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Trends in the Well-Being of America's Children and Youth, 1997

Publication Date
Mar 31, 1997

INTRODUCTION

This is the second edition of an annual report from 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 one or more graphics to highlight key trends and important population sub-group differences, and tables that provide more detailed information for the interested user. These are accompanied by text which 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 21st century.

Decisions regarding which indicators were to be included 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 were 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 including data availability (the data needed to be available for a nationally representative sample and available on a regular basis), timeliness (the most recent 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).

Other important indicators have been added for this second edition based on recommendations from the staff of statistical agencies who are participating in the Federal Interagency Forum on Child and Family Statistics, described below. Additional measures will be added to new editions of the report over time as new data become available.
 

A COMPREHENSIVE VIEW OF CHILDREN AND YOUTH

This report is intended to help readers develop a sense of how children and youth are faring overall. As an example, we offer below a selection of findings from the report that relate to the experience of teenagers.

  • The teen birth rate for 15-19 year old young women has been dropping since 1991, with the largest decreases among black teens.
  • Use of cigarettes, alcohol, marijuana and cocaine by high school students has increased during the 1990s, following periods of decreasing use during the previous decade.
  • 17-year-old students have made modest gains in mathematics and science proficiency since the early 1980s.
  • The mortality rate for black youth ages 15-19, following a sustained period of decline, increased dramatically during the late 1980s, and has remained at a very high level since 1991. During that same time period, mortality rates among white youth ages 15-19 declined.
  • Receipt of early prenatal care by teen mothers has increased steadily during the 1990s.

THE NEED FOR BETTER DATA ON CHILDREN AND YOUTH

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 which 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 which 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. Indicators related to fathering are virtually nonexistent and in need of development. 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 which 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 government programs of all sorts 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 level.

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 or analyzing 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 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. As data from these efforts become available they will be incorporated into new editions of this annual report. The forum, in response to the President's Executive Order No. 13045, also publishes an annual report on key indicators of child and youth well-being, entitled America's Children: Key National Indicators of Well-Being.

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 or always statistically 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 many cases. When such tests were not available, small 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 which were in fact higher or lower.

Finally, the user should note that, in all tables and figures, unless otherwise clearly specified, race-specific estimates (e.g., white, black, Native American, Asian) include Hispanics of those races even when a separate estimate is given for Hispanics. In cases where Hispanics have been separated out, "non-Hispanic" will follow the race designation as in "white, non-Hispanic." By contrast, in the textual descriptions of the data, races are in most cases referred to simply as white, black, Native American, or Asian, whether or not they include Hispanics. When Hispanics have been excluded, this is noted in a footnote.

ACKNOWLEDGMENTS

Members of the Federal Interagency Forum on Child and Family Statistics have given substantial support for this report through the provision of data and the careful review of relevant sections of the report. These include the National Center for Education Statistics, the Centers for Disease Control and Prevention (National Center for Health Statistics), 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 National Institute of Child Health and Human Development, and the Office of the Assistant Secretary for Planning and Evaluation at HHS.

Special thanks go to Wendell Primus, former Deputy Assistant Secretary for Human Services Policy, HHS/ASPE. It was his vision that brought the 1996 volume, and this volume, into reality. Thanks also to Matthew Stagner, HHS/ASPE, for leading the development of both the 1996 and 1997 volumes. Many others in HHS/ASPE have contributed to the development, review, and production of this report. Thanks go to Ann Rosewater, Ann Segal, Barbara Broman, Elisa Koff, Amy Nevel, Gary Hyzer, Gil Crouse, Reuben Snipper, and Bruce Gray. Chris Treston and David Peabody deserve special thanks for their creativity and dedication in completing the graphic design of this document.

Several non-Federal individuals and groups also supplied data or analyses for this report including the Survey Research Center and Institute for Social Research of the University of Michigan; the Educational Testing Service; Greg Duncan of Northwestern University; Paul Jargowski of the University of Texas at Dallas; and William Frey of the University of Michigan.

This report was produced under contract by Child Trends, Inc., of Washington, D.C. Brett Brown served as project director. Other members of the project staff included Christopher Botsko, Carla Butler, Anne Driscoll, Carol Emig, Jane Fueyo, Tawanda Greer, Charles Halla, Michelle Harper, Fanette Jones, Chisina Kapungu, Gretchen Kirby, Jennifer Manlove, Suzanne Miller, Kristin Moore, Cheryl Oakes, Angela Romano, and Richard Wertheimer.

SECTION 1 POPULATION, FAMILY, AND NEIGHBORHOOD (PF)

CHILD POPULATION CHARACTERISTICS

PF 1.1 Number of children

Though the total population of the United States has grown steadily over the last four decades, the trend in the number of children has been less steady, and the number of children has even shrunk during some periods.

Figure PF 1.1 presents trends in the total number of children under age 18 from 1950 through 1996, with projections through the year 2020. From 1950 to 1960, roughly the period of the baby boom, the number of children increased by 36 percent from 47.3 to 64.5 million. The number rose at a more modest rate in the ensuing decade to 69.8 million in 1970. The number actually declined to 63.7 million by 1980, and held steady over the next decade. Between 1990 and 1996, the number of children rose by more than five million to 69.4 million. The U.S. Census Bureau projects that the number of children will continue to rise over the next several decades, reaching 77.6 million by the year 2020.

Differences by Race and Ethnicity. Between 1996 and the year 2020, the number of children is projected to grow for all race and ethnic groups presented in the table (see Table PF 1.1). Increases will be proportionally greatest for Hispanic children, whose numbers are projected to grow from 10.0 to 17.2 million by the year 2020, an increase of more than 70 percent. Should these projections prove accurate, Hispanics could become the largest minority child population as early as 2010.
 

Figure PF 1.1 
Number of Children Under Age 18 in the U.S.: 19502020

FIGPF1_1.GIF

Source: U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 311, Estimates of the Population of the United States by Single Years of Age, Color, and Sex, 1900 to 1959, pages 22-23, 42-43. Series P-25 No. 519, Estimates of the Population of the United States, By Age, Sex, and Race: April 1, 1960 to July 1, 1973, Table 2. Series P-25, No. 917, Preliminary Estimates of the Population of the United States by Age, Sex, and Race: 1970 to 1981, Table 2. Estimates of the Population of the United States by Age, Sex, Race, and Hispanic Origin: 1990 to 1995, Updated Tables, Appendix A. Series P-25, No. 1130, Projections of the Population of the United States by Age, Sex, Race, and Hispanic Origin: 1995 to 2050, Table 2.

Table PF 1.1 
Number of Children Under 18 by Age and Race/Ethnicity: 19502020 (Number in Millions)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Projected
 
 
 
 
 
 
 
 
 
 
 
1950
1960
1970
1980
1990
1996a
2000
2010
2020
 
 
                 
All Children 
47.3
64.5
69.8
63.7
64.2
69.4
70.8
72.5
77.6
Age
 
0-5
19.1
24.3
20.9
19.6
22.5
23.5
22.9
23.9
26.4
 
6-11
15.3
21.8
24.6
20.8
21.6
23.2
24.3
23.6
25.8
 
12-14
12.9
18.4
24.3
23.3
20.1
22.7
23.6
25
25.4
 
 
 
 
 
 
 
 
 
 
 
Race/Ethnicity 
 
White
41.3
55.7
59.3
52.5
51.3
54.9
55.4
55.2
57.9
 
Non-whiteb
6
8.8
10.5
 
 
 
 
 
 
 
Black
 
8.1
9.5
9.5
9.9
10.8
11.3
12.2
13.4
 
Hispanicc
 
 
 
5.6
7.9
10
11
13.7
17.2
 
Asian
 
 
 
1.1
2.2
2.9
3.3
4.3
5.4
 
American Indian
 
 
 
0.5
0.7
0.8
0.8
0.9
1
                     
Note: a1996 estimate is for July 1. 
b"Non-white" refers to all races other than white, and includes black, Native American, Asian, and any other race except white. 
cPeople of Hispanic origin can be of any race. 

Source: U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 311, Estimates of the Population of the United States by Single Years of Age, Color, and Sex, 1900 to 1959, pages 22-23, 42-43. Series P-25, No. 519, Estimates of the Population of the United States, By Age, Sex, and Race: April 1, 1960 to July 1, 1973, Table 2. Series P-25, No. 917, Preliminary Estimates of the Population of the United States by Age, Sex, and Race: 1970 to 1981, Table 2. Estimates of the Population of the United States by Age, Sex, Race, and Hispanic Origin: 1990 to 1995, Updated Tables, Appendix A. Series P-25, No. 1130, Projections of the Population of the United States by Age, Sex, Race, and Hispanic Origin: 1995 to 2050, Table 2.


 

PF 1.2 Children as a percentage of the population

The proportion of the total population who are children can have important consequences for the entire population, including children. On the one hand, because children are for the most part dependent and in need of investment to become productive citizens, they may present special short-term fiscal challenges to society when they constitute a relatively higher proportion of the overall population. On the other hand, as they grow up to become productive adults they will provide support for those entering retirement and for the next generation of children.

Figure PF 1.2 illustrates trends in the proportion of the population under age 18 from 1940 through 1996, with projections through the year 2020. In 1940 and 1950, children constituted 31 percent of the overall population. During the next decade, children as a proportion of the population rose rapidly to 36 percent. The rise in birthrates that produced this increase in the proportion of children in the population during the 1950s is commonly known as the baby boom. Since that peak in 1960, the percentage has been declining to its current level of 26 percent. Projections by the Bureau of the Census predict that this proportion will drop further to 24 percent by the year 2010, and will remain at approximately that level through 2020.
 

Figure PF 1.2 
Children Under Age 18 as a Percentage of the Total Population: 19402020

FIGPF1_2.GIF

Source: U.S. Bureau of the Census, 1990 Census of Population and Housing, Summary Population and Housing Characteristics (CPH-1-1) Table 1. U.S. Bureau of Census, 1970 Census Volume, Characteristics of the Population, U.S. Summary, Table 52. 1980 Census Volume, General Population Characteristics, U.S. Summary, Table 41. Current Population Reports, Series P-25, No. 311, Estimates of the Population of the Unites States by Single Years of Age, Color, and Sex, 1900 to 1959. Series P-25, No. 917, Preliminary Estimates of the Population of the United States by Age, Sex, and Race: 1970 to 1981, Table 2. PPL-41 Estimates of the Population of the United States by Age, Sex, Race, and Hispanic Origin: 1990 to 1995, Updated Tables, Appendix A. Series P-25, No. 1130, Projections of the Population of the United States by Age, Sex, Race, and Hispanic Origin: 1995 to 2050, Table 2.

Table PF 1.2  
Children Under Age 18 as a Percentage of the Total Population:  19402020

 
 
 
 
 
 
 
 
 
 
 
 
             
Projected
 
1940
1950
1960
1970
1980
1990
1996
2000
2010
2020
 
                   
All Children                    
Ages 0-17
31
31
36
34
28
26
26
26
24
24
                     

Source: U.S. Bureau of the Census, 1990 Census of Population and Housing, Summary Population and Housing Characteristics (CPH-1-1) Table 1. U.S. Bureau of Census, 1970 Census Volume, Characteristics of the Population, U.S. Summary, Table 52. 1980 Census Volume, General Population Characteristics, U.S. Summary, Table 41. Current Population Reports, Series P-25, No. 311, Estimates of the Population of the Unites States by Single Years of Age, Color, and Sex, 1900 to 1959. Series P-25, No. 917, Preliminary Estimates of the Population of the United States by Age, Sex, and Race: 1970 to 1981, Table 2. PPL-41 Estimates of the Population of the United States by Age, Sex, Race, and Hispanic Origin: 1990 to 1995, Updated Tables, Appendix A. Series P-25, No. 1130, Projections of the Population of the United States by Age, Sex, Race, and Hispanic Origin: 1995 to 2050, Table 2.

PF 1.3 Proportion of families containing 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 1996, the percentage of families with four or more own children under age 18 in the household decreased from nine percent to three percent (see Figure PF 1.3). During the same period, the proportion of families with no minor children grew from 43 percent to 51 percent.

Differences by Race and Ethnicity. 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 1.3). For example, between 1970 and 1996 the percentage of black families with four or more children dropped from 19 percent to five percent. The percentage for whites during that period went from nine percent to three percent. For Hispanic families, the percentage dropped from ten percent to seven percent between 1980 (the first year for which Hispanic estimates are available) and 1996.

Black and Hispanic families were considerably less likely than white families to be without any minor children, with proportions of 43 percent, 36 percent, and 52 percent, respectively in 1996. They were also both more likely than white families to have four or more children, though these differences were smaller than in previous decades.

Figure PF 1.3  
Percentage of Families with No Children, and With Four or More Resident Children: 19601996

FIGPF1_3.GIF

Source: Estimates for 1960 - 1996 from Household and Family Characteristics, Current Population Reports, Series P-20 for various years.
 

Table PF 1.3 
Percentage Distribution of Families by Number of Own Children Under 18 Years of Age: 19601996

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

Source: Estimates for 1960 - 1996 from "Household and Family Characteristics," Current Population Reports, Series 
P-20 for various years.


 

PF 1.4 Race/Ethnicity composition

The United States has become increasingly racially and culturally diverse over the last three decades, and is projected to become even more so in the decades to come. Table PF 1.4 presents the racial and ethnic composition of Americas children from 1960 to 1996, and includes projections of likely changes in that composition through the year 2020 as estimated by the Bureau of the Census. As Figure PF 1.4 illustrates, as recently as 1980, nearly three-quarters (74 percent) of all children in this country were non-Hispanic whites. This proportion diminished to 66 percent in 1996, and is expected to continue a steady downward trend until, by the year 2020, non-Hispanic whites will constitute just over one half (55 percent) of all U.S. children. The historical trend for all whites is similar though less dramatic, since Hispanics comprise an increasingly large proportion of the white population (see Table PF 1.4).

As of 1996, blacks constituted the largest minority population group at 16 percent of the total child population. (see Table PF 1.4). They were followed by Hispanics at 14 percent, Asian Americans at 4 percent, and Native Americans at 1 percent. By the year 2010, Hispanics are projected to be 19 percent of the child population, supplanting blacks as the largest minority group in the child population. By the year 2020, more than one in five American children are expected to be Hispanic, nearly double the proportion in 1990. The Asian American population is also expected to continue its rapid growth, increasing from 4 percent in 1996 to 6 percent by the year 2020.

Figure PF 1.4  
Percentage Distribution of U.S. Children by Race/Ethnicity: 1980-2020

FIGPF1_4.GIF

Note: Population estimates for July 1.

Sources: U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 519 Estimates of the Population of the United States by Age, Sex, and Race: April, 1960 to July 1, 1973. U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 1095, U.S. Population Estimates, by Age, Sex, Race, and Hispanic Origin: 1980-1991. U.S. Bureau of the Census, Population Division, release, PPL-41, United States Population Estimates by Age, Sex, Race, and Hispanic Origin 1990 to 1995 and updated tables, Appendix A. U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 1130, Projections of the Population of the United States by Age, Sex, Race, and Hispanic Origin: 1995 to 2050.
 

Table PF 1.4 
Percentage Distribution of U.S. Children Under 18 by Race/Ethnicity: 
19602020

 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
         
Projected
 
1960
1970
1980
1990
1996
2000
2010
2020
 
               
 
               
White
86
85
82
80
79
78
76
75
White, non-Hispanic
--
--
74
69
66
64
59
55
Black
13
14
15
15
16
16
17
17
Hispanic
--
--
9
12
14
16
19
22
Asian American
--
--
2
3
4
4
6
6
Native American
--
--
1
1
1
1
1
1
                 
Note: All population estimates for July 1.  

Sources: U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 519 "Estimates of the Population of the United States by Age, Sex, and Race: April, 1960 to July 1, 1973. U.S. Bureau of the Census, Current Population Reports, Series P-25 No. 1095, "U.S. Population Estimates, by Age, Sex, Race, and Hispanic Origin: 1980-1991." U.S. Bureau of the Census, Population Division, release, PPL-41, "United States Population Estimates by Age, Sex, Race, and Hispanic Origin 1990 to 1995" and updated tables, Appendix A. U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 1130, "Projections of the Population of the United States by Age, Sex, Race, and Hispanic Origin: 1995 to 2050.


 

PF 1.5 Immigrant children

The United States is a nation of immigrants. Rates of immigration have varied substantially over periods of our history, as have the countries and cultures from which these immigrants originate. Recently the U.S. has been experiencing a period of high immigration. Immigrant children are of particular interest, since they may have special needs that must be addressed through the education system.

The percentage of Americas children and youth 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 (see Figure PF 1.5.A).

Differences by Age. Older children are more likely than younger children to be foreign born. In 1990, 6.5 percent of youth ages 15 to 19 were foreign born, compared to only 1.4 percent of children under age five (see Table PF 1.5).

Differences by Race and Ethnicity. The percentage of children who are foreign-born varies substantially by racial and ethnic background (see Figure PF 1.5.B). In 1980, less than two percent of whites, blacks and Native Americans were foreign born, compared to 40.0 percent of Asians and 14.0 percent of Hispanics. By 1990, the percentage of foreign-born Asian children had declined from 40.0 to 33.2 percent, while the percentage of foreign-born Hispanic children increased to almost 16 percent.

Figure PF 1.5.A 
Percentage of U.S. Children Ages 19 and Under Who Were Foreign Borna: 19701990

FIGPF1_5A.GIF

Notes: aIncludes both immigrants and illegal aliens.

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

Figure PF 1.5.B  
Percentage of U.S. Children Ages 19 and Under Who Were Foreign Borna by Race/Ethnicity: 1980-1990

FIGPF1_5B.GIF

Notes: aIncludes both immigrants and illegal aliens.

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

Table PF 1.5 
Percentage of U.S. Children Ages 19 and Under Who Were Foreign-Born 
by Age and Race/Ethnicity: 1970-1990
 
 
 
 
 
 
 
1970
1980
1990
 
 
   
 
All Children 
1.2
2.9
3.7
 
 
 
 
 
Under 5 years
 
0.6
1.4
1.4
5 to 9 years
 
1.1
2.6
2.7
10-14 years
 
1.4
3.2
4.3
15-19 years
 
1.8
4.1
6.5
 
 
 
 
 
Race/Ethnicity 
 
White
1.2
1.7
1.8
 
Black
0.5
1.8
2.2
 
American Indian, Eskimo, and Aleut
 
1.5
1.1
 
Asian and Pacific Islander
 
40
33.2
 
Hispanic
 
14
15.8
         

Notes: aIncludes both immigrants and illegal aliens. 

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


 

PF 1.6 Children as a percentage of the dependent population

 
Children and senior citizens frequently depend on assistance from family members, friends, and government agencies. Both the young and old are less likely than other age groups to fully support themselves through participation in the labor market. Varying proportions of both the child population and the elderly population therefore receive income transfers, health care, and other services through public programs. This indicator looks at children (under age 18) as a percentage of the dependent population (children under age 18 + adults ages 65 and older).

Senior Citizen Population Grows in Relation to Child Population. The number of children in the U.S. declined after 1970, while the number of senior citizens increased (see Table PF 1.1 earlier in this volume). Children under 18 went from being 79 percent of the dependent population in 1960 to 67 percent , where it has stayed since 1990 (see Table PF1.6). Despite the fact that the child population is growing again, this slow downward trend is expected to continue, and the growth of the elderly population will continue to outpace growth in the child population.

Differences by Race and Ethnicity. The trend toward a larger senior population relative to the child population is occurring among all racial and ethnic groups. Table PF 1.6 shows that between 1980 and 1990, children declined as a percentage of the dependent population across all racial and ethnic groups. Population projections for 2010 suggest that there will be even more seniors relative to children in each group at that time.

Yet there are also considerable differences across groups in the number of children relative to senior citizens. There are far fewer white children relative to white senior citizens than there are minority children relative to minority seniors. White children are currently estimated to make up about 61 percent of the white dependent population. African-Americans are closest to whites with children making up 79 percent of the combined child and elderly population total. Among Hispanics, children outnumber seniors by the greatest margin, with children estimated to be 86 percent of the dependent population.

Figure PF 1.6  
Percentage of Children in the Dependent Population (Persons Age 65 and Over and Those Under Age 18) by Race/Ethnicity 

FIGPF1_6.GIF

Source: U.S. Bureau of the Census, Current Population Reports, P25-1095. U.S. Bureau of the Census, Population Division, release PPL-41, United States Population Estimates by Age, Sex, Race, and Hispanic Origin 1990 to 1995" and updated tables. Day, Jennifer Cheeseman, Population Projections of the United States by Age, Race, and Hispanic Origin: 1995 to 2050. U.S. Bureau of the Census, Current Population Reports, P25-1130, U.S. Government Printing Office, Washington, D.C. 1996.
 

Table PF 1.6  
Percentage of Children in the Dependent Population (Persons Age 65 and Over and Those Under Age 18) by Race/Ethnicity

 
                                             
   
1960
1970
1980
1990
Estimate
1996
Projecteda
2010
 
 
 
 
 
 
 
 
 
 
               
Total
 
79
78
71
67
67
65
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
White, non Hispanic
 
 
68
62
61
57
 
Black
 
 
82
79
79
78
 
Hispanic
 
 
89
87
86
83
 
Asian American
 
 
88
85
81
76
 
Native Americanb
 
 
84
82
84
79
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Notes: aProjection is based on the Census Bureaus middle series. 
bIncludes Alaskan Natives. 

Source: U.S. Bureau of the Census, Current Population Reports, P25-1095. U.S. Bureau of the Census, Population Division, release PPL-41, "United States Population Estimates by Age, Sex, Race, and Hispanic Origin 1990 to 1995" and updated tables. Day, Jennifer Cheeseman, Population Projections of the United States by Age, Race, and Hispanic Origin: 1995 to 2050. U.S. Bureau of the Census, Current Population Reports, P25-1130, U.S. Government Printing Office, Washington, D.C. 1996.


 

FAMILY STRUCTURE

PF 2.1 Family structure: number of parents in household

Family structure is correlated with many factors that contribute to child well-being such as material wealth. It is also associated with many child outcomes. For example, children from disrupted or never-married families are somewhat more likely to use alcohol and drugs, to become teen parents, and to achieve lower earnings than are children from intact families, and they are less likely to attain a high school diploma. These associations are evident even after controlling for family socioeconomic status, race, and other background factors.1 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 intact families tend, on average, to be moderate to small.2

Between 1960 and 1996, the proportion of children in two-parent families (about three-quarters of whom were families with both biological parents present)3 decreased from 88 percent to 68 percent (see Figure PF 2.1)

Differences by Race and Ethnicity. The decrease in the proportion of children living in two-parent families is evident for both black and white children, though the descent is significantly steeper for black children. Between 1960 and 1996, the proportion of black children living in two-parent families fell by 34 percentage points, from 67 percent to 33 percent. By contrast, the drop for white children was only 16 percentage points, from 91 percent to 75 percent. For Hispanic children, the trend is also towards a smaller proportion of children in two-parent families, decreasing from 75 percent to 62 percent between 1980 (the first year for which Hispanic estimates are available) and 1996.

Table PF 2.1.B presents 1980 and 1990 census data for Asian and Native American families in addition to data on white, black, and Hispanic families. The percent of children living in two-parent families dropped for all five groups during that period. In 1990, Asian children were the most likely to live in a two-parent household at 84 percent followed closely by whites at 82 percent, then Hispanics (71 percent), Native Americans (64 percent) and blacks (47 percent).
 

Figure PF 2.1  
Percentage of U.S. Children Under Age 18 Living With Two Parents, by Race/Ethnicity: 19601996 

FIGPF2_1.GIF

Source: 1960 data U.S. Bureau of the Census, 1960 Census of Population, PC (2) - 4B, Persons by Family Characteristics, Tables 1 and 19. 1970 Hispanic data U.S. Bureau of the Census, 1970 Census of the Population, PC (2) - 1 C, Persons of Spanish Origin, Table 4. Data from 1970 - 1995 U.S. Bureau of the Census, Current Population Reports, Series P20-491, Marital Status and Living Arrangements: March 1995, and earlier reports. 1996 data U.S. Bureau of Census Unpublished tables.

Table PF 2.1.A  
Living Arrangements of Children Under 18 Years Old by Race/Ethnicity: Selected Years, 19601996 (in percents)

                           
   
1960
1970a
1975
1980a
1985
1990
1991
1992
1993
1994
1995
1996
   
 
 
 
 
 
 
 
 
 
 
 
 
Totals:
 
Two Parents
88
85
80
77
74
73
72
71
71
69
69
68
 
Mother Only
8
11
16
18
21
22
22
23
23
23
23
24
 
Father Only
1
1
2
2
3
3
3
3
3
3
4
4
 
No Parent
3
3
3
4
3
3
3
3
3
4
4
4
 
 
                       
White
 
Two Parents
91
90
85
83
80
79
78
77
77
76
76
75
 
Mother Only
6
8
11
14
16
16
17
18
17
18
18
18
 
Father Only
1
1
2
2
2
3
3
3
3
3
3
4
 
No Parent
2
2
2
2
2
2
2
2
2
3
3
3
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Black
 
Two Parents
67
58
49
42
40
38
36
36
36
33
33
33
 
Mother Only
20
30
41
44
51
51
54
54
54
53
52
53
 
Father Only
2
2
2
2
3
4
4
3
3
4
4
4
 
No Parent
11
10
8
12
7
8
6
7
7
10
11
9
 
 
                       
Hispanicb
 
Two Parents
--
--
--
75
68
67
66
65
65
63
63
62
 
Mother Only
--
--
--
20
27
27
27
28
28
28
28
29
 
Father Only
--
--
--
2
2
3
3
4
4
4
4
4
 
No Parent
--
--
--
3
3
3
4
3
4
5
4
5
 
 
                       
 
                         
Note: aRevised estimate based on population from the decennial census for that year. 
bHispanics may be of any race. 

Source: 1960 data U.S. Bureau of the Census, 1960 Census of Population, PC (2) - 4B, "Persons by Family Characteristics," Tables 1 and 19. 1970 Hispanic data U.S. Bureau of the Census, 1970 Census of the Population, PC (2) - 1 C, "Persons of Spanish Origin," Table 4. Data from 1970 - 1995 U.S. Bureau of the Census, Current Population Reports, Series P20-491, "Marital Status and Living Arrangements: March 1995," and earlier reports. 1996 data U.S. Bureau of Census unpublished tables.

Table PF 2.1.B 
Percentage Distribution of U.S. Families with Own Children Under Age 18, by Family Type and Race/Ethnicity: 1980 and 1990

 
 
 
 
 
 
 
 
 
1980
1990
 
 
 
 
 
 
 
 
Total
 
 
 
 
 
 
Married couple
81.5
77.1
 
 
 
Female head
16.1
17.7
 
 
 
Male head
2.4
4.1
 
 
 
 
 
 
 
 
White
 
 
 
 
 
 
Married couple
85.7
82.2
 
 
 
Female head
12.1
14
 
 
 
Male head
2.2
3.7
 
 
 
 
 
 
 
 
Black
 
 
 
 
 
 
Married couple
54.3
46.9
 
 
 
Female head
41.7
47.6
 
 
 
Male head
4
5.5
 
 
 
 
 
 
 
 
Hispanic
 
 
 
 
 
 
Married couple
76.6
71.4
 
 
 
Female head
20.4
22.1
 
 
 
Male head
3.1
6.5
 
 
 
 
 
 
 
 
Asian American
 
 
 
 
 
 
Married couple
88.5
84.3
 
 
 
Female head
9.4
9.8
 
 
 
Male head
2.1
2.9
 
 
 
 
 
 
 
 
Native American
 
 
 
 
 
 
Married couple
71.5
63.6
 
 
 
Female head
24.2
28.7
 
 
 
Male head
4.3
7.8
 
           

Source: "The Challenge of Change: What the 1990 Census Tells Us About Children," prepared by the Population Reference Bureau for the Center for the Study of Social Policy, Table 14, with data from the Bureau of the Census, 1980 Census of Population, "General Social and Economic Characteristics," PC80-1-C1, United States Summary, tables 100,121, and 131; and Census of Population and Housing 1990, Summary Tape File 3, tables P-19, P-20, and P-21.


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

2 Zill, N., Morrison, D., and 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.

PF 2.2 Percentage of all births to unmarried mothers

Children who are born to single mothers regardless of the age of the mother 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.4

Between 1960 and 1994, there was a considerable increase in the percentage of all births to unmarried mothers from 5.3 percent in 1960 to 32.6 percent in 1994 (see Figure PF 2.2). However, preliminary data for 1995, displayed in Table PF 2.2, indicate a small decline in the percentage of all births to unmarried mothers, to 32.0 percent.

Differences by Age of the Mother. Nonmarital childbearing increased among mothers of all ages between 1960 and 1994 (see Table PF 2.2). For mothers ages 15 to 19, nonmarital births increased from 14.8 percent in 1960 to 75.5 in 1994. For mothers ages 20 to 24, nonmarital births increased from 4.8 percent in 1960 to 44.9 percent in 1994. For mothers in all age groups over age 24, nonmarital births increased from three percent or less in 1960 to between 15 and 22 percent in 1994. Age data are not yet available for 1995, so it is unclear whether the overall decline in the percentage of nonmarital births noted for that year occurred for mothers of all ages or only among certain age groups.

Contrary to popular opinion, nonmarital childbearing does not occur primarily among teenagers. In 1994, about 31 percent of nonmarital births were to teenagers (young women under age 20), 35 percent were to women ages 20 to 24, and about 35 percent were to women ages 25 and older.5

Differences by Race and Ethnicity. The percentage of all births to unmarried mothers increased steadily for whites, blacks, and Hispanics between 1980 and 1994.6 Preliminary data indicate a slight decline for all three groups in 1995. In 1994, Asian and white women had the lowest percentage of nonmarital births at 24.1 and 25.5 percent, respectively. Hispanics were next at 43.1 percent, followed by American Indian and black women at 57.0 percent and 70.5 percent. This ordering is the same for all age groups, though the size of the difference can vary substantially by the age of the mother. For young women ages 15 to 19, for example, whites and Hispanics have very similar percentages of births to unmarried mothers 67.6 and 69.7 percent, respectively while the percentage among young black women ages 15 to 19 is much higher at 95.3 percent. By ages 25-29, however, percentages for Hispanic women move midway between white and black rates, with whites at 16.5 percent, Hispanics at 33.2 percent, and blacks at 57.3 percent (see Table PF 2.2).

