U.S. Department of Health and Human Services

Office of the Assistant Secretary for Planning and Evaluation

This document was produced by Child Trends, Inc. (Brett Brown, Ph.D., project director),

for the Office of the Assistant Secretary for Planning and Evaluation.

Trends in the Well-Being

of Americas Children and Youth 97
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TABLE OF CONTENTS

INTRODUCTION

SECTION 1 POPULATION, FAMILY, AND NEIGHBORHOOD (PF)

CHILD POPULATION CHARACTERISTICS

PF I .1 Number of children ........................................................................................................... 12

PF 1.2 Children as a percentage of the population ...................................................................... 14

PF 1.3 Proportion of families containing children ....................................................................... 16

PF 1.4 Race/Ethnicity composition .............................................................................................. 18

PF 1.5 Immigrant children ........................................................................................................... 20

PF 1.6 Children as a percentage of the dependent population ..................................................... 22

FAMILY STRUCTURE

PF 2.1 Family structure: number of parents in household ........................................................... 24

PF 2.2 Percentage of all births to unmarried mothers.................................................................. 28

PF 2.3 Foster care ........................................................................................................................ 32

NEIGHBORHOODS

PF 3.1 Residential stability .......................................................................................................... 34

PF 3.2 Children in poor/very poor neighborhoods........................................................................ 36

TRENDS IN THE

WELL-BEING OF

AMERICAS

CHILDREN

& YOUTH
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SECTION 2 ECONOMIC SECURITY (ES)

POVERTY AND INCOME

ES 1.1 Mean family income ......................................................................................................... 40

ES 1.2 Income distribution .......................................................................................................... 44

ES 1.3 Children in poverty ........................................................................................................... 48

ES 1.4 Lifetime childhood poverty ............................................................................................... 56

FINANCIAL SUPPORT

ES 2.1 Effect of government transfer programs ........................................................................... 58

ES 2.2 Means-tested assistance: AFDC and Food Stamps ........................................................... 60

ES 2.3 Lifetime welfare dependence ............................................................................................ 64

ES 2.4 Sources of family income ................................................................................................. 70

ES 2.5 Child support nonpayment ............................................................................................... 74

PARENTAL AND YOUTH EMPLOYMENT

ES 3.1 Parental labor force participation ..................................................................................... 76

ES 3.2 Maternal employment ...................................................................................................... 80

ES 3.3 Parental labor force detachment ....................................................................................... 84

ES 3.4 Secure parental labor force attachment ............................................................................ 88

ES 3.5 Child care .......................................................................................................................... 90

ES 3.6 Detached Youth................................................................................................................. 94

HOUSING

ES 4.1 Inadequate housing .......................................................................................................... 96

SECTION 3 HEALTH CONDITIONS AND HEALTH CARE (HC)

MORTALITY

HC 1.1.a Infant mortality .............................................................................................................. 100

HC 1.1.b Child and youth mortality .............................................................................................. 106

HC 1.2.a Youth motor vehicle deaths ............................................................................................ 112

HC 1.2.b Youth homicides ............................................................................................................. 114

HC 1.2.c Youth suicides ................................................................................................................ 118

HEALTH CONDITIONS

HC 2.1 Healthy births................................................................................................................. 120

HC 2.2.a Low birth weight ............................................................................................................ 122

HC 2.2.b Very low birth weight ..................................................................................................... 126

HC 2.3 General health conditions............................................................................................... 128

HC 2.4 Chronic health conditions ............................................................................................... 130

HC 2.5 Overweight children and adolescents ............................................................................. 132

HC 2.6 Abuse and neglect .......................................................................................................... 134

HC 2.7 Suicidal teens ................................................................................................................. 138

HC 2.8 Activity limitations ......................................................................................................... 142

HC 2.9 Lead exposure ................................................................................................................ 146

HC 2.10 Violent victimization of teens ......................................................................................... 150

HC 2.11 Dental caries ................................................................................................................... 152
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HEALTH CARE

HC 3.1 Health insurance coverage ............................................................................................. 154

HC 3.2.a Early prenatal care ......................................................................................................... 158

HC 3.2.b Late or no prenatal care.................................................................................................. 162

