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Trends in the Well-Being of America's Children and Youth, 2003

Publication Date


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

  • Population, Family, and Neighborhood;
  • Economic Security;
  • Health Conditions and Health Care;
  • Social Development and Behavioral Health; and
  • Education and Achievement.

For each indicator, graphs illustrate key trends and important population subgroup differences, while tables provide detailed information for the interested user. These graphic elements are accompanied by text that briefly discusses 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 past few years so that trends may be shown. Where possible, trends are presented from the 1970s through the year 2002. In a few cases, data for earlier years are also presented, as are projections into the future.

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

The final list of indicators was modified based on a number of practical considerations that included data availability (the data needed to be available for a nationally representative sample and on a regular basis), timeliness (the estimates had to be available for 1990 or later), and quality and consistency (the data had to be both reliable and consistently measured over time).

Several sections of this report have been revised for the 2003 edition. Two indicators have been combined, “Fertility and Birth Rates” and “Youth Births,” while other indicators have been updated with new sources of data. For example, the indicators “Foreign Born Population,” “Children in Foster Care,” “Child Care,” “Children and Youth with HIV/AIDS,” “Drug Use,” and “Student Computer Use” all have been expanded to present a more complete picture of the lives of children and youth today. Two new indicators, “Average Age of Mothers” and “Children and Youth Served Under the Individuals with Disabilities Act,” have been added to this year’s report. Indicators are removed for reasons such as unavailable timely information. The following indicators have been removed in Trends 2003: “Closeness with Parents” and “Parents’ Activities with Children.”

As part of the data verification process, agencies can, and do, revise information submitted for the most current year as well as information submitted for earlier years. As a result of these revisions, some of the information shown in this report differs from previously published figures.

The Need for Better Data on Children

As this report demonstrates, the data available for tracking the well-being of children and youth at the national level are fairly extensive. Even so, there remain some gaps in the Federal statistical system that when filled will give a more 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 preteenage children that are measured on a regular basis. Measures of mental health for any age child are limited, although one such measure was recently added to the National Health Interview Survey. Positive measures of social development and related behaviors also are limited, with the result that the current set of indicators may present a gloomier picture of our children’s overall well-being than is in fact the case. New indicators that reflect the positive developments we desire for our children and youth clearly need to be developed and incorporated into the Federal statistical system.

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

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

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

Federal Interagency Forum on Child and Family Statistics

The Federal Interagency Forum on Child and Family Statistics, (the Forum) an interagency group of leaders of Federal agencies and departments responsible for collecting data on children and youth, has adopted a mandate to improve the Federal statistical system regarding data on children, youth, and their families. Member agencies have played a crucial role in the production of this report, providing data and carefully reviewing relevant text. The Forum, created in 1994 and formally established by Executive Order in 1997, will continue to develop strategies for improving the Federal statistical system in ways that preserve existing data in these areas while filling in the data gaps described above. For recent products and activities of the Forum, see their web page, located at

Using the Document

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

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

Definitions of terms used in this report are provided at the end of this document in the glossary

For More Information

This report is intended to provide a broad cross-section of the most relevant trend data in the lives of children and youth in the United States. For those interested in more detailed information, a number of additional resources, both print and electronic, are available. Full citations are provided for all tables and figures as well as for the text. At the end of the document there is also a complete list of all sources used throughout the report. A selection of these resources are listed below, by topic area, to provide the reader with a starting point when searching for additional information in these areas.

Section 1: Population, Family and Neighborhood

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

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

Section 2: Economic Security

Bureau of Labor Statistics. The Bureau of Labor Statistics produces a variety of employment data, and can be found on the Web at

U.S. Department of Representatives, Committee on Ways and Means. The Green Book is compiled from many sources and it provides program descriptions and historical data on a wide variety of social and economic topics, including Social Security, employment, earnings, welfare, child support, health insurance, the elderly, families with children, poverty, and taxation. It may be found online at

Section 3: Health Conditions and Health Care

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

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

Section 4: Social Development and Behavioral Health

Bureau of Justice Statistics. Detailed information on juvenile offenders can be obtained at the Bureau of Justice Statistics' main web site, located at

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

Section 5: Education and Achievement

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

Additional information can be found in a related report, America’s Children: Key National Indicators of Well-Being, 2003, which is available online at

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

Child Population Characteristics

Child Population Characteristics  (In PDF format)

Family Structure

Family Structure  (In PDF format)


Neighborhoods   (In PDF format)

Section 2: Economic Security (ES)

Poverty and Income

Poverty and Income  (In PDF format)

Financial Support

Financial Support   (In PDF format)

Parental Employment

Parental Employment   (In PDF format)


Consumption   (In PDF format)

Section 3: Health Conditions and Health Care (HC)

Health Care

Health Care   (In PDF format)

Health Conditions

Health Conditions   (In PDF format)


Mortality  (In PDF format)

Section 4: Social Development and Behavioral Health (SD)

Social Development

Social Development  (In PDF format)

Behavioral Health: Physical Health and Safety

Behavioral Health: Physical Health and Safety   (In PDF format)

Behavioral Health: Smoking, Alcohol, and Substance Abuse

Behavioral Health: Smoking, Alcohol, and Substance Abuse  (In PDF format)

Behavioral Health: Sexual Activity and Fertility

Behavioral Health: Sexual Activity and Fertility   (In PDF format)

Section 5: Education and Achievement (EA)


Enrollment/Attendance   (In PDF format)


Achievement/Proficiency   (In PDF format)

Related Behaviors and Characteristics

Related Behaviors and Characteristics  (In PDF format)


Glossary  (In PDF format)


Bibliography  (In PDF format)

Child Welfare
Youth | Children