Figure PF 2.2  
Percentage of All Births to Unmarried Mothers by Age of Mother: 19601995 

FIGPF2_2.GIF

Source: 1960 - 1992 data: Ventura, S.J., 1995. Births to Unmarried Mothers: United States, 1980-92. Vital and Health Statistics Series 21, No. 53, U.S. Department of Health and Human Services, Public Health Service, June 1995. 1992 Hispanic data from unpublished tables; Stephanie Ventura: National Center for Health Statistics. 1993 data: Ventura, S.J., Martin, J.A., Taffel, S.M., et. al. Advance Report of Final Natality Statistics, 1993. Monthly Vital Statistics Report; Vol. 44, No. 3, Supp. 1, Hyattsville, Maryland: National Center for Health Statistics, 1995. 1994 data: Ventura, S.J., Martin, J.A., Matthew, T.J., Clarke, S.C. Advance Report of Final Natality Statistics, 1994. Monthly Vital Statistics Report; Vol. 44, No. 11, Supp., Hyattsville, Maryland: National Center for Health Statistics, 1996. 1995 data: Rosenberg, H.M., Ventura, S.J., Maurer, J.D., et. al. Births and Deaths: United States, 1995. Monthly Vital Statistics Report; Vol. 45, No. 3, Supp. 2, Hyattsville, Maryland: National Center for Health Statistics, 1996.

Table PF 2.2 
Percentage of All Births to Unmarried Mothers, by Age of Mother and Race/Ethnicity:a 19601995

 
     
1960
1970
1980
1985
1990
1991
1992
1993
1994
1995
                         
All Races
  All Ages
5.3
10.7
18.4
22
28
29.5
30.1
31
32.6
32
    Ages 15-19
14.8
29.5
47.6
58
67.1
68.8
70
71.3
75.5
 
    Ages 20-24
4.8
8.9
19.4
26.3
36.9
39.4
40.7
42.2
44.9
 
    Ages 25-29
2.9
4.1
9.0
12.7
18
19.2
19.8
20.7
21.8
 
    Ages 30-34
2.8
4.5
7.5
9.7
13.3
14.0
14.3
14.7
15.1
 
    Ages 35-39
3.0
5.2
9.4
11.2
13.9
14.6
15.2
15.6
16.1
 
                         
White
  All Ages 
2.3
5.7
11.2
14.7
20.4
21.8
22.6
23.6
25.5
25.3
    Ages 15-19
7.2
17.1
33.1
44.8
56.4
58.8
60.4
62.3
67.6
 
    Ages 20-24
2.2
5.2
11.7
17.7
27.8
30.2
31.7
33.4
36.3
 
    Ages 25-29
1.1
2.1
5.2
8.1
12.6
13.7
14.3
15.2
16.5
 
    Ages 30-34
1.0
2.1
4.6
6.3
9.3
9.8
10.2
10.6
11.1
 
    Ages 35-39
1.3
2.7
6.4
8.1
10.3
10.9
11.4
11.7
12.3
 
                         
Black
 
All Ages 
 
37.6
56.1
61.2
66.5
67.9
68.1
68.7
70.5
69.5
    Ages 15-19  
62.7
85.7
90.2
92
92.3
92.6
92.9
95.3
 
    Ages 20-24  
31.3
57
65.4
72.6
74.7
75.2
76.7
79.0
 
    Ages 25-29  
20.3
36.8
45.2
53.3
54.7
55
55.8
57.3
 
    Ages 30-34  
19.6
29.6
37
45.2
46.5
46.7
46.9
47.4
 
    Ages 35-39  
18.6
28.4
35.1
42.0
43.8
44.7
44.8
45.8
 
                         
Hispanic
  All Ages
 
 
23.6
29.5
36.7
38.5
39.1
40
43.1
40.8
    Ages 15-19
 
 
41.9
51.3
53.7
61.2
61.9
62.8
69.7
 
    Ages 20-24
 
 
23.8
30.9
35.1
41.5
42.3
43.4
47.0
 
    Ages 25-29
 
 
15.9
22.2
25.7
30.3
30.8
31.7
33.2
 
    Ages 30-34
 
 
15.2
19.6
23.0
26.6
27.2
27.5
28.6
 
    Ages 35-39
 
 
16.2
20.8
23.2
27.6
28.5
29.0
30.3
 
                         
Asian
  All Ages
 
 
 
 
 
 
 
 
16.2
 
    Ages 15-19
 
 
 
 
 
 
 
 
62.7
 
    Ages 20-24
 
 
 
 
 
 
 
 
30.0
 
    Ages 25-29
 
 
 
 
 
 
 
 
11.3
 
    Ages 30-34
 
 
 
 
 
 
 
 
8.0
 
    Ages 35-39
 
 
 
 
 
 
 
 
8.8
 
                         
American Indian
  All Ages
 
 
 
 
 
 
 
 
57.0
 
    Ages 15-19
 
 
 
 
 
 
 
 
82.9
 
    Ages 20-24
 
 
 
 
 
 
 
 
60.6
 
    Ages 25-29
 
 
 
 
 
 
 
 
45.5
 
    Ages 30-34
 
 
 
 
 
 
 
 
40.6
 
    Ages 35-39
 
 
 
 
 
 
 
 
38.5
 
                         

Notes: aBirths from 1980 onwards 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. 

Source: 1960 - 1992 data: Ventura, S.J., 1995. Births to Unmarried Mothers: United States, 1980-92. Vital and Health Statistics Series 21, No. 53, U.S. Department of Health and Human Services, Public Health Service, June 1995. 1992 Hispanic data from unpublished tables; Stephanie Ventura: National Center for Health Statistics. 1993 data: Ventura, S.J., Martin, J.A., Taffel, S.M., et. al. Advance Report of Final Natality Statistics, 1993. Monthly Vital Statistics Report; Vol. 44, No. 3, Supp. 1, Hyattsville, Maryland: National Center for Health Statistics, 1995. 1994 data: Ventura, S.J., Martin, J.A., Matthew, T.J., Clarke, S.C. Advance Report of Final Natality Statistics, 1994. Monthly Vital Statistics Report; Vol. 44, No. 11, Supp., Hyattsville, Maryland: National Center for Health Statistics, 1996. 1994 data for Asians and American Indians from unpublished tables; Stephanie Ventura: National Center for Health Statistics. 1995 data: Rosenberg, H.M., Ventura, S.J., Maurer, J.D., et. al. Births and Deaths: United States, 1995. Monthly Vital Statistics Report; Vol. 45, No. 3, Supp. 2, Hyattsville, Maryland: National Center for Health Statistics, 1996. Hispanic data for 1980: Ventura, S.J., Births of Hispanic parentage, 1980. Monthly Vital Statistics Report, volume 32, no. 6, Supp., Hyattsville, MD: Public Health Service. 1983. Hispanic data for 1985: Ventura, S.J. Births of Hispanic parentage, 1985. Monthly Vital Statistics Report; vol. 36, no. 11 Supp., Hyattsville, MD: Public Health Service. Hispanic data for 1990 and 1991: National Center for Health Statistics, Vital Statistics of the United States Vol. I Natality (table 1-46). Issues for 1990-91.


4 See Ventura, S.J., 1995. Births to Unmarried Mothers: United States, 1980-1992. NCHS Series 21, No. 53. U.S. Department of Health and Human Services; and McLanahan, S., and Sandefur, G. 1994. Growing up with a single parent: What hurts, what helps. Cambridge, Mass.: Harvard University Press.

5 Ventura, S.J., Martin, J.A., Matthew, T.J., Clarke, S.C. Advance Report of Final Natality Statistics, 1994. Monthly Vital Statistics Report; Vol. 44, No. 11, Supp., Hyattsville, Maryland: National Center for Health Statistics, 1996.

6 Data are available for whites from 1960, and for blacks from 1970, indicating that the percent of births which were nonmarital had also been increasing prior to 1980 for those races. Data for Hispanics are only available starting in 1980.
 

PF 2.3 Foster care

 
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 childs 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 childs 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 thousand in 1982 to 462 thousand in 1994. 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 one thousand children under age 18) also rose dramatically during the same time period, from 4.2 foster children per one thousand children under age 18 in 1982 to 6.8 in 1994 an increase of over 60 percent. Between 1990 and 1994, the rate of children in foster care continued to increase, but at a slower pace.

Figure PF 2.3 
Children Living in Foster Care: 19821994 (Rate per thousand) 

FIGPF2_3.GIF

Note: Estimate of total is the number of children in foster care on the last day of the fiscal year. 1994 is the last year in which data on foster care was collected through the Voluntary Cooperative Information System (VCIS). The Administration on Children and Families (ACF) has implemented the Adoption and Foster are 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. Thus, the new system may bring about a significant change in estimates of children in foster care. However, the first release of data from AFCARS show no significant change in estimates of children in foster care.

Source: Tatara, Tashio. U.S. Child Substitute Care Flow Data for FY 1993 and Trends in the State Child Substitute Care Populations, VCIS Research Notes, No. 11, August 1995. U.S. Bureau of the Census, Statistical Abstract of the United States, 1995 (Washington, DC: U.S. Government Printing Office, 1995).

Table PF 2.3  
Number and Rate (per thousand) of Children Living in Foster Care: 19821994

 
 
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Total Number
(in thousands)
262
269
270
270
280
300
340
383
400
414
427
445
462
                           
Rate 
(per thousand)
4.2
4.3
4.3
4.3
4.5
4.8
5.4
6
6.3
6.4
6.5
6.6
6.8
                           
Note: Estimate of total is the number of children in foster care on the last day of the fiscal year. 1994 is the last year in which data on foster care was collected through the Voluntary Cooperative Information System (VCIS). The Administration on Children and Families (ACF) has implemented the Adoption and Foster are 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. Thus, the new system may bring about a significant change in estimates of children in foster care. However, the first release of data from AFCARS show no significant change in estimates of children in foster care. 

Source: Tatara, Tashio. "U.S. Child Substitute Care Flow Data for FY 1993 and Trends in the State Child Substitute Care Populations," VCIS Research Notes, No. 11, August 1995. U.S. Bureau of the Census, Statistical Abstract of the United States, 1995 (Washington, DC: U.S. Government Printing Office, 1995).


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

NEIGHBORHOODS

PF 3.1 Residential stability

Recent 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 rootedness in a local community and its institutions on the part of frequent movers.8

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, to a low of 17 percent in 1994 (see Table PF 3.1.A).

Differences by Age. Young children were the most mobile of any child age group (see Table PF 3.1.B). In 1994, 22 percent of children under the age of five had changed residences in the previous year, compared to
17 percent among children ages 5-9, 13 percent for ages 10-14, and 15 percent for youth ages 15-17.

Differences by Race and Ethnicity. For all children under age 18 in 1994, 16 percent of white children moved during the previous year compared to 20 percent of black children and 21 percent of Hispanic children. For each group, the youngest children were the most likely to move, and children ages 10-14 were the least likely to move.

Table PF 3.1.A 
Percentage of Children Under Age 18 Who Have Moved Within the Last Year: 19601994

                 
 
1960
1970
1981
1990
1991
1992
1993
1994
 
 
 
 
 
 
 
 
 
                 
Totala 
21
19
18
18
17
18
17
17
                 

Note: aTotal children refers to all children between the ages of 1 and 17. 

Source: U.S. Bureau of the Census, March Current Population Reports, Series P-20, Geographical Mobility, various years.

Table PF 3.1.B 
Percentage of Children Under Age 18 Who Have Moved Within the Last Year, by Age and Race/Ethnicity: 19901994

               
     
1990
1991
1992
1993
1994
     
 
 
 
 
 
All Children
  Totala
18
17
18
17
17
    1-4 Years
24
23
22
23
22
    5-9 Years
19
18
18
17
17
    10-14 Years
15
14
15
14
13
    15-17 Years
15
15
14
14
15
               
White
  Totala
18
17
17
16
16
    1-4 Years
23
22
21
22
21
    5-9 Years
18
17
17
16
16
    10-14 Years
14
13
15
13
12
    15-17 Years
14
14
14
14
13
               
BLACK
  Totala
21
21
21
20
20
    1-4 Years
26
26
27
26
25
    5-9 Years
22
22
22
20
22
    10-14 Years
19
17
18
17
16
    15-17 Years
18
16
16
14
18
               
Hispinic
  Totala
25
21
24
23
21
    1-4 Years
32
27
27
28
26
    5-9 Years
28
20
25
24
20
    10-14 Years
18
19
21
19
15
    15-17 Years
21
19
19
20
21
               

Note: aTotal children refers to all children between the ages of one and 17. 

Source: U.S. Bureau of the Census, March Current Population Reports, Series P-20, Geographical Mobility, various years.


8 Coleman, J. 1988. "Social Capital and the Creation of Human Capital." American Journal of Sociology. 94: s95-s120.
 

PF 3.2 Children in poor/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 low income neighborhoods has been shown to have negative effects on early childhood development and to be associated with higher rates of high school drop out and teen parenthood.9

Overall, one in 20 American children lived in very poor neighborhoods in 1990, defined as census tracts in which 40 percent or more of the residents live in poor families. More than one in five children lived in neighborhoods in which 20 percent or more of the residents live in poor families (see Table PF 3.2).

Differences by Race and Ethnicity. Black children were the most likely to live in very poor neighborhoods, followed by Hispanic children, and at a much lower rate white children. Almost 19 percent of black children live in very poor neighborhoods, compared to 11.3 percent of Hispanic children and 1.2 percent of white children (see Figure PF 3.2).

Differences by Family Structure. Children in single-parent families were much more likely to live in a very poor neighborhood than were children in two-parent families (12.5 percent versus 2.7 percent) (see Figure PF 3.2).

Differences by Family Income. More than one in six poor children (17.5 percent) lived in very poor neighborhoods compared to 2.3 percent of nonpoor children.

Figure PF 3.2  
Percentage of Children Who Live in Very Poor (40+ % Poverty) Neighborhoods: 1990. 

FIGPF3_2.GIF

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

 Source: Tabulations by Paul A. Jargowski from 1990 Census Summary Tape File 3A (CD-ROM version)
 

Table PF 3.2 
Percentage of Children Who Live in Poor Neighborhoods: 1990

     
Neighborhood Poverty Level
     
 
     
20+ % Poor
40+ % Poor
     
 
 
         
Total 
22.9
5
         
  Age of Child    
 
 
0-4
23.5
5.3
 
 
5-17
22.7
4.9
  Family Structure    
    Two Parent
17.3
2.7
    Single Parent
41.2
12.5
  Race/Ethnicity    
    White non-Hispanic and other
12.2
1.2
    Black
56.4
18.6
    Hispanic
46.6
11.3
  Family Poverty    
    In poverty
54.6
17.5
    Not in poverty
16.0
2.3
         
Note: Neighborhoods are defined as census tracts and block-numbering areas. Both metropolitan and nonmetropolitan areas are included. The poverty rate is the percent of all persons in the neighborhood living in families below the poverty line in 1990.  

Source: Tabulations by Paul A. Jargowski from 1990 Census Summary Tape File 3A (CD-ROM version).


9 Brooks-Gunn, J., Duncan, G., Klebanov, P., and 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.
 

SECTION 2 ECONOMIC SECURITY (ES)

POVERTY AND INCOME

ES 1.1 Mean family income

Mean (average) income of families with children is a good starting point for assessing the economic well-being of children since it measures an average familys ability to purchase food, shelter, clothing, child care, and other basic goods and services required to raise children. When mean family income is rising, the likelihood is that children in an average family are enjoying a rising standard of living.

However, mean 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 childrens economic well-being, it is necessary to look at several measures of economic well-being, including those in the following sections.

Accelerating Growth in Family Income Since 1992. Between 1975 and 1992, mean income of families with children (in constant 1995 dollars)1 grew by a very modest average annual percentage rate of 0.4 percent from $42,916 to $45,747, as shown in Figure ES 1.1.A. Between 1992 and 1995, the average annual growth rate accelerated to 3.1 percent.

Growth in Family Income by Family Type. In the past, this rise was not experienced equally across all family types. Between 1975 and 1992, female-headed families enjoyed only a modest 0.3 average annual percentage increase from $18,410 to $20,354, while married-couple families with children showed an average annual increase in average incomes of 0.9 percent, from $47,572 to $55,115.2 However, this difference in growth rates reversed after 1992. Family income increased at an average annual rate of 3.4 percent for married-couple families and 3.9 percent for female-headed families.

Differences in Family Income by Family Type. There has long been a substantial gap in family income between female-headed and married-couple families, and that gap has been growing since 1975 (see Figure ES 1.1.A). In 1995, children in married-couple families enjoyed a substantial income advantage over children in female-headed families, with mean family incomes over 2.8 times as large ($60,854 versus $21,905).
As Table ES 1.1 shows, this disparity is similar within white, black, and Hispanic families with ratios ranging from 2.4 for Hispanics ($38,145 versus $15,945) to 3.0 for black families ($53,078 versus $17,645).

Differences in Mean Family Income by Race and Ethnicity. Mean family incomes are substantially higher for white families with children than for black and Hispanic families with children. Table ES 1.1 shows that, in 1995, whites enjoyed family incomes that were about 65 percent higher than black families, and 71 percent higher than Hispanic families. Among married-couple families, the white-black disparity is considerably smaller, with whites enjoying incomes that are only 16 percent higher. The disparity between whites and Hispanics remains almost as large for married-couple families, however, with white families having average incomes 61 percent higher than their Hispanic counterparts.

Since 1990, the income gap between black and white married couples with children has narrowed, while the incomes of Hispanic married couples with children have lagged behind both white and black married couples with children (see Figure ES 1.1.B). Consequently, black married-couple families earn significantly more than Hispanic married-couple families, with mean family incomes of $53,078 and $38,145, respectively, in 1995.

Among female-headed families, white families with children have an average income of $23,943 in 1995, which is 36 percent higher than that for similar black families ($17,645) and 50 percent higher than that for Hispanic families ($15,945).
 

Figure ES 1.1.A  
Mean Family Income of Families with Children Under Age 18, 1975-1995 (in constant 1995 dollars) 
 

FIGES1_1A.GIF

 
 

Sources: unpublished tables supplied by U.S. Census Bureau.

 
 
 

Figure ES 1.1.B  
Mean Family Income of Married Couple Families with Children Under Age 18, by Race and Ethnicity, 1990-1995  (in constant 1995 dollars)
 

FIGES1_1B.GIF
Sources: unpublished tables supplied by U.S. Census Bureau.

 
 

Table ES 1.1 
Mean Family Income of Families with Related Children Under Age 18,   by Family Type (1995 Dollarsa)
 

 
   
1975 
1980 
1985b 
1990 
1991 
1992c 
1993 
1994 
1995 
 
All families
$42,916 
$44,015 
$45,191 
$47,184 
$45,697 
$45,747 
$48,355 
$49,223 
$50,161 
 
White
-- 
-- 
-- 
$50,029 
$48,763 
$49,319 
$51,977 
$52,796 
$53,189 
 
Black
-- 
-- 
-- 
$29,942 
$28,051 
$27,950 
$28,541 
$30,584 
$32,268 
 
Hispanic
-- 
-- 
-- 
$32,073 
$30,759 
$31,385 
$31,011 
$31,758 
$31,039 
 
Married-couple families
$47,572 
$49,846 
$52,090 
$55,956 
$54,534 
$55,115 
$58,795 
$59,582 
$60,854 
 
White
-- 
-- 
-- 
$56,582 
$55,439 
$56,428 
$59,927 
$60,977 
$61,496 
 
Black
-- 
-- 
-- 
$46,963 
$44,373 
$44,625 
$47,207 
$48,216 
$53,078 
 
Hispanic
-- 
-- 
-- 
$37,906 
$36,541 
$37,740 
$37,712 
$38,059 
$38,145 
 
Female Householder, no
husband present
$18,410 
$19,555 
$19,240 
$20,492 
$19,858 
$19,519 
$20,354 
$21,093 
$21,905 
 
White
-- 
-- 
-- 
$22,421 
$22,086 
$21,714 
$22,608 
$22,699 
$23,943 
 
Black
-- 
-- 
-- 
$16,939 
$15,709 
$15,997 
$16,026 
$18,220 
$17,645 
 
Hispanic
-- 
-- 
-- 
$16,668 
$17,143 
$16,776 
$16,457 
$17,421 
$15,945 
 
Notes: aIncome statistics converted to constant 1995 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) incorpprates such a measure. 
bRecording of amounts for earnings from longest job increased to $299,999.  
cImplementation of 1990 census population controls.  

Source: Unpublished tables supplied by U. S. Census Bureau.


1 In constructing income figures in constant 1995 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.

2 If the CPI-U consumer price index had been used, the average annual growth rate for married-couple families would have been even lower, and the real income of female-headed families would have actually fallen.
 

ES 1.2 Income distribution

Figures ES 1.2.A and ES 1.2.B present trends in the income of the poorest and richest families with children. The poorest families are those whose income falls in the bottom 20 percent (or bottom quintile) of all families; the richest families are those whose income falls in the top 20 percent of all families. The measure shown is the income to poverty ratio, the ratio of annual family income to the poverty line. For example, families whose pretax income was half of the poverty line would have a value of 0.50 for this measure. Each figure shows results separately by type of family.

Between 1967 and 1973 the income to poverty ratio of the poorest families increased from 0.74 to 0.88 (see Figure ES 1.2.A). By 1994, the ratio had dropped to 0.66.

Differences in the Income-to-Poverty Ratio by Family Type. The poorest single-mother families fared much worse than the poorest married-couple families (see Figure ES 1.2.A). After an increase from 0.21 to 0.33 between 1967 and 1973, the ratio for the poorest single-mother families dropped and was at 0.25 in 1994. The poorest married-couple families crossed over the poverty line between 1967 and 1973 (from 0.89 to 1.16, see Figure ES 1.2.A). However, since 1979, their ratio has declined, reaching 1.06 by 1994.

Difference in the Income-to-Poverty Ratio by Income Quintile. While the poorest families with children were getting poorer, the richest families with children were getting richer (see Figure ES 1.2.B). Between 1967 and 1994, the income to poverty ratio of the richest families increased from 4.77 to 7.14.

For the richest married-couple families, the picture was even brighter (see Figure ES 1.2.B). The income to poverty ratio increased from 4.88 to 7.68 between 1967 and 1994. The richest single-parent families headed by women were also well above the poverty line throughout the entire period. Their income to poverty ratio increased from 2.78 to 4.14 between 1967 and 1989 before declining to 4.02 in 1994.

Data for all five income quintiles show that the poorest families (the bottom quintile) were the only families to lose ground between 1967 and 1994 (see Table ES 1.2). For all time periods and all income groups, families headed by single mothers had considerably less income than those headed by married couples.
 

Figure ES 1.2.A  
Income to Poverty Ratio for Families with Children, Bottom Income Quintile, by Family Type, 1967, 1973, 1979, 1989, 1992, and 1994 
 

figes1_2.gif
Note: Poverty thresholds are based on the 1989 distribution of family sizes, with no adjustment for the age of the head of household or the number of children. Quintiles are based on the number of persons. 

Source: Congressional Budget Office tabulations of data from the March Current Population Survey, 1968, 1974, 1980, 1990, 1991, 1992, 1993 and 1995. 

Figure ES 1.2.B  
Income to Poverty Ratio for Families with Children, Top Income Quintile, by Family Type, 1967, 1973, 1979, 1989, 1992 and 1994 
figs1_2b.gif
Note: Poverty thresholds are based on the 1989 distribution of family sizes, with no adjustment for the age of the head of household or the number of children. Quintiles are based on the number of persons. 

Source: Congressional Budget Office tabulations of data from the March Current Population Survey, 1968, 1974, 1980, 1990, 1991, 1992, 1993, and 1995. 

Table ES 1.2 
Average Pretax AFI (Income as a Multiple of Poverty) Among Families with Children, by Family Type and Income Quintile, Weighted by Persons, 1967, 1973, 1979, 1989, 1992, and 1994
 

Family type and Quintile
1967 
1973 
1979 
1989 
1992 
1994 
             
All families with children            
  Lowest Quintile
0.74 
0.88 
0.84 
0.74 
0.65 
0.66 
  Second Quintile
1.54 
1.88 
1.95 
1.87 
1.72 
1.73 
  Middle Quintile
2.13 
2.65 
2.84 
2.93 
2.77 
2.79 
  Fourth Quintile
2.84 
3.54 
3.85 
4.14 
4.00 
4.09 
  Highest Quintile
4.77 
5.73 
6.15 
7.20 
6.86 
7.14 
Total
2.40 
2.94 
3.13 
3.38 
3.20 
3.28 
             
Married couples with children            
  Lowest Quintile
.89 
1.16 
1.18 
1.14 
1.07 
1.06 
  Second Quintile
1.66 
2.12 
2.29 
2.34 
2.25 
2.26 
  Middle Quintile
2.23 
2.84 
3.12 
3.34 
3.26 
3.31 
  Fourth Quintile
2.93 
3.71 
4.11 
4.52 
4.43 
4.58 
  Highest Quintile
4.88 
5.94 
6.41 
7.67 
7.36 
7.68 
Total
2.52 
3.15 
3.42 
3.80 
3.67 
3.78 
             
Single mothers with children            
  Lowest Quintile
0.21 
0.33 
0.32 
0.25 
0.23 
0.25 
  Second Quintile
0.59 
0.71 
0.75 
0.64 
0.58 
0.62 
  Middle Quintile
0.91 
1.03 
1.22 
1.14 
1.06 
1.11 
  Fourth Quintile
1.45 
1.67 
2.01 
2.03 
1.89 
1.94 
  Highest Quintile
2.78 
3.29 
3.65 
4.14 
3.81 
4.02 
Total
1.19 
1.41 
1.59 
1.64 
1.51 
1.59 
             
Note: Poverty thresholds are based on the 1989 distribution of family sizes, with no adjustment for the age of the head of household or the number of children. Quintiles are based on the number of persons.  

Source: Congressional Budget Office tabulations of data from the March Current Population Survey, 1968, 1974, 1980, 1990, and 1993.

ES 1.3 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 ($15,569 for a family of four in 1995) 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,3 to become a teen parent,4 and, as an adult, to earn less and experience greater unemployment.5 The effects of being raised in a family with income significantly below the poverty line are correspondingly more damaging.

Children At, Below, and Slightly Above the Poverty Level. Figures ES 1.3.A and 1.3.B illustrate trends in the proportions of children living in various degrees of poverty and near-poverty. Specifically:

  • 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 line6 doubled from 5 percent in 1975 to 10 percent by 1993. By 1995, this percentage dropped back to 8 percent, still 60 percent higher than in 1975 (see Figure ES 1.3.A).
  • 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 29 percent from 17 percent in 1975 to 22 percent by 1993 before dropping to 20 percent by 1995. The percentage of children in poverty has remained at or above 20 percent since 1990 (see Figure ES 1.3.A).
  • Children above but near the poverty line. In contrast, as shown in the lower line of figure ES1.3.B, the proportion of children at or below 150 percent of the poverty line increased only slightly from 30 percent to 32 percent between 1975 and 1995, and, as shown in the upper line of that figure, the proportion of children at or below 200 percent of the poverty line in 1995 was 43 percent the same as in 1975.

Differences by Race and Ethnicity. There are no substantial differences by race or Hispanic origin in the trends described above, even though the incidence of poverty is consistently highest for blacks and lowest for whites (see Table ES 1.3.A). The increase in the percentage of children raised in extreme poverty occurred for all three groups, while the percentage of children at or below 200 percent of the poverty line has hardly changed at all.

Table ES 1.3.B and Figure ES 1.3.C present a more detailed (but less current) look at poverty by race and Hispanic origin using data from the decennial census.7 They show that the incidence of poverty is lowest by far for white children and highest for black and Native American children. While the incidence of poverty grew noticeably between 1979 and 1989 for all groups, the differences between the groups remained stable:

  • The poverty rate for white children was 12.1 percent in 1989.
     
  • The poverty rate for Asian children was 16.7 percent in 1989, nearly a third higher than for white children.
     
  • The poverty rate for Hispanic children was 31.8 percent in 1989, a rate 2.6 times as high as for white children.
     
  • The poverty rate for Native American children was 38.3 percent in 1989, slightly more than three times the poverty rate for white children.
     
  • The poverty rate for black children was 39.5 percent in 1989, slightly more than three times the white child poverty rate.

Child Poverty by Family Type. 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 1970 through 1995, about 50 percent of the children living in female-headed families were poor (see Table ES 1.3.C). In contrast, during the 1990s,8 only about 10 percent of children living in married-couple families were poor (see Figure ES 1.3.D).
 

Figure ES 1.3.A 
Percentage of Children Under Age 18 in Families Living Below 50% and 100% of Poverty Line 
 

FIGES1_3A.GIF
Source: Rates for 1975, 1980, and 1985 were calculated by Child Trends, Inc. based on data from the U.S. Bureau of the Census, Series P-60, No. 106, Table 7; No. 133, Table 7; No. 158, Table 4. Rates for 1990 through 1993 are from the U.S. Bureau of the Census, Series P-60, No. 175, No. 185, No. 188, and revised data for 1992 provided by the U.S. Bureau of the Census, Poverty Branch. Data for 1994 and 1995 from unpublished tables supplied by the U.S. Bureau of the Census. 

Figure ES 1.3.B 
Percentage of Children Under Age 18 in Families Living Below 150% and 200% of Poverty Line 
 

FIGES1_3B.GIF
Source: Rates for 1975, 1980, and 1985 were calculated by Child Trends, Inc. based on data from the U.S. Bureau of the Census, Series P-60, No. 106, Table 7; No. 133, Table 7; No. 158, Table 4. Rates for 1990 through 1993 are from the U.S. Bureau of the Census, Series P-60, No. 175, No. 185, No. 188, and revised data for 1992 provided by the U.S. Bureau of the Census, Poverty Branch. Data for 1994 and 1995 from unpublished tables supplied by the U.S. Bureau of the Census. 

Figure ES 1.3.C 
Percentage of Children Under Age 18 in Poor Families, by Race/Ethnicity, 1979 and 1989 
 

FIGES1_3C.GIF
Note: 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 $15,569 in 1995. Related children include biological children, stepchildren, and adopted children of the householder (or reference person) by blood, marriage, or adoption.   

Source: U.S. Bureau of the Census, Series P-60, No. 106, Table 11; No. 133, Table 11; No. 158, Table 7; No.175, Table 6; No. 181, Table 5; No. 188, Table 8, data 1994, 1995, and revised data for 1992 provided by the U.S. Bureau of the Census, Poverty Branch. 

Figure ES 1.3.D 
Percentage of Children Under Age 18 in Poor Families, by Family Type, 1970-1995 
 

FIGES1_3D.GIF
Source: U.S. Bureau of the Census, Series P-60, No. 81, Table 4; No. 86, Table 1; P-60, No. 106, Table 11; No. 133, Table 11; No. 158, Table 7; No. 175, Table 6; No. 181, Table 5; No. 188, Table 8, data for 1994, 1995, and revised data for 1992 provided by the U.S. Bureau of the Census, Poverty Branch. 

