National Health Statistics Reports

Number 138  January 22, 2020

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Demographic, Health Care, and Fertility-related 

Characteristics of Adults Aged 18–44 

Who Have Ever Been in Foster Care: 

United States, 2011–2017 

by Colleen N. Nugent, Ph.D., and Chinagozi Ugwu, M.P.H., National Center for Health Statistics; Jo Jones, Ph.D.; 

Sharon Newburg-Rinn, Ph.D., and Tammy White, Ph.D., Children’s Bureau, Administration for Children & Families

Abstract

Objective—This report presents demographic characteristics, health service 

access and use, and timing of key fertility-related milestones among adults aged 

18–44 who had ever been in foster care as compared with those who had never been 

in foster care in the United States.

Methods—The National Survey of Family Growth (NSFG) is a nationally 

representative survey, with data collected through in-person interviews of the 

household population of the United States. Analyses used 6 years of NSFG interviews 

spanning September 2011 through September 2017, and included 11,527 male and 

14,439 female respondents aged 18–44. Bivariate analyses examined demographic 

characteristics and health service access and use by having ever been in foster care, 

as measured by household roster information and childhood background items. 

Cumulative probabilities of first sexual intercourse, first marriage, and first birth by 

age were estimated using Kaplan–Meier procedures. All estimates were stratified by 

sex.

Results—Overall, 2.6% of adults aged 18–44 had ever been in foster care, and the 

percentage was higher for women (3.0%) than for men (2.3%). Lower percentages of 

men and women who were ever in foster care had a bachelor’s degree or higher (4.8% 

for men and 9.1% for women) compared with those who had never been in foster care 

(31.1% and 36.2%, respectively). Receipt of public assistance in the past 12 months 

was more likely among adults who were ever in foster care compared with those who 

were never in foster care. Adults ever in foster care were less likely than adults never 

in foster care to be currently covered by private health insurance and were more likely 

to be covered by Medicaid. Adults ever in foster care also had higher probabilities of 

first sexual intercourse and first births at younger ages than those never in foster care. 

Keywords: history in foster care • demographic profile • health care access • fertility 

behavior • National Survey of Family Growth

Introduction

In fiscal year 2017 (through 

September 30), roughly 443,000 children 

and youth were in foster care in the 

United States, a number that steadily 

increased over the 5-year period 

beginning in 2013 (1). The federal foster 

care program is authorized by Title IV–E 

of the Social Security Act, as amended, 

and implemented under the Code of 

Federal Regulations (CFR) in 45 CFR 

parts 1355, 1356, and 1357. It is intended 

to ensure the permanency, safety, and 

well being of children who have been 

removed from their homes as the result 

of maltreatment, lack of care, or lack of 

supervision. 

Some research tracks current 

outcomes in a variety of domains for 

youth and young adults who have 

transitioned out of U.S. foster care (2,3), 

including financial self-sufficiency, 

educational attainment, and high-risk 

behaviors. Other studies compare 

estimates on various outcomes for 

individuals who have been in foster care 

with those who have not, showing that 

those formerly in foster care have poorer 

health and socioeconomic outcomes 

relative to those who were never in foster 

care. For example, individuals formerly 

in foster care have higher rates of 

NCHS reports can be downloaded from: https://www.cdc.gov/nchs/products/index.htm.
Page 2 National Health Statistics Reports  Number 138  January 22, 2020

pregnancy and parenthood at young ages, 

unemployment, homelessness, mental 

illness, and lower educational attainment 

(4–11). However, these studies either 

focus only on young adults, are limited 

to specific geographic regions, or rely on 

data that are 2 or 3 decades old.

The National Survey of Family 

Growth (NSFG) is one of the few U.S. 

nationally representative surveys that 

collects information on having ever 

been in foster care during childhood 

from adult respondents across the full 

reproductive age span. NSFG also 

gathers data on men’s and women’s 

fertility, family life, and health-related 

behaviors. This report includes analyses 

of outcomes examined in other studies 

previously mentioned, building on those 

concepts with detail on other related 

measures that are uniquely contributed 

by NSFG. It provides descriptive 

profiles of adults who have ever been 

in foster care and those who have 

not to better understand associations 

between experience in foster care and 

demographic characteristics, health 

service access and use, and timing of 

key fertility-related milestones. Causal 

inferences about foster care history or the 

foster care system cannot be made based 

on these cross-sectional data, as youth 

who go into foster care may be those 

already at risk of adverse outcomes. 

However, a descriptive profile comparing 

adults who have ever been in foster care 

with those who have not contributes 

to the existing body of research on the 

association of history in foster care with 

select outcomes.

Methods

Data source and measures

NSFG uses a multistage, probability 

sample design to generate estimates 

that are nationally representative of the 

U.S. household population aged 15–49. 

Female interviewers conduct in-person 

interviews with independent samples 

of both male and female respondents. 

Further details on sample design, 

fieldwork procedures, and interview 

content are available elsewhere (12–14). 

This report is based on combined NSFG 

data for 2011–2013, 2013–2015, and 

2015–2017, resulting in a data file based 

on 6 years of interviews conducted from 

September 2011 through September 

2017. The combined data set includes 

respondents aged 15–44 and contains 

a total of 29,511 interviews—16,191 

with women and 13,320 with men. The 

overall response rate for the 2011–2017 

combined file was 69.1%: 70.4% for 

women and 67.5% for men. During this 

period response rates declined, ranging 

from 72.8% in 2011–2013 to 65.3% in 

2015–2017. This analysis is restricted 

to 14,439 women and 11,527 men aged 

18–44, as minors (defined as those under 

18) who have never spent time in foster 

care still have the potential to do so. 

