are reported. From 1975 to 1998, dropout rates fluctuated between 4 percent and 7 percent.¹²

Differences by Race and Hispanic Origin.¹³ In 1998, Hispanics had a higher dropout rate (9 percent) than whites (4 percent) or blacks (5 percent) (see Figure EA 1.4).¹⁴

⁹Event dropout rates describe the proportion of students who leave school each year without completing a high school program. This is in contrast to status dropout rates, which provide cumulative data on dropouts among all young adults within a specified age range, and cohort dropout rates, which follow a particular cohort of students over time (McMillen and Kaufman, 1997).
¹⁰ U.S. Department of Education, National Center for Education Statistics. 1998. The Condition of Education: 1998. NCES 98- 013. Indicators 31, 32, and 34. Washington, D.C.: U.S. Government Printing Office.
¹¹Marin, M.M., Chan, N., & Raymond, J. 1987. Consequences of the Process of Transition to Adulthood for Adult Economic Well Being. In R.G. Corin (ed.) Research in the Sociology of Education and Socialization. Greenwich, CT: JAI; Manlove, J. 1998. "The Influence of High School Dropout and School Disengagement on the Risk of School-Age Pregnancy." Journal of Research on Adolescence 8: 187-220.
¹²The event dropout rate reached 7 percent in the years 1974, 1977, 1978, and 1979. Data for these years are not shown in Table EA 1.4.
¹³Estimates for whites and blacks exclude Hispanics of those races.
¹⁴The finding that Hispanics are more at risk of dropping out of school than either blacks or whites has been confirmed in other national data sets, such as High School and Beyond and the National Education Longitudinal Study (Ekstron, R., Goertz, M., Pollack, J., & Rock, D. 1987. Who Drops out of High School and Why? Findings from a National Study. In G. Natriello (ed.), School Dropouts: Patterns and Policies (pp. 52-69). New York: Teachers College Press; McMillen, M., & Kaufman, P. 1994. Dropout Rates in the United States: 1994. NCES 96-863. Washington, D.C.: U.S. Department of Education, National Center for Education Statistics).

Table EA 1.4 Event dropout rate^a (percentage) for youth in the United States in grades 10 through 12 (ages 15 through 24), by gender and by race and Hispanic origin:^b Selected years, 1975-1998

	1975	1980	1985	1990^d	1991^d	1992^d,e	1993^d,e	1994^d,e,f	1995^d,e,f	1996^d,e,f	1997^d,e,f	1998^d,e,f
Total	6	6	5	4	4	4	5	5	6	5	5	5
Male	5	7	5	4	4	4	5	5	6	5	5	5
Female	6	6	5	4	4	5	4	5	5	5	4	5
White ^b
Total	5	5	4	3	3	4	4	4	5	4	4	4
Male	5	6	5	4	3	4	4	4	5	4	—	—
Female	5	5	4	3	4	4	4	4	4	4	—	—
Black ^b
Total	9	8	8	5	6	5	6	7	6	7	5	5
Male	8	8	8	4	5	3	6	7	8	5	—	—
Female	9	9	7	6	7	7	5	6	5	9	—	—
Hispanic ^c
Total	11	12	10	8	7	8	7	10	12	9	10	9
Male	10	18	9	9	10	8	5	9	12	10	—	—
Female	12	7	10	7	5	9	8	11	13	8	—	—

^aThe event dropout rate is the proportion of students enrolled in grades 10 through 12 1 year earlier who were not enrolled and not graduated in the year for which the data are presented. It is calculated using the Current Population Survey data from October of a given year.
^bNon-Hispanic.
^cPersons of Hispanic origin may be of any race.
^d Numbers for these years reflect new editing procedures instituted by the Bureau of the Census for cases with missing data on school enrollment items.
^eNumbers for these years reflect new wording of the educational attainment item in the Current Population Survey.
^fNumbers in this year may reflect changes in Current Population Survey due to newly instituted computer-assisted interviewing and/or due to the change in the population controls to the 1990 Census-based estimates, with adjustments for
undercount.
Sources: U.S. Department of Commerce, Bureau of the Census, Current Population Survey, unpublished tabulations; U.S. Department of Education, National Center for Education Statistics, Dropout Rates in the United States: 1996, Table A19, and Dropout Rates in the United States: 1997, Table B3; Dropout Rates in the United States: 1998, Table 1.

Figure EA 1.4 Event dropout rate^a for youth in the United States in grades 10 through 12 (ages 15 through 24), by race and Hispanic origin:^b Selected years, 1972-1998

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EA 1.5 High School Completion Rates for 18- Through 24-Year-Olds

High school graduates earn substantially more than persons who leave high school without graduating.15 Table EA 1.5 presents the high school completion rates for 18- through 24-year-olds who were not still enrolled in a high school program—i.e., the percentage in this age group who have received a high school diploma or its equivalent, such as passing the General Educational Development (GED) exam. In 1998, the high school completion rate was 85 percent. As can be seen in Table EA 1.5, most students receive a high school diploma rather than an equivalent credential (75 percent versus 10 percent, respectively), though the equivalency credential has become more common in recent years. Between 1972 and 1998, the completion rate has remained fairly stable at between 83 percent and 86 percent (see Table EA 1.5).

Differences by Race and Hispanic Origin.¹⁶ As Figure EA 1.5 shows, completion rates vary dramatically by race and Hispanic origin. Hispanics have had much lower high school completion rates than blacks and whites since the early 1970s. The high school completion rate for Hispanics in 1998 was only 63 percent, compared with 81 percent for blacks and 90 percent for whites. This suggests that many Hispanic youth and young adults will be less prepared than other 18- through 24-year-olds to enter or progress in the labor force.

The completion rate for blacks rose from 72 percent in 1972 to 81 percent in 1985, and it has remained at about that level through 1998 (see Table EA 1.5). The completion rate for Hispanics rose from 56 percent in 1972 to 67 percent in 1985 and stands at 63 percent in 1998, as well. The completion rate has also increased among whites, but to a lesser extent (see Figure EA 1.5).

¹⁵U.S. Bureau of the Census. 1997. Current Population Reports, P60-197. Money Income in the United States: 1996, With Separate Data on Valuation of Noncash Benefits, Table 7. Washington, D.C.: U.S. Government Printing Office; U.S. Department of Education, National Center for Education Statistics. 1996. Condition of Education 1996 (Indicators 32 and 34). Washington, D.C.: U.S. Government Printing Office.
¹⁶Estimates for whites and blacks exclude Hispanics of those races.

Table EA 1.5 High school completion rates (percentage) and method of completion for 18- through 24-year-olds^a in the United States, by race and Hispanic origin:^b Selected years, 1972-1998

	1972	1975	1980	1985	1990	1991	1992^d	1993^d	1994^d,e	1995^d,e	1996^d,e	1997^d,e	1998
Total
Completed	83	84	84	85	86	85	86	86	86	85	86	86	85
Diploma	—	—	—	—	81	81	81	81	79	78	76	77	75
Equivalent^f	—	—	—	—	5	4	5	5	7	8	10	9	10
White ^b
Completed	86	87	88	88	90	89	91	90	91	90	92	91	90
Diploma	—	—	—	—	85	85	86	86	84	83	81	81	80
Equivalent^f	—	—	—	—	5	4	5	5	6	7	11	9	10
Black ^b
Completed	72	70	75	81	83	83	82	82	83	85	83	82	81
Diploma	—	—	—	—	78	77	76	76	75	75	73	72	72
Equivalent^f	—	—	—	—	5	5	6	6	8	9	10	10	10
Hispanic ^c
Completed	56	62	57	67	59	57	62	64	62	63	62	67	63
Diploma	—	—	—	—	55	53	57	58	54	54	55	59	52
Equivalent ^f	—	—	—	—	4	3	6	6	8	9	7	8	11

^aRefers to persons not currently enrolled in high school or below. It is calculated using the Current Population Survey data from October of a given year.
^bNon-Hispanic .
^cPersons of Hispanic origin may be of any race.
^dNumbers for these years reflect new wording of the educational attainment item in the Current Population Survey.
^eNumbers for these years may reflect changes in Current Population Survey due to newly instituted computer-assisted interviewing and/or due to the change in the population controls used this year to the 1990 Census-based estimates, with adjustments for undercount.
f Diploma equivalents include passing the General Educational Development (GED) exam. Source: U.S. Department of Education, National Center for Education Statistics, Dropout Rates in the United States: 1996, Tables 13 and A25, and Dropout Rates in the United States: 1997 and 1998, Table 4.

Figure EA 1.5 High school completion rates for 18- through 24-year-olds^a in the United States, by race and
Hispanic origin:^b Selected years, 1980-1998

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^aRefers to persons not currently enrolled in high school or below. It is calculated using the Current Population Survey data from October of a given year.
^bPersons of Hispanic origin may be of any race.
Sources: U.S. Department of Education, National Center for Education Statistics. 1996. Table A25, 1997, Table 4.

EA 1.6 College Attendance and Attainment

College attendance and receipt of a bachelor’s degree increase employment opportunities and income potential. One of the National Education Goals for the year 2000, adopted by Congress, is for adult literacy and lifelong learning, with an objective of increasing the proportion of qualified students, especially minorities, who enter college, who complete at least 2 years, and who complete their degree programs.¹⁷

Table EA 1.6 presents the percentage of 25- through 29-year-old high school graduates who had completed at least some college and the percentage who had received a bachelor’s degree or higher:¹⁸

In 1999, 66 percent of high school graduates in this age group had completed at least some college, 10 percent had received an associate’s degree, and 32 percent had received at least a bachelor’s degree.¹⁹
College attendance has increased since the early 1970s, with the most rapid increases occurring during the 1990s. The percentage of high school graduates completing at least some college rose from 44 percent in 1971 to 52 percent in 1990—and then to 66 percent in 1999 (see Figure EA 1.6.A).
College completion, defined here as receipt of a bachelor’s degree, increased more modestly, from 22 percent of 25- to 29-year-old high school graduates in 1971 to 32 percent of this group in 1999 (see Figure EA 1.6.B).

Differences by Race and Hispanic Origin.²⁰ In 1997, white high school graduates were far more likely (35 percent) than their black (16 percent) or Hispanic peers (18 percent) to have received a bachelor’s degree or higher. Whites were also more likely to have attended college (68 percent) than blacks or Hispanics (54 percent each) in 1997. Whites have had far higher rates of attendance and completion than blacks or Hispanics since the early 1970s, and the gap between whites and the other two racial/ethnic groups in college attendance and completion has not decreased over time (see Figures EA 1.6.A and EA 1.6.B).