Table ES 1.3.A 
Percentage of Children Under Age 18 Living Below Selected Poverty Thresholds by Age and Race/Ethnicity, 1975-1995
 

 
1975 
1980 
1985 
1990 
1991 
1992 
1993 
1994 
1995 
 
Under 50% of Poverty
  Related Children  
  Under 18
5 
7 
8 
8 
9 
10 
10 
9 
8 
  White
  Black
14 
17 
22 
22 
25 
27 
26 
23 
20 
  Hispanic
-- 
-- 
-- 
14 
14 
15 
14 
17 
16 
 
Under 100% of Poverty
  Related Children                   
  Under 18
17 
18 
20 
20 
21 
22 
22 
21 
20 
  White
13 
13 
16 
15 
16 
17 
17 
16 
16 
  Black
41 
42 
43 
44 
46 
46 
46 
43 
42 
  Hispanic
33 
33 
40 
38 
40 
39 
40 
41 
39 
 
Under 150% of Poverty
  Related Children                   
  Under 18
30 
29 
32 
31 
32 
33 
33 
32 
32 
  White
24 
24 
26 
25 
26 
27 
27 
27 
26 
  Black
60 
57 
59 
57 
60 
60 
61 
58 
56 
  Hispanic 
-- 
-- 
-- 
55 
58 
58 
60 
58 
59 
 
Under 200% of Poverty
  Related Children                   
  Under 18
43 
42 
43 
42 
43 
44 
44 
43 
43 
  White
38 
37 
38 
37 
38 
38 
38 
38 
37 
  Black
73 
70 
71 
68 
70 
71 
72 
68 
68 
  Hispanic
-- 
-- 
-- 
69 
72 
70 
72 
72 
73 
 
Note: The poverty level is based on money income and does not include noncash benefits, such as foods 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 $15,569 in 1995. The levels shown here are derived from the ratio of the family's income to the family's poverty threshold. 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.  

Source: Rates for 1975, 1980, and 1985 were calculated by Child Trends, Inc. based on data from the U.S. Bureau of the Census, Series P-60, No. 106, Table 7; No. 133, Table 7; No. 158, Table 4. Rates for 1990 through 1994 are from the U.S. Bureau of the Census, Series P-60, No. 175, No. 188, 189, and revised data for 1992 provided by the U.S. Bureau of the Census, Poverty and Health Branch. Data for 1995 are from unpublished tables supplied by the Census Bureau.

Table ES 1.3.B
Percentage of Related Children Under Age 18 in Poverty, by Race and Hispanic Origin, 1979 and 1989
 

 
 1979 
1989 
All Children Under Age 18
16.0 
17.9 
  White  
11.0
12.1 
  Black
37.8 
39.5 
  Hispanic
29.1 
31.8 
  Asian
14.9 
16.7 
  Native American
32.5 
38.3 
 
Note: The poverty level is based on money income and does not include noncash benefits, such as foods stamps. Poverty thresholds reflect family size and composition and are adjusted each year using the annual average Consumer Price Index (CPI) level.
Source: U.S. Bureau of the Census, 1980 Census of the Population, "Detailed Population Characteristics," PC-80-1-D1-A, United States Summary, Table 304. U.S. Bureau of the Census, 1990 Census of the Population, "Social and Economic Characteristics," CP-2-1, United States Summary, Table 49.

Table ES 1.3.C 
Percentage of Children Under Age 18 Living Below the Poverty Level, by Family Type, Age, and Race/Ethnicity, 1960-1995
 

     
1960 
1965 
1970 
1975 
1980 
1985 
1990 
1991 
1992 
1993 
1994 
1995 
All Types of Families w/ 
Related Children 
under 18
27 
21 
15 
17 
18 
20 
20 
21 
22 
22 
21 
20 
    White
20 
14 
11 
13 
13 
16 
15 
16 
17 
17 
16 
16 
    Black
-- 
-- 
42 
41 
42 
43 
44 
46 
46 
46 
43 
42 
    Hispanic
-- 
-- 
-- 
-- 
33 
40 
38 
40 
39 
40 
41 
39 
 
  Related Children 
under 6
-- 
-- 
17 
18 
20 
23 
23 
24 
26 
26 
25 
24 
    White
-- 
-- 
12 
14 
16 
18 
18 
19 
20 
20 
19 
18 
    Black
-- 
-- 
42 
41 
46 
47 
51 
51 
53 
52 
49 
49 
    Hispanic
-- 
-- 
-- 
-- 
34 
41 
40 
44 
43 
43 
44 
42 
 
  Related Children 
6 to 17
-- 
-- 
14 
16 
17 
19 
18 
20 
19 
20 
20 
18 
    White
-- 
-- 
10 
12 
12 
14 
14 
15 
15 
15 
15 
14 
    Black
-- 
-- 
41 
42 
40 
41 
41 
43 
43 
43 
40 
38 
    Hispanic
-- 
-- 
-- 
-- 
32 
39 
36 
37 
37 
38 
39 
37 
 
Married Couple Families w/ 
Related Children under 18
-- 
-- 
-- 
-- 
-- 
-- 
10 
11 
11 
12 
11 
10 
    White
-- 
-- 
-- 
-- 
-- 
-- 
10 
10 
11 
10 
    Black
-- 
-- 
-- 
-- 
-- 
-- 
18 
15 
18 
18 
15 
13 
    Hispanic
-- 
-- 
-- 
-- 
-- 
-- 
27 
29 
29 
30 
30 
28 
 
  Related Children 
under 6
-- 
-- 
-- 
-- 
-- 
-- 
12 
12 
13 
13 
12 
11 
    White
-- 
-- 
-- 
-- 
-- 
-- 
11 
11 
12 
13 
11 
11 
    Black
-- 
-- 
-- 
-- 
-- 
-- 
20 
17 
22 
20 
15 
14 
    Hispanic
-- 
-- 
-- 
-- 
-- 
-- 
28 
33 
32 
33 
33 
31 
                             
  Related Children 
6 to 17
-- 
-- 
-- 
-- 
-- 
-- 
10 
10 
10 
11 
10 
9 
    White
-- 
-- 
-- 
-- 
-- 
-- 
10 
    Black
-- 
-- 
-- 
-- 
-- 
-- 
17 
14 
16 
17 
14 
12 
    Hispanic
-- 
-- 
-- 
-- 
-- 
-- 
25 
26 
26 
28 
28 
27 
 
Female Headed Families w/
Related Children 
under 18
68 
61 
53 
53 
51 
54 
53 
56 
55 
54 
53 
50 
    White
60 
53 
43 
44 
42 
45 
46 
47 
46 
46 
46 
43 
    Black
-- 
-- 
68 
66 
65 
67 
65 
68 
67 
66 
63 
62 
    Hispanic
-- 
-- 
-- 
-- 
65 
72 
68 
69 
66 
66 
68 
66 
 
  Related Children 
under 6
-- 
-- 
64 
62 
65 
66 
66 
66 
66 
64 
64 
62 
    White
-- 
-- 
59 
59 
60 
59 
60 
60 
61 
58 
59 
55 
    Black
-- 
-- 
71 
67 
72 
75 
73 
74 
73 
72 
70 
71 
    Hispanic
-- 
-- 
-- 
-- 
70 
78 
77 
74 
72 
72 
74 
72 
 
  Related Children 
6 to 17
-- 
-- 
49 
49 
46 
48 
47 
50 
49 
49 
47 
45 
    White
-- 
-- 
38 
40 
36 
40 
39 
41 
39 
40 
40 
37 
    Black
-- 
-- 
66 
66 
62 
63 
60 
65 
64 
62 
59 
57 
    Hispanic
-- 
-- 
-- 
-- 
62 
70 
64 
65 
62 
63 
65 
62 
 
Note: The poverty level is based on money income and does not include noncash benefits, such as foods stamps. Poverty thresholds reflect family size and composition and are adjusted each year using the annual average Consumer Price Index (CPI) level. The   

Source: U.S. Bureau of the Census, Series P-60 No. 81, Table 4 No. 86, Table 1; P-60, No. 106, Table 11; No. 133, Table 11; No. 158, Table 7; No. 175, Table 6; No. 181, Table 5; No. 188, Table 8, data for 1994, 1995, and revised data for 1992 provided by 


3 Parker, S., Greer, S., and Zuckerman, B. 1988. "Double Jeopardy: The Impact of Povery on Early Childhood Development." Pediatric Clinics of North America, 35: 1-10.  Hill, M.S., and Duncanc, G.D. 1987. "Parental Family Income and the Socioeconomic Attainment of Children." Social Science Research, 16: 39-37

4 An, C., Haveman, R., and Wolfe, B. 1993. "Teen Out-of-Wedlock Births and Welfare Receipt: The Role of Childhood Events and Economic Circumstances," Review of Economics and Statistics.

5 Duncan, G., and Brooks-Gunn, J. 1996. "Income Effects Across the Life Span: Integration and Interpretation," in Consequences of Growing Up Poor (G. Duncan and J. Brooks-Gunn, eds.). New York: Russell Sage Press.

6 $7,784 for a family of four in 1995.

7 These poverty estimates are based on Decennial Census data rather than the Current Population Survey data presented in other tables. Estimates from the two sources differ because the Current Population has a much smaller sample than the Decennial Census.

8 The only period for which these statistics are published.
 
 

ES 1.4 Lifetime childhood poverty

The majority of children never experience poverty while growing up, and, among those who do, most are in poverty for only a small portion of their childhood. Many children, however, and particularly many black children, spend a large proportion of their formative years living in poverty, with correspondingly negative consequences for their development and well-being.9

Changes in Childhood Poverty Over Time. Although 64 percent of all children who turned age 18 between 1985 and 1987 were never poor, 10 percent were poor for six or more years through age 17 (see Figure ES 1.4.A and Table ES 1.4). Six percent were poor for eleven or more years, and 1 percent were poor for all 17 years. Children turning age 18 three years later show a similar pattern, though they were somewhat more likely to have been poor for a greater number of years, with 14 percent poor for six or more years, and 8 percent poor for eleven or more years.

Differences by Race. The risk of experiencing long-term poverty in childhood varies substantially by race (see Figure ES 1.4.B and Table ES 1.4). Of the nonblack children who turned age 18 between 1988 and 1990, 73 percent never experienced poverty while growing up, only 8 percent were poor for six or more years, and only 4 percent were poor for at least eleven years. By contrast, nearly one half (47 percent) of all black children in that cohort were poor for six or more years, 28 percent for eleven or more years, and 6 percent for all seventeen years of their childhoods.
 

Figure ES 1.4.A  
Percentage of Children in Poverty, by Number of Years in Poverty and Birth Cohort  

FIGES1_4A.GIF
Source: Estimates supplied by Greg J. Duncan, Northwestern University, based on data from the Panel Study of Income Dynamics (PSID). 

Figure ES 1.4.B 
Percentage of Children in Poverty by Number of Years in Poverty by Race, for Cohort Who Turned 18 Between 1988 and 1990 
 

FIGES1_4B.GIF
Source: Estimates supplied by Greg J. Duncan, Northwestern University, based on data from the Panel Study of Income Dynamics (PSID). 

Table ES 1.4 
Percentage of Children in Poverty by Number of Years in Poverty During Childhood, Birth Year, and Race
 

 
-------------------- Number of Years in Poverty ------------------ 
   
Never 
One or More Years 
6 or More Years 
11 or More Years 
17 Years 
 
Turned Age 18 in 1985-1987 

(1967-69 Birth Cohort)

  All children
64 
36 
10 
  Black
24 
75 
37 
23 
  Nonblack
71 
29 
 
Turned Age 18 in 1988-1990 

(1970-72 birth cohort)

  All Children
65 
35 
14 
  Black
28 
72 
47 
28 
  Nonblack
73 
27 
             
Note: * = less than one percent.
Source: Estimates supplied by Greg J. Duncan, Northwestern University, based on data from the Panel Study of Income Dynamics (PSID).


9 Duncan, G. 1995. "Longitudinal Indicators of Children's Poverty and Dependence." Institute for Research on Poverty Special Report Series, SR#60b.
 

FINANCIAL SUPPORT

ES 2.1 Effect of government transfer programs

Although the federal system of cash and near-cash transfers (including federal income and payroll taxes)10 plays a substantial role in reducing the poverty rate of children, its collective effect has varied significantly over time. In 1979, federal cash and near-cash transfers produced a 37 percent reduction in poverty among persons in families with related children under age 18 (see Figure ES 2.1). However, by 1983, the same transfer programs produced only a 19.1 percent reduction in poverty. By 1989 the percentage poverty reduction recovered to 23.9 percent, rose again to 26.5 percent in 1993, and to 32.6 percent in 1994.

In the absence of any federal transfers and taxes, 21.4 percent of all persons living in families with children would have been poor in 1994 (see Table ES 2.1). Social insurance programs other than Social Security reduced the poverty rate to 20.6 percent. The Social Security system reduced the poverty rate further to 19.2 percent. After inclusion of means-tested cash transfers, the poverty rate fell to 17.8 percent. Food and housing benefits cut the poverty rate to 15.3 percent. Finally, the federal tax system reduced the poverty rate of all persons living in families with children to 14.4 percent.

All of the federal cash and near cash transfers considered in Table ES 2.1 except federal taxes reduced poverty among persons in families with related children under age 18 in all years. Until recently, the net impact of the federal tax system was to increase the poverty rate. By 1993, however, the impact of the tax system on the number of such persons in poverty became neutral, and in 1994, the federal tax system reduced the number of persons in poverty. This is because of the recent expansion of the Earned Income Tax Credit (EITC), which provides refundable tax credits to low-income families with children and at least one working parent whose earnings are low. Because the credit is refundable, many families eligible for the EITC receive a payment from the Treasury instead of paying federal income tax.
 

Figure ES 2.1 
Percentage Reduction in the Number of Individuals in Families (with Own Children Under Age 18) Who Are Poor, Resulting from Federal Cash and Near-Cash Transfers 
 

FIGES2_1.GIF
Source: Congressional Budget Office computations using the CBO tax model, with data from the March Current Population Survey, 1980, 1984, 1990, 1994, and 1995. Table prepared by staff from the Department of Health and Human Services, Assistant Secretary for Planning and Evaluation. 

Table ES 2.1 
Antipoverty Effectiveness of Cash and Near-Cash Transfers  (including Federal Income and Payroll Taxes) for All Individuals  in Families with Related Children Less than Age 18
 

 
 
1979 
1983 
1989 
1993 
1994 
 
Total population (in thousands)
133,435 
132,123 
135,430 
144,551 
145,814 
 
Poverty rate (in percent):
  Cash income before transfers
16.6 
21.9 
18.6 
22.3 
21.4 
Plus social Insurance (other than Social Security)
15.8 
20.4 
18 
21.4 
20.6 
Plus Social Security
14.3 
19.1 
16.8 
20.0 
19.2 
Plus means-tested cash transfers
12.9 
18.4 
15.8 
18.7 
17.8 
Plus food and housing benefits
10.2 
16.5 
13.6 
16.4 
15.3 
Less Federal taxes
10.5 
17.7 
14.1 
16.4 
14.4 
 
Total percentage reduction in poverty rate
36.6 
19.1 
23.9 
26.5 
32.6 
 
Source: Congressional Budget Office computations using the CBO tax model, with data from the March Current Population Survey, 1980, 1984, 1990, 1994, and 1995. Table prepared by staff from the Department of Health and Human Services, Assistant Secretary for Planning and Evaluation.


10 Federal cash and near-cash transfers include social security, unemployment compensation, workers' compensation, all means-tested cash transfers, food and housing benefits, and federal income and payroll taxes.
 

ES 2.2 Means-tested assistance: AFDC 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 to needy children, and to certain others in the household of such a child.12 As a result of major welfare reform enacted in August 1996, the AFDC program has now been replaced by the Temporary Assistance to Needy Families program (TANF). 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 new law includes significant new restrictions on food stamp eligibility.

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 2.2). The rate decreased slightly to 11 percent in 1989, but by 1993 had increased to 14 percent. However, by 1995, the recipiency rate dropped back to 12 percent.

More than 7 million children lived in families receiving welfare in 1979 and 1989 (see Table ES 2.2.A). By 1994, 9.5 million children were living in families receiving welfare. In 1995, the number of children on welfare dropped sharply to 8.7 million.

Administrative data show a similar rise in the number of children receiving AFDC between 1985 and 1994 (see Table ES 2.2.C). After peaking at 9.5 million in 1994, the number dropped to 9.2 million in 1995.

Children's Receipt of Food Stamps. Food stamp receipt shows a similar pattern. In both 1979 and 1989, 15 percent of all children lived in households receiving food stamps, according to survey data (see Figure ES 2.2). The proportion increased to 20 percent by 1993. In that year 14.2 million children lived in households receiving food stamps, up from 9.7 million in 1989 (see Table ES 2.2.B). However, the recipiency rate dropped to 18 percent by 1995.

Administrative data for Food Stamps also show a rise in the number of children receiving food stamps during the late 1980s and early 1990s, followed by a recent decline (see Table ES 2.2.C). According to these data, the number of children receiving Food Stamps grew from 9.9 million in 1985 to 14.4 million in 1994. By 1995, the number declined to 13.9 million, or 20.3 percent of the child population.
 

Figure ES 2.2 
Percentage of Children Under Age 18 Living in Families Receiving AFDC (or General Assistance), and in Households Receiving Food Stamps, 1979-1995 
 

FIGES2_2.GIF
Source: Estimates for 19791994 calculated by Child Trends, Inc., based on analysis of the March 1980, 1990, 1994, and 1995 Current Population Surveys. Estimates for 1995 provided by the U.S. Census Bureau. 

Table ES 2.2.A 
Percentage and Number (in thousands) of Children Under Age 18 in Families Receiving AFDC or General Assistance, 1979-1995 

 
 
1979 
1989 
1993 
1994 
1995 
 
Number (in thousands)
7,228 
7,116 
9,440 
9,463 
8,656 
Percent
12 
11 
14 
13 
12 
 
Source: Estimates for 1979 - 1994 calculated by Child Trends, Inc. Based on analysis of the March 1980, 1990, 1994, and 1995 Current Population Surveys. Estimates for 1995 provided by U.S. Census Bureau.

Table ES 2.2.B 
Percentage and Number (in thousands) of Children Under Age 18 in Households Receiving Food Stamps, 1979-1995
 

 
 
1979 
1989 
1993 
1994 
1995 
 
Number (in thousands)
9,336 
9,696 
14,193 
13,667 
13,115 
Percent
15 
15 
20 
19 
18 
 
Source: Estimates for 1979 - 1994 calculated by Child Trends, Inc., based on analysis of the March 1980, 1990, 1994, and 1995 Current Population Surveys. Estimates for 1995 provided by U.S. Census Bureau.

Table ES 2.2.C 
Percentage and Number of Children Under Age 18 Receiving AFDC or Food Stamps According to Administrative Records, 1985-1995 (number of children in thousands)
 

 
1985 
1990 
1991 
1992 
1993 
1994 
1995
 
(est)
AFDC
  Number (in thousands)
7,041 
7,620 
8,375 
9,087 
9,402 
9,464 
9,152 
Percent
11.2 
11.9 
12.9 
13.5 
13.6 
13.9 
13.4 
 
Food Stamps
  Number (in thousands)
9,906 
10,127 
11,952 
13,349 
14,196 
14,391 
13,883 
Percent
15.8 
15.8 
18.4 
20.2 
21.2 
21.2 
20.3 
 
Sources: AFDC information drawn from unpublished data, Administration for Children and Families, U.S. Department of Health and Human Services. 1995 estimate calculated by the Office of the Assistant Secretary for Planning and Evaluation. Food Stamps information drawn from calculations by the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health Services, based on unpublished data from the U.S. Department of Agriculture, Food and Consumer Service.


11 Includes "General Assistance".

12 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." In Overview of Entitlement Programs: 1994 Green Book, Committee on Ways and Means, U.S. House of Representatives.
 

ES 2.3 Lifetime welfare dependence

Chronic welfare receipt is a major concern of policy makers of all political persuasions for several reasons. First, chronic welfare receipt imposes large costs on taxpayers. Second, there is some evidence suggesting that long-term welfare receipt may have a more negative impact on adult recipients and their children than short-term receipt that helps a family weather a crisis.14

Living in a family receiving welfare at some point during childhood is a common experience, affecting 40 percent of all children, 33 percent of non-black children, and 81 percent of black children who turned age 18 in 1991-93 (see Figure ES 2.3.A). Long-term welfare receipt is considerably less common: 10 percent of all children lived in families receiving welfare for 11 or more years of their childhood.

Differences by Race. For black children, however, long-term welfare receipt is considerably more common than for non-black children. Thirty-eight (38) percent of all black children born in the years 1973-1975 spent 11 or more years of their childhood living in families receiving at least some welfare. This contrasts with the experience of non-black children, of whom only 6 percent spent 11 or more years of their childhood in families receiving welfare.

Changes Over Time. Table ES 2.3.A presents data for three cohorts of children turning age 18 in 1985-87, 1988-90, and 1991-93. The data show two contrasting trends in the lifetime experience of welfare receipt among children:

  • On the one hand, there appears to be a small increase in the proportion of children whose families never received welfare, from 57 percent to 61 percent across the three age cohorts. This trend is also evident for black children, where the proportion whose families never received welfare increased from 12 percent to 19 percent.
  • On the other hand, there is also a small increase in the percentage of children who lived in families receiving welfare for at least 11 years, from eight percent in the cohort turning age 18 in 1985-87 to 10 percent for the cohort turning age 18 in 1991-93.

These two trends indicate some polarization of the life experience of children. A slightly greater proportion is growing up in families who are chronically dependent on welfare, even while an increasing proportion of children live in families that manage to avoid welfare altogether.

Welfare Benefits As a Portion of Total Family Income. Of the 10 percent of children in families that received welfare for at least 11 years, fewer than half lived in families in which welfare benefits were at least half of total family income for at least 11 years. Similarly, although 38 percent of black children lived in families receiving welfare for at least 11 years, only 14 percent lived in families in which welfare benefits were at least half of total family income for at least 11 years (see Table ES 2.3.A, right panel). Thus, welfare is a supplement to family income rather than the primary source of income in more than half of the families receiving welfare over the long run.

AFDC Receipt. As shown in Figure ES 2.3.B, when only AFDC benefits are taken into account, the pattern is very similar to the pattern for all welfare benefits. While living in a family receiving AFDC benefits for at least one year is fairly common (19 percent of non-black children and 67 percent of black children), chronic receipt is not. Only 4 percent of non-black children lived in families receiving AFDC benefits for at least 11 years, and only 20 percent of black children lived in such families. Moreover, as shown in Table ES 2.3.B, there is no evidence of increased polarization of children with respect to AFDC receipt.
 

Figure ES 2.3.A 
Percentage of Children Receiving Welfare by Number of Years on Welfare Through Age 17: for Those Who Turned Age 18 in 19911993 
 

FIGES2_3A.GIF
Note: Welfare includes AFDC, Food Stamps, and SSI or "other welfare, which includes local General Assistance." 

Source: Estimates supplied by Greg J. Duncan, Northwestern University, based on data from the Panel Study of Income Dynamics (PSID). 

Figure ES 2.3.B 
Percentage of Children Receiving AFDC by Number of Years on AFDC Through Age 17: for Those Who Turned Age 18 in 19911993 
 

FIGES2_3B.GIF
Source: Estimates supplied by Greg J. Duncan, Northwestern University, based on data from the Panel Study of Income Dynamics (PSID). 

Table ES 2.3.A 
Percentage of Children Receiving Welfare by Number of Years on Welfare  During Childhood, by Year Turned 18 

 
     
NUMBER OF YEARS FAMILY 
RECEIVED ANY WELFARE 
BENEFIT 
NUMBER OF YEARS IN WHICH 
WELFARE BENEFITS WERE 
AT LEAST HALF OF TOTAL 
FAMILY INCOME 
 
______________________________ 
_______________________________ 
 
One or 
Six or 
11 or 
 
One or 
Six or 
11 or 
 
More 
More 
More 
 
More 
More 
More 
Never 
Years 
Years 
Years 
Never 
Years 
Years 
Years 
______ 
______ 
______ 
______ 
______ 
______ 
______ 
______ 
 
Turned age 18 in 1985-1987
(1967-69 birth cohort)
  All children
57 
43 
16 
Black
12 
88 
66 
35 
Non-black
64 
36 
 
Turned age 18 in 1988-1990
(1970-72 birth cohort)
  All children
58 
43 
21 
12 
Black
19 
81 
67 
40 
Non-black
65 
35 
13 
 
Turned age 18 in 1991-1993
(1973-75 birth cohort)
  All children
61 
40 
17 
10 
83 
17 
Black
19 
81 
52 
38 
50 
50 
30 
14 
Non-black
67 
33 
12 
88 
12 
 
Note: Welfare includes AFDC, Food Stamps and SSI or "other welfare, which includes local General Assistance."
Source: Estimates supplied by Greg J. Duncan, Northwestern University, based on data from the Panel Study of Income Dynamics (PSID).

Table ES 2.3.B 
Percentage of Children Receiving AFDC by Number of Years on AFDC During Childhood, by Year Turned 18 

 
 
 
 
 
 
 
 
 
 
   
Number of years family 
received any AFDC 
benefit 
Number of years in which 
AFDC benefits were 
at least half of 
total family income 
 
 
 
 
 
 
 
One or 
Six or 
11 or 
 
One or 
Six or 
11 or 
 
 
 
More 
More 
More 
 
More 
More 
More 
 
 
Never 
Years 
Years 
Years 
Never 
Years 
Years 
Years 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Turned age 18 in 1985-1987 
(1967-69 birth cohort)
 
All children
77 
23 
10 
87 
13 
 
Black
29 
71 
45 
19 
44 
56 
15 
 
Non-black
85 
15 
94 
 
Turned age 18 in 1988 -1990 
(1970-72 birth cohort)
 
All children
71 
28 
15 
84 
17 
 
Black
28 
73 
45 
23 
49 
51 
16 
 
Non-black
80 
20 
91 
10 
 
 
 
 
 
 
 
 
 
 
Turned age 18 in 1991 -1993 
(1973-75 birth cohort)
 
All children
76 
25 
11 
85 
15 
 
Black
34 
67 
39 
20 
54 
47 
23 
10 
 
Non-black
81 
19 
89 
11 
                   
Source: Estimates supplied by Greg J. Duncan, Northwestern University based on data from the Panel Study of Income Dynamics (PSID).


13 For this indicator, "welfare" has been defined to include Aid to Families with Dependent Children, Food Stamps, Supplemental Security Income, and "other welfare," which includes local General Assistance.

14 Duncan, G., and Brooks-Gunn, J. 1996. "Income Effects Across the Life Span: Integration and Interpretation," in Consequences of Growing Up Poor (G. Duncan and J. Brooks-Gunn, eds.).
 

ES 2.4 Sources of family income

Although most families with children receive most of their income from their own earnings and other private sources, federal transfer programs providing both cash and in-kind benefits are an important supplement for many families and the most important source of income for some. Thus, many children's standard of living is significantly affected by these programs. Most families with children pay taxes to the federal government to help pay for these programs.

Federal Cash Benefits. Many families receive some of their income in the form of government transfers, although the overwhelming majority of families (95 percent in 1993), had other, private sources of income as well (see Figure ES 2.4.A).

  • The most common federal cash benefit was the earned Income Tax Credit (EITC)15, which the federal government paid to 29 percent of families with children.
  • The federal government paid cash social insurance benefits (including Social Security, Workers' Compensation, and Unemployment Insurance benefits) to 20 percent of families with children.
  • Cash benefits from the AFDC program were paid to 16 percent of families with children.
  • Supplemental Security Income (SSI) benefits were provided to only 4 percent of families with children.
  • A small percentage of families with children received cash benefits from other means-tested cash programs.

Single-parent families with children are less likely than married-couple families with children to have pre-transfer income (see Table ES 2.4.A). While 98 percent of married-couple families with children had pre-transfer income, only 85 percent of single-parent families had income before transfers. It is not surprising, therefore, that single-parent families with children were more likely than married-couple families with children to receive means-tested cash benefits. For example, while only 6 percent of married-couple families received AFDC benefits, 40 percent of single-parent families received these benefits.

Federal In-Kind Benefits. Many families also receive in-kind benefits from the federal government (see Figure ES 2.4.A).

  • The federal government provided food stamps to 20 percent of families with children.
  • Housing benefits were provided to 6 percent of families with children.

Single-parent families with children were much more likely than married-couple families to receive in-kind benefits (see Table ES 2.4.A). For example, while only 9 percent of married-couple families received food stamps, 45 percent of single-parent families did so. Similarly, only one percent of married-couple families received housing benefits, but 17 percent of single-parent families did so.

Federal Taxes. Most families with children pay both social security (FICA) taxes16 and federal income taxes (see Figure ES 2.4.B). In 1993, 91 percent of all families with children paid social security taxes, while 76 percent paid federal income taxes. Married-couple families were more likely than single-parent families to pay federal taxes. While 97 percent of married-couple families paid social security taxes, only 76 percent of single-parent families did so. Similarly, while 88 percent of married-couple families paid federal income taxes, only 48 percent of single-parent families did so.
 

Figure ES 2.4.A  
Percentage of All Families with Children Receiving Various Sources of Income, 1993 

FIGES2_4A.GIF
Source: 1994 Current Population Survey, as processed by the Urban Institute's TRIM model. 
Figure ES 2.4.B  
Percentage of All Families with Children Who Pay Federal Taxes, by Type of Tax and Family Type, 1993 
FIGES2_4B.GIF
 
Source: 1994 Current Population Survey, as processed by the Urban Institute's TRIM model. 

Table ES 2.4.A 
Percentage of Families with Children Receiving Various Sources of Income, by Family Type, 1993

 
 
Single-Parent 
Married-Couple 
All 
 
______ 
______ 
______ 
Pre-transfer income
85 
98 
95 
 
Cash Benefits
  Social insurance income
21 
20 
20 
 
AFDC
40 
16 
SSI
Other means-tested cash benefits
 
In-Kind Benefits
  Food Stamps
45 
20 
 
Housing
17 
 
Earned income tax credit
51 
19 
29 
 
 
Source: 1994 Current Population Survey, as processed by the Urban Institute's Transfer Income Model (TRIM), which simulates for a representative sample of the U.S. population eligibility for and payment of cash and in-kind benefits based upon the characteristics of the persons, families, and households contained in the sample. TRIM also simulates the payment of federal income and payroll taxes for this same representative sample. The results of TRIM simulations may differ from the results produced by other data sets or models because, for most programs, TRIM uses data corrected for under- and non-reporting. In the case of the Earned Income Tax Credit (EITC), for example, TRIM estimates differ from those of the U.S. Treasury because TRIM assumes that nearly everyone who is eligible for the EITC actually receives it. In reality, some ineligible families receive it and some eligible families do not. The errors do not exactly offset one another.