Some states have opted to allow youth 

to remain in foster care up to age 21 

(15) to help achieve a more successful 

transition to adulthood. Therefore, the 

few NSFG respondents aged 18–21 (n = 

5) who were currently living with foster 

parents at the time of interview were 

excluded to ensure that the dichotomous 

variable for ever having been in foster 

care reflects only past experience. This 

measure is constructed from information 

on the household roster and childhood 

background questions. Further details 

can be found in the Definition of terms 

(Technical Notes).

This report compares adults who 

have ever been in foster care with 

those who have not, highlighting 

differences by several key demographic 

characteristics including age at 

interview, Hispanic origin and race, 

marital or cohabiting status, educational 

attainment, receipt of public assistance 

in the past 12 months, and labor force 

status for women and men. The report 

also presents differences by history 

in foster care for outcomes related to 

health service access and use, as well 

as the timing of key fertility-related 

milestones. Selected health service 

access and use measures include: the 

respondent’s current type of health 

insurance, whether the respondent lacked 

health insurance at any time in the past 

year, the respondent’s usual place of 

health care, whether the respondent 

ever had an HIV test outside of blood 

donation, and the contraceptive method 

used during the last sexual intercourse in 

the past 12 months. Key fertility-related 

milestones include the respondent’s first 

sexual intercourse, first marriage, and 

first birth. All measures are described 

in detail in the Definition of terms 

(Technical Notes). 

Statistical analysis

Estimates for this report were 

generated using SAS-callable SUDAAN 

software (http://www.rti.org/sudaan) to 

produce standard errors accounting for 

the complex sample design of NSFG. 

Life table cumulative probabilities 

of key fertility-related milestones by 

selected ages were calculated using the 

Kaplan–Meier procedure. This method 

incorporates censored cases (cases that 

have not yet experienced the fertilityrelated milestone events) and accounts 

for NSFG’s complex survey design (16). 

For ease of interpretation, probabilities 

are described as percentages, such 

as the percentage who have had 

sexual intercourse by age 18. All 

estimates in this report were based on 

sampling weights designed to produce 

unbiased estimates that are nationally 

representative of the reproductiveaged household population of the 

United States (13,14). These analyses 

were conducted using the 6-year sample 

weights constructed for the 2011–2017 

data; population size estimates in this 

report reflect the approximate midpoint 

of 2011–2017 interviewing (July 2014).

All estimates presented meet the 

National Center for Health Statistics 

guidelines for presentation of proportions 

(17). Distributions of demographic 

characteristics, health service access and 

use indicators, and timing of fertilityrelated milestones by ever being in 

foster care may vary significantly for 

men compared with women. Therefore, 

estimates were stratified by sex, and 

comparisons between men and women 

with foster care histories were made 

for most estimates. Contraceptive use 

estimates were not compared because 

men’s reporting reflects the fact that 

they may not be aware of the use of some 

female methods. When percentages 

between groups were compared, 

statistical significance was determined 

by using two-tailed t tests at the 5% 

level. No adjustments were made for 

multiple comparisons. Terms such as 

“greater than” and “less than” indicate 
National Health Statistics Reports  Number 138  January 22, 2020 Page 3

that a statistically significant difference 

was found. Terms such as “similar” 

and “no difference” indicate that the 

estimates being compared were not 

significantly different. In addition to the 

cross-sectional nature of the survey data 

precluding valid causal inferences, the 

data presented in this report are bivariate 

associations that may be explained by 

other factors not controlled for in this 

analysis.

Results

Percentage ever in foster 

care overall and by sex and 

race and Hispanic origin

Figure 1 presents the percentage of 

adults aged 18–44 in 2011–2017 who had 

ever been in foster care by sex and race 

and Hispanic origin. 

● Overall, 2.6% of adults aged 18–44 

in 2011–2017 had ever been in foster 

care in the United States. A higher 

percentage of women (3.0% or about 

1.7 million) had ever been in foster 

care than men (2.3% or about 1.2 

million). 

● The percentages of non-Hispanic 

black men and women who had 

ever been in foster care were higher 

than the percentages for men and 

women in other race and Hispanicorigin groups. Among non-Hispanic 

black men, 3.8% had been in 

foster care compared with 2.4% of 

non-Hispanic white men and 1.1% of 

Hispanic men. Among non-Hispanic 

black women, 5.0% had been in 

foster care compared with 2.7% of 

non-Hispanic white women and 

3.0% of Hispanic women. A higher 

percentage of Hispanic women 

had been in foster care (3.0%) than 

Hispanic men (1.1%); the observed 

differences between women and 

men were not statistically significant 

among non-Hispanic white or 

non-Hispanic black adults.

Selected demographic 

characteristics by history in 

foster care

Table 1 presents a profile of selected 

demographic characteristics by history 

in foster care for men and women aged 

18–44 in 2011–2017.

● For women, the percentage aged 

35–44 was lower among those who 

had been in foster care (28.5%) than 

among those who had not (36.3%). 

A similar pattern was seen among 

men, but the observed difference 

was not statistically significant. 

Among those ever in foster care and 

never in foster care, no difference 

was seen in age distributions 

between men and women.

● For both men and women, those who 

had been in foster care were less 

likely to be currently married than 

those who had never been in foster 

care. About 3 in 10 men (29.8%) 

and approximately 2 in 10 women 

(22.4%) who had been in foster care 

were currently married compared 

with 4 in 10 men and women 

Figure 1. Percentage of adults aged 18–44 who had ever been in foster care, by sex and race and Hispanic origin: United States, 2011–2017

1Significantly different from men.

2Significantly different from Hispanic persons in the same sex category.

3Significantly different from non-Hispanic white persons in the same sex category.

SOURCE: NCHS, National Survey of Family Growth, 2011–2017. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
Page 4 National Health Statistics Reports  Number 138  January 22, 2020

(40.3% and 42.2%, respectively) 

who had never been in foster care. 

For both men and women, a higher 

percentage of those ever in foster 

care were currently cohabiting 

compared with those never in foster 

care (22.6% compared with 14.3% 

for men; 20.1% compared with 

15.6% for women). Women ever 

in foster care were nearly twice 

as likely as women never in foster 

care to be formerly married, not 

cohabiting. 