¹⁷National Education Goals Panel. 1997. The National Education Goals Report: Building a Nation of Learners, 1997 (Goal 6, p. xvi). Washington, D.C.: U.S. Government Printing Office.
¹⁸Note that the measure of college attendance changed from “one or more years of college” in 1971-1991 to “some college or more” in 1992-1997. Similarly, the measure of college completion changed from “four or more years of college” in 1971-1991 to “bachelor’s degree or higher” in 1992-1997.
¹⁹Based on analyses of the 1993 Baccalaureate and Beyond Longitudinal study, it is estimated that about 10 percent of all persons with a bachelor's degree also hold an associate’s degree. National Center for Education Statistics.
²⁰Estimates for whites and blacks exclude Hispanics of those races.

Table EA 1.6 Percentage of 25- through 29-year-old high school graduatesa in the United States who have attended some college or who have received a bachelor’s degree or higher, by race and Hispanic origin:c Selected years, 1971-1999

	1971	1975	1980	1985	1990	1991	1992	1993	1994	1995	1996	1997	1998	1999
Some college or more ^d	44	50	52	51	52	53	57	59	61	62	65	65	66	66
White^b	45	51	54	52	54	55	59	61	63	65	67	68	69	69
Black^b	31	39	42	43	44	43	45	48	50	52	56	54	57	58
Hispanic^c	31	41	40	44	40	42	47	49	52	50	51	54	52	51
Bachelor’s degree or higher ^b	22	26	26	26	27	27	27	27	27	28	31	32	31	32
White^b	23	28	28	27	30	30	30	30	30	31	34	35	35	36
Black^b	12	15	15	14	16	13	14	16	16	18	17	16	18	17
Hispanic^c	11	17	13	18	14	16	16	14	13	16	16	18	17	14
Associate's degree	—	—	—	—	—	—	8	9	10	10	10	9	10	10
White^b	—	—	—	—	—	—	8	9	10	10	10	9	10	10
Black^b	—	—	—	—	—	—	8	6	8	8	8	7	8	10
Hispanic^c	—	—	—	—	—	—	7	8	9	7	8	9	9	9

^aHigh school completion or high school graduate is defined as 12 years of school completed for 1971-1991 and high school diploma or equivalency certificate for 1992-1997. Beginning in 1992, the Current Population Survey changed the questions used to obtain educational attainment of respondents.
^bNon-Hispanic .
^cPersons of Hispanic origin may be of any race.
^dThis was measured as “one or more years of college” for 1971-1991 and as “some college or more” for 1992-1997.
^eThis was measured as “four or more years of college” for 1971-1991 and as “bachelor’s degree or higher” for 1992-1997.
Sources: U.S. Department of Education, National Center for Education Statistics. 1998. The Condition of Education 1997, Tables 22-2 and 22-3; Associate degree data published in Federal Interagency Forum on Child and Family Statistics, 1998, Table ED6.

Figure EA 1.6.A Percentage of 25- through 29-year-old high school graduates^a in the United States who have attended some college, by race and Hispanic origin:^b Selected years, 1971-1999

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Figure EA 1.6.B Percentage of 25- through 29-year-old high school graduates^a in the United States who have received a bachelor’s degree,^b by race and Hispanic origin: c Selected years, 1971-1999

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Achievement/Proficiency

EA 2.1 Reading Proficiency for Children Ages 9, 13, and 17

Literacy proficiency and reading achievement are vital to educational reform efforts in the United States.²¹ One of the National Education Goals for the year 2000, adopted by Congress, is for adult literacy and lifelong learning, with objectives of having all students demonstrate competency in English and having all adults be literate.²² Levels of reading achievement will help measure the extent to which these goals are being met.

In order to monitor progress in the reading achievement of students in the United States, the National Assessment of Educational Progress (NAEP) has conducted national assessments of the reading performance of 9-, 13-, and 17-year-olds. There are five levels of reading proficiency reported by NAEP, ranging from Level 150 (completing simple, discrete reading tasks) to Level 350 (learning from specialized reading materials).²³ The following tables report the average reading proficiency scores of students in the three age groups between 1971 and 1996.

Trends in Reading Proficiency Scores. Among 9-year-olds, average reading proficiency scores improved between 1971 and 1980, declined between 1980 and 1984, and remained steady until 1996, so that the average score in 1996 (212) was similar to the score in 1975 (210) (see Table EA 2.1.A). Among 13-year-olds, average reading proficiency scores varied from year to year and were similar in 1996 (259) and 1971 (255) (see Table EA 2.1.B). Among 17-year-olds, average scores increased between 1971 and 1988, remained stable between 1988 and 1992, and then showed a slight decline through 1996, so that the average score in 1996 (287) was similar to the score in 1975 (286) (see Table EA 2.1.C).

Differences by Gender. Females have scored consistently higher than males over time and for all ages. For example, among 13-year-olds in 1996, females had an average score of 265, compared with an average score of 253 for males (see Table EA 2.1.B).

Differences by Race and Hispanic Origin.²⁴ There are large and consistent differences in reading proficiency by race and Hispanic origin among all age groups; for example, among 17-year-olds in 1996, whites had higher average reading proficiency scores (294) than either blacks (265) or Hispanics (265) (see Table EA 2.1.C). However, black 17-year-olds had especially high gains in achievement relative to whites in the 1980s; thus, the gaps in reading proficiency scores between whites and blacks have narrowed since the mid-1970s among 17-year-olds (see Figure EA 2.1). The gap has also narrowed between white and Hispanic 17-year-olds (see Figure EA 2.1).

Differences by Parents’ Education Level.²⁵ Average reading proficiency levels vary dramatically by parents’ education level;26 for example, among 13-year-olds and 17-year-olds in 1996, the lowest average reading proficiency scores were among teens whose better-educated parent did not have a high school education, while the highest scores were among teens who had a parent with post-high school education. In fact, the average reading proficiency score among 13-year-old children of parents with post-high school education levels (270) was similar to the average score among 17-year-old children of parents without a high school degree (267) (see Tables EA 2.1.B and EA 2.1.C).

Differences by Type of School. Average reading proficiency scores have been consistently higher among students attending nonpublic schools than among students attending public schools. This is true for every age group and every year reported (see Tables EA 2.1.A, EA 2.1.B, and EA 2.1.C).

²¹ Campbell, J.R., Voelkl, K.E., & Donahue, P.L. 1997. NAEP 1996 Trends in Academic Progress. NCES 97-985. Washington, D.C.: National Center for Education Statistics.
²²National Education Goals Panel. 1999. The National Education Goals Report: Building a Nation of Learners, 1999 (Goal 6). Washington, D.C.: U.S. Government Printing Office.
²³NAEP has regularly been conducting assessments of students in public and private schools in the United States in order to monitor trends in academic achievement in core curriculum areas since the 1970s. NAEP uses proficiency scales that range from 0 to 500. To give meaning to the results, students’ performance is characterized at five levels along the proficiency scales (150, 200, 250, 300, 350).
²⁴Estimates for whites and blacks exclude Hispanics of those races.
²⁵Parents’ education level refers to the highest level of education completed by either parent.
²⁶Parents’ education level is not reported at age 9 because approximately one-third of these students did not know their parents’ education level.

Table EA 2.1.A Average reading proficiency for children age 9 in the United States, by gender, race and Hispanic origin,^a and type of school: Selected years, 1971-1996

	1971	1975	1980	1984	1988	1990	1992	1994	1996
Total	208	210	215	211	212	209	211	211	212
Gender
Male	201	204	210	208	208	204	206	207	207
Female	214	216	220	214	216	215	215	215	218
Race and Hispanic origin ^a
White, non-Hispanic	214	217	221	218	218	217	218	218	220
Black, non-Hispanic	170	181	189	186	189	182	185	185	190
Hispanic	—	183	190	187	194	189	192	186	194
Type of school
Public	—	—	214	209	210	208	209	209	210
Nonpublic	—	—	227	223	223	228	225	225	227

^aPersons of Hispanic origin may be of any race.
Note: The reading proficiency scale ranges from 0 to 500:
Level 150: Simple, discrete reading tasks
Level 200: Partial skills and understanding
Level 250: Interrelates ideas and makes generalizations
Level 300: Understands complicated information
Level 350: Learns from specialized reading materials
Source: Campbell, Voelkl, & Donahue, 1997, Table C.16.

Table EA 2.1.B Average reading proficiency for children age 13 in the United States, by gender, race and Hispanic origin,^a parents’ education level,^b and type of school: Selected years, 1971-1996

	1971	1975	1980	1984	1988	1990	1992	1994	1996
Total	255	256	259	257	258	257	260	258	259
Gender
Male	250	250	254	253	252	251	254	251	253
Female	261	262	263	262	263	263	265	266	265
Race and Hispanic origin ^a
White, non-Hispanic	261	262	264	263	261	262	266	265	267
Black, non-Hispanic	222	226	233	236	243	242	238	234	236
Hispanic	—	232	237	240	240	238	239	235	240
Parents’ education level ^b
Less than high school	238	239	239	240	247	241	239	237	241
Graduated high school	256	255	254	253	253	251	252	251	252
Some education after high school	270	270	271	268	265	267	270	269	270
Type of school
Public	—	—	257	255	256	255	257	256	257
Nonpublic	—	—	271	271	268	270	276	276	274

^aPersons of Hispanic origin may be of any race.
^bParents’ education level refers to the highest level of education completed by either parent.
Note: The reading proficiency scale ranges from 0 to 500:
Level 150: Simple, discrete reading tasks
Level 200: Partial skills and understanding
Level 250: Interrelates ideas and makes generalizations
Level 300: Understands complicated information
Level 350: Learns from specialized reading materials
Source: Campbell, Voelkl, & Donahue, 1997, Table C.17.

Table EA 2.1.C Average reading proficiency for children age 17 in the United States, by gender, race and Hispanic origin,^a parents’ education level,^b and type of school: Selected years, 1971-1996

	1971	1975	1980	1984	1988	1990	1992	1994	1996
Total	285	286	286	289	290	290	290	288	287
Gender
Male	279	280	282	284	286	284	284	282	280
Female	291	291	289	294	294	297	296	295	294
Race and Hispanic origin ^a
White, non-Hispanic	291	293	293	295	295	297	297	296	294
Black, non-Hispanic	239	241	243	264	274	267	261	266	265
Hispanic	—	252	261	268	271	275	271	263	265
Parents’ education level ^b
Less than high school	261	263	262	269	267	270	271	268	267
Graduated high school	283	281	278	281	282	283	281	276	273
Some education after high school	302	301	299	301	300	300	299	299	297
Type of school
Public	—	—	284	287	289	289	288	286	286
Nonpublic	—	—	298	303	300	311	310	306	294

Figure EA 2.1 Average reading proficiency for children age 17 in the United States, by race and Hispanic origin: ^a Selected years, 1971-1996

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^aPersons of Hispanic origin may be of any race.
Note: The reading proficiency scale ranges from 0 to 500.
Level 150: Simple, discrete reading tasks
Level 200: Partial skills and understanding
Level 250: Interrelates ideas and makes generalizations
Level 300: Understands complicated information
Level 350: Learns from specialized reading materials
Source: Campbell, JVoelkl, & Donahue, 1997, Table C.18.