Table ES 2.4.B 
Percentage of Families with Children with Federal Tax Liability, by Family Type, 1993

 
 
 
 
 
 
 
Single-Parent 
Married-Couple 
All 
 
 
 
 
 
Social Security (FICA)
76 
97 
91 
 
 
     
Federal Income Tax
48 
88 
76 
         
Source: 1994 Current Population Survey, as processed by the Urban Institute's Transfer Income Model (TRIM), which simulates for a representative sample of the U.S. population eligibility for and payment of cash and in-kind benefits based upon the characteristics of the persons, families, and households contained in the sample. TRIM also simulates the payment of federal income and payroll taxes for this same representative sample. The results of TRIM simulations may differ from the results produced by other data sets or models because, for most programs, TRIM uses data corrected for under- and non-reporting. In the case of the Earned Income Tax Credit (EITC), for example, TRIM estimates differ from those of the U.S. Treasury because TRIM assumes that nearly everyone who is eligible for the EITC actually receives it. In reality, some ineligible families receive it and some eligible families do not. The errors do not exactly offset one another.


15 This benefit is paid to families with children, at least one working parent, and relatively low family income. If the credit is larger than a family's federal income tax liability, the difference is refunded to the family. The 29 percent figure refers only to families that received a refund and not to families whose EITC only partially offset their federal income tax liability.

16 FICA taxes cover the Old Age, Survivors, and Disability Insurance (Social Security) program plus Medicare.
 

ES 2.5 Child support nonpayment

The issue of child support has gained in importance in recent years. As rates of divorce and non-marital birth have risen, an increasing proportion of children and their custodial parents must depend on this source of income for financial support, and suffer correspondingly 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, 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. Among those who do have court orders, about half (49 percent) do not receive all of the money they are owed in a given year.17

Table ES 2.5 shows the proportion of families who had court orders for child support but received no support at all for selected years between 1978 and 1991. Estimates are presented for all eligible families, and separately for population subgroups defined by marital status (married, divorced, separated, and never married) and race/ethnicity (white, black, and Hispanic). During that time period, the proportion of all eligible families who received no support whatsoever ranged between 21 and 28 percent. Rates of nonpayment decreased somewhat from 1978 to 1985, from 28 to 21 percent, then rose to about 25 percent by the end of the decade. This general historical pattern is consistent regardless of marital status, race, or ethnicity.

Differences by Marital Status. Women who are separated or never married were substantially less likely to have court orders for child support than those who were divorced, or who had remarried.18 Once a court order is established, however, the rates of nonpayment appear to be fairly similar across all marital status groups. In 1991, for example, rates of nonpayment ranged from about 24 percent for divorced women to 28 percent for never married women.19

Differences by Race and Ethnicity. In most years, eligible white families experienced lower rates of nonpayment than either black or Hispanic families. For example, in 1991, the most recent year for which estimates are available, the percentage of eligible families receiving no payment was 23 percent for whites, 31 percent for blacks, and 35 percent for Hispanics.

Methods of Payment. Some custodial parents receive their child support payments directly from the non-custodial parent or that parent's place of employment. 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. Families receiving AFDC and Medicaid benefits are required to cooperate with their state's child support enforcement agency. Other families may request these services. Since fiscal year 1992, collections made by child support enforcement agencies have increased by nearly 40 percent, from $8 billion in fiscal year 1992 to $11 billion in fiscal year 1995.20 For the same period, paternity establishments increased more than 40 percent and child support orders increased 16 percent.
 

Table ES 2.5 
Child Support Nonpayment: Percentage of Eligible Women  Who Are Not Receiving Child Support, 1978-1991

 
 
1978 
1981 
1983 
1985 
1987 
1989 
1991a 
______ 
______ 
______ 
______ 
______ 
______ 
______ 
Total ........................
28 
23 
24 
21 
24 
25 
25 
 
Marital Status
  Married ...........
32 
25 
28 
24 
27 
28 
25 
  Divorced ..............
27 
23 
24 
21 
22 
23 
24 
  Separated ..............
27 
16 
13 
12 
26 
20 
26 
  Never Married ..............
19 
27 
24 
20 
17 
27 
28 
 
Race/Ethnicity
  White ..............
27 
23 
23 
21 
23 
24 
23 
  Black ..............
37 
23 
31 
22 
27 
30 
31 
  Hispanic ..............
35 
29 
38 
26 
25 
30 
35 
 
Note: aEstimates for 1991 were produced using somewhat different assumptions then in previous years, and should not be contrasted with earlier estimates.
Eligible Families are those with court orders for child support.
Source: 1978-1987 data from Child Support and Alimony, Series P23, Nos. 112, 140, 141, 154, and Current Population Reports Series P60, No. 173. Data for 1991 from Current Population Reports Series P60, No.187.


17 Child Support for Custodial Mothers and Fathers. Current Population Reports Series P60, No. 187.

18 Ibid.

19 In some years rates of nonpayment appear to be substantially smaller for women who were separated or never married than for those who are divorced or remarried, but estimates for the former groups are based on small samples sizes which are subject to greater error. Disparities in sample size may account for the apparent cross-group differences in those years. ( See, for example, years 1983, 1985, and 1987)

20 Preliminary data from the Office of Child Support Enforcement, U.S. Department of Health and Human Services.
 

PARENTAL AND YOUTH EMPLOYMENT

ES 3.1 Parental labor force participation

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.21 These factors have reduced the percentage of children who have a parent at home full time. Figure ES 3.1 presents data on the percentage of children who have all resident parents participating in the labor force22 at some level for the years 1985, 1990, and 1994 through 1996.

Parents in the Labor Force by Family Type. Between 1985 and 1996, the percentage of children who have all resident parents in the labor force increased from 59 percent to 66 percent (see Figure ES 3.1). Since 1990, the percentage of children who have all resident parents participating in the labor force has been similar for both married-couple families and single-mother families. In 1996, the rate was 64 percent for married-couple families and 66 percent for single-mother families. The rate for children in single-father families has remained much higher, at 88 percent.

Parents in the Labor Force by Age of Child. Children under age 6 have been less likely than older children to have all resident parents in the labor force (see Table ES 3.1). In 1996, 58 percent of younger children had all resident parents in the labor force, compared with 70 percent for older children.

Parents in the Labor Force by Race and Ethnicity. Between 1985 and 1990, white children, black children, and Hispanic children all became more likely to have all their resident parents in the labor force (see Table ES 3.1). However, between 1990 and 1996, the rates stayed virtually the same for blacks and Hispanics, and increased modestly for whites. By 1996, 66 percent of white children, 64 percent of black children, and 50 percent of Hispanic children lived in families in which all resident parents were working.
 

Figure ES 3.1  
Percentage of Children with Both Parents or Only Resident Parent in the Labor Force: 1985-1996 

FIGES3_1.GIF
 
Sources: 1985, 1990, 1994, and 1995 statistics calculated by Child Trends, Inc., based on the March 1985, 1990, 1994, and 1995 Current Population Surveys. 1996 statistics calculated by the U.S. Bureau of the Census based on the 1996 Current Population Survey. 

Table ES 3.1 
Percentage of Children with Both Parents or Only Resident Parent in the Labor Force: 1985-1996

               
     
1985 
1990 
1994 
1995 
1996 
     
______ 
______ 
______ 
______ 
______ 
               
All children .........
59 
63 
64 
65 
66 
  < age 6 .........
51 
55 
56 
59 
58 
  age 6-17 .........
63 
67 
68 
69 
70 
               
Family type
               
  Married-couple .........
57 
61 
63 
65 
64 
    < age 6 .........
51 
54 
57 
59 
58 
    age 6-17 .........
61 
65 
67 
68 
67 
               
  Single-mother .........
61 
63 
62 
64 
66 
    < age 6 .........
49 
51 
52 
54 
56 
    age 6-17 .........
67 
70 
68 
69 
72 
               
  Single-father .........
89 
88 
86 
88 
88 
    < age 6 .........
90 
90 
85 
86 
86 
    age 6-17 .........
89 
88 
86 
88 
89 
               
Race/ethnicity group
               
  White .........
59 
63 
64 
66 
66 
    < age 6 .........
51 
55 
57 
59 
58 
    age 6-17 .........
63 
67 
68 
70 
70 
               
  Black .........
60 
63 
62 
64 
64 
    < age 6 .........
54 
55 
56 
57 
58 
    age 6-17 .........
63 
67 
66 
67 
68 
               
  Hispanic .........
45 
50 
49 
50 
50 
    < age 6 .........
40 
44 
41 
44 
43 
    age 6-17 .........
48 
54 
54 
54 
55 
               
               
Sources: 1985, 1990, 1994 and 1995 statistics calculated by Child Trends, Inc., based on the March 1985, 1990, 1994, and 1995 Current Population Surveys. 1996 statistics calculated by the U.S. Bureau of the Census based on the 1996 Current Population Survey.


21 Bianchi, S. M. 1995. "Changing Economic Roles of Women and Men" in State of the Union: American in the 1990s: Volume I. Reynolds Farley (ed.). New York: Russell Sage Foundation, 1995.

22 Participating in the labor force means either working or looking for work.
 

ES 3.2 Maternal employment

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 low-wage 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.A). From 1990 to 1995, rates increased at a slower pace from 63 percent to 66 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.A. In 1995, 54 percent of mothers with children under age 3 were employed, compared to 62 percent and 73 percent for mothers with youngest children ages 3-5 and 6-17, respectively.

Differences by Race and Ethnicity. In 1995, 67 percent of white mothers, 62 percent of black mothers, and 49 percent of Hispanic mothers were employed (see Table ES 3.2.A). Black mothers were the most likely to be employed full-time (50 percent). Although all three groups substantially increased their rates of employment between 1980 and 1990, only white mothers continued to increase their rate of employment substantially between 1990 and 1995.

Differences by Marital Status. Throughout the period between 1988 and 1995, divorced mothers had higher rates of employment than never-married or currently married mothers. Employment increased from 62 percent to 67 percent for married mothers, from 40 to 48 percent for never-married mothers, and from 75 to 77 percent for divorced mothers.

Full-Time Versus Part-Time Employment. As shown in Figure ES 3.2.B, among all employed mothers, 70 percent were working full time in 1995. Employed mothers with older children were more likely to work full time than those with young children, with rates ranging from 65 percent for mothers with children under age 3, to 73 percent for mothers with a youngest child between the ages of 6 and 17. Divorced mothers were more likely to work full time (83 percent) than never-married mothers (72 percent) and married mothers (68 percent). Black mothers who were employed were more likely to work full time (82 percent) than white mothers (68 percent).
 

Figure ES 3.2.A  
Percentage of Mothers Who Are Employed, by Age of Youngest Child: 1980-1995 
FIG3_2A.GIF
 
Note: Percentages for 1980 are not presented separately by marital status and full-time vs. part-time due to incompatibilities with definitions used in later years. Sums may not add to totals due to rounding. Source: Unpublished tables, Bureau of Labor Statistics, based on analyses of March Current Population Surveys for 1980, 1988, 1990, 1994, and 1995 

Figure ES 3.2.B  
Percentage of Employed Mothers Who Worked Full Time, 1995 

FIG3_2B.GIF
 
 
Source: Unpublished tables, Bureau of Labor Statistics, based on analysis of March Current Population Survey for 1995. 

Table ES 3.2.A 
Maternal Employment: Percentage of Mothers with Children Under Age 18 Who were Employed, Full Time and Part Time,a 1980-1995

 
1980 
1988 
1990 
1994 
1995 
______ 
______ 
______ 
______ 
______ 
Total Employed
53 
60 
63 
64 
66 
 
Working Full Time 
-- 
44 
46 
45 
46 
 
Working Part Time 
-- 
16 
17 
19 
19 
 
Age of Youngest Child
< Age 3 Employed
37 
47 
50 
52 
54 
  Working Full Time
-- 
32 
34 
34 
35 
  Working Part Time
-- 
15 
16 
18 
19 
 
Ages 3-5 Employed
50 
57 
61 
60 
62 
  Working Full Time
-- 
40 
43 
41 
42 
  Working Part Time
-- 
17 
18 
19 
20 
 
Ages 6-17 Employed
60 
70 
70 
72 
73 
  Working Full Time
-- 
53 
53 
53 
53 
  Working Part Time
-- 
17 
17 
19 
19 
 
Marital Status
Married, Spouse Present Employed
-- 
62 
63 
66 
67 
  Working Full Time
-- 
43 
44 
45 
45 
  Working Part Time
-- 
19 
19 
21 
22 
 
Never Married Employed 

 

-- 
40 
45 
46 
48 
  Working Full Time
-- 
32 
36 
34 
35 
  Working Part Time
-- 
12 
13 
 
Divorced Employed
-- 
75 
75 
74 
77 
  Working Full Time
-- 
66 
66 
63 
64 
  Working Part Time
-- 
11 
13 
 
Race/Ethnicity
White Employed
52 
62 
63 
65 
67 
  Working Full Time
-- 
44 
44 
45 
46 
  Working Part Time
-- 
18 
19 
20 
21 
 
Black Employed
54 
56 
61 
58 
62 
  Working Full Time
-- 
48 
53 
47 
50 
  Working Part Time
-- 
11 
11 
 
Hispanic Employed
42 
49 
50 
48 
49 
  Working Full Time
-- 
38 
39 
36 
37 
  Working Part Time
-- 
11 
11 
12 
12 
 
Note: aPercentages for 1980 are not presented separately by marital status and full-time vs. part-time due to incompatibilities with definitions used in later years. Sums may not add to totals due to rounding.
Source: Unpublished tables, Bureau of Labor Statistics, based on analyses of March Current Population Surveys for 1980, 1988, 1990, 1994, and 1995.

Table ES 3.2.B 
Number and Percentage of Employed Mothers Who Worked Full Time, 1995

 
   
Full time (thousands) 
Part time (thousands) 
Total 
(thousands)
 
  Percentage   
Full time
 
   
   
________ 
________ 
________ 
________ 
 
All mothers
16,349 
6,846 
23,195 
70 
 
Age of youngest child
  < age 3
3,385 
1,787 
5,172 
65 
  3-5
2,982 
1,433 
4,415 
68 
  6-17
9,982 
3,626 
13,608 
73 
Marital status
  Married
11,642 
5,553 
17,195 
68 
  Never married
1,267 
487 
1,754 
72 
  Divorced
2,340 
477 
2,817 
83 
 
Race/ethnicity group
  White
13,010 
6,040 
19,050 
68 
  Black
2,552 
567 
3,119 
82 
  Hispanic
1,621 
506 
2,127 
76 
 
Source: Unpublished Tables, Bureau of Labor Statistics, based on analysis of March Current Population Survey for 1995.
 

ES 3.3 Parental labor force detachment

Attachment to the labor force is, for the vast majority of families, a necessary prerequisite for financial and social stability. Children who have no parents in the labor force are at considerably higher risk of poverty, which can have long-term negative consequences for their well-being.23,24

Figure ES 3.3 presents trends in the proportion of children living in families where there were no resident parents attached to the labor force. Data are presented for 1985, 1990, and 1994 through 1996, by family type, age of child, and race/ethnicity. During that period, approximately one in 10 children lived in families in which all resident parents were detached from the labor force. The percentages fluctuated within a narrow range throughout the period.

Labor Force Detachment by Family Type and Age of Child. The rate of parental labor force detachment for children in married couple families was very low, fluctuating between 2 and 3 percent between 1985 and 1996. However, detachment rates for children in families headed by single mothers were more than ten times higher throughout the period. In 1985, 39 percent of children living in single-mother families had a nonworking mother (see Figure ES 3.3). This percentage dropped to 34 percent by 1996. For children under age 6 in single-mother families, the reduction was somewhat larger, from 51 percent in 1985 to 44 percent in 1996 (see Table ES 3.3).

In families headed by single mothers, mothers of children under age six were more likely to be detached from the labor force than mothers of older children. The gap between the two age groups has narrowed over time, however, decreasing from 26 percentage points in 1985 (59 percent versus 33 percent) to 16 percentage points in 1996 (44 percent versus 28 percent). Children living in families headed by single fathers experienced parental labor force detachment rates between 11 and 14 percent during this time period. This is substantially less than rates experienced by children in families headed by single mothers (12 percent versus 34 percent in 1996), but substantially higher than those in married-couple families (2 percent).

Labor Force Detachment by Race and Ethnicity. White children were much less likely than black or Hispanic children to have no resident parents in the labor force in 1996, with rates of 7 percent, 25 percent, and 17 percent, respectively.
 

Figure ES 3.3 
Parental Labor Force Detatchment: Percentage of Children with No Resident Parent in the Labor Force, 1985-1996 

FIGES3_3.GIF
Sources: 1985, 1990, 1994, and 1995 statistics calculated by Child Trends, Inc., based on analyses of the March 1985, 1990, 1994, and 1995 Current Population Surveys. 1996 statistics calculated by the U.S. Bureau of the Census based on the 1996 Current Population Survey. 

Table ES 3.3  
Parental Labor Force Detachment: Percentage of Children With No Resident Parent in the Labor Force, 1985-1986

 
 
1985 
1990 
1994 
1995 
1996 
______ 
______ 
______ 
______ 
______ 
All children  
11 
10 
12 
11 
11 
  < age 6  
12 
13 
14 
14 
13 
  age 6-17  
10 
9 
11 
10 
9 
 
Family type
  Married-couple  
3 
2 
3 
3 
2 
    < age 6  
    age 6-17  
                 
  Single-mother  
39 
37 
38 
36 
34 
    < age 6  
51 
49 
48 
46 
44 
    age 6-17  
33 
30 
32 
31 
28 
                 
  Single-father  
11 
12 
14 
12 
12 
    < age 6  
10 
10 
15 
14 
14 
    age 6-17  
11 
12 
14 
12 
11 
                 
Race/ethnicity group
  White  
8 
7 
9 
8 
7 
    < age 6  
11 
10 
    age 6-17  
                 
  Black  
27 
26 
27 
27 
25 
    < age 6  
33 
34 
33 
33 
32 
    age 6-17  
24 
21 
24 
23 
21 
                 
  Hispanic  
19 
17 
19 
19 
17 
    < age 6  
20 
19 
22 
21 
20 
    age 6-17  
19 
16 
18 
17 
15 
 
 
Sources: 1985, 1990, 1994 and 1995 statistics calculated by Child Trends, Inc., based on analyses of the March 1985, 1990, 1994, and 1995 Current Population Surveys. 1996 statistics calculated by the U.S. Bureau of the Census based on the 1996 Current Population Survey.


23 Blau, F., and Grossberg, A. 1992. "Maternal Labor Supply and Children's Cognitive Development, "Review of Economics and Statistics.

24 Duncan, G., and Brooks-Gunn, J. 1996. "Income Effects Across the Life Span: Integration and Interpretation," in Consequences of Growing Up Poor (G. Duncan and J. Brooks-Gunn, eds.).
 

ES 3.4 Secure parental labor force attachment

Parents' full-time employment over the course of an entire year indicates a secure attachment to the labor force and produces a degree of financial security for their children. As shown in Table ES 3.4, the percentage of children in families with at least one securely attached parent increased from 69 percent to 74 percent over the parental attachment to the labor force by racial and ethnic groups, poverty status, age of children, and family structure.

Differences by Race and Ethnicity. The parents of children in white families consistently have the highest rates of secure attachment to the labor force. Throughout the entire 1984-1995 period, more than 70 percent of white children had at least one parent with a secure labor force attachment. In 1995, the rate for white children was 78 percent (see Figure ES 3.4). In contrast only about half of black children and about 60 percent of Hispanic children lived in families with at least one parent who was securely attached to the labor force. In 1995 the rate for black children was 53 percent, and the rate for Hispanic children was 61 percent.

Differences by Poverty Status. Secure parental labor force attachment is associated with escaping poverty (see Figure ES 3.4). In 1995, only 25 percent of poor families with children had at least one parent with a secure labor force attachment while 86 percent of nonpoor families had at least one securely attached parent. The percentage of poor families with at least one parent securely attached to the labor force has increased over the period from 20 percent in 1984 to 25 percent in 1995.

Differences by Age of Children. Secure parental labor force attachment is more common among families with older children. In 1995, 78 percent of families with children ages 12 through 17 had at least one parent who was securely attached to the labor force, compared to 69 percent of families with children younger than age six (see Figure ES 3.4).

Differences by Family Structure. Married-couple families are far more likely than other family types to have at least one parent securely attached to the labor force. In 1995, 87 percent of married-couple families had at least one securely attached parent. In contract, only 38 percent of the single-mother families and 67 percent of the single-father families had a securely attached parent (see Figure ES 3.4).
 

Figure ES 3.4  
Secure Parental Labor Force Attachment: Percentage of Children Under Age 18 with At Least One Fully Employed (full-time, full-year) Resident Parent: 1995 

FIGES3_4.GIF
Source: 1995 statistics calculated by the U.S. Bureau of the Census based on the 1985 and 1996 Current Population Surveys. 

Table ES 3.4  
Secure Parental Labor Force Attachment: Percentage of Children with At Least One Fully Employed (full-time, full-year) Resident Parent in the Labor Force, 1984-1995

   
1984 
1989 
1993 
1994 
1995 
   
______ 
______ 
______ 
_______ 
_______ 
Total
69 
73 
71 
73 
74 
Race/Ethnicity
  White
73 
78 
76 
77 
78 
  Black
48 
51 
49 
52 
53 
  Hispanic
58 
62 
57 
59 
61 
Poverty Status
  Poor
20 
22 
21 
24 
25 
  Nonpoor
83 
85 
85 
86 
86 
Child's Age
  < age 6
65 
69 
67 
68 
69 
  11-Jun
70 
74 
72 
73 
75 
  17-Dec
73 
78 
75 
76 
78 
Family Structure
  Married-couple
80 
85 
85 
86 
87 
  Single-mother
32 
34 
33 
35 
38 
  Single-father
61 
64 
61 
60 
67 
 
Source: 1984 - 1994 statistics calculated by Child Trends, Inc., based on analyses of the March 1985, 1994 and 1995 Current Population Surveys. 1995 statistics calculated by U.S. Bureau of the Census based on analyses of the March 1996 Current Population Survey.
 
 

ES 3.5 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. Yet the quality of care varies substantially in the United States.25 Research has clearly demonstrated that child care quality can have substantial impacts on the development of a young child's personality, cognitive skills, social skills, and well-being.

Child Care Centers and Preschools. As shown in Table ES.3.5.A, 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. By 1993, 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 23 percent in 1993.

Child Care in a Non-Relative's Home. For children of full-time working mothers, care in a non-relative's home peaked at 27 percent in the mid-1980s, then declined to 18 percent by 1993. Similarly, for children whose mothers worked part time, care in a non-relative's home peaked at 19 percent in 1982 and has since declined to 14 percent.

Care by Fathers and Other Relatives. The fraction of children of full-time working mothers cared for by fathers or other relatives in the child's home was 28 percent in 1993 exactly the same as in 1965. The fraction of children of part-time working mothers cared for by fathers or other relatives in the child's home was 38 percent in 1993 about the same as in 1977 and slightly higher than in 1965.

Child Care Arrangements by Various Child and Family Characteristics. Table ES.3.5.B presents 1993 estimates of the distribution of child care types used by all working mothers (regardless of hours worked) by child's race/ethnicity, 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:

  • Prior to age 3, the most common arrangement for child care is in another home by either a relative or non-relative. Forty percent for children under age one and 37 percent of children ages 1-2 whose mothers are employed are in this kind of care arrangement.
  • For children ages 3-4 whose mothers are employed, the most common arrangement for care is child care centers and preschools. Thirty-nine percent of children are in this care arrangement. Twenty-four percent are cared for by a relative or non-relative in another home. Hispanic families, however, are much less likely than white and black non-Hispanics to use day care centers and preschools.
  • Children with mothers of higher socioeconomic status are the most likely to be receiving care from a day care center or preschool. For example, 20 percent of poor children under age 5 receive care from such sources, compared to 31 percent of non-poor children. Only 20 percent of children whose mothers have less than a high school diploma receive care from a day care center or preschool, compared to 36 percent of children whose mothers have a college degree. In contrast, 52 percent of children of poor mothers are cared for by relatives compared with only 40 percent of children of non-poor mothers, and 54 percent of children of mothers without a high school diploma are cared for by relatives compared with only 31 percent of children of mothers with a college degree.
  • Children whose families participate in the Aid to Families with Dependent Children (AFDC) program appear somewhat less likely than other children to attend day care centers or preschools (26 percent for participants versus 30 percent for nonparticipants). They are also less likely to be cared for by their fathers (5 percent for participants versus 16 percent for nonparticipants). However, 40 percent of children in AFDC families are cared for by other relatives compared with only 24 percent for children whose families do not participate in AFDC.

Table ES 3.5.A 
Percentage of Children Under Age Five with Employed Mothers in Differing Child Care Arrangements, by Employment Status, 1965-1993

 
 
1965a,b 
1977b 
1982b 
1984-85 
1988 
1991 
1993 
Mother Employed Full - Time
Day care center or preschool
15 
20 
30 
31 
28 
34 
Non-relative care in provider's home
20 
27 
25 
27 
27 
21 
18 
Grandparent/other relative in relative's home
18 
21 
21 
16 
14 
14 
17 
Father in child's home
10 
11 
11 
10 
15 
11 
Other care in child's home
37 
18 
16 
13 
13 
15 
15 
Other care outside child's homec
 
Mother Employed Part - Time
Day care center or preschool
17 
17 
15 
23 
Non-relative care in provider's home
16 
19 
14 
17 
13 
14 
Grandparent/other relative in relative's home
13 
16 
16 
11 
11 
13 
Father in child's home
23 
23 
21 
22 
27 
29 
25 
Other care in child's home
24 
20 
20 
18 
14 
17 
15 
Other care outside child's homec
33 
19 
26 
13 
14 
15 
10 
 
 
Notes: aData for 1965 are for children under 6 years old.  
bData for 1982 and earlier are based on survey questions that asked about care arrangements for youngest child in the family. Percentages for 1982 and earlier have been recalculated after removal of cases in "don't know" category.  
cIncludes children who are cared for by their mother at work, or in kindergarten or school-based activities.
Source: U. S. Bureau of the Census, Current Population Reports, Series P-70, No. 9, P-70, No. 30, and P-70, No. 36, Who's Minding the Kids? Child Care Arrangements: Winter 1984-1985, 1988 and 1991, 1987, Table 3; 1992, Table 1; and 1994, Table 1; Series P-23, No. 117, Trends in Child Care Arrangements of Working Mothers, Table A; and Series P-70, No. 53, Who's Minding Our Preschoolers?, Table 1: U.S. Government Printing Office, Washington, D.C.

Table ES 3.5.B 
Percentage of Children Under Age Five with Employed Mothers in Differing Child Care Arrangements, by Selected Characteristics, 1993

 
Day care centera 
Father in child's home 
Other Relative in child's home 
Non- relative in child's home 
Relative in another home 
Non- relative in another home 
Mother cares for childb 
Other care Arrange- mentsc 
 
______ 
_______ 
_______ 
_______ 
______ 
_______ 
_______ 
_______ 
All preschoolers
30 
16 
10 
5 
15 
17 
6 
1 
Race/ethnicity
  White, not Hispanic
31 
17 
14 
18 
  Black, not Hispanic
33 
18 
21 
14 
  Hispanicd
21 
15 
16 
23 
13 
  Other  
24 
18 
18 
13 
13 
 
Age of child
  Less than 1 year
19 
17 
10 
18 
22 
  1-2 years
24 
17 
11 
18 
19 
  3-4 years
39 
14 
12 
12 
 
Marital status
  Married, husband present
30 
19 
14 
16 
  All other marital statusese
29 
20 
20 
17 
 
Educational attainment
  Less than high school
20 
17 
20 
17 
15 
  High school, 4 years
27 
17 
11 
20 
16 
  College, 1-3 years
32 
16 
15 
16 
  College, 4 or more years
36 
14 
10 
19 
 
Poverty levelf
  At or below poverty
20 
16 
14 
7 
22 
12 
8 
1 
  Above poverty
31 
16 
9 
5 
15 
17 
6 
1 
 
Monthly family incomef
  Less than $1,200
20 
16 
11 
23 
15 
  $1,200 to $2,999
26 
20 
19 
15 
  $3,000 to $4,499
29 
18 
10 
14 
19 
  $4,500 and over
39 
10 
10 
11 
17 
 
Program Participation
  AFDC recipient
26 
18 
22 
16 
  AFDC nonrecipient
30 
16 
15 
17 
 
aIncludes day care centers, nursery schools, and pre-schools.     dPersons of Hispanic origin may be of any race.
bIncludes mothers working at home or away from home. eIncludes widowed, separated, divorced, and never married.
cIncludes preschoolers in kindergarten and school-based activities. fOmits preschoolers whose families did not report income.
Source: U.S. Bureau of the Census, Current Population Reports, Series P-70, No. 53, Who's Minding Our Preschoolers? Table 2.

25 Whitebook, M., Phillips, D., and Howes, C. 1989. National Child Care Staffing Study. Oakland, CA: Child Care Employees Project; and Hayes, C.D., Palmer, J.L., and Zaslow, M.J. (Eds.). 1990. Who Cares for America's Children? Child Care Policy for the 1990s. Washington, D.C.: National Academy Press.
 

ES 3.6 Detached Youth

"Detached youth" refers to young people ages 16-19 who are neither 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.26

Since 1975, the percentage of detached youth has fluctuated between 9 and 12 percent (see Table ES 3.6). In 1994, 10 percent of all youth ages 16-19 were detached.
 

Table ES 3.6 
Detached Youth: Percentage of 16-19 Year Olds  Who Are Both Not in School and Not Working,a 1975-1994

                 
 
1975 
1980 
1985 
1990 
1991 
1992 
1993 
1994 
 
_______ 
_______ 
_______ 
_______ 
_______ 
_______ 
_______ 
_______ 
Percent
12 
11 
11 
10 
10 
10 
10 
                 
Note: aThe figures represent a yearly average based on responses for the nine months youth typically are in school (September through May). Youth are asked about their activities for the week prior to the survey.
 
Source: Special tabulations of Current Population Survey microdata prepared by the Bureau of Labor Statistics. 