● The percentage of men and women 

aged 22–44 ever in foster care who 

did not have a high school diploma 

or GED (24.9% for men; 21.3% for 

women) was just over twice the 

percentage of those who had never 

been in foster care (12.0% and 9.6%, 

respectively) (Figure 2). For both 

men and women, the percentage 

of those ever in foster care who 

had completed some college was 

similar to those never in foster care. 

However, the percentage of men 

and women ever in foster care who 

had completed a bachelor’s degree 

or higher (4.8% for men; 9.1% for 

women) was lower compared with 

those who had never been in foster 

care (31.1% and 36.2%, respectively). 

● Although women were more likely 

than men to receive any public 

assistance in the past 12 months, a 

higher proportion of both women 

and men who had been in foster care 

received public assistance in the 

past 12 months compared with those 

never in foster care. Two-thirds 

(66.8%) of women ever in foster care 

received public assistance income 

in the past year compared with 

one-third (33.1%) of women never in 

foster care. For men, the percentages 

were 51.9% and 23.8%. 

● Lower percentages of both men 

and women who had ever been in 

foster care were currently working 

or attending school (75.0% for 

men; 63.6% for women) compared 

with those who had not been in 

foster care (87.0% and 78.2%, 

respectively).

Selected health service 

access and use indicators by 

history in foster care

Table 2 presents a profile of health 

service access and use by history in 

foster care for men and women aged 

18–44.

● A lower percentage of both men and 

women who had ever been in foster 

care were covered by private health 

insurance at the time of interview 

than those who had not been in 

foster care (35.0% compared with 

62.7% for men; 26.9% compared 

with 61.5% for women), and a 

higher percentage were covered by 

Medicaid (22.9% compared with 

10.0% for men; 45.5% compared 

with 16.8% for women) (Figure 3). In 

addition, a higher percentage of men 

who had been in foster care were 

uninsured compared with those who 

had not been in foster care (34.3% 

compared with 22.4%). Among 

adults who had been in foster care, 

the percentage of men currently 

covered by Medicaid was lower than 

Figure 2. Percent distribution of educational attainment based on ever being in foster care among men and women aged 22–44:

United States, 2011–2017

1Significantly different from never in foster care in the same sex category.

2Significantly different from men never in foster care in the same educational category.

NOTE: Totals may not add to 100 due to rounding.

SOURCE: NCHS, National Survey of Family Growth, 2011–2017. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
National Health Statistics Reports  Number 138  January 22, 2020 Page 5

for women (22.9% compared with 

45.5%), but the percentage uninsured 

was higher (34.3% compared with 

21.5%). This pattern was also seen 

among adults who had never been in 

foster care.

● A higher percentage of both men and 

women who had ever been in foster 

care did not have health insurance 

for a period of time in the preceding 

year (43.2% for men; 30.5% for 

women) compared with those who 

were never in foster care (28.9% and 

24.3%, respectively). Among those 

who had been in foster care, the 

percentage of men who did not have 

health insurance for the full year 

(43.2%) was higher than for women 

(30.5%), a pattern that was also seen 

among those who were never in 

foster care.

● Men who had been in foster care 

were less likely to use a private 

doctor’s office or HMO as their 

usual place of health care (27.0%) 

compared with men never in foster 

care (44.3%). The same pattern 

existed for women (51.8% compared 

with 63.4%). Also, a significantly 

higher percentage of men who had 

been in foster care had no usual 

place of care (40.0%) compared with 

men never in foster care (31.8%). 

Among those who had been in 

foster care, twice as many men had 

no usual place of care (40.0%) as 

women (19.8%), a relationship that 

also existed among men and women 

who were never in foster care. 

● Compared with men and women 

who were never in foster care, 

a higher percentage of men and 

women who had ever been in foster 

care had an HIV test outside of 

blood donation (79.2% compared 

with 49.6% among men; 80.9% 

compared with 65.4% among 

women). 

● When considering contraceptive 

method use at last sex in the past 

year, no differences were seen by 

history in foster care for either men 

or women.

Selected fertility-related 

milestones by history in 

foster care

Table 3 presents the cumulative 

probability of key fertility-related 

milestones by selected ages and history 

in foster care for men and women aged 

18–44.

● Both men and women who had been 

in foster care had their first sexual 

intercourse at earlier ages than those 

who had not. By age 15, more than 

one-half of men and women (59% 

and 55%) who had ever been in 

foster care had had their first sexual 

intercourse compared with 28% of 

men and 25% of women who had 

never been in foster care. Among 

men and women who had been 

in foster care, 9 in 10 had sexual 

intercourse by age 18, compared 

with 7 in 10 men and women never 

in foster care (Figure 4). Men and 

women who had been in foster 

care had comparable cumulative 

probabilities of having sexual 

intercourse by selected ages.

Figure 3. Percent distribution of current type of health insurance based on ever being in foster care among men and women aged 18–44: 

United States, 2011–2017

1Significantly different from never in foster care in the same sex category.

2Significantly different from men ever in foster care in the same health insurance category.

3Significantly different from men never in foster care in the same health insurance category.

NOTE: Totals may not add to 100 due to rounding.

SOURCE: NCHS, National Survey of Family Growth, 2011–2017. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
Page 6 National Health Statistics Reports  Number 138  January 22, 2020

● Compared with those who had 

never been in foster care, men 

and women who had ever been in 

foster care had higher probabilities 

of a first marriage by age 20. For 

example, 11% of men who had 

been in foster care were married 

by age 20 compared with 6% of 

men who had never been in foster 

care. By age 25, the probabilities 

of first marriage were similar for 

those who had been in foster care 

and those who had not among both 

men and women. Beyond age 25, 

this similarity between groups 

remained for men. However, among 

women, the probability of a first 

marriage was lower by ages 30 and 

35 for those who had been in foster 

care (51% and 59%, respectively) 

compared with those who had not 

(64% and 74%). Among those ever 

in foster care, women were more 

likely to be married by age 20 

compared with men, but they had 

similar cumulative probabilities at 

older ages.