EA 2.2 Mathematics Proficiency for Children Ages 9, 13, and 17

One of the National Education Goals for the year 2000, adopted by Congress, is to improve the relative standing of students in the United States in mathematics achievement.²⁷ In a1995 comparison of 8th graders in the United States with their peers in 40 other countries, the Third International Math and Science Study showed that students in the United States had significantly lower overall mathematics proficiency scores than students in 20 countries, had similar scores to students in 13 countries, and had higher scores than students in 7 countries.²⁸

In order to monitor progress in the mathematics achievement of students in the United States, the National Assessment of Educational Progress (NAEP) has conducted national assessments of the mathematics performance of 9-, 13-, and 17-year-olds. There are five levels of mathematics proficiency reported by NAEP, ranging from Level 150 (understanding simple arithmetic facts) to Level 350 (multi-step problem solving and algebra).²⁹ The following tables report the average mathematics proficiency scores of students in the three age groups between 1973 and 1996.

Trends in Mathematics Proficiency Scores. Among 9-year-olds, average mathematics proficiency scores remained the same between 1973 and 1982 and then increased substantially to 231 in 1994; scores remained stable from 1994 to 1996 (see Table EA 2.2.A). Among 13-year-olds, mathematics proficiency scores increased between 1978 (264) and 1994 (274); again, scores remained stable from 1994 to 1996 (see Table EA 2.2.B). Among 17-year-olds, average proficiency scores declined between 1973 and 1982, after which they increased and stabilized at a level slightly higher than that obtained in 1973 (see Table EA 2.2.C).

Differences by Gender. In 1996, mathematics proficiency scores were higher for males than for females across all age groups; however, differences are small and in many years were virtually nonexistent for 9- and 13-year-olds. Proficiency scores in 1996 were higher for males by an average of 4 points for 9-year-olds and 13-year-olds and 5 points for 17-year-olds.

Differences by Race and Hispanic Origin.³⁰ There are consistently large differences in mathematics proficiency by race and Hispanic origin. For example, among 17-year-olds in 1996, blacks and Hispanics had lower proficiency scores (286 and 292, respectively) than whites (313) (see Table EA 2.2.C); however, black and Hispanic 17-year-olds had substantial gains in achievement between 1973 and 1996 (see Figure EA 2.2).

Differences by Parents’ Education Level.³¹ There are large variations in average mathematics proficiency levels by level of parental education for 13- and 17-year-olds (see Tables EA 2.2.B and EA 2.2.C).³² For example, in 1996, 13-year-olds whose better-educated parent did not have a high school education had the lowest average proficiency scores (254), while those whose parent(s) had graduated from college had the highest scores (283) (see Table EA 2.2.B).

Differences by Type of School. Average mathematics proficiency scores among students in public schools have been consistently lower than average scores among students in non-public schools. This is true for every age group and every year reported (see Tables EA 2.2.A, EA 2.2.B, and EA 2.2.C).

²⁷National Education Goals Panel. 1997.
²⁸U.S. Department of Education, National Center for Education Statistics. 1997. Pursuing Excellence: A Study of U.S. Eighth-Grade Mathematics and Science Teaching, Learning, Curriculum, and Achievement in International Context. No. 97-198. Washington, D.C.: U.S. Government Printing Office.
²⁹NAEP has regularly been conducting assessments of students in public and private schools in the United States in order to monitor trends in academic achievement in core curriculum areas since the 1970s. NAEP uses proficiency scales that range from 0 to 350. To give meaning to the results, students’ performance is characterized at five levels along the proficiency scales (150, 200, 250, 300, 350).
³⁰Estimates for whites and blacks exclude Hispanics of those races.
³¹Parents’ education level refers to the highest level of education completed by either parent.
³²Parents’ education level is not reported at age 9 because approximately one-third of these students did not know their parent's education level.

Table EA 2.2.A Average mathematics proficiency for children age 9 in the United States, by gender, race and Hispanic origin,^a and type of school: Selected years, 1973-1996

	1973	1978	1982	1986	1990	1992	1994	1996
Total	219	219	219	222	230	230	231	231
Gender
Male	218	217	217	222	229	231	232	233
Female	220	220	221	222	230	228	230	229
Race and Hispanic origin
White^a	225	224	224	227	235	235	237	237
Black^a	190	192	195	202	208	208	212	212
Hispanic ^b	202	203	204	205	214	212	210	215
Type of school
Public	—	217	217	220	229	228	229	230
Nonpublic	—	231	232	230	238	242	245	239

^aNon-Hispanic.
^bPersons of Hispanic origin may be of any race.
Note: The mathematics proficiency scale ranges from 0 to 350
Level 150: Simple arithmetic facts
Level 200: Beginning skills and understanding
Level 250: Numerical operations and beginning problem solving
Level 300: Moderately complex procedures and reasoning
Level 350: Multi-step problem solving and algebra
Sources: Campbell, Voelkl, & Donahue, 1997, Table B.16.

Table EA 2.2.B Average mathematics proficiency for children age 13 in the United States, by gender, race and Hispanic origin,^a parents’ education level,^b and type of school: Selected years, 1973-1996

	1973	1978	1982	1986	1990	1992	1994	1996
Total	266	264	269	269	270	273	274	274
Gender
Male	265	264	269	270	271	274	276	276
Female	267	265	268	268	270	272	273	272
Race and Hispanic origin^a
White, non-Hispanic	274	272	274	274	276	279	281	281
Black, non-Hispanic	228	230	240	249	249	250	252	252
Hispanic	239	238	252	254	255	259	256	256
Parents’ education level^b
Less than high school	—	245	251	252	253	256	255	254
Graduated high school	—	263	263	263	263	263	266	267
Some education after high school	—	273	275	274	277	278	277	278
Graduated college	—	284	282	280	280	283	285	283
Type of school
Public	—	263	267	269	269	272	273	273
Nonpublic	—	279	281	276	280	283	285	286

^a Persons of Hispanic origin may be of any race.
^b Parents’ education level refers to the highest level of education completed by either parent.
Note: The mathematics proficiency scale ranges from 0 to 350:
Level 150: Simple arithmetic facts
Level 200: Beginning skills and understanding
Level 250: Numerical operations and beginning problem solving
Level 300: Moderately complex procedures and reasoning
Level 350: Multi-step problem solving and algebra
Sources: Campbell, Voelkl, & Donahue, 1997, Table B.17.

Table EA 2.2.C Average mathematics proficiency for children age 17 in the United States, by gender, race and Hispanic origin,^a parents’ education level,^b and type of school: Selected years, 1973-1996

	1973	1978	1982	1986	1990	1992	1994	1996
Total	304	300	299	302	305	307	306	307
Gender
Male	309	304	302	305	306	309	309	310
Female	301	297	296	299	303	305	304	305
Race and Hispanic origin^a
White, non-Hispanic	310	306	304	308	310	312	312	313
Black, non-Hispanic	270	268	272	279	289	286	286	286
Hispanic	270	268	272	279	289	286	286	286
Parents’ education level^b
Less than high school	—	280	279	279	285	286	284	281
Graduated high school	—	294	293	293	294	298	295	297
Some education after high school	—	305	304	305	308	308	305	307
Graduated college	—	317	312	314	316	316	318	317
Type of school
Public	—	300	297	301	304	305	304	306
Nonpublic	—	314	311	320	318	320	319	316

^aPersons of Hispanic origin may be of any race.
^bParents’ education level refers to the highest level of education completed by either parent.
Note: The mathematics proficiency scale ranges from 0 to 350:
Level 150: Simple arithmetic facts
Level 200: Beginning skills and understanding
Level 250: Numerical operations and beginning problem solving
Level 300: Moderately complex procedures and reasoning
Level 350: Multi-step problem solving and algebra
Sources: Campbell, Voelkl, & Donahue, 1997, Data for 1973 appear in NAEP 1992 Trends in Academic Progress. Report No. 23-TR01, Table B.18.

Figure EA 2.2 Average mathematics proficiency for children age 17 in the United States, by race and Hispanic
aorigin: Selected years, 1973-1996

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^aPersons of Hispanic origin may be of any race.
Note: The mathematics proficiency scale ranges from 0 to 350.
Level 150: Simple arithmetic facts
Level 200: Beginning skills and understanding
Level 250: Numerical operations and beginning problem solving
Level 300: Moderately complex procedures and reasoning
Level 350: Multi-step problem solving and algebra
Sources: Campbell, Voelkl, & Donahue, 1997. Data for 1973 appear in NAEP 1992 Trends in Academic Progress. Report No. 23-TR01, Table B.18.

EA 2.3 Science Proficiency for Children Ages 9, 13, and 17

One of the National Education Goals for the year 2000, adopted by Congress, is to improve the relative standing of students in the United States in science achievement.³³ In a 1995 comparison of 8th graders in the United States with 8th-graders in 40 other countries, the
Third International Math and Science Study showed that students in the United States had significantly lower overall science proficiency scores than students in 9 countries, had similar scores to students in 16 countries, and had higher scores than students in 15 countries.³⁴

In order to present time trends in science proficiency levels, the National Assessment of Educational Progress (NAEP) reports five different proficiency levels, ranging from Level 150 (knows everyday science facts) to Level 350 (integrates specialized scientific information).³⁵ The following tables report the average science proficiency scores of students in the three age groups between 1977 and 1996.

Trends in Science Proficiency Scores. Average science proficiency scores have increased among all age groups since 1977. Among 9-year-olds, average science proficiency scores increased between 1977 (220) and 1994 (231) and remained stable through 1996 (230) (see Table EA 2.3.A). Similarly, among 13-year-olds, average scores increased between 1977 (247) and 1994 (257) and remained constant through 1996 (256) (see Table EA 2.3.B). Among 17-year-olds, average science proficiency scores declined between 1977 (290) and 1982 (283), after which they increased to 296 in 1996 (see Table EA 2.3.C). Thus, gains in science proficiency levels among 17-year-olds from 1977 to 1996 were not as great as gains for the other two age groups.

Differences by Gender. Average science proficiency scores have been consistently higher for males than females over time and for all age groups, though differences are smaller among 9-year-olds. Among 13-year-olds in 1996, boys scored on average 9 points higher than girls; among 17-year-olds, the average difference was 8 points; and among 9-year-olds, males scored on average 4 points higher than females.

Differences by Race and Hispanic Origin.³⁶ There are large differences in science proficiency scores by race and Hispanic origin among all age groups. For example, among 17-year-olds in 1996, whites had higher average science proficiency scores (307) than blacks (260) or Hispanics (269) (see Table EA 2.3.C); however, black 17-year-olds had especially high gains in achievement since 1977 (see Figure EA 2.3). Black 9-year-olds and 13-year-olds also showed high gains in science achievement over time.