26 Brett Brown. 1996. "Who are America's Disconnected Youth?," report prepared for the American Enterprise Institute.
 

HOUSING

ES 4.1 Inadequate housing

Housing is a major expense for most families. 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.27

Table ES 4.1 presents recent trends in the physical quality of housing for children, reporting the percentage of families with children under age 18 living in housing units with moderate to severe physical problems as defined by the U.S. Department of Housing and Urban Development.28 Data are presented for every other year from 1985 through 1993. Across this time period, the percentage of children's households with moderate to severe physical problems fluctuated slightly from 9 percent in 1985 to 7 percent in 1993.29

Differences by Type of Family. Data are also presented separately for three types of households containing children: married couples, other types of households containing two or more adults (which could include, for example, cohabiting couples, adult siblings, mother and grandmother, or adult house mates), and households with one or no adult. The data consistently indicate that married-couple families with children are the least likely to experience housing with physical problems as defined here, followed by households with one or no adult, and households with two or more adults who are not married. In 1993, for example, 6 percent of married-couple households with children, 10 percent of households with one or no adult, and 11 percent of households with two or more unmarried adults lived in housing with moderate to severe physical problems (see Figure ES 4.1).
 

Figure ES 4.1  
Inadequate Housing: Percentage of Households Containing Children Under Age 18 in Housing with Moderate to Severe Physical Problems: 1993 

FIGES4_1.GIF
 
Note: Physical problems include problems with plumbing, heating, electricity, upkeep, and/or hallways. For detailed definitions of "moderate" and "severe" physical problems, see American Housing Survey for the United States, 1993, page A-13. 
Source: Current Housing Reports: American Housing Survey for the United States for 1993. 

Table ES 4.1 
Inadequate Housing: Percentage of Households Containing Children Under Age 18 in Housing with Moderate to Severe Physical Problems, 1985-1993

   
1985 
1987 
1989 
1991 
1993 
------- 
------ 
------ 
------ 
------ 
All Households with Children under Age 18
9 
8 
9 
9 
7 
  Married couples
  Other households with two or more adults
15 
15 
13 
14 
11 
  Households with one or no adults
12 
13 
13 
13 
10 
 
Note: Physical problems include problems with plumbing, heating, electricity, upkeep, and/or hallways. For detailed definitions of "moderate" and "severe" physical problems, see American Housing Survey for the United States, 1993, page A-13.
Source: Current Housing Reports: American Housing Survey for the United States for 1985, 1987, 1989, 1991, and 1993.

27 U.S. Department of Health and Human Services and U.S. Department of Education. 1995. The JOBS Evaluation: How Well 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. See also Blackman, T., Evason, E., Melaugh, M. And Woods, R. 1989. Housing and Health: a Case Study of Two Areas in West Belfast. Journal of Social Policy, 18(1): 1-26.

28 Physical problems can include problems with plumbing, heating, electricity, upkeep, and/or hallways.

29 It is not clear whether or not this downward trend is statistically significant. The level of fluctuation in this estimate from year to year would indicate that the contrast may be the result of random error.

SECTION 3 HEALTH CONDITIONS AND HEALTH CARE (HC)

MORTALITY

HC 1.1.a Infant mortality

Infancy is commonly divided into the neonatal period, the first 27 days of life, and the postneonatal period, 28 days to less than one 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 (one year and younger) are congenital anomalies, disorders relating to a short gestation period and low birth weight, and sudden infant death syndrome (SIDS).1 In 1995, 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 1995.2

The U.S. infant mortality rate has decreased rapidly over the past three decades. Between 1960 and 19953 the rate fell from 26.0 to 7.5 infant deaths per thousand live births (see Figure HC 1.1.A.1). There was a steep decline in the rate of neonatal deaths (from 18.7 to 4.8 infant deaths per thousand live births) and a smaller, more gradual decline in the rate of postneonatal deaths (from 7.3 to 2.7 infant deaths per thousand 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 1992, the rate of infant deaths per thousand live births was 4.5 in Japan, 6.6 in the United Kingdom, 6.8 in France, and 6.2 in Germany, compared to 8.5 deaths per thousand live births in the United States in that year.4 The Russian Federation, in contrast, has an infant mortality rate of 18.4 deaths per thousand live births.

Differences by Race and Ethnicity. While infant mortality rates have declined for all races and ethnic groups in the United States, there is nevertheless considerable variation by race and ethnicity (see Figure HC 1.1.A.2). Specifically:3
 

  • For white infants, the infant mortality rate has declined by 72 percent between 1960 and 1995 from 22.9 to 6.3 deaths per thousand live births (see Table HC 1.1.A.1).
  • For black infants, the infant mortality rate has declined by 66 percent between 1960 and 1995 from 44.3 to 14.9 deaths per thousand live births (see Table HC 1.1.A.1).
  • For Hispanic infants, the infant mortality rate has declined by 24 percent between 1985 and 1994 from 8.6 to 6.5 deaths per thousand live births (see Table HC 1.1.A.1).


    For Asian infants, the infant mortality rate has declined by 20 percent from an average of 8.3 deaths per thousand live births during the period 1983-1985 to an average of 6.6 deaths per thousand live births during the period 1989-19915 (see Table HC 1.1.A.2).

  • For Native American infants, the infant mortality rate declined by nine percent from an average of 13.9 deaths per thousand live births during the period 1983-1985 to an average of 12.6 deaths per thousand live births during the period 1989-1991 (see Table HC 1.1.A.2).

Figure HC 1.1.A.1 
Infant, Neonatal, and Postneonatal Deaths Per Thousand Live Births, 1960-1995 

HC1_1A1.gif

Notes: Includes births and deaths of persons who were not residents of the 50 states and the District of Columbia. Data by race for 1960 are by race of child; all other years are by race of mother. Data for 1995 are preliminary.
Source: National Center for Health Statistics. Health, United States, 1995. Hyattsville, Maryland: Public Health Service. 1996. Table 23 for totals and race breaks. Data for 1994 and 1995 data from: Births and Deaths: United States, 1995. Monthly Vital Statistics Report; Vol. 45, No. 3, Supplement 2. Hyattsville, Maryland: Public Health Service, 1996.
 

Figure HC 1.1.A.2 
Infant Deaths Per Thousand Live Births, by Race and Hispanic Origin,a 1960-1995 

HC1_1A2.GIF

Note: aHispanic rates not available prior to 1985. Infant mortality by Hispanic-origin 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; and 49 States and the District of Columbia in 1993 and 1994. bIncludes births and deaths of persons who were not residents of the 50 states and the District of Columbia. cData by race for 1960 are by race of child; all other years are by race of mother. dData for 1995 are preliminary.
Source: National Center for Health Statistics. Health, United States, 1995. Hyattsville, Maryland: Public Health Service. 1996 (table 23 for totals and race breaks). 1970 data from: National Center for Health Statistics. Vital Statistics of the United States, 1992. Vol. II, Mortality, Part A. Washington: Public Health Service. 1996 (table 2-2). Hispanic data for 1985 from: National Center for Health Statistics: Vital Statistics of the United States, 1985, Vol. II, Mortality, Part A. Washington: Public Health Service. 1988 (table 2-19). 1990 Hispanic data from: Monthly Vital Statistics Report. Vol. 41, No. 7 (Supplement), January, 1993 (table 26). 1991 Hispanic data from: Monthly Vital Statistics Report, Vol. 42, No. 2 (Supplement), August, 1993 (table 25). 1992 Hispanic data from: Monthly Vital Statistics Report, Vol. 43, No. 6 (Supplement), March, 1995 (table 28). 1993 Hispanic data from: Monthly Vital Statistics Report, Vol. 44, No. 7(s), February, 1996 (table 32). 1994 Hispanic data from: Singh, G.K., Kochanek, K.D., and MacDorman, M.F. Advance Report of Final Mortality Statistics, 1994. Monthly Vital Statistics Report, Vol. 45, No. 3. Hyattsville, Maryland: Public Health Service, 1996 (table 25). Data for 1994 and 1995 from: Rosenberg, H.M., Ventura, S.J., Maurer, J.D., Heuser, R.L. and Freedman, M.A. Births and Deaths: United States, 1995. Monthly Vital Statistics Report; Vol. 45, No. 3, Supplement 2. Hyattsville, Maryland: Public Health Service, 1996 (table 13).
 
 

Table HC 1.1.A.1
nfant, Neonatal, and Postneonatal Deaths per Thousand Live Births, by Race and Hispanic Origin, 1960-1995

 
 
 
 
 
 
 
 
 
 
 
 
   
1960a,b
1970
1980
1985
1990
1991
1992
1993
1994
1995c
 
 
 
 
 
 
 
 
 
 
 
 
Infant (under one year)
Death Rate 
26
20
12.6
10.6
9.2
8.9
8.5
8.4
8
7.5
 
White
22.9
17.6
10.9
9.2
7.6
7.3
6.9
6.8
6.6
6.3
 
Black
44.3
33.3
22.2
19
18
17.6
16.8
16.5
15.8
14.9
 
Hispanicd
 
 
 
8.6
7.8
7.5
6.8
6.7
6.5
 
 
 
 
 
 
 
 
 
 
 
 
 
Neonatal (under 28 days)
Death Rate 
18.7
15.1
8.5
7
5.8
5.6
5.4
5.3
5.1
4.8
 
White
17.2
13.7
7.4
6
4.8
4.5
4.3
4.3
4.2
4
 
Black
27.8
23.2
14.6
12.6
11.6
11.2
10.8
10.7
10.2
9.6
 
Hispanicd
 
 
 
5.4
5
4.6
4.3
4.1
4.1
 
 
 
 
 
 
 
 
 
 
 
 
 
Postneonatal (28 days to under one year)
Death Rate 
7.3
4.9
4.1
3.7
3.4
3.4
3.1
3.1
2.9
2.7
 
White
5.7
4
3.5
3.2
2.8
2.8
2.6
2.5
2.4
2.2
 
Black
16.5
10.1
7.6
6.4
6.4
6.3
6
5.8
5.6
5.3
 
Hispanicd
 
 
 
3.2
2.8
2.8
2.5
2.6
2.5
 
                       
Notes: aIncludes births and deaths of persons who were not residents of the 50 states and the District of Columbia. 
bData by race for 1960 are by race of child; all other years are by race of mother.  
cData for 1995 are preliminary. 
dInfant mortality by Hispanic-origin 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; and 49 States and the District of Columbia in 1993 and 1994. 

Source: National Center for Health Statistics. Health, United States, 1995. Hyattsville, Maryland: Public Health Service. 1996 (table 23 for totals and race breaks). 1970 data from: National Center for Health Statistics. Vital Statistics of the United States, 1992. Vol. II, Mortality, Part A. Washington: Public Health Service. 1996 (table 2-2). Hispanic data for 1985 from: National Center for Health Statistics: Vital Statistics of the United States, 1985, Vol. II, Mortality, Part A. Washington: Public Health Service. 1988 (table 2-19). 1990 Hispanic data from: Monthly Vital Statistics Report. Vol. 41, No. 7 (Supplement), January, 1993 (table 26). 1991 Hispanic data from: Monthly Vital Statistics Report, Vol. 42, No. 2 (Supplement), August, 1993 (table 25). 1992 Hispanic data from: Monthly Vital Statistics Report, Vol. 43, No. 6 (Supplement), March, 1995 (table 28). 1993 Hispanic data from: Monthly Vital Statistics Report, Vol. 44, No. 7(s), February, 1996 (table 32). 1994 Hispanic data from: Singh, G.K., Kochanek, K.D., and MacDorman, M.F. "Advance Report of Final Mortality Statistics, 1994." Monthly Vital Statistics Report, Vol. 45, No. 3. Hyattsville, Maryland: Public Health Service, 1996 (table 25). Data for 1994 and 1995 from: Rosenberg, H.M., Ventura, S.J., Maurer, J.D., Heuser, R.L. and Freedman, M.A. " Births and Deaths: United States, 1995." Monthly Vital Statistics Report; Vol. 45, No. 3, Supplement 2. Hyattsville, Maryland: Public Health Service, 1996 (table 13).

 
 

Table HC 1.1.A.2 
Infant, Neonatal, and Postneonatal Deaths Per Thousand Live Births for Asians and Native Americans, Combined Years: 1983-1985, 1986-1988 and 1989-1991

     
1983-1985
1986-1988
1989-1991
     
 
 
 
Infant (under 1 year)
  Infant Death Rate (All Races)
10.6
9.8
9
    Asiana
8.3
7.3
6.6
    Native Americanb
13.9
13.2
12.6
 
Neonatal (under 28 days)
  Neonatal Death Rate (All Races) 
6.9
6.3
5.7
    Asiana
5.2
4.5
3.9
    Native Americanb
6.7
5.9
5.9
 
Postneonatal (28 days to one year)
  Postneonatal Death Rate (All Races) 
3.7
3.5
3.3
 
 
Asiana
3.1
2.8
2.6
    Native Americanb
7.2
7.3
6.7
 
aIncludes Pacific Islanders. 
bIncludes Alaskan Natives.  
Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Data computed by the Division of Health and Utilization Analysis from data compiled by the Division of Vital Statistics for the National Linked Files of Live Births and Infant Deaths.


1 Rosenberg, H.M., Ventura, S.J., Maurer, J.D., Heuser, R.L., and M.A. Freedman. "Births and Deaths:United States, 1995." Monthly Vital Statistics Report. Vol. 45, No. 3 (Supplement 2). Hyattsville, Md.: National Center for Health Statistics. 1996.

2 Press release from the U.S. Department of Health and Human Services. "Reduction in SIDS Deaths Helps Bring Low Infant Mortality." October 9, 1996.

3 1995 data are preliminary.

4 National Center for Health Statistics. "Health, United States, 1995." Hyattsville, Maryland: Public Health Service. 1996.

5 Infant mortality data for Asians and Native Americans are presented from the national linked birth and infant death files in Table HC 1.1.A.1. Rather than relying solely on the often inaccurate reporting of race on death certificates of infants, the linked files use race from birth certificates and, therefore, provide more accurate data for these populations. The National Linked Birth and Infant Death Files data are available from 1983-1991. The linked files will be produced on a regular basis again beginning with 1995 data.

 

HC 1.1.b Child and youth mortality

Injuries are a common cause of death for children of all ages.6 Among children ages one to four, injuries accounted for 44 percent of all deaths in 1993. Following injury, the leading causes of death in this age group were congenital anomalies, malignant neoplasm, diseases of the heart, and HIV or AIDS.7 Injuries accounted for 52 percent of deaths to children ages five through 14 in 1993, and 80 percent of all deaths to adolescents ages 15 through 19.8

Overall, child mortality rates have decreased substantially over the past several decades9 (see Table HC 1.1.B.1). In 1994, the latest year for which data were available, mortality rates per 100 thousand were 42.9 for one- through four-year-olds, 19.9 for five- through nine-year-olds, 25.2 for 10- through 14-year-olds, and 86.8 for 15- through 19-year-olds.

Differences by Age. The most dramatic declines in mortality occurred among children under age 15 with decreases of approximately 60 percent among children ages one to four and five to nine, and a 43 percent decrease among children ages 10 through 14 since 1960 (see Figure HC 1.1.B.1). Most of the decline in the mortality rate for these groups occurred between 1960 and 1990; mortality rates since then have been fairly constant. In contrast, mortality rates for youth ages 15 through 19 have decreased by only six percent since 1960. Moreover, unlike the fairly steady declines among the younger age groups, the adolescent mortality rate has had a variable pattern over the last thirty years (see Figure HC 1.1.B.1).

Differences by Race and Ethnicity. Multiyear data from the National Center for Health Statistics is used to examine the differences in the mortality rate of children and youth for several racial and ethnic groups across two time periods 1989-1991 and 1992-1993 (see Table HC 1.1.B.2). For both children and youth ages one to 14 and ages 15 to 24, blacks have the highest mortality rate, followed by Native Americans, Hispanics and whites. Asian children and youth consistently have the lowest mortality rate. The disparity in mortality rates by race and ethnic group is greater among youth ages 15 to 24 than among children ages one to 14 (see Table HC 1.1.B.2).

The mortality rate for children ages one to 14 decreased for all racial and ethnic groups except Native Americans between the periods 1989-1991 and 1992-1993. In contrast, the mortality rate for youth ages 15 to 24 declined only for whites and Native Americans, and increased for blacks, Hispanics and Asians across these two time periods.

Differences by Race for Younger Children. Data for earlier decades are available only for black and white children (see Table HC 1.1.B.1). These data show substantial differences between white and black children since at least 1970 for children ages one through four, five through nine, and 10 through 14. By 1994, the mortality rate for black children ages 10 through 14 was nearly 65 percent higher than the rate for white children in that age group, 81 percent higher for children ages five though nine, and twice as high for children ages one through four.

Differences by Race For Adolescents. The blackwhite disparity among adolescents ages 15 through 19 was substantial in 1970, but had declined by 1980 to the point where black youth registered lower mortality rates than white youth (see Figure HC 1.1.B.2). This reversal was short lived, however. Black mortality rates surged from a low of 85.2 per 100 thousand in 1985 to 145.0 per 100 thousand by 1994, while white mortality rates remained fairly stable. Much of this recent increase in black teen mortality reflects a substantial increase in black teen male homicide rates, which are reviewed in Section HC 1.2.B of this report.

Differences by Gender. Male child death rates are higher than female rates for all age groups, but the differences are far more pronounced for the older age groups, for whom violent and injury-related deaths disproportionately affect males10 (see Table HC 1.1.B.1).
 
 

Figure HC 1.1.B.1 
Child and Youth Mortality Rates by Age Group, 1960-1994 
(rates per 100,000 population in age group) 

HC1_1B1.GIF

Source: National Center for Health Statistics (NCHS), unpublished data provided by the Statistical Resources Branch and Gardner, P. and Hudson, B.L. Advance Report of Final Mortality Statistics, 1993. National Center for Health Statistics. 1996.
 
 

Figure HC 1.1.B.2 
Mortality Rates for White and Black Youth Ages 15 to 19, 1970-1994 (rates per 100,000 population in age group) 

HC1_1B2.GIF

Source: National Center for Health Statistics (NCHS), unpublished data provided by the Statistical Resources Branch and Gardner, P. and Hudson, B.L. Advance Report of Final Mortality Statistics, 1993. National Center for Health Statistics. 1996.
 
 

Table HC 1.1.B.1 
Child and Youth Mortality Rates by Age Group, Gender and Race:  Selected Years, 1060 to 1994 (rates per 100,000 population in age group)

         1960 1965 1970 1975 1980 1985 1990 1991 1992 1993 1994
1-4 years
 All Children
109.1
95.9
84.5
69.9
63.9
51.8
46.8
47.4
43.6
44.8
42.9
Gender
   Male
119.5
104.3
93.2
76.7
72.6
58.5
52.4
52.0
48.0
49.5
47.3
  Female
98.4
87.1
75.4
62.7
54.7
44.8
41.0
42.7
39.0
39.9
38.2
Race
   White
95.2
83.2
75.1
63.3
57.9
46.6
41.1
41.7
38.1
38.3
36.5
  Black
__
__
140.0
106.2
97.6
80.7
76.8
79.7
73.2
79.1
77.2
 5-9 years 
 All children
49.0
43.9
42.1
35.2
30.4
25.0
22.2
21.5
20.4
21.1
19.9
Gender
   Male
56.3
50.8
49.7
41.4
35.0
28.5
25.6
24.5
23.7
23.2
22.6
  Female
41.5
36.8
34.2
28.6
25.6
21.4
18.5
18.4
16.8
19.0
17.0
Race
   White
46.2
40.8
39.9
33.0
28.4
22.9
20.3
19.8
18.3
19.0
17.6
  Black
__
__
56.4
47.4
41.7
36.2
32.3
32.0
32.1
32.9
31.8
 10-14 years
 All Children
44.0
40.5
40.6
35.3
30.8
28.0
26.0
25.8
24.6
25.6
25.2
Gender
  Male
55.0
50.9
51.3
44.9
38.3
35.0
31.6
32.9
30.7
31.7
31.2
  Female
32.6
29.7
29.5
25.3
22.9
20.6
20.2
18.2
18.2
19.2
18.8
Race
  White
41.4
38.6
38.4
33.7
29.8
27.0
24.3
24.2
22.8
23.7
23.0
  Black
__
__
54.6
44.3
36.6
34.8
36.6
36.4
35.3
37.2
37.9
 15-19 years
 All Children
92.2
95.3
110.3
100.2
97.9
80.5
87.9
89.0
84.3
86.9
86.8
Gender
  Male
130.1
136.0
157.8
145.4
141.4
113.4
127.2
128.6
122.4
126.0
126.6
  Female
54.0
53.9
61.7
53.8
53.1
46.2
46.4
47.2
44.0
45.6
44.8
Race
  White
87.9
90.9
103.1
98.0
99.1
80.2
81.4
80.5
75.6
77.0
76.8
  Black
__
__
158.0
114.4
92.3
85.2
127.7
141.2
135.5
143.6
145.0
                             
Source: National Center for Health Statistics (NCHS), unpublished data provided by the Statistical Resources Branch and Gardner, P. and Hudson, B.L. "Advance Report of Final Mortality Statistics, 1993." National Center for Health Statistics. 1996.

 
 

Table HC 1.1.B.2
Child and Youth Mortality Rates by Age Group, Gender, Detailed Race and Hispanic Origina for 1989-1991 and 1992-1993 (rates per 100,000 population in age group)

 
     
Combined Years 1989-1991
Combined Years 1992-1993
     
Total
Male
Female
Total
Male
Female
     
 
 
 
 
 
 
ONE TO 14 Years
  All Races
31.4
36.2
26.3
29.3
33.7
24.6
    White
28.4
32.8
23.8
26.1
30.3
21.7
    Black
48.3
56.1
40.3
47.1
53.4
40.7
    Asianb
22.7
25.3
20.0
20.3
23.1
17.4
    Native Americanc
37.3
45.1
29.2
38.9
47.0
30.6
    Hispanic Origin
30.2
34.7
25.5
28.4
32.4
24.2
 
15 TO 24 YEARS
  All Races
99.1
146.1
50.0
97.0
144.0
47.9
    White
89.3
129.5
47.0
84.2
122.3
44.1
    Black
161.9
254.9
69.8
174.8
279.5
70.6
    Asianb
50.1
70.8
28.1
56.1
80.1
31.1
    Native Americanc
142.0
208.3
71.1
129.4
184.2
71.4
    Hispanic Origin
103.3
156.5
40.9
107.5
167.3
40.2
 
Note: aPersons of Hispanic origin may be of any race. The four race groups listed in the table include persons of Hispanic and non-Hispanic origin. Death rates reported for white, black, and Hispanic persons are based on highly consistent information. However, persons identified as American Indian or Asian in the data from the Census Bureau (denominator of death rates) are sometimes misreported as white on the death certificate (numerator), resulting in underestimate of about 22-30 percent for death rates of American Indians and 12 percent for death rates of Asians (National Centers for Health Statistics, Health United States 1993, Table 33; Sorlie, P.D., Rogot E., and Johnson, N.J. "Validity of demographic characteristics on the death certificate," Epidemiology 3(2): 181-184, 1992). 
bAsian and Pacific Islander. 
cNative American or Alaskan Native. 

Source: 1989-1991 data from: Centers for Disease Control and Prevention, National Center for Health Statistics (1994), Health United States 1993, Table 32; NCHS: Data computed by the Division of Analysis from data compiled by the Division of Vital Statistics and from national population for race groups from national population estimates for race groups. 1992-1993 data computed by Infant and Child Health Studies Branch, National Center for Health Statistics from Mortality Data compiled by Division of Vital Statistics.


6 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.

7 Gardner, P., and Hudson, B.L. (1996) "Advance Report of Final Mortality Statistics, 1993." Monthly Vital Statistics Report. Vol. 44, No.7 (S). Hyattsville, Maryland: National Center for Health Statistics; and, National Center for Health Statistics (1996). 1993 Detail Mortality File. Unpublished data. Cited in: Health Resources & Services Administration. Child Health USA 95. DHHS Pub. No. HRSA-M-DSEA-96-5. Public Health Service, Washington, 1996.

8 Discussion and data regarding motor vehicle crashes, the largest category of injury-related death for 15-19 year olds, follows in the next section [HC 1.2].

9 Health Resources & Services Administration. Child Health USA 95. DHHS Pub. No. HRSA-M-DSEA-96-5. Public Health Service, Washington, 1996.

10 Section HC 1.2 further highlights the differences in mortality rates between males and females ages 15-19 for violent and injury-related deaths.
 

HC 1.2.a Youth motor vehicle deaths

Motor vehicle deaths are among the leading causes of injury-related mortality11 for 15- to 19-year-olds, accounting for approximately 40 percent of all teenage injury deaths in 1993.12 However, as a fraction of all violent deaths to teens, motor vehicle crashes have declined. In 1994, motor vehicle deaths claimed 29.3 lives per 100 thousand teens ages 15 through 19, compared to 43.6 per 100 thousand teens in 1970 (see Figure HC 1.2.A). Slight increases in the rate of motor vehicle crash deaths among youths were seen in 1993 and 1994.

Differences by Gender and Race. The decrease in the rate of youth motor vehicle deaths between 1970 and 1994 has been greatest among males, falling from 67.1 to 41.7 deaths per 100 thousand among white males, and from 43.4 to 29.0 deaths per 100 thousand among black males (see Table HC 1.2.A). Among females ages 15 through 19, rates declined less dramatically over this period, from 24.4 to 21.3 per 100 thousand for whites, and from 11.1 to 10.4 per 100 thousand for blacks.

Differences by Age. Among youth ages 10 through 14, motor vehicle death rates are quite low in comparison to older youth, and have dropped from 9.6 to 6.0 per 100 thousand between 1970 and 1994. This decline was evident for both white and black males and females, with most of the decline occurring before 1990.
 

Figure HC 1.2.A 
Youth Motor Vehicle Crash Deaths: 1970-1994 (rate per 100,000) 

HC1_2A.GIF

Source: National Center for Health Statistics, unpublished work tables prepared by the Mortality Statistics Branch, Division of Vital Statistics, 1995, and 1996.
 

Table HC 1.2.A
Youth Motor Vehicle Crash Deaths: Selected Years, 1970-1994 
(rate per 100,000)

Population
Groups
1970
1975
1980
1985
1990
1991
1992
1993
1994
 
 
 
 
 
 
 
 
 
 
 
All youth
  Ages 10-14
9.6
8.4
8.1
7.4
6.4
6.1
5.5
5.9
6.0
  Ages 15-19
43.6
38.4
43.0
33.5
33.1
31.2
28.2
28.6
29.3
 
White males
  Ages 10-14
12.6
10.9
10.9
9.8
7.7
7.8
7.0
7.1
7.5
  Ages 15-19
67.1
61.7
69.1
51.3
49.3
44.5
39.6
41.6
41.7
 
White females
  Ages 10-14
6.6
5.8
5.7
5.6
5.3
4.4
4.1
4.4
4.8
  Ages 15-19
24.4
20.6
25.6
22.6
22.2
23.0
21.0
20.2
21.3
 
Black males
  Ages 10-14
11.9
9.6
7.9
8.9
7.9
8.8
7.8
8.3
7.6
  Ages 15-19
43.4
24.6
24.4
22.1
28.7
29.5
26.2
26.7
29.0
 
Black females
  Ages 10-14
6.4
4.2
4.0
3.0
3.8
3.3
3.6
4.8
4.8
  Ages 15-19
11.1
7.1
6.7
7.5
9.7
9.0
9.1
8.2
10.4
 
Source: National Center for Health Statistics, unpublished work tables prepared by the Mortality Statistics Branch, Division of Vital Statistics, 1995 and 1996.


11 Injury-related mortality is the leading cause of death for 15-19 year old teenagers, accounting for 80% 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.

12 National Center for Health Statistics (1996). 1993 Detail Mortality File. Unpublished data.
 
 

HC 1.2.b Youth homicides

The rate of death from homicide for teens ages 15 through 19 more than doubled between 1970 and 1994, increasing from 8.1 per 100 thousand in 1970 to 20.3 per 100 thousand in 1994 (see Table HC 1.2.B.1). Virtually all of this increase has taken place since 1985 (see Figure HC 1.2.B.1).

Male Youth Homicide Rates by Race. As large as the overall increase has been, this trend has been most alarming for males ages 15 to 19. The rate of death from homicide for this age group of black males has increased dramatically from 46.7 per 100 thousand in 1985 to 135.8 per 100 thousand in 1994, a rate nearly nine times that for white males of the same age (see Figure HC 1.2.B.2). The homicide rate for black males aged 15 to 19 actually declined nearly 30 percent from 1970 to 1985, but rose again after 1985. Even with slight declines in the homicide rate in 1992 and 1994, the rate for young black males has nearly tripled since 1985. While the homicide rate for white males of the same age group (15 through 19) is substantially less than that of black males, this rate has also doubled since 1985 (from 7.2 to 15.4 per 100 thousand), and has tripled since 1970.

Female Youth Homicide Rates by Race. Homicide rates for females ages 15 through 19 of both races are considerably lower than among males in this age group. For example, the rate for black females was 15.1 per 100 thousand in 1994, approximately one-ninth 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 1994, the homicide rate for white females ages 15 through 19 was 3.4 deaths per 100 thousand, nearly 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 four and one half times higher in 1994.

Homicide Rates for Younger Youth. The homicide rate for youth ages 10 through 14 was 2.2 per 100 thousand in 1994 substantially lower than the rate for older youth. Nevertheless, this rate has nearly doubled between 1970 and 1994. For whites, there is little difference in the homicide rates of males and females in this younger age group. For blacks, however, there is a disparity between males and females, although it is not as pronounced as the difference for older black males and females. In 1994, the homicide rate of 9.1 for young black males was virtually twice that of females in the same age group, with a rate of 4.6 per 100 thousand.

Homicides Involving Firearms. In examining the rate of homicides due to firearms in proportion to total homicides, it is evident that firearms have been involved in the majority of youth homicides since 1980 (see Figure HC 1.2.B.3). 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 thousand out of a total of 10.6 deaths per 100 thousand due to homicide). The percentage of firearm-related homicides increased to 87 percent by 1994. 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 1.2.B.2). In 1994, 93 percent of homicides among older male black youth (ages 15 through 19) involved a firearm, compared to 84 percent among white male youth. Homicides among female youth involve a firearm less often, although firearms are still the means of the majority of female homicides.
 

Figure HC 1.2.B.1 
Youth Homicides: 1970-1994 (rate per 100,000) 

HC1_2B1.GIF

Source: National Center for Health Statistics, unpublished work tables prepared by the Mortality Statistics Branch, Division of Vital Statistics, 1995 and 1996.
 
 

Figure HC 1.2.B.2 
Male Youth Homicides Ages 15-19, by Race: 1970-1994 (rate per 100,000) 

HC1_2B2.GIF

Source: National Center for Health Statistics, unpublished work tables prepared by the Mortality Statistics Branch, Division of Vital Statistics, 1995 and 1996.
 