● The cumulative probabilities of 

having a first birth by selected ages 

were higher among both men and 

women who had ever been in foster 

care than for men and women who 

had not. One-half of women ever 

in foster care had given birth to a 

child by age 20, and 8 in 10 had a 

first birth by age 30. This compares 

with one-quarter of women who 

had never been in foster care having 

a first birth by age 20 and twothirds doing so by age 30. Overall, 

women who had been in foster care 

experienced a first birth at earlier 

ages than men ever in foster care, 

a relationship that was also seen 

between men and women who had 

never been in foster care.

Summary

This report is the first to present a 

profile of adults aged 18–44 who had 

ever been in foster care as compared 

with those who had never been in 

foster care using recent, nationally 

representative data from NSFG for 

2011–2017. The percentage of those who 

had ever been in foster care compared 

with never in foster care was higher 

for non-Hispanic black adults than for 

Hispanic and non-Hispanic white men 

and women. Men and women who had 

been in foster care were less likely 

than those who had not to be currently 

married. Demographic profiles also 

show that both women and men who 

had been in foster care had lower levels 

of educational attainment and higher 

percentages having received public 

assistance in the past year compared with 

those never in foster care. Furthermore, 

they were less likely to be currently 

working or attending school than those 

who had not been in foster care. Past 

research has found similar patterns of 

poorer socioeconomic outcomes such 

as lower educational attainment, as well 

as higher rates of unemployment and 

receipt of public assistance for those who 

had been in foster care (5–10), but these 

studies were more limited in geography 

and sample age range or used older data.

Both men and women who had ever 

been in foster care had lower levels of 

Figure 4. Cumulative probability of first sexual intercourse based on ever being in foster care among men and women aged 18–44, by 

selected age: United States, 2011–2017

1Significantly different from never in foster care for all ages among both men and women.

2Significantly different from men never in foster care.

SOURCE: NCHS, National Survey of Family Growth, 2011–2017. 
National Health Statistics Reports  Number 138  January 22, 2020 Page 7

health care access and use than those 

who had not. They were less likely to 

have private health insurance coverage 

and more than twice as likely to be on 

Medicaid. They were also more likely 

to have experienced time without health 

insurance in the past year, and less likely 

to use a private doctor’s office as their 

usual place of care. These disparities 

were especially pronounced for men who 

had been in foster care, who were the 

most likely to be uninsured, experience 

time without health insurance in the past 

year, and have no usual place of care. 

Higher percentages of those who had 

been in foster care had been tested for 

HIV compared with men and women 

who had not been in foster care.

Men and women ever in foster care 

had first sexual intercourse at younger 

ages than those never in foster care. 

They were also more likely to experience 

a first marriage by age 20, and then 

women who had been in foster care 

became less likely to get married as they 

reached selected older ages compared 

with women never in foster care. Finally, 

results support prior findings related to 

early parenthood for young adults ever 

in foster care—men and women who 

had been in foster care were more likely 

to father or birth a first child at younger 

ages compared with those never in foster 

care (6–8), and this earlier timing was 

even more pronounced for women.

Several limitations should be taken 

into consideration when interpreting 

these results. First, the 2011–2017 

data range spans 6 years and covers 

a period of changes in some policies, 

such as health insurance availability, 

and the effects of these changes 

on these estimates are unknown. 

Information on what ages respondents 

were in foster care and how long ago 

they exited was not available in the 

2011–2017 data file. Without details 

on the timing of foster care, it is 

not known whether some fertilityrelated outcomes such as first sexual 

intercourse occurred before, during, or 

after time in foster care. Information 

on the type of foster care setting (e.g., 

relative or nonrelative family foster 

home, group home, or institution) is 

also not collected. As a householdbased survey, the NSFG sample 

excludes institutionalized individuals 

(e.g., those in prisons, military bases, 

and long-term psychiatric hospitals), 

individuals living in group quarters, and 

individuals without a physical address; 

individuals with prior experience being 

homeless or incarcerated may also 

be underrepresented. As such, some 

differences in measures presented in 

this report by history in foster care may 

be underestimated given that a higher 

proportion of adults who had ever 

been in foster care have experienced 

homelessness or incarceration than 

adults who have never been in foster 

care (8,18). Finally, as previously stated, 

these analyses are cross-sectional and 

therefore cannot be used to assess causal 

relationships. This means that outcomes 

may not be due solely to foster care itself 

and may be linked with characteristics of 

those entering foster care that preceded 

their experience in the system. Indeed, 

some research suggests that those who 

have been in foster care have later life 

outcomes that are more comparable to 

those with similar sociodemographic and 

family characteristics (and no history 

in foster care) than with the general 

population (19).

NSFG is the only national survey 

with any information on ever having 

been in foster care among adults up to 

age 44. This allows basic descriptive 

analyses comparing different 

socioeconomic and health care measures 

and fertility-related life course events 

by history in foster care. Although 

causal inferences cannot be made, these 

results show an association between 

having been in foster care and having 

fewer socioeconomic and health care 

resources, as well as earlier timing of 

some key fertility-related milestones. 

The results presented here may be due 

to other intervening events or decisions. 

For example, having a first birth at a 

younger age, regardless of history in 

foster care, may decrease an individual’s 

educational attainment and employment 

opportunities (20). The reduced 

employment opportunities that may 

result from early childbearing may also 

lead to higher use of public assistance 

(20) or Medicaid. Nevertheless, these 

results help to document associations 

between ever having been in foster care 

and key socioeconomic, health care, and 

fertility-related measures. 