Differences by Parents’ Education Level.³⁷ Average science proficiency levels vary dramatically by level of parents’ education.³⁸ For example, among 13-year-olds and 17-year-olds in 1996, the lowest average science proficiency scores were among teens whose better-educated parent did not have a high school education, while the highest scores were among teens who had a parent who had graduated from college. In 1996, the average science proficiency score among 13-year-old children of parents with a college education (266) was similar to the average score among 17-year-old children of parents without a high school diploma (261) (see Tables EA 2.3.B and EA 2.3.C).

Differences by Type of School. Average science proficiency scores have been consistently higher among students attending nonpublic schools than among students attending public schools. This is true for every age group and every year reported (see Tables EA 2.3.A, EA 2.3.B, and EA 2.3.C).

³³National Education Goals Panel. 1997.
³⁴U.S. Department of Education, National Center for Education Statistics. 1997.
³⁵NAEP has regularly been conducting assessments of students in public and private schools in the United States in order to monitor trends in academic achievement in core curriculum areas since the 1970s. NAEP uses proficiency scales that range from 0 to 350. To give meaning to the results, students’ performance is characterized at five levels along the proficiency scales (150, 200, 250, 300, 350).
³⁶Estimates for whites and blacks exclude Hispanics of those races.
³⁷Parents’ education level refers to the highest level of education completed by either parent.
³⁸Parents’ education is not reported at age 9 because approximately one-third of these students did not know their parents’ education level.

Table EA 2.3.A Average science proficiency for children age 9 in the United States, by gender, race and Hispanic origin,a and type of school: Selected years, 1977-1996

	1977	1982	1986	1990	1992	1994	1996
Total	220	221	224	229	231	231	230
Gender
Male	222	221	227	230	235	232	232
Female	218	221	221	227	227	230	228
Race and Hispanic origin
White^a	230	229	232	238	239	240	239
Black^a	175	187	196	196	200	201	202
Hispanic ^b	192	189	199	206	205	201	207
Type of school
Public	218	220	223	228	229	230	229
Nonpublic	235	232	233	237	240	242	238

^aNon-Hispanic.
^bPersons of Hispanic origin may be of any race.
Note: The science proficiency scale ranges from 0 to 350:
Level 150: Knows everyday science facts
Level 200: Understands simple scientific principles
Level 250: Applies general scientific information
Level 300: Analyzes scientific procedures and data
Level 350: Integrates specialized scientific information
Source: Campbell, Voelkl, & Donahue, 1997, Table A.16.

Table EA 2.3.B Average science proficiency for children age 13 in the United States, by gender, race and Hispanic origin,^a parents’ education level,^b and type of school: Selected years, 1977-1996

	1977	1982	1986	1990	1992	1994	1996
Total	247	250	251	255	258	257	256
Gender
Male	251	256	256	259	260	259	261
Female	244	245	247	252	256	254	252
Race and Hispanic origin
White ^a	256	257	259	264	267	267	266
Black ^a	208	217	222	226	224	224	226
Hispanic ^b	213	226	226	232	238	232	232
Parents’ education level^c
Less than high school	224	225	229	233	234	234	232
Graduated high school	245	243	245	247	246	247	248
Some education after high school	260	259	258	263	266	260	260
Graduated college	266	264	264	268	269	269	266
Type of school
Public	245	249	251	254	257	255	255
Nonpublic	268	264	263	269	265	268	268

^a Non-Hispanic.
^b Persons of Hispanic origin may be of any race.
^c Parents’ education level refers to the highest level of education completed by either parent.
Note: The science proficiency scale ranges from 0 to 350:
Level 150: Knows everyday science facts
Level 200: Understands simple scientific principles
Level 250: Applies general scientific information
Level 300: Analyzes scientific procedures and data
Level 350: Integrates specialized scientific information
Source: Campbell, Voelkl, & Donahue. 1997. Table A.17.

Table EA 2.3.C Average science proficiency for children age 17 in the United States, by gender, race and Hispanic origin^a, parents’ education level^b, and type of school: Selected years, 1977-1996

	1977	1982	1986	1990	1992	1994	1996
Total	290	283	289	290	294	294	296
Gender
Male	297	292	295	296	299	300	300
Female	282	275	282	285	289	289	292
Race and Hispanic origin
White^a	298	293	298	301	304	306	307
Black^a	240	235	253	253	256	257	260
Hispanic^b	262	249	259	262	270	261	269
Parents’ education level^c
Less than high school	265	259	258	261	262	256	261
Graduated high school	284	275	277	276	280	279	282
Some education after high school	296	290	295	297	296	295	297
Graduated college	309	300	304	306	308	311	308
Type of school
Public	288	282	287	289	292	292	295
Nonpublic	308	292	321	308	312	310	303

^aNon-Hispanic.
^bPersons of Hispanic origin may be of any race.
^cParents’ education level refers to the highest level of education completed by either parent.
Note: The science proficiency scale ranges from 0 to 350:
Level 150: Knows everyday science facts
Level 200: Understands simple scientific principles
Level 250: Applies general scientific information
Level 300: Analyzes scientific procedures and data
Level 350: Integrates specialized scientific information
Source: Campbell, Voelkl, & Donahue. 1997. Table A.18.

Figure EA 2.3 Average science proficiency for children age 17 in the United States, by race and Hispanic origin: ^a Selected years, 1977-1996

src=

^aPersons of Hispanic origin may be of any race.
Note: The science proficiency scale ranges from 0 to 350.
Level 150: Knows everyday science facts
Level 200: Understands simple scientific principles
Level 250: Applies general scientific information
Level 300: Analyzes scientific procedures and data
Level 350: Integrates specialized scientific information
Source: Campbell, Voelkl, & Donahue. 1997. Table A.18.

EA 2.4 Arts Proficiency for Children in Grade 8

Artistic expression is one of the key vehicles for individual creativity and for the reflection and transmission of cultural messages. An understanding and appreciation of the arts therefore helps to nurture human creativity and fosters the celebration of a diverse cultural heritage. Recent research suggests that arts education can improve student performance in other intellectual and academic areas, including math and science.³⁹ College Board data show that children who have participated in sequential arts programs outperform their peers who have not had arts training on both the verbal and math components of the SAT.⁴⁰

The National Assessment of Educational Progress (NAEP) completed assessments of 8th graders’ music, visual arts, and theater skills in 1997.⁴¹ For the music and visual arts assessments, data were collected on students’ ability to respond to, analyze, or evaluate musical pieces or works of art.⁴² Average scores were coded on a scale of 0 to 300. Because ability scores had different ranges across music and the visual arts, comparisons should not be made between student results across disciplines. In other words, a score of 100 in the visual arts is not necessarily “better” than a score of 90 in music.

Differences by Gender. Girls outperformed boys in responding to and analyzing musical pieces (see Figure EA 2.4.A). For example, 8th-grade girls had an average music score of 160, whereas boys had an average score of 140. For evaluating visual artwork, girls’ scores were 8 points higher than boys’ scores (154 versus 146) (see Table EA 2.4).

Differences by Race and Hispanic Origin.⁴³ There are significant differences in students’ artistic evaluation skills by racial/ethnic group (see Table EA 2.4). White and Asian students had higher average music scores (158 and 152, respectively) than did black (130) and Hispanic students (127). A similar pattern is seen for the visual arts (see Table EA 2.4). White and Asian students had higher average scores (159 and 153, respectively) than did black or Hispanic students (124 and 128, respectively).

Differences by Parents’ Education Level.⁴⁴ Consistent with other NAEP assessments, higher levels of parental education were associated with higher levels of student performance in both music and the visual arts. For example, 8th graders whose better-educated parent had graduated from college had higher music scores (159) than students whose parent(s) had some education past high school (150) or whose parent(s) graduated high school (139). Students whose better-educated parent did not finish high school had the lowest scores (129) (see Figure EA 2.4.B). The same pattern is evident for the visual arts scores.

Differences by Type of School. Students from nonpublic schools had higher scores for the visual arts (167) than did students from public schools (148). The same pattern held true for music scores (see Table EA 2.4).

³⁹Kane, E., & Frankonis, E. May. 1998. Arts Education in the New Millennium. Education New York 2 (5): 3.
⁴⁰Childress, J. May. 1998. Art Education Pays Off. Education New York, 2 (5): 5.
⁴¹ Unlike other NAEP assessments that are typically conducted on nationally representative samples of students in grades 4, 8, and 12, the 1997 arts assessments were conducted on grade 8 students only. This was due to budgetary constraints.
Because the theater assessment was conducted on a "targeted" sample rather than a nationally representative sample, results are not presented here. Finally, although NAEP conducted an arts assessment in music and visual arts in 1974 and 1978, considerable changes were made to the 1997 assessment such that comparable data for trends analyses are not possible. Therefore, only results from the 1997 NAEP music and visual arts assessments are presented here.
⁴² Students were also scored on their ability to create and perform works of art; however, only students’ ability to respond to art will be discussed here.
⁴³ Estimates for whites and blacks exclude Hispanics of those races.
⁴⁴ Parents’ education level refers to the highest level of education completed by either parent.

Table EA 2.4 Average music and visual arts proficiency^a for children in grade 8 in the United States, by gender, race and Hispanic origin,^b parents’ education level,^c and type of school: 1997

	Music	Visual Arts
Total	150	150
Gender
Male	140	146
Female	160	154
Race and Hispanic origin
White ^d	158	159
Black ^d	130	124
Hispanic ^d	127	128
Asian	152	153
Parents’ education level^b
Less than high school	129	125
Graduated high school	139	138
Some education after high school	150	153
Graduated college	159	158
Type of school
Public	149	148
Nonpublic	158	167

^a The music and visual arts scale scores range from 0 to 300.
^b Persons of Hispanic origin may be of any race.
^cParents’ education level refers to the highest level of education completed by either parent.
^dNon-Hispanic.
Source: National Center for Education Statistics, National Assessment of Educational Progress (NAEP), 1997 Arts
Assessment. As published in Persky, Sandene, & Askew, 1999, Tables 6.4, 6.5, 6.7, 6.8, 6.10, 6.11, 6.13, and 6.14.

Figure EA 2.4.A Average music and visual arts proficiency scores^a for children in grade 8 in the United States, by gender: 1997

src=

^aThe music and visual arts scale scores range from 0 to 300.
Source: National Center for Education Statistics, National Assessment of Educational Progress (NAEP), Tables 6.4 and 6.5.