 

Figure HC 1.2.B.3 
Percentage of Homicides to Youth Ages 15-19 Due to Firearmsa: 1980-1994 

\HC1_2B3.GIF

Note: aIncludes assault by handguns and all other and unspecified firearms.
Source: National Center for Health Statistics, unpublished work tables prepared by the Mortality Statistics Branch, Division of Vital Statistics, 1996.
 
 

Table HC 1.2.B.1
Youth Homicidesa: Selected Years, 1970-1994 (rate per 100,000)

 
   
1970
1975
1980
1985
1990
1991
1992
1993
1994
   
 
 
 
 
 
 
 
 
 
All Youth
  Ages 10-14
1.2
1.2
1.4
1.5
2.1
2.2
2.4
2.5
2.2
  Ages 15-19
8.1
9.6
10.6
8.6
17
19.6
19.3
20.7
20.3
White males
  Ages 10-14
0.6
1
1.1
1.4
1.7
1.8
2
1.9
1.8
  Ages 15-19
5.2
8.1
10.9
7.2
12.5
14.4
15.2
15.2
15.4
White females
  Ages 10-14
0.6
0.8
1.1
0.9
0.9
0.9
1
1.2
0.9
  Ages 15-19
2.1
3.2
3.9
2.7
3.6
3.6
3.6
3.6
3.4
Black males
  Ages 10-14
6.8
4.1
3.9
4.2
8.1
9.1
9.6
10.5
9.1
  Ages 15-19
65.2
51.4
48.8
46.7
115.7
134.6
128.5
140.7
135.8
Black females
  Ages 10-14
2.3
2.3
2.4
1.7
4.8
3.8
5.1
5.2
4.6
  Ages 15-19
10.6
15.3
11
10.4
15.6
15.6
14.2
18.4
15.1
 
Note: aHomicide includes death by legal intervention 

Source: National Center for Health Statistics, unpublished work tables prepared by the Mortality Statistics Branch, Division of Vital Statistics, 1995 and 1996.

 
 

Table HC 1.2.B.2
Youth Homicides Due to Firearmsa: Selected Years, 1980-1994
(rate per 100,000)

 
   
1980
1985
1990
1991
1992
1993
1994
   
 
 
 
 
 
 
 
All Youth
  Ages 10-14
0.8
0.8
1.5
1.6
1.9
1.9
1.7
  Ages 15-19
7
5.7
13.8
16.4
16.7
17.8
17.7
White Males
  Ages 10-14
0.7
0.8
1.1
1.2
1.5
1.3
1.3
  Ages 15-19
7.2
4.9
9.4
11.6
12.9
12.5
13
White Females
  Ages 10-14
0.4
0.4
0.4
0.4
0.6
0.6
0.4
  Ages 15-19
1.7
1.1
1.7
1.9
2.1
2
2.2
Black Males
  Ages 10-14
3.2
2.8
6.1
7.6
7.7
9.2
7.1
  Ages 15-19
38.4
36.7
104.4
122.5
118.7
130.1
126.6
Black Females
  Ages 10-14
1
*
2.9
2.5
3.2
3.3
3
  Ages 15-19
6.3
4.7
9.6
10.3
9.8
13.4
9.9
 
Note: Calculations by Child Trends, Inc., to combine rates of assault by handguns and rates of assault by all other and unspecified firearms may affect overall rates due to previous rounding. 
aIncludes assault by handguns and all other and unspecified firearms. 
* = Not calculated because of unreliability due to infrequency of the event. 

Source: National Center for Health Statistics. Unpublished work tables prepared by the Morality Statistics Branch, Division of Vital Statistics, 1996.


 

HC 1.2.c 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 death rate for youth ages 15 through 19 nearly doubled, from 5.9 to 11.1 per 100 thousand (see Figure HC 1.2.C). Since 1990, the overall suicide death rate has stabilized at approximately 11 deaths per 100 thousand youth ages 15 through 19.

Differences by Gender. Male teens are more likely than females to commit suicide (see Table HC 1.2.C). The suicide rate for white males ages 15 through 19 was 18.7 per 100 thousand in 1994, more than five times the rate of 3.5 per 100 thousand for white females. The suicide rate for black males ages 15 through 19 is 16.6 deaths per 100 thousand, compared to 2.4 per 100 thousand for black females in this age group.

Differences by Race. White male youth ages 15 through 19 have long had a higher suicide rate than their black male peers (see Table HC 1.2.C). In 1970, white males ages 15 through 19 were twice as likely as black males to die from suicide (9.4 versus 4.7 per 100 thousand). However, the gap between white and black male suicide rates has narrowed in recent years, with suicide rates of 18.7 and 16.6 per 100 thousand in 1994 for white and black males, respectively. Among females ages 15 through 19, white females and black females were equally likely to commit suicide in 1970 with rates of 2.9 per 100 thousand. By 1975, white female suicide rates were twice that of their black peers ages 15 through 19. This trend held in all subsequent years in which data could be calculated for black females until 1994, when the suicide rate for ages 15 through 19 was 2.4 per 100 thousand among black females and 3.5 per 100 thousand among white females.

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 1.2.C). In this age group, suicide is infrequent for both sexes and races, making gender or racial differences small as well.
 

Figure HC 1.2.C 
Youth Suicides: Selected Years 1970-1994 (rate per 100,000) 

HC1_2C.GIF

Source: National Center for Health Statistics, unpublished work tables prepared by the Mortality Statistics Branch, Division of Vital Statistics, 1995 and 1996.
 
 

Table HC 1.2.C
Youth Suicides: Selected Years 1970-1994 (rate per 100,000)

 
   
1970
1975
1980
1985
1990
1991
1992
1993
1994
   
 
 
 
 
 
 
 
 
 
All Youth
  Ages 10-14
0.6
0.8
1.2
1.6
1.5
1.5
1.7
1.7
1.7
  Ages 15-19
5.9
7.5
8.5
9.9
11.1
11
10.8
10.9
11.1
White males
 
Ages 10-14
1.1
1.4
1.4
2.5
2.3
2.4
2.6
2.4
2.5
 
Ages 15-19
9.4
12.9
15
17.1
19.3
19.1
18.4
18.5
18.7
White females
 
Ages 10-14
0.3
0.4
0.3
0.9
0.9
0.8
1.1
1
1
 
Ages 15-19
2.9
3.1
3.3
4.1
4
4.2
3.7
4.2
3.5
Black males
 
Ages 10-14
0.3
0.2
0.5
*
1.6
2
2
2.3
2.1
 
Ages 15-19
4.7
6.1
5.6
8.2
11.5
12.2
14.8
14.4
16.6
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
 
* = Not calculated because of unreliability due to infrequency of the event. 

Source: National Center for Health Statistics, unpublished work tables prepared by the Mortality Statistics Branch, Division of Vital Statistics, 1995 and 1996.


 

HEALTH CONDITIONS

HC 2.1 Healthy births

A healthy birth is defined here as a birth with the following characteristics: a five-minute Apgar13 score of nine or more out of ten, weight at birth of at least 2,500 grams (5.5 pounds), a gestational age of at least 37 weeks, and maternal receipt of prenatal care within the first trimester.

Increasing Percentages of Healthy Births. Table HC 2.1 reports the percentage of all births qualifying as healthy births for 1985, 1991 and 1994, by race and ethnic group, and by the mothers marital status and educational background. The table shows an increase in the percentage of all healthy births between 1985 and 1994, as well as increases for each population subgroup presented. The percent of all births qualifying as healthy increased from 59.1 percent to 65.9 percent during that period of time.

Continued Disparities Across Population Subgroups. While healthy births are increasing for all the subgroups presented in Table HC 2.1, there are also persistent disparities across subgroups. For example:

  • In 1994, 49.7 percent of births to black women were defined as healthy, compared to 55.4 percent of births to Hispanic women and 69.8 percent of births to white women.
  • In 1994, 73 percent of births to married women were healthy, compared to 50.6 percent of births to single women.
  • In 1994, 70.1 percent of births to mothers with at least a high school education were healthy, compared to 48.8 percent of births to mothers with less than a high school education (see Figure HC 2.1).

Figure HC 1.2 
Percentage of All Births Defined as Healthy,a by Mothers Education: 1994 

HC2_1.GIF

Note: aHealthy birth is defined as follows: 5-minute Apgar score of 9+, birth weight 2,500+ grams, gestational age of 37+ weeks, prenatal care in the first trimester. Source: Special tabulation for 1994 birth data by Sally C. Clarke, National Center for Health Statistics.
 
 

Table HC 2.1 
Percentage of All Births Defined as Healthy,a by Selected Sociodemographic Characteristics: 1985, 1991, and 1994

 
   
1985
1991
1994
 
   
 
 
 
 
Total
59.1
61.1
65.9
 
Race/Ethnicity
  White
62.7
65
69.8
 
  Black
41.5
43.3
49.7
 
  Hispanic
48.6
49.8
55.4
 
Mothers Marital Status
  Married
65
68.6
73
 
  Singleb
37.9
43.1
50.6
 
Mothers Education
  High school or more
64
67.1
70.1
 
  Less than high school
40
43.3
48.8
 
 
Notes: aHealthy birth is defined as follows: 5 - minute Apgar score of 9+, birth weight 2,500+ grams, gestational age of 37+ weeks, prenatal care in the first trimester.  
bSingle status includes mothers who have never been married, or are divorced or widowed. 

Source: 1985 and 1991 data from: Morrison, D.R. (1994). "Healthy Birth Index". Final Report. Submitted to the Annie E. Casey Foundation, Kids Count Indicator Development Project, Child Trends, Inc., Washington, DC, 1994. Special tabulation for 1994 birth data by Sally C. Clarke, National Center for Health Statics.


13 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., and C. Berrien. (1953). "Evaluation of the Newborn Infant-2nd Report." Current Research in Anesthesia and Analgesia, Vol. 32: 260-267.
 
 

HC 2.2.a Low birth weight

Low birth weight infants (babies born weighing less than 2,500 grams or 5.5 pounds) face an increased risk of physical and developmental complications and death.14 These babies account for nearly two-thirds of all neonatal deaths (deaths under 28 days of age).15

The percentage of all infants born at low birth weight declined between 1970 and 1985, from 7.9 percent to 6.8 percent (see Table HC 2.2.A). By 1995, however, that percentage had increased to 7.3 percent of all infants.16 This pattern is evident for both white and black births and across almost all age groups of mothers.

Differences by Race and Ethnicity. Low birth weight rates are consistently higher for blacks than for whites and Hispanics. In 1970, 6.9 percent of white infants and 13.9 percent of black infants born in the U.S. were low birth weight. This gap continued into the 1990s; by 1995, 13.0 percent of black infants and 6.2 percent of white infants were born at low birth weight. The rates for Hispanics have remained at or slightly below 6.3 percent between 1980 (the first year for which Hispanic data are available) and 1995.

Differences by Age of Mother. For mothers 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:

  • Mothers under age 15 consistently have the highest rates of low weight births (see Figure HC 2.2.A). While the percentage of low weight births to mothers under age 15 improved between 1970 and 1994, the trend has not been one of consistent improvement. Instead, the percentage of low weight births to these very young mothers decreased considerably between 1970 and 1985 from 16.6 percent to 12.9 percent but then increased to 13.3 percent in 1990 and to 13.7 percent in 1994.
  • For mothers in all other age groups, rates of low weight births have stayed within 1.5 percentage points of their 1970 rate.
  • Mothers between the ages of 25 and 29 consistently have the lowest rates of low weight births.

Figure HC 2.2.A 
Percentage of All Births Born at Low Birth Weight, by Age of Mother:a 1994 

HC2_2A.GIF

Notes: aBefore 1979, low birth weight defined as: Infants weighing < 2,500 grams. 1979 and beyond, low birth weight defined as: Infants weighing < 2,500 grams.
Source: Ventura, S.J., Martin, J.A., Mathews, T.J. and Clarke S.C. Advance Report of Final Natality Statistics, 1994. Monthly Vital Statistics Report, Vol. 44, No. 11, Supplement. Hyattsville, Maryland: National Center for Health Statistics. 1996 (tables 24 and 44).
 

Table HC 2.2.A
Percentage of All Births Born at Low Birth Weight,a Selected Years: 1970-1995

 
     
1970
1975
1980
1985
1990
1992
1993
1994
1995d
     
 
 
 
 
 
 
 
 
 
 
Total    
7.9
7.4
6.8
6.8
7
7.1
7.2
7.3
7.3
 
  Race/Ethnicityb,c
    Black
13.9
13.2
12.7
12.7
13.3
13.3
13.3
13.2
13
    White
6.9
6.3
5.7
5.7
5.7
5.8
6
6.1
6.2
    Hispanic
--
--
6.1
6.2
6.1
6.1
6.2
6.3
6.3
 
  Age of Mother
    Under 15
16.6
14.1
14.6
12.9
13.3
13.2
13.5
13.7
--
    15-19
10.5
10
9.4
9.3
9.3
9.3
9.2
9.3
--
    20-24
7.4
7.1
6.9
6.9
7.1
7.1
7.2
7.3
--
    25-29
6.9
6.1
5.8
5.9
6.2
6.2
6.4
6.4
--
    30-34
7.5
6.8
5.9
6.1
6.4
6.5
6.7
6.7
--
    35-49
8.8
8.4
7.2
7.1
7.4
7.8
8.1
8.2
--
 
Notes: aBefore 1979, low birth weight defined as: Infants weighing < 2,500 grams (< 5.5 pounds). 1979 and beyond, low birth weight defined as: Infants weighing < 2,500 grams (<5.5 pounds).  
bPercentages are based on the race and ethnicity of the mother.  
cPercentage low birth weight by ethnicity are not available before 1980. Birth figures for Hispanic infants in 1980 are based on data from 22 States which report Hispanic origin on the birth certificate; 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 in 1993.  
dData for 1995 are preliminary. 

Sources: National Center for Health Statistics. Health, United States, 1995. Hyattsville, Maryland: Public Health Service. 1996. Table 11 for totals and race/ethnicity breaks for 1970-1993. 1970 data from: National Center for Health Statistics, Health, United States, 1982, Table 24; 1975 data from: Vital Statistics of the U.S., 1975, Table 1-37; 1980 data from: Monthly Vital Statistics Report, Vol. 31 No. 8 , Supplement. 1982; 1985 data from: National Center for Health Statistics: Vital Statistics of the United States, 1985, Vol. I, Natality. DHHS Pub. No. (PHS) 81-1113. Public Health Service; Washington. 1988. Table 1-81. 1990 data from: Monthly Vital Statistics Report, Vol. 41, No. 9(s), February, 1993, Tables 13 and 26; 1992 data from: Ventura, S.J., Martin, J.A., Taffel, S.M., Mathews, T.J. and Clarke S.C. Advance Report of Final Natality Statistics, 1992. Monthly Vital Statistics Report, Vol. 43, No. 5, Supplement. Hyattsville, Maryland: National Center for Health Statistics. 1994 (tables 24 and 44); 1993 data from: Ventura, S.J., Martin, J.A., Taffel, S.M., Mathews, T.J. and Clarke S.C. Advance Report of Final Natality Statistics, 1993. Monthly Vital Statistics Report, Vol. 44, No. 3, Supplement. Hyattsville, Maryland: National Center for Health Statistics. 1995 (tables 24 and 44); 1994 data from: Ventura, S.J., Martin, J.A., Mathews, T.J. and Clarke S.C. Advance Report of Final Natality Statistics, 1994. Monthly Vital Statistics Report, Vol. 44, No. 11, Supplement. Hyattsville, Maryland: National Center for Health Statistics. 1996 (tables 24 and 44). 1995 preliminary data from: Rosenberg, H.M., Ventura, S.J., Maurer, J.D., Heuser, R.L., Freedman, M.A. Births and Deaths: United States, 1995. Monthly Vital Statistics Report, Vol 45, No. 3, Supplement 2. Hyattsville, Maryland: National Center for Health Statistics. 1996. 


14 Disorders relating to short gestation and unspecified low birth weight were the second leading cause of death to infants in 1995 as reported in Rosenberg, H.M., Ventura, S.J., Maurer, J.D., Heuser, R.L., and M.A. Freedman. "Births and Deaths: United States, 1995." Monthly Vital Statistics Report. Vol. 45, No. 3 (Supplement 2). Hyattsville, Maryland: National Center for Health Statistics. 1996.

15 Ventura, S.J., Martin, J.A., Mathews, T.J., Clarke, S.C. "Advance Report of Final Natality Statistics, 1994." Monthly Vital Statistics Report, Vol. 44, No. 11 (S). Hyattsville, Maryland: National Center for Health Statistics, 1996.

16 Data for 1995 are preliminary.
 
 

HC 2.2.b Very low birth weight

Very low birth weight infants (babies born weighing less than 1,500 grams, or 3.3 pounds) 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 weight infants to survive.

The percentage of infants born at very low birth weight has remained constant for the last 24 years (see Table HC 2.2.B). Between 1970 and 1989 (not shown), 1.2 percent of all infants were classified as very low birth weight.17 The proportion then increased slightly to 1.3 percent, where it has remained from 1990 to 1994.

Differences by Race and Ethnicity. The percentage of babies born at very low birth weight varies by race and ethnicity (see Table HC 2.2.B). For whites, the percentage of very low weight births has remained at or about 1.0 percent from 1970 through 1994. For blacks, the percentage of very low birth weight babies increased from 2.4 percent in 1970 to 3.0 percent by 1992, where it has remained through 1994. In contrast, the percentage of low birth weight babies (as distinct from "very low") decreased for both blacks and whites from 1970 to the mid-1980s, then increased (see Table HC 2.2.A in the previous discussion). The percentage of very low weight births among Hispanics was 1.0 percent for the years shown between 1980 and 1992, and 1.1 percent in 1993 and 1994.

Differences by Age of Mother. Age of mother appears to be an important factor in the likelihood of very low birth weight, particularly at the youngest ages. The percentage of very low weight infants born to mothers under age 15 has increased since 1975, reaching its highest proportion in 1993 at 3.6 percent, and then decreasing slightly to 3.4 percent by 1994. The percentage of very low weight births among mothers age 15 to 19 is lower than the proportion of such births to their younger counterparts but remains slightly higher than the proportion observed for women age 20 and older.
 
 

Table HC 2.2.B  
Percentage of All Births Born at Very Low Birth Weight,a Selected Years: 1970-1994

 
     
1970
1975
1980
1985
1990
1992
1993
1994
     
 
 
 
 
 
 
 
 
Total    
1.2
1.2
1.2
1.2
1.3
1.3
1.3
1.3
Race/Ethnicityb,c
    White
1
0.9
0.9
0.9
1
1
1
1
    Black
2.4
2.4
2.5
2.7
2.9
3
3
3
    Hispanic
 
 
1
1
1
1
1.1
1.1
Age of Mother
    Under 15
 
3.1
3.4
3.1
3.2
3.1
3.6
3.4
    15-19
 
1.8
1.7
1.8
1.8
1.8
1.8
1.7
    20-24
 
1.1
1.1
1.2
1.3
1.3
1.3
1.3
    25-29
 
0.9
1
1
1.1
1.1
1.1
1.2
    30-34
 
1
1
1.1
1.2
1.2
1.2
1.2
    35-49
 
1.2
1.2
1.3
1.4
1.5
1.5
1.6
 
Notes: aBefore 1979, very low birth weight defined as: < 1,500 grams, 1979 and beyond, very low birth weight defined as: Infants Weighing < 1,500 grams.  
bPercentages are based on the race and ethnicity of the mother.  
cPercentage very low birth weight by ethnicity are not available before 1980. Birth figures for Hispanic infants in 1980 are based on data from 22 States which reported Hispanic origin of the mother on the birth certificate; 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 in 1993 and 1994.  

Sources: National Center for Health Statistics. Health, United States, 1995. Hyattsville, Maryland: Public Health Service. 1996. Table 11 for totals and race/ethnicity breaks for 1970-1993. 1975 data from: Vital Statistics of the U.S., 1975, Table 1-37; 1980 data from: Monthly Vital Statistics Report, Vol. 31 No. 8, Supplement. Hyattsville, Maryland: National Center for Health Statistics. 1982 (table 13); 1985 data from: Monthly Vital Statistics Report, Vol. 36 No.4, Supplement. Hyattsville, Maryland: National Center for Health Statistics. 198 (table 17); 1990 data from: Monthly Vital Statistics Report, Vol. 41, No. 9, Supplement. Hyattsville, Maryland: National Center for Health Statistics. 1993 (table 13); 1992 data from: Ventura, S.J., Martin, J.A., Taffel, S.M., Mathews, T.J. and Clarke S.C. "Advance Report of Final Natality Statistics, 1992." Monthly Vital Statistics Report, Vol. 43, No. 5, Supplement. Hyattsville, Maryland: National Center for Health Statistics. 1994 (tables 24 and 44); 1993 data from: Ventura, S.J., Martin, J.A., Taffel, S.M., Mathews, T.J. and Clarke S.C. "Advance Report of Final Natality Statistics, 1993." Monthly Vital Statistics Report, Vol. 44, No. 3, Supplement. Hyattsville, Maryland: National Center for Health Statistics. 1995 (tables 24 and 44); 1994 data from: Ventura, S.J., Martin, J.A., Mathews, T.J. and Clarke S.C. "Advance Report of Final Natality Statistics, 1994." Monthly Vital Statistics Report, Vol. 44, No. 11, Supplement. Hyattsville, Maryland: National Center for Health Statistics. 1996 (tables 24 and 44).


17 Data for individual years indicate that the rate remained at 1.2 percent through 1989 (not shown).
 
 

HC 2.3 General health conditions

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. These reports vary little by gender; there are modest differences by age of child for some population subgroups (see Table HC 2.3).

Differences by Race. Parents reports of their childrens health vary by race. Between 1984 and 1994, black parents were less likely than white parents to report that their children were in very good or excellent health. In 1994, 72 percent of black children under age five were reported in very good or excellent health, compared to 83 percent of white children. Sixty-eight percent of black children ages five to 17 were reported in very good or excellent health, compared to 81 percent of white children in this age group (see Table HC 2.3).

Differences by Family Income. Parents reports of their childrens 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 1994, 67 percent of children under age five in families with annual incomes under $10 thousand were reported to be in very good or excellent health, compared to 90 percent of children in families with incomes of $35 thousand or more. A similar pattern exists for children ages five to 17 (see Figure HC 2.3).
 
 

Figure HC 2.3  
Percentage of Children Under Age 18 Reported by Their Parents to Be in Very Good or Excellent Health, by Family Income: 1994 

HC2_3.GIF

Source: National Center for Health Statistics. Current Estimates from the National Health Interview Survey: United States, 1994. Vital and Health Statistics, Series 10, No. 193 (table 70).
 
 

Table HC 2.3 
Percentage of Children Under Age 18 Reported by Their Parents to Be in Very Good or Excellent Health: Selected Years, 1984-1994

 
     
Age: <5
Age: 5-17
     
1984
1987
1990
1992
1993
1994
1984
1987
1990
1992
1993
1994
     
 
 
 
 
 
 
 
 
 
 
 
 
Total
79
81
81
80
80
81
77
80
80
80
79
79
  Race
    Black
67
71
72
70
71
72
65
66
68
68
70
68
    White
81
84
83
82
82
83
80
83
83
82
81
81
  Gender
    Male
78
 
80
79
80
81
78
 
81
80
79
79
    Female
79
 
82
81
80
81
77
 
80
79
78
78
  Family Incomea
    Under $10,000          
67
         
62
    $10,000-$19,999          
74
         
68
    $20,000-$34,999          
80
         
77
    $35,000 or more          
90
         
88
 
 
Notes: aFamily 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.  

Source: National Center for Health Statistics. "Current Estimates from the National Health Interview Survey: United States," 1984, 1987, 1990, 1992, 1993, 1994; Vital and Health Statistics, Series 10, Nos. 156, 166, 181, 189, 190, and 193, 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 lose time from work, and increase a familys medical expenses.

Over the period from 1984 to 1994, respiratory conditions have been the most prevalent chronic health problems experienced by children under age 17, followed by skin conditions, and impairments (see Figure HC 2.4). In general, there are few pronounced patterns of improvement or deterioration among those conditions shown (see Table HC 2.4). Two exceptions, however, are asthma and chronic sinusitis. The prevalence of these two chronic conditions increased incrementally from 1984 to 1993, but declined slightly in 1994. In 1984, asthma affected 43 children per thousand, compared with 69 children per thousand in 1994; chronic sinusitis affected 47 children per thousand in 1984, and 65 children per thousand by 1994.
 
 

Figure HC 2.4  
Selected Chronic Health Conditions per 1,000 Children Ages 0-17: 1994 

HC2_4.GIF

Source: National Center for Health Statistics, Current Estimates from the National Health Interview Survey: United States 1994, Vital and Health Statistics, Series 10, No. 193, Table 70.
 
 

Table HC 2.4 
Selected Chronic Health Conditionsa per 1,000 Children 
Ages 0-17: Selected Years, 1984-1994

 
     
number per 1,000
Type of Conditions
1984
1987
1990
1992
1993
1994
 
 
 
 
 
 
 
 
  Respiratory Conditions
    Hay fever, allergic rhinitis without Asthma
61
64
57
71
57
61
    Chronic bronchitis
50
62
53
54
59
55
    Chronic sinusitis
47
58
57
69
80
65
    Asthma
43
53
58
63
72
69
    Chronic diseases of tonsils or adenoids
34
30
23
28
26
23
 
  Skin Conditions
    Dermatitis
39
32
31
41
36
38
    Serious acne
26
26
26
25
28
29
 
  Impairments
    Deformity or orthopedic impairment
35
36
29
33
29
28
    Speech impairment
16
19
14
21
20
21
    Hearing impairment
24
16
21
15
17
18
    Visual impairment
9
10
9
10
7
9
 
  Other Conditions
    Heart disease
23
22
19
19
20
18
    Migraine headache
11
8
14
13
13
16
    Anemia
11
8
10
11
9
12
    Epilepsy
7
4
4
3
5
5
 
Notes: aChronic conditions as defined in the National Health Interview Survey are conditions that either a) were first noticed three 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.  

Source: National Center for Health Statistics, "Current Estimates from the National Health Interview Survey: United States," 1984, 1987, 1990, 1992, 1993, 1994; Vital and Health Statistics, Series 10, Nos. 150, 156, 166, 181, 189, 190, and 1993, Tables 57 and 62.


 

HC 2.5 Overweight 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.18 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.

Differences by Age. Overweight prevalence was similar among children ages six to 11 years old and adolescents 12 to 17 years old (see Table HC 2.5). For both age groups and sexes, overweight prevalence has increased from 15 percent in the earliest time period to approximately 22 percent in 1988-1991.

Differences by Gender. During the time period 1988-1991, there was little difference in the overweight prevalence of male and female children and adolescents 22 percent of male children and 23 percent of female children were overweight, and 22 percent of male adolescents and 21 percent of female adolescents were overweight.

Differences by Race Among Male Children and Adolescents. In the earliest time periods (1963-1965 and 1971-1974), the percentage of black male children who were overweight was at least six percentage points lower than that of white male children. This was reversed in the most recent period (1988-1991), with black male children recording an overweight prevalence rate that is five percentage points higher than that of their white peers. Blackwhite differences were less among the older age group, but the same pattern is evident (see Figure HC 2.5).

Differences by Race for Female Children and Adolescents. With the exception of the earliest time period, the percentage of black females who were overweight was higher than that of white females for both children and adolescents. By the most recent time period 31 percent of black female children and 30 percent of black female adolescents were overweight compared with 22 percent of white female children and 20 percent of white female adolescents (see Figure HC 2.5).
 
 

Figure HC 2.5  
Age-Adjusted Prevalence of Overweight Adolsecents (Ages 12-17) from National Surveys, by Sex: 1976-1980 and 1988-1991a 

HC2_5.GIF

Note: aPrevalence of overweight is determined by those children and adolescents who were at or above the 85th percentile of body mass index (BMI) from the National Health and Nutrition Examination Surveys II and III. Determinations of overweight with BMI were sex- and age-specific.
Source: Troiano, Richard P. and Katherine M. Flegal, Robert J. Kuczmarski, Stephen M. Campbell, Clifford L. Johnson, 1995. Overweight Prevalence and Trends for Children and Adolescents: The National Health and Nutrition Examination Surveys, 1963-1991. Archives of Pediatrics and Adolescent Medicine. Vol. 149 (October). Estimates were calculated from National Health and Nutrition Examination Survey (NHANES); 1976 to 1980 for NHANES II, and 1988 to 1991 for NHANES III.
 
 

Table HC 2.5 
Age-Adjusted Prevalence of Overweight Children and Adolescents: Selected Years, 1963-1991a

 
     
1963-1965
1966-1970
1971-1974
1976-1980
1988-1991
     
 
 
 
 
 
Ages 6 through 11
  Maleb
15.2
 
18.2
19.9
22.3
    White
16
 
19.5
20.8
22.3
    Black
10.3
 
12.3
15.1
27.2
  Femaleb
15.2
 
13.9
15.8
22.7
    White
15.7
 
13.4
15.4
22
    Black
12.1
 
16.8
18.4
30.7
Ages 12 through 17
  Maleb 
 
15.1
14.9
16.3
21.7
    White
 
15.8
15.3
16.6
22.6
    Black
 
10.4
12.3
14.5
23.3
  Female
 
15.2
19.7
15.5
21.2
    White
 
15
19.7
15.2
20.3
    Black
 
16.5
20.8
18.2
29.9
 
Notes: aPrevalance of overweight is determined by those children and adolescents who were at or above the 85th percentile of body mass index (BMI) from the National Health Examination Surveys II and III. Determinations of overweight with BMI were sex- and age-specific.  
bTotals for male and female children and adolescents include data for race groups not shown separately.  

Source: Troiano, Richard P. and Katherine M. Flegal, Robert J. Kuczmarski, Stephen M. Campbell, Clifford L. Johnson, 1995. "Overweight Prevalence and Trends for Children and Adolescents: The National Health and Nutrition Examination Surveys, 1963-1991." Archives of Pediatrics and Adolescent Medicine. Vol. 149 (October). Estimates were calculated from National Health Examination Survey; 1963-1965 for ages 6 through 11, and 1966 to 1970 for ages 12 through 17 years and from the National Health and Nutrition Examination Survey (NHANES); 1971 to 1974 for NHANES I, 1976 to 1980 for NHANES II, and 1988 to 1991 for NHANES III.


18 Troiano, Richard P. and Katherine M. Flegal, Robert J. Kuczmarski, Stephen M. Campbell, Clifford L. Johnson, 1995. "Overweight Prevalence and Trends for Children and Adolescents: The National Health and Nutrition Examination Surveys, 1963-1991." Archives of Pediatrics and Adolescent Medicine. Vol. 149 (October).
 

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.19 They can result in serious injury or, in extreme cases, death.

