Teen Birth Rate Down, Exposure to Secondhand Smoke Drops Kids More Likely to be Overweight

The well-being of America's children has improved in many respects, with infant and childhood death rates continuing to drop, fewer adolescents smoking, fewer children exposed to secondhand smoke, fewer adolescent girls giving birth, and more adolescents taking honors courses.

On the other hand, children are more likely to be overweight than in previous years, the percentage of children with a parent working full time dropped slightly, and the percentage of low birth weight infants increased slightly.

These findings are described in detail in America's Children: Key National Indicators of Well-Being 2003, the 7th annual monitoring report of the status of the nation's children released by the U.S. Government.

Many other indicators of child well-being in the report held steady. For example, the percentage of children with health insurance remained at the previous year's all time high. After many years of decline, the child poverty rate leveled off, the percentage of children living in married, two-parent families has remained the same, and the percentage of children living in households reporting any housing problems has not changed since 1995.

The report, compiled by the Federal Interagency Forum on Child and Family Statistics, presents a comprehensive look at critical areas of child well-being, including economic security, health status, behavior and social environment, and education.

"Contrary to what many people may think, the Nation's children are faring better in many respects than they have in previous years," said Duane Alexander, M.D., Director of the National Institute of Child Health and Human Development. "The report provides an accurate snap shot of our children, showing areas where strong gains have been made, and where we need to remain vigilant."

For the first time, this year's America's Children Report contains previously unpublished 1990 and 2000 decennial census data that highlight changes in the lives of America's children for all 50 States and the District of Columbia. The decennial census figures show that the percentage of children living in married-couple families decreased from 72 percent in 1990 to 68 percent in 2000, and that this decline occurred in every state in the nation. However, the post-1990 decline in the national share of children living with married parents all occurred in the first half of the.decade. Utah had the highest percentage of children living in married-couple families in both 1990 and 2000.

"The U.S. Census Bureau is pleased to provide decennial census data highlighting changes in the well-being of America's children," said Louis Kincannon, Director of the U.S. Census Bureau. "This is the first time that this report has presented data at the state level, enabling one to see the variability among the states, as well as details of change during the past decade.

The percentage of children living in crowded housing rose nationally over the 1990s, from 16 percent in 1990 to 19 percent in 2000. Nevada had the greatest increase in children living in crowded housing, from 20 percent in 1990 to 27 percent in 2000. Texas had the greatest decrease, from 25 percent in 1990 to 15 percent in 2000. The report defined crowded housing as households having more than one person per room.

Nationally, the proportion of children ages 3 to 5 enrolled in preprimary education rose from 42 percent in 1990 to 61 percent in 2000, an increase of 19 percentage points. Georgia had the largest increase--from 41 percent in 1990 to 67 percent in 2000.

After many years of decline, the poverty rate remained stable from 2000 to 2001 at 16 percent. Yet, while the child poverty rate remained stable overall, it continued to drop for Black children in female-householder families, from 49 percent in 2000 to 47 percent in 2001. In addition, the percentage of children with at least one parent employed full time all year fell slightly in 2001 to 79 percent, and the percentage of households with children that had any housing problems has remained at 36 percent since 1995.

The health section of this year's report introduces a new indicator on overweight. The proportion of children ages 6 to 18 that were overweight increased from 6 percent in 1976-1980 to 11 percent in 1988-1994 to 15 percent in 1999-2000. The report added that Black, non-Hispanic girls and Mexican American boys are at particularly high risk of being overweight. In 1999-2000, 24 percent of Black, non-Hispanic girls and 29 percent of Mexican American boys were overweight. According to the report: "overweight is defined as body mass index (BMI) at or above the 95th percentile of the 2000 Centers for Disease Control and Prevention BMI-for-age growth charts. BMI is calculated as weight in kilograms divided by the square of height in meters."

The continued increase in overweight among America's children demands attention and calls for action," said Dr. Edward J. Sondik, Director of the National Center for Health Statistics, Centers for Disease Control and Prevention. Our children learn by example, so as a nation, we all need to adopt healthier diets and become more physically active, he said.