Figure EA 2.4.B Average music and visual arts proficiency scores^a for children in grade 8 in the United States, by parents’ education level:^b1997

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^a The music and visual arts scale scores range from 0 to 300.
^b Parents’ education level refers to the highest level of education completed by either parent.
Source: National Center for Education Statistics, National Assessment of Educational Progress , Tables 6.13 and 6.14.

Related Behaviors And Characteristics

EA 3.1 Family-Child Engagement in Literacy Activities

Numerous studies have documented the importance of parental involvement in literacy activities with their children. One of the National Education Goals stresses the importance of family/child engagement in literacy activities, especially among children who are “at risk” of school failure, in order for all children in the United States to be able to start school ready to learn.⁴⁵

Table EA 3.1 presents three types of literacy activities that parents may engage in with their children. In 1999, a majority of 3- to 5-year-old children (53 percent) were read to by a parent or other family member every day. Fifty percent of children were regularly told stories in 1999 (three or more times a week), a substantial increase from 1991 levels (39 percent).

Differences by Race and Hispanic Origin.⁴⁶ There are substantial differences in all literacy activities by race and Hispanic origin; for example, in 1999, white children were more likely to be read to every day (61 percent) than black children (41 percent) or Hispanic children (33 percent). Similarly, white children (53 percent) were more likely to be told a story frequently than either black or Hispanic children (45 and 40 percent respectively) (see Table EA 3.1). Also, more white children visited a library at least once in the past month in 1999 (39 percent) than either black children (35 percent) or Hispanic children (25 percent). These differences have been fairly stable over time.

Differences by Socioeconomic Status. Children in families living at or above the poverty threshold are much more likely to be engaged in literacy activities on a regular basis than are children who live in poverty; for example, in 1999, 58 percent of children in nonpoor families were read to every day by a parent or other family member, compared with 38 percent of children in poor families (see Figure EA 3.1). There are also substantial differences in literacy activities by mother’s education level. For example, about one-fifth (18 percent) of children whose mothers did not have a high school diploma visited a library once or more in the past month, compared with 30 percent of children whose mothers had graduated high school and 50 percent whose mothers were college graduates (see Table EA 3.1).

Differences by Family Structure. Children in two-parent families were more likely to participate in all three types of literacy activities than children who lived with one or no parent.

Differences by Mother’s Employment Status. Children whose mothers were employed 35 hours or more per week were slightly less likely to engage in any of the three literacy activities than children whose mothers were either working part-time or not working.

⁴⁵National Education Goals Panel. 1997. (Goal 1, p. xiv).
⁴⁶ Estimates of whites and blacks exclude Hispanics of those races.

Table EA 3.1 Percentage of 3- through 5-year-olds^a in the United States who have participated in literacy activities with a family member, by child and family characteristics: 1991, 1993, 1995, 1996, and 1999

	Read to every day					Told a story at least three times a week					Visited a library at least once in the past month
	1991	1993	1995	1996	1999	1991	1993	1995	1996	1999	1991	1993	1995	1996	1999
Total	—	53	58	57	53	39	43	50	55	50	35	38	39	37	36
Gender
Male	—	51	57	56	51	37	43	49	55	49	34	38	37	37	35
Female	—	54	59	57	54	41	43	51	56	50	36	38	41	36	38
Race and Hispanic origin^b
White	—	59	65	64	61	40	44	53	59	53	39	42	43	41	39
Black	—	39	43	44	41	34	39	42	47	45	25	29	32	31	35
Hispanic	—	37	38	39	33	38	38	42	47	40	23	26	27	27	25
Poverty status
At or above poverty	—	56	62	61	58	39	44	53	58	52	38	42	43	41	40
Below poverty	—	44	48	46	38	38	39	44	49	42	26	29	30	28	24
Family structure^c
Two parents	—	55	61	61	57	39	44	52	59	52	38	41	43	40	40
One or no parent	—	46	49	46	42	37	41	46	47	44	23	30	30	29	29
Mother’s education level^d
Less than high school	—	37	40	37	38	34	37	39	47	36	16	22	20	19	18
High school/GED	—	48	48	49	44	38	41	48	54	48	29	31	33	31	30
Vocational/technical or some college	—	57	64	62	53	41	45	53	55	52	40	44	42	41	40
Graduated college	—	71	76	77	70	42	48	55	64	55	55	55	57	56	50
Mother’s employment status^d
35 hours or more per week	—	52	55	54	48	37	43	49	53	48	30	34	35	32	—
Less than 35 hours per week	—	56	63	59	55	40	45	53	56	55	41	47	46	39	—
Not in labor force	—	55	60	59	60	42	43	50	56	60	38	37	42	40	40

^aEstimates are based on children who have yet to enter kindergarten.
^bPersons of Hispanic origin may be of any race. Estimates for whites and blacks exclude persons of Hispanic origin.
^cParents include any combination of a biological, adoptive, step-, and foster mother and/or father. No parents in the household indicates that the child is living with nonparent guardians (e.g., grandparents).
^dChildren without mothers in the home are not included in estimates dealing with mother’s education or mother’s employment status. A mother is defined as a biological mother, adoptive mother, stepmother, foster mother, or female guardian (e.g., grandmother) who resides in the home with the child.
Sources: U.S. Department of Education, National Center for Education Statistics, 1991, 1993, 1995, 1996, and 1999 National Household Education Survey (unpublished data); Tabulated by U.S. Department of Education, National Center for Education Statistics; Estimates of “read to every day” as published in Federal Interagency Forum on Child and Family Statistics, 1998, Table ED1.

Figure EA 3.1 Percentage of 3- through 5-year-olds in the United States who have participated in literacy activities with a family member, by poverty status: 1999

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Sources: U.S. Department of Education, National Center for Education Statistics, 1999 National Household Education Survey (unpublished data); Tabulated by U.S. Department of Education, National Center for Education Statistics; Estimates of “read to every day” as published in Federal Interagency Forum on Child and Family Statistics, 1998, Table ED1.

EA 3.2 Reading Habits of Children and Youth

Independent reading is one necessary aspect of literacy development. The National Assessment of Educational Progress (NAEP) has documented the association between students who read for fun in their free time and reading achievement. Students ages 9, 13, and 17 who read more frequently for fun had consistently higher average reading proficiency scores than those students who read less often.⁴⁷ Table EA 3.2 presents the percentage of students who read for fun on a daily basis for three age groups (9-, 13-, and 17-year-olds).

Differences by Age. In 1996, over half of 9-year-olds (54 percent) reported reading for fun on a daily basis, compared with about one-third of 13-year-olds (32 percent) and about one-quarter of 17-year-olds (23 percent) (see Table EA 3.2).

Differences by Gender. Among children ages 9 and 13, larger proportions of girls than boys reported frequent reading in their spare time. For example, more than half (57 percent) of 9-year-old girls read for fun on a daily basis, compared with 51 percent of 9-year-old boys, in 1996. Among 17-year-olds, however, similar proportions of boys (22 percent) and girls (24 percent) reported reading on a daily basis in 1996 (see Figure EA 3.2).

Differences by Race and Hispanic Origin.⁴⁸ In 1996, the percentage of 9-, 13-, and 17-year-olds who reported reading for fun on a daily basis was similar for all racial/ethnic groups (see Table EA 3.2).

Differences by Parents’ Education Level.⁴⁹ In 1996, 13-year-olds whose better-educated parent had some education after high school were more likely to read for fun than students whose parent(s) had no education beyond high school (see Table EA 3.2). A similar pattern is found among 17-year-olds; for example, in 1996, 28 percent of 17-year-olds whose better-educated parent had graduated from college read for fun on a daily basis. In contrast, 18 percent of 17-year-olds whose parent(s) had graduated from high school (but had no education beyond that) and 14 percent whose parent(s) had not finished high school reported reading for fun on a daily basis (see Table EA 3.2).

Differences by Type of School. Larger percentages of 13- and 17-year-olds who attended nonpublic schools read for fun on a daily basis than did their counterparts in public schools (see Table EA 3.2). Among 9-year-olds, a larger percentage of public school students reported reading for fun in 1992 and 1994, but this pattern reversed in 1996 (see Table EA 3.2).

⁴⁷Campbell, Voelkl, & Donahue. 1997, p. 141.
⁴⁸Estimates for whites and blacks exclude Hispanics of those races.
⁴⁹Parents’ education level refers to the highest level of education completed by either parent.

Table EA 3.2 Percentage of students ages 9, 13, and 17 in the United States who read for fun on a daily basis, by gender, race and Hispanic origin,^a parents’ education level,^b and type of school: 1992, 1994, and 1996

	Age 9			Age 13			Age 17
	1992	1994	1996	1992	1994	1996	1992	1994	1996
Total	56	58	54	37	32	32	27	30	23
Gender
Male	48	49	51	30	25	27	23	29	22
Female	64	66	57	44	39	38	30	30	24
Race and Hispanic origin^a
White, non-Hispanic	57	58	54	37	38	33	29	34	24
Black, non-Hispanic	54	58	51	35	18	29	14	16	21
Hispanic	54	58	56	44	15	28	25	17	21
Parents’ education level^b
Less than high school	—	—	—	16	24	29	23	15	14
Graduated high school	—	—	—	33	28	28	16	25	18
Some education after high school	—	—	—	37	40	41	28	30	22
Graduated college	—	—	—	44	37	34	35	36	28
Type of school
Public	57	57	54	36	31	33	26	29	21
Nonpublic	52	54	61	49	40	36	44	46	28

^aPersons of Hispanic origin may be of any race.
^bParents’ education level refers to the highest level of education completed by either parent.
Source: U.S. Department of Education, National Center for Education Statistics, National Assessment of Educational Progress (NAEP), 1992, 1994, and 1996 Long-Term Trends, Reading Assessment, unpublished data. Tabulated by U.S. Department of Education, National Center for Education Statistics.

Figure EA 3.2 Percentage of students ages 9, 13, and 17 in the United States who read for fun on a daily basis, by gender: 1996

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Source: U.S. Department of Education, National Center for Education Statistics, National Assessment of Educational Progress (NAEP), 1992, 1994, and 1996 Long-Term Trends, Reading Assessment, unpublished data. Tabulated by U.S. Department of Education, National Center for Education Statistics.

EA 3.3 Parental Involvement in Child’s School

Many educators consider parental involvement in school activities to have a beneficial effect on children’s school performance. They associate higher levels of parental involvement with greater monitoring of school and classroom activities, a closer coordination of teacher and parent efforts, greater teacher attention to the child, and earlier identification of problems that might inhibit learning.⁵⁰ Indeed, in two-parent families, parental involvement of both mothers and fathers in their child’s school is significantly associated with an increased likelihood of 1st- through 12th-grade children earning mostly A’s and with a reduced likelihood that these children will ever repeat a grade.⁵¹

Differences by Children’s Grade Level. Figure EA 3.3 presents national estimates for 1999 on the degree of parental school participation among parents of children in grades 3 through 5, 6 through 8, and 9 through 12. Possible activities include (1) attending general school meetings (e.g., a PTA meeting or back-to-school night), (2) going to a regularly scheduled parent/teacher conference, (3) attending a school or class event such as a play or sports event, and (4) volunteering at the school or serving on a school committee.⁵² As the figure indicates, the level of parental involvement in school activities decreases substantially as children get older.