The National Research Council distinguishes four categories of child maltreatment: (1) physical abuse, (2) sexual abuse, (3) emotional maltreatment, and (4) neglect.20 The first three are commonly grouped together under the term "abuse," although there are currently no universally accepted definitions of any of these terms. (For example, the point at which corporal punishment becomes physical abuse is not agreed upon by child welfare professionals or lay people).

According to data from the most comprehensive annual data collection efforts undertaken to date, there were about 875 thousand substantiated cases21 of child abuse and neglect in 1994a rate of 12.9 cases per thousand children under age 18 (see Figure HC 2.6). This is a substantial increase over the roughly 720 thousand cases substantiated in 1990, when the rate was only 11.4 cases per thousand.22 Although maltreatment was about evenly split between abuse and neglect, abuse accounted for a somewhat smaller share of the total in 1994 than in 1990.

The number of substantiated cases shown in Figure HC 2.6 may substantially understate the actual number of cases of maltreatment. In order for a case to be substantiated, it must first be reported to child welfare authorities, and child protective services workers must undertake an investigation which finds sufficient evidence of abuse or neglect to proceed further with the case.

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 cases in 1993. This study includes (1) all cases reported to child protective services (regardless of whether they were investigated and substantiated)23 and (2) cases known to community professionals but not necessarily reported to child protective services.

Differences by Race. Black children account for a disproportionate share of substantiated maltreatment cases relative to their share of the child population (see Table HC 2.6).

  • Black children, who constituted only 16 percent of all children under age 18, accounted for 26 percent of the abuse and neglect cases in 1994.
  • White children, who constituted 79 percent of all children under age 18, accounted for only 56 percent of abused and neglected children in 1994.
  • Hispanic children, who constituted about 14 percent of all children under age 18, accounted for only nine percent of the abuse and neglect cases.

Differences by Age. No age group accounts for an obviously disproportionate share of abuse and neglect cases. In 1994, (see Table HC 2.6) infants under age one accounted for about seven percent of substantiated cases; children ages one to five accounted for about 33 percent of substantiated cases; children ages six to 12 accounted for 38 percent of substantiated cases; and children ages 13 to 17 accounted for about 20 percent of substantiated cases.
 
 

Figure HC 2.6  
Substantiated Cases of Child Maltreatment, 1990-1994 
(number, and rate per 1,000 children under age 18) 

HC2_6.GIF

Note: Statistics for 1990-1992 have been revised, to obtain consistent representation of the same number of jurisdictions over the entire 1990-1994 period. Statistics are for the 50 states plus the District of Columbia.
Sources: 1994, National Center on Child Abuse and Neglect, Child Maltreatment, 1994: Reports from the States to the National Center on Child Abuse and Neglect (Washington, D.C.: U.S. Government Printing Office, 1996). 1993, National Center on Child Abuse and Neglect, Child Maltreatment, 1993: Reports from the States to the National Center on Child Abuse and Neglect (Washington, D.C.: U.S. Government Printing Office, 1995). 1992, National Center on Child Abuse and Neglect, Child Maltreatment, 1992: Reports from the States to the National Center on Child Abuse and Neglect (Washington, D.C.: U.S. Government Printing Office, 1994). 1990- 91, National Center on Child Abuse and Neglect, 1991 Summary Data Component. (Washington, DC: U.S. Government Printing Office, 1993). U.S. Bureau of the Census, Statistical Abstract of the United States, 1994 (Washington, D.C.: U.S. Government Printing Office, 1995). U.S. Bureau of the Census, Statistical Abstract of the United States, 1995 (Washington, D.C.: U.S. Government Printing Office, 1996).
 
 

Table HC 2.6 
Substantiated Cases of Child Maltreatment, 1990-1994 
(number, and rate per 1,000 children under age 18)

 
     
1990
1991
1992
1993
1994
     
 
 
 
 
 
Total
 
Number 
722,414
741,175
849,448
903,342
875,560
  Rate per thousand
11.4
11.4
12.8
13.5
12.9
 
  Type of Maltreatment (% of Total Cases)
    Abuse
51
50
45
46
44
    Neglect
49
50
55
54
56
 
  Race/Ethnicity (% of Total Cases)
    White
55
56
55
54
56
    Black
25
27
26
25
26
    Hispanic
9
10
10
9
9
    Other
4
4
4
4
4
    Unknown
7
5
6
9
4
 
  Sex (% of Total Cases)
    Male
47
46
46
47
47
    Female
53
54
54
53
53
               
  Age (% of Total Cases)
    Under 1
8
8
7
7
7
    1 to 5
31
32
32
33
33
    6 to 12
37
38
37
38
38
    13 to 17
20
20
19
20
20
    18+/unknown
5
2
5
2
2
 
Note: Statistics for 1990-1992 have been revised, to obtain consistent representation of the same number of jurisdictions over the entire 1990-1994 period. Statistics are for the 50 states plus the District of Columbia.  

Sources: 1994, National Center on Child Abuse and Neglect, "Child Maltreatment, 1994: Reports from the States to the National Center on Child Abuse and Neglect" (Washington, D.C.: U.S. Government Printing Office, 1996). 1993, National Center on Child Abuse and Neglect, "Child Maltreatment, 1993: Reports from the States to the National Center on Child Abuse and Neglect" (Washington, D.C.: U.S. Government Printing Office, 1995). 1992, National Center on Child Abuse and Neglect, Child Maltreatment, 1992: Reports from the States to the National Center on Child Abuse and Neglect (Washington, D.C.: U.S. Government Printing Office, 1994). 1990- 91, National Center on Child Abuse and Neglect, "1991 Summary Data Component." (Washington, DC: U.S. Government Printing Office, 1993). U.S. Bureau of the Census, "Statistical Abstract of the United States, 1994" (Washington, D.C.: U.S. Government Printing Office, 1995). U.S. Bureau of the Census, "Statistical Abstract of the United States, 1995" (Washington, D.C.: U.S. Government Printing Office, 1996).


19 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.

20 National Research Council, Panel on Child Abuse and Neglect, Understanding Child Abuse and Neglect. Washington, DC: National Academy Press, 1993.

21 In most states, each reported incident is counted even if multiple incidents are reported for the same child.

22 The apparent drop between 1993 and 1994 should be viewed with caution since there are important inconsistencies in data collection methodology from year to year.

23 According 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

Suicide is a major cause of death among American youth (see Section HC 1.2.C). Attempted suicide has been related to mental health problems including depression and adjustment or stress reactions, as well as to substance abuse.24

In 1995, 24 percent of youth in grades nine through 12 report having seriously considered suicide during the previous 12 months (see Table HC 2.7.A). During the same time period, nine percent, or one in eleven, report having actually attempted suicide during the previous year (see Table HC 2.7.B). These rates are considerably higher than the proportion of youth who actually commit suicide (see Section HC 1.2.C).

Rates for contemplation of suicide range from 29 percent in 1991 to 24 percent in 1993 and 1995 (see Table HC 2.7.A). The percentage of youth who report actually attempting suicide has remained around nine percent in recent years (see Table HC 2.7.B).

Differences by Race/Ethnicity.25 Black youths report somewhat lower rates of considering suicide in comparison with their white and Hispanic peers (20 percent for black youth versus 25 percent for both whites and Hispanics in 1995). Rates of reported attempted suicide are similar across the three groups, ranging from eight to ten percent.

Differences by Gender. In 1995, female youth were more likely than male youth to report having thought seriously about suicide (30 percent versus 18 percent) and having attempted suicide (12 percent versus six percent) during the previous year (see Figure HC 2.7). However, the rate of actual suicides, particularly among teens ages 15 to 19, are considerably higher for males than for females, as discussed in section HC 1.2.C.
 
 

Figure HC 2.7  
Suicide: Percentage of Students in Grades 9-12 Who Report Having Seriously Considered or Attempted Suicide in the Previous 12 Months: 1995 

HC2_7.GIF

Source: Youth Risk Behavior Surveillance - United States 1995. In: CDC Surveillance Summaries, MMWR 1996; Vol. 45 (No. 55-4): 1-85.
 

Table HC 2.7.A 
Suicidal Teens: Percentage of Teens in Grades 9-12 Who Report Having Seriously Considered Suicide in the Previous 12 Months: For Selected Years 1990-1995

 
     
1990
1991
1993
1995
     
 
 
 
 
Total
27
29
24
24
    Male
21
21
19
18
    Female
34
37
30
30
  Grade
 
 
9
30
29
24
26
    10
26
30
25
25
    11
29
32
25
26
    12
33
26
23
20
  Race/Ethnic Group
    White non-Hispanic
28
30
24
25
    Black non-Hispanic
20
22
20
20
    Hispanic
30
27
26
25
 
Source: Data for 1990 from "1990-1991 Youth Risk Behavior Surveillance System," Morbidity and Mortality Weekly Report reprints, Centers for Disease Control and Prevention. Data for 1991 from Public Health Reports, Vol. 108, Supplement 1, U.S. Public Health Service. Data for 1993 from "Youth Risk Behavior Surveillance- United States 1993," Vol. 44, No. SS-1, U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention. Data for 1995 from Kann, L., Warren, C.W., Harris, W.A., Collins, J.L., Williams, B.I., Ross, J.G., and Kolbe, L.J. "Youth Risk Behavior Surveillance -- United States, 1995." In: CDC Surveillance Summaries, September 27, 1996. Morbidity and Mortality Weekly Report 1996; 45 (No. 55-4): 1-85. All data from Youth Risk Behavior Surveys 1990-1995.

Table HC 2.7.B 
Suicidal Teens: Percentage of Teens in Grades 9-12 Who Report Having Attempted Suicide in the Previous 12 Months: Selected Years, 1990-1995

 
     
1990
1991
1993
1995
     
 
 
 
 
Total
8
7
9
9
    Male
6
4
5
6
    Female
10
11
13
12
  Grade
    9
9
9
10
11
    10
9
8
9
10
    11
8
6
8
9
    12
7
6
7
6
  Race/Ethnic Group
    White non-Hispanic
8
7
8
8
    Black non-Hispanic
7
7
8
10
    Hispanic
12
8
14
13
 
Source: Data for 1990 from "1990-1991 Youth Risk Behavior Surveillance System," Morbidity and Mortality Weekly Report reprints, Centers for Disease Control and Prevention. Data for 1991 from Public Health Reports, Vol. 108, Supplement 1, U.S. Public Health Service. Data for 1993 from "Youth Risk Behavior Surveillance- United States 1993," Vol. 44, No. SS-1, U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention. Data for 1995 from Kann, L., Warren, C.W., Harris, W.A., Collins, J.L., Williams, B.I., Ross, J.G., and Kolbe, L.J. "Youth Risk Behavior Surveillance -- United States, 1995." In: CDC Surveillance Summaries, September 27, 1996. Morbidity and Mortality Weekly Report, 1996; 45 (No. 55-4): 1-85. All data from Youth Risk Behavior Surveys 1990-1995.


24 Alcohol, Drug Abuse, and Mental Health Administration. Report of the Secretarys 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, 1990.

25 Estimates for whites and blacks 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.26 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 (a) an inability to perform the major activity for a person in his or her age group, (b) being able to perform the major activity but being limited in the kind or amount of this activity, or (c) 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 hildren ages five 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.

Between 1990 and 1994 the percentage of children under age 18 with chronic conditions that limit any of their activity has risen from 4.9 percent to 6.7 percent (see Table HC 2.8.A). This trend is true for both males and females and whites and blacks, although the percentages are higher for males and for blacks. The percentage of children with limitations in major activities follows a similar upward trend since 1990 (see Table HC 2.8.B).

Differences by Gender. Males have consistently accounted for a greater percentage of youth with an activity limitation due to a chronic condition. In 1994, 7.9 percent of males compared to 5.6 percent of females had activity limitations that were caused by a chronic condition (see Figure HC 2.8.A). Looking only at limitations in major activities in 1994, 6.0 percent of males had such limitations compared to 3.8 percent of females (see Figure HC 2.8.B).

Differences by Race. Black youth are more likely than white youth to have activity limitations due to chronic conditions (see Table HC 2.8.A). In 1994, 8.8 percent of black youth had activity limitations compared to 6.4 percent of white youth. A similar gap existed for major activity limitations with 6.7 percent of black youth being limited in major activities and 4.7 percent of white youth.
 

Figure HC 2.8.A  
Percentage Under Age 18 With an Activity Limitation Due to Chronic Conditions, by Gender: Selected Years, 1983-1994 

HC2_8A.GIF

Source: National Center for Health Statistics, Current Estimates from the National Health Interview Survey: United States 1983, 1985, 1990, 1991, 1992, 1993, 1994.
 
 

Figure HC 2.8.B  
Percentage Under Age 18 With a Major Activity Limitation Due to Chronic Conditions, by Gender: Selected Years, 1983-1994 

HC2_8B.GIF

Source: National Center for Health Statistics, Current Estimates from the National Health Interview Survey: United States 1983, 1985, 1990, 1991, 1992, 1993, 1994.
 
 

Table HC 2.8.A 
Activity Limitations:a Percentage Under Age 18 With an Activity Limitation Due to Chronic Conditionsb

 
     
1983
1985
1990
1991
1992
1993
1994
 
Total
5.1
5.1
4.9
5.8
6.1
6.6
6.7
  Gender
    Males
5.9
6
5.6
6.8
7.1
7.8
7.9
    Females
4.3
4.2
4.2
4.7
5
5.3
5.6
  Race/Ethnicity
    White
5
5.1
4.8
5.7
5.9
6.5
6.4
    Black
5.7
5.8
5.5
6.8
7.5
7.7
8.8
 
Notes: aAn activity limitation is defined as follows: Persons are classified in terms of the major activity usually associated with their particular age group. The major activities for the age groups are a) ordinary play for children under 5 years of age, b) attending school for those 5-17 years of age. A person is classified as having an activity limitation if he or she is: a) unable to perform the major activity, b) able to perform the major activity but limited in the kind or amount of this activity, c) not limited in the major activity but limited in the kind or amount of other activities.  
bA condition is considered chronic if a) the respondent indicates it was first noticed more than 3 months before the reference date of the interview or b) it is a type of condition that ordinarily has a duration of more than 3 months.  

Source: National Center for Health Statistics, "Current Estimates from the National Health Interview Survey: United States" 1983, 1985, 1990, 1991, 1992, 1993, 1994.

Table HC 2.8.B 
Major Activity Limitations:a Percentage Under Age 18 With an Activity Limitation In a Major Activity Due to Chronic Conditionsb

 
     
1983
1985
1990
1991
1992
1993
1994
     
 
 
 
 
 
 
 
Total
3.5
3.7
3.6
4.2
4.4
4.6
4.9
  Gender
 
 
Males
4.2
4.4
4.2
5
5.2
5.6
6
 
 
Females
2.8
2.9
3
3.3
3.7
3.5
3.8
  Race/Ethnicity
    White
3.4
3.5
3.5
4.1
4.3
4.5
4.7
    Black
4.5
4.6
4.2
5.2
6
5.7
6.7
 
Notes:   aAn activity limitation is defined as follows: Persons are classified in terms of the major activity usually associated with their particular age group. The major activities for the age groups are a) ordinary play for children under 5 years of age, b) attending school for those 5-17 years of age. A person is classified as having an activity limitation if he or she is: a) unable to perform the major activity, b) able to perform the major activity but limited in the kind or amount of this activity, c) not limited in the major activity but limited in the kind or amount of other activities.  
bA condition is considered chronic if a) the respondent indicates it was first noticed more than 3 months before the reference date of the interview or b) it is a type of condition that ordinarily has a duration of more than 3 months.  

Source: National Center for Health Statistics, "Current Estimates from the National Health Interview Survey: United States" 1983, 1985, 1990, 1991, 1992, 1993, 1994.


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

HC 2.9 Lead exposure

Exposure to lead has long been recognized as a serious health hazard, particularly for infants, toddlers, and preschool-age children, whose developing nervous systems are sensitive to lead. Research during the past two decades has shown that adverse health effects can occur from blood lead levels (BLLs) that had previously been considered safe. Based on this research the Centers for Disease Control and Prevention now consider BLLs at least as low as ten micrograms per deciliter of blood as hazardous for children ages one to five.27

Dramatic Decreases in Blood Lead Levels. The percentage of very young children who have been exposed to potentially dangerous levels of lead declined dramatically in the 1980s (see Table HC 2.9). Data gathered between 1976 and 1980 revealed that 88.2 percent of children between the ages of one and five had blood lead levels which have been shown to have adverse health effects. Subsequent data gathered between 1988 and 1991 found that only 8.9 percent of children had hazardous levels of lead in their blood. This dramatic decrease has been attributed primarily to the removal of lead from gasoline and from soldered food and soft drink cans. Other contributing factors have been the ban on leaded paint for residential use in 1978, the ban on lead in solder for household plumbing, and the ongoing screening of children for lead exposure. Deteriorating lead-based paint and lead-contaminated dust in older homes are the primary source of lead exposure for children in the United States today.28

Differences by Race/Ethnicity,29 Family Income, and Place of Residence. The decline in blood lead levels occurred among both non-Hispanic black and non-Hispanic white children.30 However, non-Hispanic black children, poor and near-poor children, and children living in the central areas of large cities still faced considerably higher risks of being exposed to high levels of lead (see Figure HC 2.9 and Table HC 2.9). For many children, these higher risks were probably related to residence in older homes which contained deteriorated lead-based paint.
 
 

Figure HC 2.9  
Percentage of Children Ages 1-5 With Blood Lead Levels Greater Than or Equal To Ten Micrograms per Deciliter 

HC2_9.GIF

Source: Pirkle, James L., Brody, Debra J., Gunter, Elaine W., Kramer, Rachel A., Paschal, Daniel C., Flegal, Katherine M., and Matte, Thomas D. (1994) The Decline in Blood Lead Levels in the United States: The National Health and Nutrition Examination Surveys (NHANES) in Journal of the American Medical Association Volume 272, pp. 284-291. Brody, Debra J., Pirkle, James L., Kramer, Rachel A., Flegal, Katherine M., Matte, Thomas D., Gunter, Elaine W., and Paschal, Daniel C. (1994). Blood Lead Levels in the U.S. Population: Phase 1 of the Third National Health and Nutrition Examination Survey (NHANES III, 1988 to 1991) in Journal of the American Medical Association Volume 272, pp. 277-283.
 
 

Table HC 2.9 
Percentage of Children Ages 1-5 With Blood Lead Levels Greater Than or Equal To Ten Micrograms per Deciliter

 
   
1976-1980
1988-1991
   
 
 
       
ALL CHILDREN AGES 1-5
88.2
8.9
 
  Ages 1-2
88.3
11.5
  Ages 3-5
88.1
7.3
 
Race/Ethnicity
  White, non-Hispanic
85
5.5
  Black, non-Hispanic
97.7
20.6
 
Income
  0 to 129% of Poverty
 
16.3
  130% to 299% of Poverty
 
5.4
  300% of Poverty or Greater
 
4
 
Urban Status
  Central City Greater Than 1 Million
 
21
  Central City Less Than 1 Million
 
16.4
  NonCentral City
 
5.8
 
Source: Pirkle, James L., Brody, Debra J., Gunter, Elaine W., Kramer, Rachel A., Paschal, Daniel C., Flegal, Katherine M., and Matte, Thomas D. (1994) "The Decline in Blood Lead Levels in the United States: The National Health and Nutrition Examination Surveys (NHANES)" in Journal of the American Medical Association Volume 272, pp. 284-291. Brody, Debra J., Pirkle, James L., Kramer, Rachel A., Flegal, Katherine M., Matte, Thomas D., Gunter, Elaine W., and Paschal, Daniel C. (1994). "Blood Lead Levels in the U.S. Population: Phase 1 of the Third National Health and Nutrition Examination Survey (NHANES III, 1988 to 1991)" in Journal of the American Medical Association Volume 272, pp. 277-283.


27 Centers for Disease Control. Preventing Lead Poisoning in Young Children: A Statement by the Centers for Disease Control. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service: 1991.

28 Centers for Disease Control. " Blood Lead Levels -- United States, 1988-1991. Morbidity and Mortality Weekly Report August 5, 1994, Vol. 43, No. 30; and, Pirkle, James L., Brody, Debra J., Gunter, Elaine W., Kramer, Rachel A., Paschal, Daniel C., Flegal, Katherine M., and Matte, Thomas D. (1994) "The Decline in Blood Lead Levels in the United States: The National Health and Nutrition Examination Surveys (NHANES)" in Journal of the American Medical Association Volume 272, pp. 284-291.

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

30 Data for Mexican-American children for 1982-1984 and 1988-1991 show a similar trend. While 61.5 percent of 4-5 year old Mexican-American children had hazardous levels of lead in their blood in 1982-1984 the total was 4.9 percent by 1988-91. Pirkle, James L., Brody, Debra J., Gunter, Elaine W., Kramer, Rachel A., Paschal, Daniel C., Flegal, Katherine M., and Matte, Thomas D. (1994) "The Decline in Blood Lead Levels in the United States: The National Health and Nutrition Examination Surveys (NHANES)" in Journal of the American Medical Association Volume 272, pp. 284-291.
 

HC 2.10 Violent victimization of teens

Violent crimes include simple and aggravated assaults, rape, and robbery (stealing by force or threat of violence). In order to keep track of the incidence of these and other crimes, the United States 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 rose from 79 to 99 per thousand between 1980 and 1990 (see Figure HC 2.10) Rates continued to increase to a high of 123 per thousand in 1993 before declining to 118 per thousand in 1994.

Differences by Gender. Boys are considerably more likely than girls to be victims of violent crimes. In 1994, 141 per thousand boys ages 12 to 17 were victims of violent crimes compared to 95 per thousand girls.
 

Figure HC 2.10  
Violent Victimization of Youth: Rates (per 1,000) for Youth Ages 12-17 

HC2_10.GIF

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 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: Unpublished tables, Bureau of Justice Statistics, National Crime Victimization Survey, 1980-1994.
 
 

Table HC 2.10 
Violent Victimization of Youth: Rates (per 1,000) for Youth Ages 12-17

 
   
1980
1985
1990
1991
1992
1993
1994
   
 
 
 
 
 
 
 
Age
  12-17
79.0
84.3
98.6
106.2
117.9
123.1
118.4
  12-14
70.4
81.4
102.1
97.6
119.3
121.0
118.2
  15-17
86.6
87.1
95.1
115.0
116.4
125.2
118.6
 
Race/Ethnicity
  White
77.7
87.7
95.4
105.1
121.4
125.7
118.4
  Black
91.1
69.3
122.1
127.6
111.8
132.9
135.8
  Other
49.7
71.7
76.1
54.2
79.2
49.4
64.7
 
Sex
  Male
106.4
113.0
131.0
148.9
146.2
149.3
140.5
  Female
50.4
54.3
64.4
61.2
88.1
95.5
95.1
 
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 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: Unpublished tables, Bureau of Justice Statistics, National Crime Victimization Survey, 1980-1994.


 

HC 2.11 Dental caries

"Dental caries" is a technical term referring to either treated or untreated tooth 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.31

Racial and Ethnic Differences in Dental Caries. Mexican American children ages two through four had the highest prevalence of dental caries in their primary teeth (see Figure HC 2.11). Almost one-third of Mexican American children had dental caries compared to 22 percent of black children and 13 percent of white children. Mexican American children also had the highest prevalence of dental caries in permanent teeth, but the gap among children ages five through 17 was much smaller than it was for younger children. Black children had the lowest percentage of dental caries with 39 percent, compared to 45 percent for white children and 49 percent for Mexican American children.
 

Figure HC 2.11  
Percentage of Children with Dental Caries 1988-1991 

HC2_11.GIF

Source: 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, 631-641. Rockville, MD: National Institutes of Health. National Institute of Dental Research, Division of Epidemiology and Oral Disease Prevention.
 
 

Table HC 2.11 
Percentage of Children with Dental Caries 1988-1991

 
 
Non-Hispanic White
Non-Hispanic Black
Mexican-American
 
 
 
 
 
Percent of children ages 2-4 w/dental
caries in primary teeth
13
22
32
 
Percent of children ages 5-17
w/dental caries in permanent teeth
45
39
49
 
Source: 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, 631-641. Rockville, MD: National Institutes of Health. National Institute of Dental Research, Division of Epidemiology and Oral Disease Prevention.


31 Kaste, L.M., R.H. Selwitz, R.J. Oldakowski, J.A. Brunelle, D.M. Winn and L.J. Brown (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: 631-641. Rockville, MD: National Institutes of Health. National Institute of Dental Research, Division of Epidemiology and Oral Disease Prevention.
 
 

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.32 Regular care increases the continuity of care, which is important to the maintenance of good health.

Since 1987, the percentage of children who are not covered by health insurance has stayed stable at 13 to 14 percent (see Table HC 3.1.A). Rates of coverage vary little by age of child, though older children are slightly less likely to be covered.

Differences by Race and Ethnicity. Hispanic children are far less likely to be covered than either white or black children. In 1995, 27 percent of Hispanic children were not covered by health insurance, compared to 13 percent of whites and 15 percent of black children (see Figure HC 3.1.A).

Children Covered by Medicaid. The proportion of children who are covered by Medicaid has grown substantially over time, increasing from 15 percent in 1987 to a high of 24 percent in 1993, before declining slightly to 23 percent in 1994 and 1995 (see Figure HC 3.1.B). Young children are considerably more likely to be covered by Medicaid. In 1995, 30 percent of children under age six were covered, compared to 17 percent of children ages 12 through 17. Finally, a very large proportion of black and Hispanic children rely on Medicaid for their medical coverage. In 1995, 45 percent of black and 37 percent of Hispanic children were covered by Medicaid, compared to 18 percent of white children.
 

Figure HC 3.1.A  
Percentage of Children Under Age 18 Not Covered by Health Insurance, by Race and Ethnicity Group: 1995 

HC3_1A.GIF

Source: Unpublished Tables, based on Analyses from the March Current Population Surveys. Housing and Household Economic Statistics Division, U.S. Bureau of the Census.
 
 

Figure HC 3.1.B  
Percentage of Children Under Age 18 Who Were Covered by Medicaid: 1987-1995 

HC3_1B.GIF

Source: Unpublished Tables, based on Analyses from the March Current Population Surveys. Housing and Household Economic Statistics Division, U.S. Bureau of the Census.
 
 

Table HC 3.1.A 
Percentage of Children Under Age 18 Not Covered by Health Insurance: 1987-1995

 
   
1987
1988
1989
1990
1991
1992
1993
1994
1995
   
 
 
 
 
 
 
 
 
 
 
All Children
13
13
13
13
13
13
14
14
14
 
Age 0-5
12
13
13
11
11
11
12
14
13
Age 6-11
13
13
13
13
12
12
13
13
13
Age 12-17
14
14
14
15
15
15
17
15
14
 
Race/Ethnicity
  White
12
12
12
13
12
12
13
13
13
  Black
17
16
16
15
15
14
16
17
15
  Hispanic
28
29
30
28
27
25
26
28
27
 
Source: Unpublished Tables, based on Analyses from the March Current Population Surveys. Housing and Household Economic Statistics Division, U.S. Bureau of the Census. 

Table HC 3.1.B 
Percentage of Children Under Age 18 Covered by Medicaid: 1987-1995

 
     
1987
1988
1989
1990
1991
1992
1993
1994
1995
     
 
 
 
 
 
 
 
 
 
 
All Children
15
16
16
19
20
22
24
23
23
 
    Age 0-5
18
19
20
24
27
30
32
30
30
    Age 6-11
15
15
15
17
19
20
22
22
23
    Age 12-17
12
12
11
14
15
15
17
16
17
                       
Race/Ethnicity
    White
11
11
11
14
16
17
19
18
18
    Black
38
38
37
42
44
46
47
44
45
    Hispanic
26
25
25
30
34
37
39
37
37
 
Source: Unpublished Tables, based on Analyses from the March Current Population Surveys. Housing and Household Economic Statistics Division, U.S. Bureau of the Census. 


32 National Center for Health Statistics, "Health of Our Nations Children" 1988. Vital Statistics Health Series, No. 191.
 
 

HC 3.2.a 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 number 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.33

The percentage of mothers receiving prenatal care in the first trimester has increased from 68.0 percent in 1970 to 81.2 percent in 1995 (see Table HC 3.2.A). 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 three months of pregnancy has increased over the past two decades for white, black, and Hispanic women.34 While the gains have been greatest for black and Hispanic women, white women are still the most likely to receive prenatal care in their first trimester (see Figure HC 3.2.A).
 

  • 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 to 60.6 percent in 1990, but continued to increase in subsequent years, reaching 70.3 percent by 1995.
  • The percentage of Hispanic women who receive early prenatal care has increased steadily, from 60.2 percent in 1980 to 70.4 percent by 1995.
  • 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 83.5 percent by 1995.

Differences by Age of Mother. Older women are more likely to receive early prenatal care than are younger women. Although there have been improvements in the receipt of early prenatal care by teenagers, this age group is consistently the least likely to receive prenatal care in the first trimester of pregnancy.

  • Receipt of early prenatal care among women under age 15 improved considerably between 1975 and 1994, increasing from 30.9 percent to 45.7 percent.
  • The percentage of women age 35 and over who received early prenatal care also improved during this time period, increasing from 68.4 percent in 1975 to 86.2 percent by 1994.
  • More than 80 percent of mothers age 25 and older received early prenatal care throughout the 1990s.

Figure HC 3.2.A  
Percentage of Mothers Receiving Prenatal Carea in the First Trimester, by Race/Ethnicity,b for Selected Years 1970-1995 

HC3_2A.GIF

Notes: aThe data refer to those women who had live births.
bPercentages are based on the race and ethnicity of the mother.
cFigures for Hispanic women in 1980 are based on data from 22 States which report Hispanic origin on the birth certificate; 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.
dData for 1995 are preliminary.