HC 3.2.c Inadequate prenatal care ................................................................................................ 166

HC 3.3 Immunization ................................................................................................................. 168

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

SOCIAL DEVELOPMENT

SD 1.1 Life goals ........................................................................................................................ 176

SD 1.2 Peer approval .................................................................................................................. 180

SD 1.3 Religious attendance and religiosity .............................................................................. 184

SD 1.4 Voting behavior of young adults..................................................................................... 188

SD 1.5 TV viewing habits ........................................................................................................... 192

SD 1.6 Youth violent crime arrest rates ...................................................................................... 196

SD 1.7 Low-risk teens ................................................................................................................ 198

BEHAVIORAL HEALTH: PHYSICAL HEALTH AND SAFETY

SD 2.1 Physical Fighting by Youth ............................................................................................. 200

SD 2.2 Weapons carrying among high school youth .................................................................. 202

SD 2.3 Seat belt use ................................................................................................................... 206

SD 2.4 Regular physical exercise ............................................................................................... 210

BEHAVIORAL HEALTH: SMOKING, ALCOHOL, AND SUBSTANCE ABUSE

SD 3.1 Cigarette smoking ........................................................................................................... 214

SD 3.2 Smokeless tobacco use ................................................................................................... 218

SD 3.3 Binge drinking................................................................................................................ 220

SD 3.4 Exposure to drunk driving ............................................................................................. 224

SD 3.5 Illicit drug use ................................................................................................................ 226

SD 3.6 Peer attitudes towards alcohol, marijuana, cocaine, and smoking ................................. 232

SD 3.7 Abuse of alcohol or other controlled substances ............................................................. 236

BEHAVIORAL HEALTH: SEXUAL ACTIVITY AND FERTILITY

SD 4.1 Sexually experienced teens ............................................................................................. 238

SD 4.2 Sexually active teens ...................................................................................................... 242

SD 4.3 Contraceptive use by teens ............................................................................................. 244

SD 4.4 Number of sex partners .................................................................................................. 248

SD 4.5 Teen pregnancy .............................................................................................................. 252

SD 4.6 Abortion among teens .................................................................................................... 256

SD 4.7 Teen births ...................................................................................................................... 260

SD 4.8 Teen non-marital births .................................................................................................. 264

SD 4.9 Second and higher order births to teens ......................................................................... 268

SD 4.10 Sexually transmitted diseases among adolescents ......................................................... 270
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SECTION 5 EDUCATION AND ACHIEVEMENT (EA)

ENROLLMENT/ATTENDANCE

EA 1.1 Early childhood program enrollment .............................................................................. 278

EA 1.2 Grade retention............................................................................................................... 282

EA 1.3 School absenteeism ........................................................................................................ 284

EA 1.4 Teen dropout .................................................................................................................. 286

EA l.5 High school completion .................................................................................................. 288

EA 1.6 College attendance and attainment ................................................................................ 292

ACHIEVEMENT/PROFICIENCY

EA 2.1 Reading proficiency ........................................................................................................ 296

EA 2.2 Mathematics proficiency ................................................................................................. 300

EA 2.3 Science proficiency ......................................................................................................... 304

RELATED BEHAVIORS AND CHARACTERISTICS

EA 3.1.a Family-child engagement in literacy activities ................................................................ 308

EA 3.1.b Reading habits of children and youth ............................................................................ 312

EA 3.2 Parental involvement in childs school ........................................................................... 314

EA 3.3 Difficulty speaking English ............................................................................................ 318
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INTRODUCTION

This is the second edition of an annual report from HHS on trends in the well-being of our nations children

and youth. The report presents the most recent and reliable estimates on more than 80 indicators of wellbeing. 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:

9äpopulation, family, and neighborhood;

ä economic security;

ä health conditions and health care;

ä social development, behavioral health, and teen fertility; and

ä 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 wellbeing. 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.
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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.

ä The teen birth rate for 15-19 year old young women has been dropping since 1991, with the largest

decreases among black teens.

ä 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.

ä 17-year-old students have made modest gains in mathematics and science proficiency since the early

1980s.

ä 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.

ä 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 childrens 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 childrens 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.
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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 Presidents 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.
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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.