Sixty-eight percent of children in grades 3 through 5 had parents who were classified as highly involved in their children’s schools, meaning that they had been involved in three or more types of activities described above during the school year.
Children in grades 6 through 8 and 9 through 12 had parents with substantially lower involvement levels, with 54 and 40 percent, respectively, classified as highly involved.
Just over one-third (35 percent) of children in grades 9 through 12 had parents who were classified as having a low level of involvement, defined as having participated in one or no school activities.

Differences by Race and Hispanic Origin.⁵³ Parents of white children were more likely than parents of black or Hispanic children to be highly involved in their children’s schools at each grade level (see Table EA 3.3).

Differences by Socioeconomic Status. Children living in nonpoor households were much more likely to have highly involved parents than children living in poor households, for all grade levels. Children whose mothers had higher levels of education had more highly involved parents than children whose mothers had lower education levels, at all grades (see Table EA 3.3).

Differences by Family Structure. Children in two-parent families were more likely than children in single-parent families to have parents who were highly involved in school activities. For example, among students in grades 3 through 5, 73 percent of children with two parents had parents who were highly involved in their schools, compared with 59 percent of children with one or no parent (see Table EA 3.3).

Among children in two-parent families, mothers were more likely to be highly involved than fathers. For example, in 1999, about half of students in grades 6 through 8 had highly involved mothers, but only one-quarter had highly involved fathers (see Table EA 3.3).

Children in single-mother families were somewhat less likely to have highly involved mothers (44 percent for grades 6 through 8) than comparable children in two-parent families (52 percent). However, children in single-father families were more likely to have a highly involved father (50 percent for grades 6 through 8) than comparable children in two-parent families (29 percent).

Differences by Mother’s Employment Status. Children in grades 3 through 8 and whose mothers worked part-time (less than 35 hours per week) had more highly involved parents than 3rd through 8th graders whose mothers either worked full-time (35 hours or more per week) or who were not in the labor force. For instance, 76 percent of children in grades 3 through 5 whose mothers worked part-time had parents who were classified as highly involved, compared with 66 percent of children whose mothers worked full-time and 69 percent of children whose mothers were not in the labor force (see Table EA 3.3). Among children in grades 9 through 12, those whose mothers were in the labor force had more involved parents than children whose mothers were not in the labor force (see Table EA 3.3).

⁵⁰Zill, N., & Nord, C.W. 1994. Running in Place: How American Families Are Faring in a Changing Economy and Individualistic Society. Washington, D.C.: Child Trends.
⁵¹Nord, C.W., Brimhall, D., & West, J. 1997. Fathers’ Involvement in Their Children's Schools. NCES 98-091. Washington, D.C.: National Center for Education Statistics.
⁵² The level of involvement depends on the number of different activities reported by the parents, ranging from 0 or 1 (low involvement) to 2 (moderate involvement) to 3 or more activities (high involvement). Note that the number of times that the parent has been involved in each activity was not measured.
⁵³Estimates for whites and blacks exclude Hispanics of those races.

Table EA 3.3 Percentage of children in the United States whose parents are involved in their schools, by level of involvement,^a grade, and child and family characteristics: 1999

	Low Involvement			Moderate Involvement			High Involvement
	Grades 3-5	Grades 6-8	Grades 9-12	Grades 3-5	Grades 6-8	Grades 9-12	Grades 3-5	Grades 6-8	Grades 9-12
Total	13	21	35	19	26	26	68	54	40
Gender
Male	14	21	36	19	26	25	67	54	39
Female	11	20	34	19	25	26	70	55	40
Race and Hispanic origin
White^b	10	17	31	16	25	26	74	58	43
Black^b	19	27	40	24	28	26	58	45	34
Hispanic^c	20	31	49	23	26	24	57	43	27
Poverty status
At or above poverty	10	17	32	17	25	26	73	59	43
Below poverty	21	35	48	27	29	25	53	36	26
Family structure^d
Two parents	10	17	31	17	24	25	73	59	45
Mother	14	21	36	18	27	24	68	52	41
Father	40	47	55	26	25	21	34	29	24
One or no parent^e	18	28	43	24	28	27	59	44	30
Mother-only	17	29	42	22	28	28	61	44	30
Father-only	18	22	38	25	28	25	57	50	37
Nonparent guardian(s)	24	26	51	32	31	28	44	44	21
Mother's education level^f
Less than high school	27	38	58	30	28	26	44	34	16
High school/GED	17	24	41	21	28	25	62	48	35
Vocational/technical or some college	9	19	34	17	28	25	74	54	41
College graduate	6	11	20	13	18	27	81	71	53
Mother's employment status^f
35 hours or more per week	12	19	34	22	26	27	66	55	39
Less than 35 hours per week	8	18	30	16	24	24	76	59	46
Not in labor force	16	26	40	15	25	23	69	49	36

^aLow involvement = involvement in 0 or 1 activity. Moderate involvement = involvement in 2 activities. High involvement = involvement in 3 or more activities . Possible activities include (1) attending general school meetings, (2) going to a regularly scheduled parent-teacher conference, (3) attending a school or class event, and (4) volunteering at the school or serving on a school committee.
^bNon-Hispanic.
^c Persons of Hispanic origin may be of any race.
^dParents include any combination of a biological, adoptive, step-, and foster mother and/or father. No parents in the household indicates that the child is living with nonparent guardians (e.g., grandparents).
^eEstimates for single parent households may include involvement of other adults living in the household.
^fChildren without mothers in the home are not included in estimates of mother’s education or mother’s employment status. A mother is defined as a biological mother, adoptive mother, stepmother, foster mother, or female guardian (e.g., grandmother) who resides in the home with the child.
Note: Because of rounding, percents may not add to 100.
Source: U.S. Department of Education, National Center for Education Statistics, 1996 National Household Education Survey. Tabulated by U.S. Department of Education, National Center for Education Statistics (unpublished).

Figure EA 3.3 Percentage of parental involvement^a in child’s school activities by grade level, in the United States: 1999

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EA 3.4 Difficulty Speaking English

Difficulty speaking English may limit children’s educational progress and their future employment prospects. Children may also need special instruction in school to improve their English. Difficulty speaking English is most common among immigrant children and U.S.-born children of immigrants. In the past three decades, the great majority of immigrants to the United States have come from Asia, Latin America, and the Caribbean.

In 1995, of the 6.7 million children ages 5 through 17 in the United States who spoke a language other than English at home, 2.4 million (36.5 percent) had difficulty speaking English. This represents a 3.8 percentage point increase from the proportion of similar children who had difficulty speaking English in 1979 (see Table EA 3.4). While the proportion of all children experiencing difficulty speaking English nearly doubled between 1979 and 1995, this group constituted only 5.1 percent of the total population of children ages 5 through 17 in 1995 (see Table EA 3.4).

Differences by Race and Hispanic Origin. Children of Hispanic or “other” ethnic origin are more likely than black or white children to have difficulty speaking English. For example, in 1995, 31.0 percent of all Hispanic children and 14.1 percent of children of “other” races (including Asians) had difficulty speaking English, compared with about 1 percent each of black and white children. These differences are due in part to the fact that Hispanic and Asian children are more likely than whites or blacks to speak another language in the home (see Table EA 3.4). Nearly one-third (31.8 percent) of non-Hispanic black children from homes where a language other than English was spoken had difficulty speaking English in 1995 (see Figure EA 3.4), an increase from 25.6 percent in 1979. Among Hispanic children from such homes, 41.9 percent had difficulty speaking English. Nineteen percent of non-Hispanic white children from homes where a language other than English was spoken had difficulty speaking English in 1995. The proportion was similarly low in 1979, 1989, and 1992 for these children.

Differences by Region. The percentage of children who speak another language at home varies substantially by geographic region, ranging from 5.9 percent in the Midwest to 26.4 percent in the West in 1995. Further, in the West more than 1 in 10 children have difficulty speaking English, compared to 2.3 percent in the Midwest.

Table EA 3.4 Difficulty speaking English: children ages 5 to 17 who speak a language other than English at home and who are reported to have difficulty speaking English,^a by race and Hispanic origin and by region: Selected years, 1979-1995

	1979	1989	1992	1995^b
Children who speak another language at home
Number (in thousands)	3,825	5,293	6,375	6,656
Percentage of children ages 5-17	8.5	12.6	14.2	14.1
Race and Hispanic origin
White, non-Hispanic	3.2	3.5	3.7	3.6
Black, non-Hispanic	1.3	2.4	4.2	3.0
Hispanic^c	75.1	71.2	76.6	73.9
Other, non-Hispanic	44.1	53.4	58.3	45.5
Region^d
Northeast	10.5	13.5	16.2	15.1
Midwest	3.7	4.9	5.6	5.9
South	6.8	10.7	11.1	11.7
West	17.0	24.2	27.2	26.4
Children who have difficulty speaking English
Number (in thousands)	1,250	1,850	2,178	2,431
Percentage of children ages 5-17	2.8	4.4	4.9	5.1
Race and Hispanic origin
White, non-Hispanic	0.5	0.8	0.6	0.7
Black, non-Hispanic	0.3	0.5	1.3	0.9
Hispanic^c	28.7	27.4	29.9	31.0
Other, non-Hispanic	19.8	20.4	21.0	14.1
Region^d
Northeast	2.9	4.8	5.3	5.0
Midwest	1.1	1.3	1.6	2.3
South	2.2	3.8	3.5	3.4
West	6.5	8.8	10.4	11.4
Percentage of those speaking another lanugage at home who have difficulty speaking English	32.7	34.9	34.2	36.5
Race and Hispanic origin
White, non-Hispanic	17.3	22.6	17.2	19.0
Black, non-Hispanic	25.6	22.5	31.0	31.8
Hispanic^c	38.2	38.5	39.0	41.9
Other, non-Hispanic	44.9	38.1	36.1	31.1

^aRespondents were asked if the children in the household spoke a language other than English at home and how well they could speak English. Categories used for reporting were “Very well,” “Well,” “Not well,” and “Not at all.” All those reported to speak English less than “Very well” were considered to have difficulty speaking English.
^bNumbers in this year may reflect changes in the Current Population Survey because of newly instituted computer-assisted interviewing techniques and/or because of the change in the population controls to the 1990 Census-based estimates, with adjustments.
^cPersons of Hispanic origin may be of any race.
^dRegions: Northeast includes CT, ME, MA, NH, NJ, NY, PA, RI, and VT. Midwest includes IL, IN, IA, KS, MI, MN, MO, NE, ND, OH, SD, and WI. South includes AL, AR, DE, DC FL, GA, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, and WV. West includes AK, AZ, CA, CO, HI, ID, MT, NV, NM, OR, UT, WA, and WY.
Source: National Center for Education Statistics. Tabulations based on October 1992 and 1995 and November 1979 and 1989
Current Population Surveys, U.S. Bureau of the Census. As published in Federal Interagency Forum on Child and Family Statistics, 1998, Table POP4.