Source: National Center for Health Statistics. Health, United States, 1995. Hyattsville, Maryland: Public Health Service. 1996. (table 7 for totals and race/ethnicity breaks for 1970-1993); 1975 data from: Monthly Vital Statistics Report. Vol. 25, No. 10, Supplement. 1976 (table 17); 1980 data from: Monthly Vital Statistics Report. Vol. 31, No. 8, Supplement. 1982 (table 20); 1985 data from: Monthly Vital Statistics Report. Vol. 36, No. 4, Supplement. 1987 (table 25); 1990 data from: Monthly Vital Statistics Report. Vol. 41, No. 9, Supplement. 1993 (tables 26 and 30); 1992 data from: Ventura, S.J., Martin, J.A., Taffel, S.M., Mathews, T.J. and Clarke S.C. Advance Report of Final Natality Statistics, 1992. Monthly Vital Statistics Report, Vol. 43, No. 5, Supplement. Hyattsville, Maryland: National Center for Health Statistics. 1994 (tables 24 and 33); 1993 data from: Ventura, S.J., Martin, J.A., Taffel, S.M., Mathews, T.J. and Clarke S.C. Advance Report of Final Natality Statistics, 1993. Monthly Vital Statistics Report, Vol. 44, No. 3, Supplement. Hyattsville, Maryland: National Center for Health Statistics. 1995 (tables 24 and 33); 1994 data from: Ventura, S.J., Martin, J.A., Mathews, T.J. and Clarke S.C. Advance Report of Final Natality Statistics, 1994. Monthly Vital Statistics Report, Vol. 44, No. 11, Supplement. Hyattsville, Maryland: National Center for Health Statistics. 1996 (tables 24 and 33). 1995 preliminary data from: Rosenberg, H.M., Ventura, S.J., Maurer, J.D., Heuser, R.L., Freedman, M.A. Births and Deaths: United States, 1995. Monthly Vital Statistics Report, Vol 45, No. 3, Supplement 2. Hyattsville, Maryland: National Center for Health Statistics. 1996 (table A).
 
 

Table HC 3.2.A  
Percentage of Mothers Receiving Prenatal Care in the First Trimester:  Selected Years, 1970-1995a

 
   
1970
1975
1980
1985
1990
1992
1993
1994
1995d
   
 
 
 
 
 
 
 
 
 
 
Total 
68.0
72.4
76.3
76.2
75.8
77.7
78.9
80.2
81.2
 
Race/Ethnicityb,c
  White
72.3
75.8
79.2
79.3
79.2
80.8
81.8
82.8
83.5
  Black
44.2
55.5
62.4
61.5
60.6
63.9
66.0
68.3
70.3
  Hispanic
 
 
60.2
61.2
60.2
64.2
66.6
68.9
70.4
 
Age of Mother
  Under 15
 
30.9
34.5
36.0
37.9
42.9
44.8
45.7
 
  15-19
 
53.3
56.3
53.9
55.1
59.5
61.9
64.3
 
  20-24
 
73.4
74.9
71.7
68.9
71.2
72.8
74.6
 
  25-29
 
81.5
84.0
83.1
81.7
82.9
83.6
84.5
 
  30-34
 
78.9
84.4
85.5
85.3
86.4
86.9
87.7
 
  35 and older
 
68.4
76.1
81.3
83.4
84.6
85.3
86.2
 
 
Note: aThe data refer to those women who had live births.  
bPercentages are based on the race and ethnicity of the mother.  
cFigures for Hispanic women in 1980 are based on data from 22 States which report Hispanic origin on the birth certificate; 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.  
dData for 1995 are preliminary.  

Sources: National Center for Health Statistics. Health, United States, 1995. Hyattsville, Maryland: Public Health Service. 1996. (table 7 for totals and race/ethnicity breaks for 1970-1993); 1975 data from: Monthly Vital Statistics Report. Vol. 25, No. 10, Supplement. 1976 (table 17); 1980 data from: Monthly Vital Statistics Report. Vol. 31, No. 8, Supplement. 1982 (table 20); 1985 data from: Monthly Vital Statistics Report. Vol. 36, No. 4, Supplement. 1987 (table 25); 1990 data from: Monthly Vital Statistics Report. Vol. 41, No. 9, Supplement. 1993 (tables 26 and 30); 1992 data from: Ventura, S.J., Martin, J.A., Taffel, S.M., Mathews, T.J. and Clarke S.C. "Advance Report of Final Natality Statistics, 1992." Monthly Vital Statistics Report, Vol. 43, No. 5, Supplement. Hyattsville, Maryland: National Center for Health Statistics. 1994 (tables 24 and 33); 1993 data from: Ventura, S.J., Martin, J.A., Taffel, S.M., Mathews, T.J. and Clarke S.C. "Advance Report of Final Natality Statistics, 1993." Monthly Vital Statistics Report, Vol. 44, No. 3, Supplement. Hyattsville, Maryland: National Center for Health Statistics. 1995 (tables 24 and 33); 1994 data from: Ventura, S.J., Martin, J.A., Mathews, T.J. and Clarke S.C. "Advance Report of Final Natality Statistics, 1994." Monthly Vital Statistics Report, Vol. 44, No. 11, Supplement. Hyattsville, Maryland: National Center for Health Statistics. 1996 (tables 24 and 33). 1995 preliminary data from: Rosenberg, H.M., Ventura, S.J., Maurer, J.D., Heuser, R.L., Freedman, M.A. "Births and Deaths: United States, 1995." Monthly Vital Statistics Report, Vol 45, No. 3, Supplement 2. Hyattsville, Maryland: National Center for Health Statistics. 1996  
(table A).


33 U.S. Public Health Service. "Caring for Our Future: The Content of Prenatal Care." Washington, D.C.: U.S. Department of Health and Human Services. 1989.as increased from 68.0 percent in 1970 to 81.2 percent in 1995 (see Table HC 3.2.A). Following a decade of essentially no change, the proportion of women receiving early prenatal care has improved incrementally throughout the 1990s.

34 This data includes only those women who gave birth, not all women who were pregnant.
 

HC 3.2.b 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 low birth weight, who are stillborn, or who die within the first year of life.35 Between 1970 and 1994, the percentage of women receiving late or no prenatal care declined from 7.9 percent to 4.4 percent (see Figure HC 3.2.B).

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

  • Black mothers have seen the most dramatic improvement, with the percentage receiving late or no prenatal care dropping by half between 1970 and 1994. In 1994, 8.2 percent of black mothers received late or no prenatal care.
  • The percentage of Hispanic women receiving late or no prenatal care has decreased every year since 1990, and at 7.6 percent in 1994 was lower than the rate for black women.
  • White women have consistently been least likely to receive late or no prenatal care. In 1994, 3.6 percent of white women received late or no prenatal care.

Differences by Age. In general, as the age of the mother increases, the likelihood of receiving late or no prenatal care decreases. The percentage of mothers age 15 and younger who received late or no prenatal care is nearly double that of mothers ages 15 through 19, and three to five times greater than mothers 20 years and older. Although their rates remain much higher than any other age group, the percentage of mothers age 15 and under who received late or no prenatal care has improved dramatically since 1975, decreasing to 15.9 percent by 1994. Percentages among mothers age 15 through 19 have also improved over this time period, decreasing to 8.0 percent in 1994. Less than four percent of women in each age group over 25 received late or no prenatal care during pregnancy, especially women age 30 through 34 whose rate of late or no prenatal care reached a new low of 2.7 percent in 1994.
 

Figure HC 3.2.B  
Percentage of Mothers Receiving Latea or No Prenatal Care: Selected Years, 1970-1994b 

HC3_2B.GIF

Notes: aLate prenatal care is defined as 7th month or later. bThe data refer to those women who had live births. Source: 1970 and 1975 data from: Unpublished tabulations, National Center for Health Statistics. 1980 - 1993 data from: National Center for Health Statistics. Health United States, 1995. Hyattsville, Maryland: Public Health Service, 1996 (table 7). 1994 data from: Ventura, S.J., Martin, J.A., Mathews, T.J. and Clarke, S.C. Advance Report of Final Natality Statistics, 1994. Monthly Vital Statistics Report, Vol. 44, No. 11, Supplement. Hyattsville, Maryland: National Center for Health Statistics. 1996 (tables 24 and 33).
 
 

Table HC 3.2.B 
Percentage of Mothers Receiving Latea or No Prenatal Care: Selected Years, 1970-1994b

 
   
1970
1975
1980
1985
1990
1992
1993
1994
   
 
 
 
 
 
 
 
 
 
Total
7.9
6
5.1
5.7
6.1
5.2
4.8
4.4
 
                 
Race/Ethnicityc,d
  White
6.3
5
4.3
4.8
4.9
4.2
3.9
3.6
  Black
16.6
10.5
8.9
10.2
11.3
9.9
9
8.2
  Hispanic
 
 
12
12.4
12
9.5
8.8
7.6
 
Age
  < 15
 
21.1
20
20.5
20.3
17.2
16.6
15.9
  15-19
 
10.8
10.3
12
11.9
9.7
8.9
8
  20-24
 
5.8
5.4
6.9
8
6.7
6.2
5.6
  25-29
 
3.6
3.1
3.8
4.4
3.9
3.7
3.4
  30-34
 
4.3
3
3.1
3.4
3
2.9
2.7
  35 and older
 
7.5
5.4
4.5
4.1
3.6
3.4
3.1
 
Notes:  aLate prenatal care is defined as 7th month or later.  
bThe data refer to those women who had live births.  
cPercentages are based on the race and ethnicity of the mother.  
dFigures for Hispanic women in 1980 are based on data from 22 States which report Hispanic origin on the birth certificate; 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: 1970 and 1975 data from: Unpublished tabulations, National Center for Health Statistics. Health, United States, 1995. Hyattsville, Maryland: Public Health Service. 1996. (table 7 for totals and race/ethnicity breaks for 1980-1993); 1980 data from: Monthly Vital Statistics Report. Vol. 31, No. 8, Supplement. 1982 (table 20); 1985 data from: Monthly Vital Statistics Report. Vol. 36, No. 4, Supplement. 1987 (table 25); 1990 data from: Monthly Vital Statistics Report. Vol. 41, No. 9, Supplement. 1993  
(tables 26 and 30); 1992 data from: Ventura, S.J., Martin, J.A., Taffel, S.M., Mathews, T.J. and Clarke, S.C. "Advance Report of Final Natality Statistics, 1992." Monthly Vital Statistics Report, Vol. 43, No. 5, Supplement. Hyattsville, Maryland: National Center for Health Statistics. 1994 (tables 24 and 33); 1993 data from: Ventura, S.J., Martin, J.A., Taffel, S.M., Mathews, T.J. and Clarke S.C. "Advance Report of Final Natality Statistics, 1993." Monthly Vital Statistics Report, Vol. 44, No. 3, Supplement. Hyattsville, Maryland: National Center for Health Statistics. 1995 (tables 24 and 33); 1994 data from: Ventura, S.J., Martin, J.A., Mathews, T.J. and Clarke S.C. "Advance Report of Final Natality Statistics, 1994." Monthly Vital Statistics Report, Vol. 44, No. 11, Supplement. Hyattsville, Maryland: National Center for Health Statistics. 1996  
(tables 24 and 33).


35 U.S. Public Health Service. "Caring for Our Future: The Content of Prenatal Care." Washington, D.C.: U.S. Department of Health and Human Services. 1989.ve late or no prenatal care has declined substantially for mothers in all race and ethnic groups (see Table HC 3.2.B):
 

HC 3.2.c Inadequate 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. After fluctuating for the latter half of the 1980s, the percentage of mothers receiving inadequate prenatal care has decreased since 1990.

Differences by Race. While the percentages of both black and white women receiving inadequate prenatal care have declined since 1990, the percentage of black women receiving inadequate care has consistently been more than twice as high as the percentage of white women receiving inadequate care. This gap has existed since at least 1984 (see Table HC 3.2.C). For example, in 1994, 12.0 percent of black women received inadequate prenatal care, compared to 4.9 percent of white women.
 

Table HC 3.2.C 
Percentage Receiving Inadequate Prenatal Care (Based on the Kessner Indexa), by Race for Selected Years: 1984-1994b

                   
   
1984
1986
1988
1990
1991
1992
1993
1994
   
 
 
 
 
 
 
 
 
Racec
  White
6.2
6.3
6.1
6.8
6.4
5.7
5.3
4.9
  Black
15.1
15.3
15.5
16.4
15.5
14.5
13.1
12
 
Notes: aThe Kessner Index provides a measure for the adequacy of prenatal care by assessing the timeliness and frequency with which prenatal care is received according to the gestational age of the baby. Using the Kessner Index standards, prenatal care is determined to be adequate, intermediate or inadequate. Adequate prenatal care must begin within the first trimester of pregnancy and follow a prescribed number of minimum prenatal visits by gestational period. Inadequate care encompasses all women who started care after the sixth month of pregnancy (3rd trimester) and all women who had a low frequency of prenatal visits that followed the pattern described in the following chart: 
 
Gestation (Weeks)
 
Number of Prenatal Visits
 
 
 
17 - 21
and
0
22 - 29
and
1 or less
30 - 31
and
2 or less
32 - 33
and
3 or less
34 or More
and
4 or less
bBased on 49 states for 1984-1988 and all 50 states of the United States, 1989-1994. Births with period of gestation, number of prenatal visits or month pregnancy care began not stated were excluded from tabulation.  
cIn 1990, 1991, 1992, 1993 and 1994 race is of mother; for 1984, 1986 and 1988, race is of child.  

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


 

HC 3.3 Immunization

Childhood vaccinations can prevent diseases that killed or permanently impaired many children in past decades. The Centers for Disease Control and Prevention recommend that 80 percent of all routine childhood vaccinations be administered within the first two years of life. Vaccination coverage is particularly important before children enter preschool to prevent the spread of disease.

There were substantial increases in the proportion of children vaccinated between 1991 and 1994 for each of the recommended vaccines presented in Table HC 3.3.A. These improvements are observed for all children, but particularly for low-income children, minority children, and children living in urban and rural areas (see Table HC 3.3.A). Between 1991 and 1994 there was also a substantial improvement in the proportion of children receiving the combined series of DTP, OPV and MMR (4:3:1)36 vaccination (see Figure HC 3.3.A).

Even with the increases of recent years, more than one million children remain unvaccinated for serious preventable diseases.37 In particular, there are differences in immunization rates by income, race, and place of residence.

Differences by Income. Children in households at or above poverty are more likely to have received each of the vaccinations specified in each year from 1991 to 1994 than are children in households below poverty. However, the gap between vaccination levels of poor and non-poor children decreased from 1991 to 1994. For instance, the percentage of poor children vaccinated for polio was 38.7 percent in 1991, compared to 59.5 percent of children at or above the poverty line, nearly a 21 percentage point gap. By 1994, that gap had closed to less than one percentage point, with respective percentages at 79.4 and 79.9.

Differences by Race. White infants ages 19 to 35 months have higher percentages of vaccination receipt than do black children or children of other races. The disparity in vaccination levels between white and black infants has narrowed from 1991 to 1994, as the vaccination levels of black children have greatly improved.

Differences by Place of Residence. For many, but not all diseases, suburban children are more likely than either rural or urban children to have been vaccinated.

Provider-Adjusted Estimates. Unlike data for previous years, which were based only on parent reports, 1994-1995 immunization estimates are based on information from parents and health care providers. These newer estimates are more accurate and reflect higher rates of immunization than those based on parent reports alone. Data for 1994-1995 cannot be compared to estimates for 1991-1994, however, since an undetermined portion of the observed increase is due to this change in methodology.

The most recent provider-adjusted estimates (July 1994June 1995) indicate that 75 percent of children ages 19 to 35 months received their 4:3:1 combined series vaccinations. Fifty-one percent of all children in that age group had received their Hepatitis B vaccination (see Table HC 3.3.B).
 

Figure HC 3.3.A  
Percentage of Children 19-35 Months Who Received the Combined Seriesa Immunizations:b 1991-1994 

HC3_3A.GIF

Note: aFour doses DTP, three doses poliovirus, one dose measles-mumps-rubella vaccine. bData are based on household interviews of a sample of the non-civilian, non- institutionalized population. Refusals and unknowns were excluded.

Source: Centers for Disease Control and Prevention. Data computed by the National Immunization Program, Center for Prevention Services from data compiled by the Division of Health Interview Statistics, National Center for Health Statistics.
 
 

Figure HC 3.3.B  
Vaccination Coverage Levels Among Children Aged 19-35 Months, by Selected VaccinesNational Immunization Survey, U.S., July 1994June 1995 

HC3_3B.GIF

Note: a3 DTP/DT is 3 or more doses of diphtheria and tetanus toxoids and pertussis vaccine/diphtheria and tetanus toxoids.
b4 DTP/DT is 4 or more doses of DTP/DT.
cPoliovirus is 3 or more doses of poliovirus vaccine.
dHib is 3 or more doses of Haemophilus influenzas type b vaccine.
eMMR is 1 or more doses of measles-mumps-rubella vaccine.
fHepatitis B is 3 or more doses of Hepatitis B vaccine.

Source: Morbidity and Mortality Weekly Reports. National, State and Urban Area Vaccination Coverage Levels Among Children Aged 19-35 Months - United States, July 1994 - June 1995, June 21, 1996, Vol. 45, No. 24, Table 1.
 
 

Table HC 3.3.A 
Percentage of Children Aged 19-35 Months Who Have Received Vaccinations for Routinely Recommended Vaccinesa, by Selected CharacteristicsU.S.: 1991-1994

 
   
Race
Poverty Statusb
Location of Residencec
         
Below
Poverty
At/Above
Poverty
     
 
Total
White
Black
Otherd
Urban
Suburban
Rural
>3 Doses DTP* 
1991
68.8
73.4
50.6
58
53
75.7
64.8
72.3
67.6
1992
83.1
84.8
74.7
79.3
79.7
84.6
82.5
84.4
80.7
1993
88.2
89.4
82.6
84.5
80.6
90.8
85.8
89.8
88.5
1994
89.5
90.6
84.4
87.9
88.8
90.3
87.7
90.4
90
>4 Doses DTP*`
1991
43.3
47.3
27.9
33.1
29.9
48.6
36.4
46.4
47.5
1992
59
59.5
55
62.4
54.4
61
59.7
60
55.4
1993
72.1
73
69.2
64.7
65.3
74.6
68.5
75.6
70.6
1994
70.1
70.8
64.4
77.3
67.7
71.2
67.2
72.1
69.9
>3 Doses Poliovirus
1991
53.2
57.3
35.6
49.8
38.7
59.5
49.9
55.8
52.5
1992
72.4
74.1
62.7
75.5
66.6
74.7
74.1
72.6
69
1993
78.9
79.8
73.4
80.8
73.3
81
75.3
79.7
82.5
1994
79.2
80.3
73.2
81.7
79.4
79.9
76.4
80.9
79.5
>3 Doses Hib**
1991
1.7
1.9
1.4
0
0
2.2
0.9
2.5
1.2
1992
28.2
29.1
25.5
23
23
29.8
27.5
31.8
20.8
1993
55
56.9
44.8
56.9
43.9
59.6
47.8
60.5
55.2
1994
75
76.6
67.2
72.3
72.1
76.6
70.6
76.7
77.6
Measles
1991
82
82.9
77.4
83.8
73.4
86.6
78.4
85
81.1
1992
82.5
83.6
77.9
79.9
80.2
84.3
84.5
83.3
77.2
1993
84.1
86
76.9
72.5
78.4
86.9
84.2
86.2
79.8
1994
90.3
91.7
86
81.1
88.3
91.8
87.9
91.7
91
>3 Doses Hepatitis B
1991
 
 
 
 
 
 
 
 
 
1992
 
 
 
 
 
 
 
 
 
1993
16.3
16.3
16
16.7
11.3
18.2
17.4
19
9.3
1994
34.4
33.7
36.2
39.7
31.6
35.2
33.8
37.8
27.1
Combined Series: 4:3:1
1991
37
41.4
20.8
27.5
23.8
42.2
31.7
38.6
41.9
1992
55.3
55.9
50.9
57.5
51.4
56.7
57.7
55.4
50.5
1993
67.1
68.4
61.8
58.4
58.7
70.5
62.1
71.4
66
1994
67.5
68.4
61.2
72.4
64.9
68.8
63.5
69.7
68.3
Combined Series: 3:3:1§
1991
50
54.5
31.4
44.2
34.3
56.6
46.6
52.8
49.4
1992
68.7
70
60.2
71.9
65
70.2
72.4
68.2
63.2
1993
74.5
75.7
69.2
68
66.8
77.7
71.5
76.3
75.3
1994
77.3
78.7
70.5
76.3
76.6
78.4
72.9
79.5
78.9
 
*Diphtheria, tetanus toxoids, and pertussis vaccine.  
**Hemophilus influenzas type b vaccine.  
Any vaccination containing measles vaccine.  
Four doses DTP, three doses poliovirus, one dose measles-mumps-rubella vaccine.  
§Three doses DTP, three doses poliovirus, one dose measles-mumps-rubella vaccine.  
aData are based on household interviews of a sample of the non-civilian, non institutionalized population. Refusals and unknowns were excluded. Exclusions included unknown vaccine type.  
bPoverty status is based on family income and family size using Bureau of the Census poverty thresholds.  
cRural areas were those not in a metropolitan statistical area (MSA); suburban areas were those in an MSA but outside the central city; and urban areas were the central city of the MSA.  
dLimitations in sample size precluded collection of data about ethnicity and analysis of data for races other than black and white.  

Source: Centers for Disease Control and Prevention. Data computed by the National Immunization Program, Center for Prevention Services from data compiled by the Division of Health Interview Statistics, National Center for Health Statistics.

 
 

Table HC 3.3.B 
Percentage of Children Aged 19-35 Months Who Have Received Vaccinations for Routinely Recommended Vaccine, by Selected VaccinesNational Immunization Survey, U.S.a 
July 1994June 1995

 
Vaccine  Dose 
July 1994 - June 1995
 
DPT/DT*
  >3 Doses
94
  >4 Doses
78
Poliovirus  
 
>3Doses
86
Hib¶  
  >3 Doses 
91
MMR§  
  >1 Dose
89
Hepatitis B  
  >3 Doses 
51
    19-24 Months
64
    25-30 Months
51
    31-35 Months
34
Combined Series  
  4 DTP/3 Polio/1 MMR
75
  4 DTP/3 Polio/1 MMR/3 Hib
73
 
*Diphtheria and tetanus toxoids and pertussis vaccine/Diphtheria and tetanus toxoids.  
¶Hemophilus influenzas type b vaccine.  
§Measles-mumps-rubella vaccine.  
Four doses DTP/DT, three doses poliovirus vaccine, and one dose MMR.  
Four doses DTP/DT, three doses poliovirus vaccine, one dose MMR, three doses Hib.  
aData are based on household interviews of a sample of the non-civilian, non-institutionalized population.  
Refusals and unknowns were excluded.  

Note: In 1994-1995, data from the household interviews is supplemented with information from medical providers and cannot be compared to 1991-1993 data.  

Source: Morbidity and Mortality Weekly Reports. "National, State and Urban Area Vaccination Coverage Levels Among Children Aged 19-35 Months," June 21, 1996, Vol. 45, No. 24, Table 1. (Data from the National Immunization Survey.)


36 Four doses diphtheria, tetanus toxoids and pertussis vaccine (DTP); three doses poliovirus vaccine (OPV); and one dose measles-mumps-rubella vaccine (MMR).

37 Centers for Disease Control and Prevention. "Vaccination Coverage Levels Among Children Aged 19-35 Months -- United States, April-December 1994." Morbidity and Mortality Weekly Report. Vol. 44, No. 33, August 25, 1995
 
 

SECTION 4 SOCIAL DEVELOPMENT, BEHAVIORAL HEALTH, AND TEEN FERTILITY (SD)

SOCIAL DEVELOPMENT

SD 1.1 Life goals

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 1976 through 1995 are presented in Table SD 1.1. Personal goals include being successful at 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 the community.

From 1976 through 1995, high school seniors have been fairly consistent in the relative importance they assign to various life goals. Specifically:

  • Having a Good Marriage and Family Life and Being Successful in My Line of Work have been cited most often by high school seniors as being extremely important. By 1995, four out of five high school seniors felt it extremely important to have a good marriage and family life (see Figure 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. The percentage of seniors who find these goals important is considerably lower, hovering between 20 and 30 percent 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 the Community are important goals for only small percentages of high school seniors 10 percent and 12 percent, respectively, in 1995 (see Figure SD 1.1.B).

Differences by Race. In 1995, black students were more likely than whites to view as extremely important issues such as being successful at work (72 percent versus 59 percent), having lots of money (41 percent versus 21 percent), and correcting social and economic inequalities (18 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 time.

Differences by Gender. Across the six goals, rates vary little between male students and female students with two exceptions. In 1995, females were more likely to indicate that having a good marriage and family life was extremely important (83 percent versus 73 percent), and were less likely to report that having lots of money was an extremely important goal (19 percent versus 30 percent).
 

Figure SD 1.1.A  
Percentage of High School Seniors Who Rate Selected Personal Goals as Being Extremely Important, 1995 

SD1_1A.GIF

Source: Bachman, J.G., Johnston, L.D., and OMalley, P.M. Monitoring the Future: Questionnaire responses from the Nations High School Seniors, 1995. Questionnaire form 1 numbers, A007A, A007B, A007C. 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 1.1.B  
Percentage of High School Seniors Who Rate Selected Social Goals as Being Extremely Important, 1995 

SD1_1B.GIF

Source: Bachman, J.G., Johnston, L.D., and OMalley, P.M. Monitoring the Future: Questionnaire responses from the Nations High School Seniors, 1995. Questionnaire form 1 numbers, A007G, A007H, A007L. Data based on one of six questionnaire forms with a resulting sample size one-sixth of the total sample size for each year.
 
 

Table SD 1.1  
Percentage of High School Seniors Who Rate Selected Life Goals as Being "Extremely Important," 1976-1995

                       
       
1976
1981
1986
1991
1992
1993
1994
1995
       
 
 
 
 
 
 
 
 
                       
Personal Goals
Being Successful in My Line of Work
                       
Total
53
57
61
62
66
65
63
62
  Gender 
    Male  
53
58
62
60
63
63
61
62
    Female  
52
57
60
64
69
67
66
62
  Race
    White  
50
55
58
59
65
62
60
59
    Black  
67
71
73
75
80
74
79
72
                       
Having a Good Marriage and Family Life
                       
Total
73
76
75
76
78
79
76
78
  Gender
    Male  
66
71
69
71
72
74
70
73
    Female  
80
82
82
83
84
85
81
83
  Race 
    White  
72
77
76
76
79
79
76
78
    Black  
75
73
76
78
75
76
72
76
                       
Having Lots of Money
                       
Total
15
18
27
28
29
26
26
25
  Gender
    Male  
20
24
34
37
35
32
32
30
    Female  
11
13
18
19
22
18
19
19
  Race 
    White  
12
15
24
25
24
20
22
21
    Black  
33
32
38
39
46
45
47
41
                       
 

 
 

Table SD 1.1 Continued 
Percentage of High School Seniors Who Rate Selected Life Goals as Being "Extremely Important," 1976-1995

                       
       
1976
1981
1986
1991
1992
1993
1994
1995
       
 
 
 
 
 
 
 
 
                       
Social Goals
                       
Making a Contribution to Society
Total
18
18
17
21
22
24
24
20
  Gender 
    Male  
16
19
18
20
22
25
23
19
    Female  
20
17
16
22
23
25
25
21
  Race
    White  
18
18
16
20
22
24
23
19
    Black  
23
21
20
27
27
25
29
25
                       
Working to Correct Social and Economic Inequalities
Total
10
10
9
12
15
15
14
10
  Gender
    Male  
8
9
7
11
14
14
12
9
    Female  
13
10
11
13
17
16
16
10
  Race
    White  
8
7
7
10
13
12
11
8
    Black  
20
21
19
21
26
21
25
18
                       
Being a Leader in My Community
Total
7
8
9
11
13
13
14
12
  Gender
    Male  
8
8
11
12
14
17
14
14
    Female  
6
7
6
10
11
10
13
10
  Race
    White  
6
7
8
9
11
12
12
10
    Black  
14
14
12
17
21
19
21
22
                       
Source: Bachman, J. G., Johnston, L. D. & O Malley, P. M. "Monitoring the Future: Questionnaire Responses from the Nations High School Seniors" 1976, 1981, 1986, 1991, 1992, 1993, 1994, 1995 Questionnaire Form 1 numbers. A007A, A007B, A007C, A007G, A007H, A007L. Data based on one of six questionnaire forms with a resulting sample size one-sixth of the total sample size for each year.


 

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 1995, the percentage of 12th graders reporting that their peers value good grades stayed fairly constant, varying between 44 percent and 49 percent (see Table 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 33 percent in 1990, and remained at that level before rising slightly to 36 percent in 1995 (see Table SD 1.2.B).

Differences by Age. Eighth grade students were more likely than either 10th or 12th graders to report that their peers consider good grades to be of great or very great importance in 1995 (55 percent versus 44 and 46 percent, respectively). On the other hand, 12th grade students were more likely than 8th or 10th graders to report peer disapproval of intentionally angering a teacher in school (36 percent versus 22 and 24 percent, respectively).

Differences by Gender. Female students in each grade were 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 1995, 50 percent of females and only 41 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, 41 percent of 12th grade females and 32 percent of 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 1995, 40 percent of white and 67 percent of black 12th graders reported that their peers believed that good grades were of great or very great importance.
 

Figure SD 1.2.A  
Percentage of 12th Grade Students Reporting that Good Grades Have Great or Very Great Importance to Peers, by Race, Selected Years, 1980-1995 

SD1_2A.GIF

Source: Bachman, J. G., Johnston, L. D., O Malley, P. M. Monitoring the Future: Questionnaire Responses from the Nations High School Seniors 1980, Questionnaire Form 5 number E06D. Bachman, J. G., Johnston, L. D. & O Malley, P. M. Monitoring the Future: Questionnaire Responses from the Nations High School Seniors 1985, 1990-1995, Questionnaire Form 3 number E06D.
 
 

Figure SD 1.2.B  
Percentage of 12th Grade Students Reporting Peer Disapproval of Intentionally Angering a Teacher in School, by Race: Selected Years, 1980-1995 

SD1_2B.GIF

Source: Bachman, J. G., Johnston, L. D., O Malley, P. M. Monitoring the Future: Questionnaire Responses from the Nations High School Seniors 1980, 1985 1990, 1991-1995 Questionnaire Form 1 number D007.
 
 

Table SD 1.2.A  
Positive Peer Influences: Percentage of 8th, 10th, and 12th Grade Students Reporting that Good Grades Have Great or Very Great Importance to Peers, by Gender and Race/Ethnicity: Selected Years, 1980-1995

                       
     
 
1980
1985
1990
1991
1992
1993
1994
1995
     
 
 
 
 
 
 
 
 
 
8th Grade
Total 
--
--
--
51
52
54
54
55
  Gender
    Male
 
--
--
--
50
50
54
52
52
    Female
 
--
--
--
53
53
54
55
56
  Race
    White
 
--
--
--
47
47
49
49
48
    Black
 
--
--
--
72
72
70
70
72
                       
10th Grade
Total
--
--
--
44
43
39
42
44
  Gender
 
 
Male  
--
--
--
42
42
36
39
43
 
 
Female  
--
--
--
46
44
42
45
45
 
Race 
    White  
--
--
--
38
38
35
38
39
    Black  
--
--
--
67
66
59
64
67
                       
12th Grade
Total
48
49
48
44
45
46
45
46
  Gender
    Male  
48
50
46
41
42</