The report stated that the reasons for the increase in overweight were not clear but suggested that eating out, diets low in fruits and vegetables, and lack of exercise probably play a role.

Falling childhood death rates were among the favorable trends in this year's report. In 2000, child and adolescent mortality rates reached record lows of 32 deaths per 100,000 children ages 1 to 4, 18 deaths per 100,000 children ages 5-14, and 67 deaths per 100,000 adolescents ages 15 to 19.

"One of the most striking improvements in children's health over the past decade has been the dramatic decline in childhood death rates," said Dr. Sondik. "For young children, prevention efforts have led to fewer fatalities in motor vehicle crashes, and among teenagers, we've seen dramatic declines in gun-related deaths, especially among Black, non-Hispanic males and Hispanic males," he said. In another favorable trend, the infant mortality rate has decreased steadily since 1983, when there were 10.9 deaths per 1000 live births. In 2000, there were 6.9 deaths per 1000 births, a slight drop from 7.0 in 1999. Although the infant mortality rate has been steadily declining, the percentage of infants of low birthweight inched up to 7.7 percent in 2001. Previously, this figure held steady at 7.6 each year from 1998 to 2000.

The adolescent birth rate also declined, from 27 births per 1000 females ages 15 to 17 in 2000, to 25 births per 1000 females in this age group in 2001. The birth rate for Black, non-Hispanic females in this age group dropped by nearly half in between 1991 and 2001, from 86 to 45 per 1000 females.

Another favorable trend shows that fewer children were exposed to secondhand tobacco smoke. According to the report, children exposed to secondhand smoke have "an increased probability of experiencing a number of adverse health effects, including infections of the lower respiratory tract, bronchitis, pneumonia, fluid in the middle ear, and sudden infant death syndrome (SIDS)."

As indicated by blood cotinine levels, children's exposure to secondhand smoke dropped in recent years. The best indication of exposure to secondhand smoke is the measurement of cotinine in blood. The substance cotinine is produced when nicotine is broken down by the body and the presence of cotinine in the blood indicates exposure to tobacco smoke within the previous two days. Overall, 64 percent of children ages 4 to 11 had cotinine in their blood in 1999-2000, down from 88 percent in 1988-1994. In 1999-2000, 86 percent of Black, non-Hispanic children ages 4 to 11 had cotinine in their blood, as did 63 percent of White, non-Hispanic children, and 49 percent of Mexican American children.

"This decrease in children's exposure to secondhand smoke is good news, and part of a larger national trend, as more and more people realize the serious health risks from secondhand smoke and take action to reduce their exposure," said Jeff Holmstead, Assistant Administrator for the Office of Air and Radiation at the Environmental Protection Agency.

The number of teens who smoke cigarettes daily dropped to the lowest point since data were first collected in 1975, to 5 percent of eighth graders, 10 percent of tenth graders, and 17 percent of twelfth graders. Moreover, the percentage of 10th graders who reported episodes of heavy drinking declined from 25 percent in 2001 to 22 percent in 2002. Heavy drinking is defined as 5 or more drinks in a row at least once in the past two weeks. In addition, among tenth graders, illicit drug use in the past 30 days declined from 23 percent in 2001 to 21 percent in 2002.

Among the report's education indicators, the high school completion rate of 18 to 24 year olds has increased slightly from 84 percent in 1980 to 87 percent in 2001 and more high school graduates are taking high level courses. In 2000, 34 percent of high school graduates took honors-level English courses, up from 29 percent of 1998 graduates. Also, high school graduates in 2000 were more likely than graduates in 1982 to have taken high-level mathematics, science, English, and foreign language courses.

The report noted that in 2001, there were 72.6 million children in the United States, comprising 25 percent of the population. The percentage of children in the U.S. population peaked in 1964 at 36 percent. In 2000, 64 percent of U.S. children were White, non-Hispanic, 16 percent were Hispanic, 15 percent were Black, non-Hispanic, 4 percent were Asian/Pacific Islander, and 1 percent were American Indian/Alaska native. The percentage of children living with at least one parent who was foreign-born was 20 percent in 2002, up from 15 percent in 1999.