References

1. U.S. Department of Health and 

Human Services, Administration for 

Children & Families, Administration 

on Children, Youth and Families, 

Children’s Bureau. The AFCARS 

report: Preliminary FY 2017 

estimates as of August 10, 2018. No. 

25. 2018. Available from:

https://www.acf.hhs.gov/sites/

default/files/cb/afcarsreport25.pdf. 

2. National Youth in Transition 

Database (NYTD). Highlights 

from the NYTD survey: Outcomes 

reported by young people at ages 

17, 19, and 21 (Cohort 1). NYTD 

Data Brief #5. 2016. Available from: 

https://www.acf.hhs.gov/sites/default/

files/cb/nytd_data_brief_5.pdf. 

3. National Youth in Transition 

Database (NYTD). Comparing 

outcomes reported by young people 

at ages 17 and 19 in NYTD cohort 

2. NYTD Data Brief #6. 2017. 

Available from: https://www.acf.hhs.

gov/sites/default/files/cb/nytd_data_

brief_6.pdf. 

4. The Annie E. Casey Foundation. 

Fostering youth transitions: Using 

data to drive policy and practice 

decisions. 2018. Available from: 

https://www.aecf.org/resources/

fostering-youth-transitions/. 

5. Blome WW. What happens to foster 

kids: Educational experiences of a 

random sample of foster care youth 

and a matched group of non-foster 

care youth. Child Adolesc Social 

Work J 14(1):41–53. 1997.

6. Cook RJ. Are we helping foster care 

youth prepare for their future? Child 

Youth Serv Rev 16(3–4):213–29. 

1994.

7. Courtney ME, Dworsky A, Ruth 

G, Havlicek J, Perez A, Keller T. 

Midwest evaluation of the adult 

functioning of former foster youth: 

Outcomes at age 21. Chicago: 

Chapin Hall Center for Children. 

2007. Available from: https://

pdxscholar.library.pdx.edu/cgi/

viewcontent.cgi?referer=http://

scholar.google.com/&httpsredir=1&a

rticle=1059&context=socwork_fac. 

8. Courtney ME, Dworsky A, Lee 

JS, Raap M. Midwest evaluation 

of the adult functioning of former 
Page 8 National Health Statistics Reports  Number 138  January 22, 2020

foster youth: Outcomes at ages 

23 and 24. Chicago: Chapin Hall 

at the University of Chicago. 

2010. Available from: https://

rhyclearinghouse.acf.hhs.gov/sites/

default/files/docs/18690-Midwest_

Evaluation-Outcomes_at_Ages_23_

and_24.pdf. 

9. Macomber JE, Cuccaro-Alamin 

S, Duncan D, Kuehn D, McDaniel 

M, Vericker T, et al. Coming of 

age: Employment outcomes for 

youth who age out of foster care 

through their middle twenties. 

Urban Institute. 2008. Available 

from: http://webarchive.urban.

org/UploadedPDF/1001174_

employment_outcomes.pdf. 

10. Pecora PJ, Kessler RC, O’Brien K, 

White CR, Williams J, Hiripi E, 

et al. Educational and employment 

outcomes of adults formerly placed 

in foster care: Results from the 

Northwest Foster Care Alumni 

Study. Child Youth Serv Rev 

28(12):1459–81. 2006.

11. Zlotnick C, Tam TW, Soman LA. 

Life course outcomes on mental and 

physical health: The impact of foster 

care on adulthood. Am J Public 

Health 102(3):534–40. 2012. 

12. Groves RM, Mosher WD, 

Lepkowski J, Kirgis NG. Planning 

and development of the continuous 

National Survey of Family Growth. 

National Center for Health Statistics. 

Vital Health Stat 1(48). 2009. 

Available from: https://www.cdc.

gov/nchs/data/series/sr_01/sr01_048.

pdf. 

13. Lepkowski JM, Mosher WD, Davis 

KE, Groves RM, Van Hoewyk J. 

The 2006–2010 National Survey 

of Family Growth: Sample design 

and analysis of a continuous survey. 

National Center for Health Statistics. 

Vital Health Stat 2(150). 2010. 

Available from: https://www.cdc.

gov/nchs/data/series/sr_02/sr02_150.

pdf. 

14. Lepkowski JM, Mosher WD, Groves 

RM, West BT, Wagner J, Gu H. 

Responsive design, weighting, 

and variance estimation in the 

2006–2010 National Survey of 

Family Growth. National Center for 

Health Statistics. Vital Health Stat 

2(158). 2013. Available from: 

https://www.cdc.gov/nchs/data/

series/sr_02/sr02_158.pdf. 

15. Child Welfare Information Gateway. 

Extension of foster care beyond 

age 18. Washington, DC: U.S. 

Department of Health and Human 

Services, Administration for 

Children & Families, Children’s 

Bureau. 2017. Available from: 

https://www.childwelfare.gov/topics/

systemwide/laws-policies/statutes/

extensionfc/. 

16. Lewis TH. Complex survey data 

analysis with SAS. Boca Raton, FL: 

CRC Press. 2017.

17. Parker JD, Talih M, Malec DJ, 

Beresovsky V, Carroll M, Gonzalez 

JF Jr, et al. National Center for 

Health Statistics data presentation 

standards for proportions. National 

Center for Health Statistics. Vital 

Health Stat 2(175). 2017. Available 

from: https://www.cdc.gov/nchs/

data/series/sr_02/sr02_175.pdf. 

18. Montgomery AE, Szymkowiak D, 

Marcus J, Howard P, Culhane DP. 

Homelessness, unsheltered status, 

and risk factors for mortality: 

Findings from the 100,000 homes 

campaign. Public Health Rep 

131(6):765–72. 2016.

19. Buehler C, Orme JG, Post J, 

Patterson DA. The long-term 

correlates of family foster 

care. Child Youth Serv Rev 

22(8):595–625. 2000.

20. Fletcher JM, Wolfe BL. Education 

and labor market consequences of 

teenage childbearing: Evidence 

using the timing of pregnancy 

outcomes and community fixed 

effects. J Hum Resour 44(2):303–25. 