Figure EA 3.4 Percentage of children ages 5 through 17 in the United States who speak a language other than English at home and who are reported to have difficulty speaking English,^a by race and Hispanic origin:^b 1995

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^aParents were asked if their child spoke a language other than English at home and how well the child could speak English. Categories used for reporting were “Very well,” “Well,” “Not well,” and “Not at all.” All children who were reported to speak below the level of “Very well” were considered to have difficulty speaking English.
^bPersons of Hispanic origin may be of any race.
^cNon-Hispanic.
Source: National Center for Education Statistics. Tabulations based on October 1992 and 1995 and November 1979 and 1989 Current Population Surveys, U.S. Bureau of the Census. As published in Federal Interagency Forum on Child and Family Statistics, 1998, Table POP4.

EA 3.5 Student Computer Use

Computer literacy has become increasingly important for success in the workplace. Computers have become an essential tool for retrieving and manipulating information, for producing reports, and for communicating with colleagues. The extent to which children have access to computers, and the uses children make of computers, may be an indicator of how well prepared students will be to enter an increasingly technological workplace.

Tables EA 3.5.A and EA 3.5.B present data on the frequency of computer use by children at school and at home. A review of these tables reveals the following general trends:

The percentage of 4th, 8th, and 12th graders who reported using a computer for schoolwork 1-2 times a week increased substantially between 1992 and 1998 (see Table EA 3.5.A). For example, 14 percent of 12th graders reported using a computer at school 1-2 times a week in 1992, compared with 28 percent in 1998.

Differences by Grade. Computer usage for schoolwork appears to increase as students enter the higher grades. For example, in 1998, 8 percent of 4th graders reported using a computer every day for schoolwork, while 21 percent of 12th graders reported the same.

Differences by Family Income.⁵⁴ Data from the Current Population Survey indicate that students from high-income families were more likely than students from middle- and low-income families to report using a computer at home or at school (see Table EA 3.5.B).
However, family income appears to have a stronger impact on children’s exposure to computers at home than at school. For example, in 1997, the rate of computer usage at home was 15 percent for students in grades 7-12 from low-income families, compared with 79 percent for students from high-income families in the same grades. The corresponding computer usage rates at school were 68 percent and 75 percent for students in grades 7-12 from low-income and high-income families, respectively (see Table EA 3.5.B).

⁵⁴Low income is the bottom 20 percent of all family incomes; high income is the top 20 percent of all family incomes; and middle income is the 60 percent in between.

Table EA 3.5.A Percentage of students who reported using a computer for schoolwork, by grade and frequency of use: Selected years, 1992-1998

	Grade 4			Grade 8			Grade 12
	1992	1994	1996	1992	1994	1996	1992	1994	1996
Frequency of use
Never	67	60	54	58	51	32	45	37	22
Ever	33	40	46	42	49	68	55	63	78
1–2 times a week	17	21	20	14	16	25	14	18	28
1–2 times a month	10	11	18	20	23	29	22	26	30
Every day	6	9	8	8	10	15	18	18	21

Source: U.S. Department of Education, National Center for Education Statistics, National Assessment of Educational Progress. 1988. Almanac: Writing, 1984 to 1996. As published in The Condition of Education 1998, p. 38. Some tabulations performed by Child Trends.

Table EA 3.5.B Percentage of students who reported using a computer at school or at home, by grade level and family income: October 1984, 1989, 1993,^a and 1997

	Total				Low				Middle				High
Location of Computer	1984	1989	1993	1997	1984	1989	1993	1997	1984	1989	1993	1997	1984	1989	1993	1997
Grades 1-6
At home	11.8	16.1	23.0	41.3	2.5	3.2	3.9	12.4	9.7	13.1	18.0	36.4	24.4	33.6	48.5	74.6
At school	30.5	52.4	66.6	79.1	18.5	39.4	57.4	70.9	29.5	52.3	66.2	78.6	42.2	62.5	74.0	86.5
At school or home	36.2	56.9	70.7	83.8	20.0	40.5	58.1	71.9	34.5	56.3	69.5	82.8	53.0	70.9	82.4	95.0
Grades 7-12
At home	13.4	21.1	27.7	49.2	3.3	5.7	5.6	14.9	10.1	17.0	22.2	44.2	24.8	38.3	51.2	78.6
At school	28.9	43.0	57.0	73.5	20.0	36.7	49.0	67.6	28.4	42.6	57.3	74.1	34.1	47.2	60.7	75.4
At school or home	36.2	52.1	65.6	84.3	22.2	39.0	50.4	70.7	33.6	49.9	64.1	83.5	48.1	63.9	77.0	93.3

^aData for 1984, 1989, and 1993 are revised from previously published figures.
Note: Low income is the bottom 20 percent of all family incomes; high income is the top 20 percent of all family incomes; and middle income is the 60 percent in between.
Source: U.S. Department of Education, National Center for Education Statistics, National Assessment of Educational Progress. 1998. Almanac: Writing, 1984 to 1996. As published in The Condition of Education 1998, p. 38.

Figure EA 3.5.A Percentage of students who reported using a computer for schoolwork 1-2 times a week, by grade level: Selected years, 1992-1998

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Source: U.S. Department of Education, National Center for Education Statistics, National Assessment of Educational
Progress. Almanac: Writing, 1998. As published in The Condition of Education 1998, p. 38. Some tabulations performed by
Child Trends.

Figure EA 3.5.B Percentage of students in grades 7-12 who reported using a computer at home, by family income:^a 1984, 1989, 1993, and 1997

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^aLow income is the bottom 20 percent of all family incomes; high income is the top 20 percent of all family incomes; and middle income is the 60 percent in between.
Source: U.S. Department of Commerce, Bureau of the Census, October Current Population Surveys (CPS). As published in The Condition of Education 1998, Table 3-1.

Glossary

ABORTION. The Centers for Disease Control and Prevention’s (CDC) surveillance program counts legal abortions only. For surveillance purposes, legal abortion is defined as a procedure performed by a licensed physician or someone acting under the supervision of a licensed physician to induce the termination of a pregnancy.

ACTIVITY LIMITATION. Long-term reductions in activities resulting from a chronic disease or impairment. A person is classified as having an activity limitation if he or she reports (1) an inability to perform the major activity for a person in his or her age group, (2) being able to perform the major activity but being limited in the kind or amount of this activity, or (3) not being limited in the major activity but being limited in the kind or amount of other activities. For children under age 5, the major activity consists of ordinary play. For children ages 5 to 17, the major activity is attending school. Children are classified as being limited in a major activity if they are unable to engage in the major activity or are limited in the kind or amount of this activity (classifications (1) and (2) above).

AIDS CUMULATIVE TOTAL. The number of cases of AIDS in the United States reported through December 1998.

APGAR SCORE. A numerical expression of the physical condition of an infant shortly after delivery.

BINGE DRINKING. Five or more drinks in a row in the previous 2 weeks.

BIRTHWEIGHT . The first weight of the newborn obtained after birth. Low birthweight is defined as less than 2,500 grams or 5 pounds 8 ounces. Very low birthweight is defined as less than 1,500 grams or 3 pounds 4 ounces. Before 1979 low birthweight was defined as 2,500 grams or less and very low birthweight as 1,500 grams or less.

BODY MASS INDEX (BMI). A measure that adjusts body weight for height. It is calculated as weight in kilograms divided by height in meters squared. Sex- and age-specific cut points of BMI are used in this book in the definition of overweight.

CENTER-BASED PROGRAMS. Includes day care centers, Head Start programs, preschools, prekindergartens, and other early childhood programs.

CHRONIC DISEASE OR IMPAIRMENT. Has been apparent for at least 3 months or is a new condition that will ordinarily last for more than 3 months.

CHRONIC HEALTH CONDITIONS. Conditions that (a) were first noticed 3 months or more before the reference date of the interview; or (b) belong to a group of conditions (including heart diseases, diabetes, and others) that are considered chronic regardless of when they began.

CURRENT SMOKING. Smoking on 1 or more of the previous 30 days.

FAMILY. Refers to a group of two or more people related by birth, marriage, or adoption who reside together; the Census Bureau considers all such people as members of one family. Two or more people living in the same household who are related to one another, but are not related to the householder, form an “unrelated subfamily.” Beginning with the 1980 Current Population Survey, the Census Bureau excluded unrelated subfamilies from the count of families and unrelated subfamily members from the count of family members.

FERTILITY RATE. Computed by relating total births, regardless of age of mother, to women ages 15-44.

FOOD STAMPS. The Food Stamp act of 1977 was enacted for the purpose of increasing the food purchasing power of eligible households through the use of coupons to purchase food. The Food and Nutrition Service of the U.S. Department of Agriculture (USDA) administers the Food Stamp Program through state and local welfare offices. The Food Stamp Program is the major national income support program which provides benefits to all low-income and low-resource households regardless of household characteristics (e.g., sex, age, disability, etc.). The questions on participation in the Food Stamp Program in the March Current Population Survey were designed to identify households in which one or more of the current members received food stamps during the previous calendar year. Once a food stamp household was identified, a question was asked to determine the number of current household members covered by food stamps during the previous calendar year. Questions were also asked about the number of months food stamps were received during the previous calendar year and the total face value of all food stamps received during that period.

FOREIGN BORN. Includes both immigrants and illegal aliens.

FOSTER CARE. A living arrangement where a child resides outside his or her own home, under the case management and planning responsibility of a state child welfare agency. These living arrangements include relative and nonrelative foster homes, group homes, child-care facilities, emergency shelter care, supervised independent living, and nonfinalized adoptive homes.

FREQUENT SMOKING. Smoking on 20 or more of the previous 30 days.

FULL EMPLOYMENT. Having worked at least 50 weeks during the preceding year, working at least 35 hours per week for the majority of those weeks.

GESTATION. The interval between the first day of the mother’s last normal menstrual period and the date of birth.

HALLUCINOGENS. Substances such as LSD or other psychedelic drugs such as mescaline, peyote, psilocybin, or PCP.

HEALTHY BIRTH. 5-minute Apgar Score of 9 or above, birthweight of at least 2500 grams, gestational age of 37 weeks or more, and prenatal care in the first trimester.

HIGH SCHOOL GRADUATES. 12 years of school completed for 1971-1991 and high school diploma or equivalency certificate for 1992-1998.