2009.

21. Office of Management and Budget. 

Revisions to the standards for the 

classification of federal data on race and 

ethnicity. Fed Regis 62(210):58782–90. 

1997. Available from: https://

obamawhitehouse.archives.gov/omb/

fedreg_1997standards. 
National Health Statistics Reports  Number 138  January 22, 2020 Page 9

Table 1. Percent distribution of selected demographic characteristics among men and women aged 18–44, by history in foster care:

United States, 2011–2017

Men Women

Characteristic Ever in foster care Never in foster care Ever in foster care Never in foster care

All men and women aged 18–44

Weighted number (thousands) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,240 53,800 1,696 54,249

Unweighted number of respondents in sample . . . . . . . . . . . . . . . . . . . . . . 329 11,198 608 13,831

Percent distribution (standard error)

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 ... 100.0 ... 100.0 ... 100.0 ...

Age

18–24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26.8 (3.30) 26.3 (0.71) 29.4 (2.66) 25.7 (0.67)

25–34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43.4 (4.43) 38.2 (0.71) 42.0 (2.79) 38.0 (0.60)

35–44 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.7 (3.72) 35.5 (0.82) 128.5 (2.91) 36.3 (0.67)

Hispanic origin and race

Hispanic or Latino. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110.1 (1.82) 21.4 (1.18) 219.7 (2.89) 20.1 (1.15)

Not Hispanic or Latino . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

White, single race . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61.4 (3.91) 56.8 (1.32) 249.5 (3.36) 56.2 (1.32)

Black, single race . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119.9 (3.27) 11.7 (0.73) 122.7 (2.39) 13.4 (0.81)

Other, single race or multiple race . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.6 (1.62) 10.0 (0.70) 8.1 (1.41) 10.3 (0.81)

Marital or cohabiting status

Currently married. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129.8 (4.60) 40.3 (0.99) 122.4 (2.73) 42.2 (0.78)

Currently cohabiting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122.6 (3.26) 14.3 (0.58) 120.1 (2.20) 15.6 (0.52)

Formerly married, not cohabiting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.2 (1.49) 5.1 (0.22) 1,216.0 (2.21) 38.8 (0.36)

Never married, not cohabiting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40.5 (3.99) 40.3 (0.88) 141.5 (3.08) 333.3 (0.75)

Educational attainment4

No high school diploma or GED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124.9 (3.44) 12.0 (0.65) 121.3 (2.36) 39.6 (0.51)

High school diploma or GED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147.6 (4.85) 27.2 (0.87) 138.6 (3.40) 323.0 (0.73)

Some college, no bachelor’s degree . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.7 (3.78) 29.7 (0.81) 31.0 (3.17) 31.3 (0.79)

Bachelor’s degree or higher . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.8 (1.36) 31.1 (1.21) 19.1 (1.86) 336.2 (1.19)

Received any public assistance in past 12 months5. . . . . . . . . . . . . . . . . . . 151.9 (4.16) 23.8 (0.76) 1,266.8 (3.33) 333.1 (0.83)

Working or attending school6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175.0 (2.83) 87.0 (0.52) 1,263.6 (2.84) 378.2 (0.61)

... Category not applicable. 1Significantly different from never in foster care in the same sex category.

2Significantly different from men ever in foster care.

3Significantly different from men never in foster care.

4Limited to respondents aged 22–44 at time of interview.

5Includes public assistance or welfare; food stamps; Women, Infants, and Children Nutrition Program; help with transportation or childcare services; or job training in the calendar year before the 

interview.

6Working includes temporary leaves due to illness, vacation, strike, and maternity or family.

NOTE: Percentages may not add to 100 due to rounding.

SOURCE: NCHS, National Survey of Family Growth, 2011–2017.
Page 10 National Health Statistics Reports  Number 138  January 22, 2020

Table 2. Percent distribution of selected health service access and use indicators among men and women aged 18–44, by history in foster 

care: United States, 2011–2017

Men Women

Characteristic Ever in foster care Never in foster care Ever in foster care Never in foster care

Percent distribution (standard error)

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 ... 100.0 ... 100.0 ... 100.0 ...

Current type of health insurance 

Private or Medigap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135.0 (4.41) 62.7 (0.96) 126.9 (2.85) 61.5 (1.02)

Medicaid, CHIP, or state-sponsored plan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122.9 (2.68) 10.0 (0.54) 1,245.5 (3.27) 316.8 (0.66)

Other public, including military and Medicare. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.8 (2.10) 4.9 (0.58) 6.1 (1.32) 4.4 (0.52)

Uninsured, single-service plan, or Indian Health Service. . . . . . . . . . . . . . . . . . . . . . 134.3 (4.49) 22.4 (0.76) 221.5 (2.43) 317.2 (0.71)

Had any time of no health insurance in past year . . . . . . . . . . . . . . . . . . . . . . . . . . . 143.2 (4.58) 28.9 (0.81) 130.5 (2.82) 24.3 (0.80)

Usual place of care

Private doctor’s office or HMO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127.0 (3.67) 44.3 (0.82) 1,251.8 (3.11) 363.4 (0.91)

Community or health clinic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.3 (2.82) 8.5 (0.46) 116.8 (2.37) 311.4 (0.52)

Other clinic or hospital setting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.6 (3.33) 15.4 (0.74) 211.6 (1.65) 310.1 (0.57)

No usual place of care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140.0 (3.87) 31.8 (0.78) 219.8 (2.37) 315.1 (0.54)

Ever had HIV test outside of blood donation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179.2 (2.63) 49.6 (0.93) 180.9 (2.93) 365.4 (0.95)

Contraceptive method use at last sex in past 12 months4,5

No method6. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.0 (4.06) 25.0 (0.73) 23.3 (2.93) 20.7 (0.61)

Least effective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.5 (3.83) 26.6 (0.79) 21.5 (2.18) 24.9 (0.68)

Moderately effective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.2 (3.36) 26.6 (0.73) 16.7 (2.75) 21.7 (0.65)

Most effective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27.3 (4.56) 21.7 (0.81) 38.6 (3.47) 32.7 (0.68)

... Category not applicable.

1Significantly different from never in foster care in the same sex category.

2Significantly different from men ever in foster care.

3Significantly different from men never in foster care.

4Because men may not have knowledge of female partner’s use of contraception, this may represent an underestimate of actual use among men and comparisons between men and women were not 

made.

5Methods categorized by effectiveness: most effective (sterilization, contraceptive implant, and intrauterine device); moderately effective (oral contraceptive pill, injectable [e.g., Depo–Provera], 

contraceptive patch, contraceptive ring, and diaphragm); and least effective (condom, withdrawal, rhythm method or natural family planning, female condom, foam, jelly, suppository, emergency 

contraception, and other).

6May include those who are currently pregnant, seeking pregnancy, or otherwise not in need of contraception at time of interview.

NOTES: CHIP is Children’s Health Insurance Program. HMO is health maintenance organization. Percentages may not add to 100 due to rounding.

SOURCE: NCHS, National Survey of Family Growth, 2011–2017.
National Health Statistics Reports  Number 138  January 22, 2020 Page 11

Table 3. Cumulative probability of key fertility-related milestones by selected ages among men and women aged 18–44, by history in foster 

care: United States, 2011–2017

Men Women

Fertility-related milestone Ever in foster care Never in foster care Ever in foster care Never in foster care

Probability of first sexual intercourse by age

15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.59 (0.04) 0.28 (0.01) 0.55 (0.03) 0.25 (0.01)

16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.72 (0.03) 0.44 (0.01) 0.74 (0.03) 0.41 (0.01)

17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.84 (0.02) 0.58 (0.01) 0.85 (0.02) 0.57 (0.01)

18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.91 (0.02) 0.70 (0.01) 0.90 (0.02) 0.69 (0.01)

19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.95 (0.01) 0.77 (0.01) 0.91 (0.02) 0.76 (0.01)

20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.95 (0.01) 0.81 (0.01) 0.93 (0.02) 0.81 (0.01)

Probability of first marriage by age

20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.11 (0.02) 0.06 (0.00) 0.20 (0.02) 0.15 (0.01)

25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.35 (0.05) 0.31 (0.01) 0.38 (0.03) 0.44 (0.01)

30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.49 (0.05) 0.56 (0.01) 0.51 (0.04) 0.64 (0.01)

35 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.61 (0.06) 0.70 (0.01) 0.59 (0.04) 0.74 (0.01)

40 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . --- --- 0.77 (0.01) --- --- 0.78 (0.01)

Probability of first birth by age

20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.30 (0.04) 0.09 (0.00) 0.51 (0.03) 0.23 (0.01)

25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.56 (0.05) 0.28 (0.01) 0.71 (0.03) 0.45 (0.01)

30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.72 (0.04) 0.51 (0.01) 0.81 (0.03) 0.66 (0.01)

35 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . --- --- 0.67 (0.01) --- --- 0.79 (0.01)

40 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . --- --- 0.75 (0.01) --- --- 0.83 (0.01)

--- Data not available.

SOURCE: NCHS, National Survey of Family Growth, 2011–2017.
Page 12 National Health Statistics Reports  Number 138  January 22, 2020

Technical Notes

Definition of terms

Age—The recode variable AGER 

indicates the respondent’s age at the time 

of interview.

Age at first birth—The recode 

variable AGEBABY1 indicates the age 

that a respondent first fathered or gave 

birth to a child where live birth was the 

outcome. For the 2015–2017 National 

Survey of Family Growth (NSFG) 

public-use files, this recode shows age in 

whole years. 

Age at first marriage—The recode 

variable FMAR1AGE for women who 

have been married indicates the age of 

the female respondent at the century 

month date of her first marriage. 

For men, an analogous measure was 

calculated using the century month 

of the date of first marriage and the 

century month of the male respondent’s 

own birth. In the 2015–2017 file, these 

century month variables were suppressed 

for public use and are available through 

the National Center for Health Statistics 

Research Data Center.

Age at first sexual intercourse—The 

recode variable VRY1STAG indicates 

the age at first vaginal intercourse for 

both male and female respondents. It is 

based on a question asking respondents 

how old they were the first time they 

had sexual intercourse with a person of 

the opposite sex, which is asked only of 

respondents who reported ever having 

such sexual intercourse.

Any time of no insurance in past 

year—The raw variable COVER12 

captures whether there was any time in 

the past 12 months that the respondent 

did not have any health insurance 

coverage, even though they may have 

had coverage at the time of interview. 

It is a measure of access to health care 

that indicates continuity and stability of 

insurance coverage.

Contraceptive use at last sexual 

intercourse within past 12 months—

Use of contraception at last sexual 

intercourse within the past 12 months 

(among those who have had sexual 

intercourse in the past 12 months) is 

based on the recode series METH12M1–

METH12M4, which indicates up to four 

method types used at last sex in the past 

12 months, as well as the recode variable 

MTHUSE12 for women, which indicates 

any use or nonuse of contraception at 

last sex in the past 12 months. This 

measure groups method types into the 

following categories: no method, least 

effective (i.e., condom, withdrawal, 

rhythm method or natural family 

planning, female condom, foam, jelly, 

suppository, emergency contraception, 

and other), moderately effective (i.e., 

oral contraceptive pill, injectable [e.g., 

Depo–Provera], contraceptive patch, 

contraceptive ring, and diaphragm), 

and most effective (i.e., sterilization, 

contraceptive implant, and intrauterine 

device).

Current type of health insurance—

The recode variable CURR_INS 

follows the classification rules of the 

National Health Information Survey and 

is the type of insurance coverage the 

respondent has at the time of interview. 