HISPANIC ORIGIN. Persons of Hispanic origin may be of any race.

HOMICIDES. Includes death by legal intervention.

HOMICIDES DUE TO FIREARMS. Includes assault by handguns and all other and unspecified firearms.

HOUSEHOLDS. Consist of all people who occupy a housing unit. The Census Bureau regards a house, an apartment or other group of rooms, or a single room as a housing unit when it is occupied or intended for occupancy as separate living quarters: the occupants do not live and eat with any other people in the structure and there is direct access from the outside OR through a common hall. A household includes the related family members and all the unrelated people, if any, such as lodgers, foster children, wards, or employees who share the housing unit. The Census Bureau also counts a person living alone in a housing unit or a group of unrelated people sharing a housing unit as partners as a household. The count of households excludes group quarters.

HOUSING PROBLEMS. Includes physical problems, excessive cost burden, and over crowding.

ILLICIT DRUGS. Includes marijuana, cocaine (including crack), heroin, hallucinogens (including PCP), inhalants, and non-medical use psychotherapeutics.

INCOME. For each person in the sample 15 years old and over, the Current Population Survey asks questions on the amount of money income received in the preceding calendar year from each of the following sources: 1. Earnings. 2. Unemployment compensation. 3. Workers’ compensation. 4. Social Security. 5. Supplemental Security Income. 6. Public assistance. 7. Veterans’ payments. 8. Survivor benefits. 9. Disability benefits. 10. Pension or retirement income. 11. Interest. 12. Dividends. 13. Rents, royalties, and estates and trusts. 14. Educational assistance. 15. Alimony. 16. Child support. 17. Financial assistance from outside of the household. 18. Other income.

INDICATED. Sufficient reason for state to suspect that a child may have been maltreat-
ed or is at risk of maltreatment, but the allegation cannot be substantiated to
the level of evidence required by state law.

INFANT. Child under 1 year old.

INFANT DEATH. The death of a live-born child before his or her first birthday. Deaths in the first year of life may be further classified according to age as neonatal and postneonatal. Neonatal deaths are those that occur before the 28th day of life; postneonatal deaths are those that occur between 28 and 365 days of age.

INHALANTS. Substances such as glues and aerosols.

INJURY-RELATED DEATHS. Includes death from motor vehicle crashes, fires, burns, drowning, suffocation, and accidents caused by firearms and other explosive materials, as well as homicides, suicides, and other external causes of death.

KESSNER INDEX. A measure for the adequacy of prenatal care by assessing the timeli- ness and frequency with which prenatal care is received according to the gestational age of the baby.

LABOR FORCE. Persons are classified as in the labor force if they are employed, unemployed, or in the Armed Forces during the survey week. The “civilian labor force” includes all civilians classified as employed or unemployed. The file includes labor force data for civilians age 15 and over. However, the official definition of the civilian labor force is age 16 and over.
1. Employed. Employed persons comprise (1) all civilians who, during the survey week did any work at all as paid employees or in their own business or profession, or on their own farm, or who work 15 hours or more as unpaid workers on a farm or a business operated by a member of the family; and (2) all those who have jobs but who are not working because of illness, bad weather, vacation, or labor-management dispute, or because they are taking time off for personal reasons, whether or not they are seeking other jobs. These persons would have a Labor Force Status Recode (LFSR) of 1 or 2 respectively in character 145 of the person record which designates “at work” and “with a job, but not at work.” Each employed person is counted only once. Those persons who held more than one job are counted in the job at which they worked the greatest number of hours during the survey week. If they worked an equal number of hours at more than one job, they are counted at the job they held the longest.
2. Unemployed. Unemployed persons are those civilians who, during the survey week, have no employment but are available for work, and (1) have engaged in any specific job-seeking activity within the past 4 weeks such as registering at a public or private employment office, meeting with prospective employers, checking with friends or relatives, placing or answering advertisements, writing letters of application, or being on a union or professional register; (2) are waiting to be called back to a job from which they had been laid off; or (3) are waiting to report to a new wage or salary job with 30 days.

LATE PRENATAL CARE. Medical care provided after the 7th month of pregnancy to pregnant women.

LIMITATION OF ACTIVITY . In the National Health Interview Survey limitation of
activity refers to a long-term reduction in a person’s capacity to perform the
usual kind or amount of activities associated with his or her age group. Each
person is classified according to the extent to which his or her activities are lim-
ited, as follows:

Persons unable to carry on major activity;
Persons limited in the amount or kind of major activity performed;
Persons not limited in major activity but otherwise limited; and
Persons not limited in activity.

LIVE BIRTH. In the World Health Organization’s definition, also adopted by the United Nations and the National Center for Health Statistics, a live birth is the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of the pregnancy, which, after such separation, breathes or shows any other evidence of life such as heartbeat, umbilical cord pulsation, or definite movement of voluntary muscles, whether the umbilical cord has been cut or the placenta is attached. Each product of such a birth is considered live born.

LOW BIRTHWEIGHT. See BIRTHWEIGHT .

LOW INCOME. Total family income for the year of the interview below 130 percent of the federal poverty threshold, middle is between 130 and 350 percent, and high is over 350 percent.

MARITAL STATUS. Classified through self-reporting into the categories married and unmarried. The term married encompasses all married people including those separated from their spouses. Unmarried includes those who are single (never married), divorced, or widowed. The Abortion Surveillance Reports of the Centers for Disease Control and Prevention classified separated people as unmarried before 1978.
National estimates of births to unmarried women are based on two methods of determining marital status. For 1994 through 1996, birth certificates in 45 states and the District of Columbia included a question about the mother’s marital status. Beginning in 1997, California added a direct question to their birth certificate; thus in 1997, all but four states (Connecticut, Michigan, Nevada, and New York) included a direct question on their birth certificates. Nevada asks for the mother’s marital status through the electronic birth registration process, but this item is not included on certified or paper copies of the birth certificate.
In the three states that used inferential procedures to compile birth statistics by marital status in 1997, a birth is inferred as nonmarital if any of these factors, listed in priority-of-use order, is present: a paternity acknowledgment was received, the father’s name is missing, or the father’s and mother’s current surnames are different.
The marital status classification identifies four major categories in the Current Population Survey data: single (never married), married, widowed, and divorced. These terms refer to the marital status at the time of enumeration.
The category “married” is further divided into “married, civilian spouse present,” “married, Armed Forces spouse present,” “married, spouse absent,” “married, Armed Forces spouses absent,” and “separated.” A person is classified as “married, spouse present” if the husband or wife is reported as a member of the household even though he or she may be temporarily absent on business or on vacation, visiting, in a hospital, etc., at the time of the enumeration. Persons reported as “separated” included those with legal separations, those living apart with intentions of obtaining a divorce, and other persons permanently or temporarily estranged from their spouses because of marital discord.
For the purpose of this file, the group “other marital status” includes “widowed and divorced,” “separated,” and “other married, spouse absent.”

NEONATAL. Child under 28 days old.

OVERWEIGHT . Body mass index (BMI) at or above the sex- and age-specific 95th percentile. BMI cutoff points calculated at 6-month age intervals for children ages 6 through 11, and for adolescents ages 12 through 17.

PARENTAL INVOLVEMENT . Low parental involvement consists of 0-1 activity; moderate parental involvement consists of 2 activities; high parental involvement consists of 3 or more activities.

PARENTS’ EDUCATION LEVEL. Refers to the highest level of education completed by either parent.

PHYSICAL PROBLEMS. Include plumbing, heating, electricity, upkeep, and/or condition of apartment hallways.

POSITIVE BEHAVIOR. Good grades, always employed, sports, school clubs, and religious involvement.

POSTNEONATAL. Child who is 28 days to 1 year old.

POVERTY LEVEL. Poverty statistics are based on definitions originally developed by the Social Security Administration. These include a set of money income thresholds that vary by family size and composition. Families or individuals with income below their appropriate thresholds are classified as below the poverty level. These thresholds are updated annually by the U.S. Bureau of the Census to reflect changes in the Consumer Price Index for all urban consumers (CPI-U). For example, the average poverty threshold for a family of four was $15,569 in 1995 and $13,359 in 1990.

PREVALENCE. Prevalence is the number of cases of a disease, infected persons, or per-
sons with some other attribute present during a particular interval of time. It is
often expressed as a rate (for example, the prevalence of diabetes per 1,000 per-
sons during a year). See related Incidence.

RACE. Beginning in 1976, the federal government’s data systems classified individuals into the following racial groups: American Indian or Alaska Native, Asian or Pacific Islander, black, and white. Depending on the data source, the classification by race may be based on self-classification or on observation by an interviewer or other persons filling out the questionnaire. Starting in 1989, data from the National Vital Statistics System for newborn infants and fetal deaths are tabulated according to race of mother, and trend data by race shown in this report have been retabulated by race of mother for all years, beginning with 1980. Before 1980, data were tabulated by race of newborn and fetus according to race of both parents. If the parents were of different races and one parent was white, the child was classified according to the race of the other parent.
When neither parent was white, the child was classified according to father’s race, with one exception: if either parent was Hawaiian, the child was classified Hawaiian. Before 1964, the National Vital Statistics System classified all births for which race was unknown as white. Beginning in 1964 these births were classified according to information on the previous record.
In the National Health Interview Survey, children whose parents are of different races are classified according to the race of the mother. Vital event rates for the American Indian or Alaska Native population shown in this book are based on the total U.S. resident population of American Indians and Alaska Natives as enumerated by the U.S. Bureau of Census. In contrast, the Indian Health Service calculates vital event rates for this population based on U.S. Bureau of Census county data for American Indians and Alaska Natives who reside on or near reservations.

REGULAR DRINKING. Having an alcoholic beverage on more than two occasions in the previous 30 days.

RELATED CHILDREN. Related children in a family include own children and all other children in the household who are related to the householder by birth, marriage, or adoption. For each type of family unit identified in the Current Population Survey, the count of own children under 18 years old is limited to single (never married) children; however, “own children under 25” and “own children of any age,” include all children regardless of marital status. The totals include never-married children living away from home in college dormitories.

RISK BEHAVIORS. Regular alcohol abuse, regular binge drinking, regular tobacco use, marijuana use, cocaine use, sexual intercourse, physical fighting, weapon carrying, suicidal thoughts, and suicide attempt.

SERIOUS VIOLENT VICTIMIZATION. Being a victim of violent crime. (See VIOLENT CRIMES)

SINGLE STATUS. A man or woman who has never been married, or is divorced or widowed.

TWO PARENTS. Biological and adoptive parents only.

VERY LOW INCOME. Incomes at or below one-half the median income in a geographic area

VIOLENT CRIMES. Includes aggravated assaults, rape, and robbery.

WEAPON. Includes guns, knives, and clubs.

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