The four categories are created 

hierarchically and include: 

1. Private insurance or Medigap

2. Medicaid, Children’s Health 

Insurance Program, or a statesponsored health plan

3. Any other public coverage 

(including military and Medicare)

4. No insurance—Includes Indian 

Health Service coverage and singleservice plans (e.g., dental, vision, or 

prescription coverage) 

Educational attainment—The 

recode variable HIEDUC provides a 

measure of the respondent’s highest 

degree or highest year of completed 

schooling as of the date of interview. 

Results are presented only for 

respondents aged 22 and over because 

respondents aged 18–21 may still be 

completing a degree.

Ever had HIV test outside of 

blood donation—The recode variable 

EVHIVTST classifies respondents as 

ever having had an HIV test and in what 

context (i.e., as part of blood donation 

or outside of blood donation). The four 

categories for this recode variable were:

0 = No HIV test reported

1 = Yes, only as part of blood 

 donation

2 = Yes, only outside of blood 

donation

3 = Yes, in both contexts

For this report, categories 0 and 1 

were combined as “Never tested for 

HIV (except for blood donation)” and 

categories 2 and 3 were combined as 

“Ever tested for HIV outside of blood 

donation.”

Hispanic origin and race—The 

recode variable HISPRACE2 classifies 

Hispanic origin and race according to 

the 1997 Office of Management and 

Budget guidelines for the presentation 

of race and ethnic-origin data in 

federal statistics (21). In this report, the 

categories Hispanic; non-Hispanic white, 

single race; non-Hispanic black, single 

race; and non-Hispanic other, either 

single or multiple race are shown.

History in foster care—This 

dichotomous variable with categories 

“Ever in foster care” and “Never in foster 

care” is constructed using the variables 

r_foster and EVRFSTER. The r_foster 

variable is computed (or defined) within 

the instrument to indicate whether a 

respondent has ever lived with a foster 

parent based on information from 

the household roster and childhood 

background questions. The EVRFSTER 

variable is a raw question asking 

respondents who have not always 

lived with their biological or adoptive 

parents whether they have ever lived in 

state-sponsored foster care, including 

settings such as a family foster home, a 

relative foster home, a group home, an 

institution, or supervised independent 

living.

Labor force status—The recode 

variable LABORFOR indicates what 

respondents were doing in the week 

before interview. This report presents the 

category “Working or attending school,” 

which combines working full time and 

part time; not working due to temporary 

illness, vacation, strike, or maternity or 

family leaves; and attending school.

Marital or cohabiting status—The 

recode variable RMARITAL indicates 

the respondent’s marital and cohabiting 

status at the time of interview and is 

defined in relation to opposite-sex 

partners or spouses.
National Health Statistics Reports

 Number 138 January 22, 2020 Page 13

Receipt of public assistance in the 

past 12 months—The recode variable 

PUBASSIS indicates whether the 

respondent or any family members 

received public assistance in the calendar 

year before the interview. It includes 

public assistance or welfare; food stamps; 

Women, Infants, and Children Nutrition 

Program; help with transportation or 

childcare services; or job training.

Usual place of care—Based on 

the raw variables USUALCAR and 

USLPLACE, this measure indicates 

where a respondent goes when he or she 

is sick or needs advice about health, or 

whether he or she does not have a usual 

place of care. If a respondent answered 

“No” on USUALCAR, which asks if 

there is a place he or she usually goes 

when sick or needing advice about health, 

they are presented in this report as 

having “No usual place of care.”
National Health Statistics Reports Number 138 January 22, 2020 National Health Statistics Reports Number 138 January 22, 2020

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Suggested citation

Nugent CN, Ugwu C, Jones J, Newburg-Rinn 

S, White T. Demographic, health care, and 

fertility-related characteristics of adults aged 

18–44 who have ever been in foster care: 

United States, 2011–2017. National Health 

Statistics Reports; no 138. Hyattsville, MD: 

National Center for Health Statistics. 2020.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health Statistics

Jennifer H. Madans, Ph.D., Acting Director

Amy M. Branum, Ph.D., Acting Associate

Director for Science

Division of Vital Statistics

Steven Schwartz, Ph.D., Director

Hanyu Ni, Ph.D., M.P.H., Associate

Director for Science

Acknowledgments

The National Survey of Family Growth (NSFG) is conducted by the National Center for Health Statistics (NCHS) with the support and assistance 

of a number of other organizations and individuals. Fieldwork and related tasks for the 2011–2017 NSFG data used in this report were carried out 

by the University of Michigan’s Survey Research Center, Institute for Social Research, under a contract with NCHS. NSFG was jointly planned 

and funded by the following programs and agencies of the U.S. Department of Health and Human Services: 

This report was prepared in the Division of Vital Statistics (DVS) under the general direction of Steven Schwartz, Director of NCHS’ DVS; Isabelle 

Horon, Chief, Reproductive Statistics Branch (RSB); and Anjani Chandra, Team Lead, RSB NSFG Team. The authors are grateful for the valuable 

comments provided by Hanyu Ni, DVS Associate Director for Science, and Amy Branum, Acting NCHS Associate Director for Science.

• National Center for Health Statistics (CDC)

• Eunice Kennedy Shriver National Institute of Child Health and 

Human Development (National Institutes of Health)

• Office of Population Affairs

• Division of HIV/AIDS Prevention (CDC)

• Division of Sexually Transmitted Disease Prevention (CDC)

• Division of Reproductive Health (CDC)

• National Center on Birth Defects and Developmental Disabilities 

(CDC)

• Division of Cancer Prevention and Control (CDC)

• Office of Planning, Research, and Evaluation; Administration for 

Children & Families

• Children’s Bureau, Administration for Children & Families 

• Division of Adolescent and School Health (CDC)

• Division of Nutrition, Physical Activity and Obesity (CDC)

• Office on Women’s Health