Children's health is influenced by their biology, social and physical environment, behavior, and the availability of services. Birth outcomes (preterm birth, low birth weight, and infant mortality) are influenced by a variety of factors, including prenatal care, and affect a child's long-term health and development. Several health conditions among school-aged children, including asthma, emotional and behavioral difficulties, and obesity, are of particular public health concern.
Infants born preterm or with low birthweight32 are at high risk of early death and long-term health and developmental problems.33 Following many years of increases, the preterm birth rate declined for the fourth straight year, from 12.8 percent in 2006 to 12.0 percent in 2010 (Figure 14). Late preterm births (infants born at 34–36 weeks' gestation) accounted for most of the increase over the past two decades and for the recent declines. Between 2009 and 2010, preterm rates declined for White, non-Hispanic (10.9 percent to 10.8 percent), Black, non-Hispanic (17.5 percent to 17.1 percent), and Hispanic women (12.0 percent to 11.8 percent).34 The percentage of infants born with low birthweight in 2010 (8.1 percent) was unchanged from 2009, although it declined from 2006 to 2010.
NOTE: Data for 2010 are preliminary. Late preterm infants are born at 34–36 weeks of gestation; early preterm infants are born at less than 34 weeks of gestation. Moderately low birthweight infants weigh 1,500–2,499 grams at birth; very low birthweight infants weigh less than 1,500 grams at birth.
SOURCE: National Center for Health Statistics, National Vital Statistics System.
The infant mortality rate declined each year from 2007 to 2010. Between 2009 and 2010 the rate declined from 6.4 to 6.1 infant deaths per 1,000 live births.
Asthma is one of the most common chronic diseases among children. In 2010, 9 percent of all children were reported to currently have asthma, which includes children with active asthma symptoms and children with well-controlled asthma. This percentage has increased slightly from 2001 to 2010.
Children with active asthma symptoms are at risk for poorer health outcomes. Over the past decade, between 5 and 6 percent of all children (or 3 out of 5 children who currently have asthma) had one or more asthma attacks in the previous 12 months.
Good emotional and behavioral health is important for children's sense of well-being, their relationships with family and peers, and achieving their potential. In 2010, 6 percent of parents reported that their child had serious difficulties with emotions, concentration, behavior, or being able to get along with other people (Figure 15). The percentage for boys (7 percent) was higher than that for girls (5 percent); the percentage for children in poverty (10 percent) was twice that for children from families with incomes of 200 percent or more of the poverty threshold (5 percent); and the percentage for children from single-mother families (10 percent) was more than twice that of children from two-parent families (4 percent).
NOTE: Children with serious emotional or behavioral difficulties are defined as those whose parent responded "yes, definite" or "yes, severe" to the following question on the Strengths and Difficulties Questionnaire (SDQ):35 "Overall, do you think that (child) has difficulties in any of the following areas: emotions, concentration, behavior, or being able to get along with other people?" Response choices were: (1) no; (2) yes, minor difficulties; (3) yes, definite difficulties; (4) yes, severe difficulties. These difficulties may be similar to but do not equate with the Federal definition of serious emotional disturbances (SED), used by the Federal government for planning purposes.
SOURCE: National Center for Health Statistics, National Health Interview Survey.
Although the prevalence of obesity among children ages 6–17 increased sharply from 1976–1980 to 1999–2000, there was no significant change between 2001–2002 and 2009–2010. In 2009–2010, 18 percent of children ages 6–17 were obese, not statistically different from 2007–2008. In 2009–2010, Mexican American and Black, non-Hispanic children were more likely to be obese than White, non-Hispanic children.
Poor diet quality is a major factor in the high rate of obesity among children. In 2007–2008, on average, the diets of children ages 2–17 were too high in saturated fat and sodium, had too many calories from solid fats and added sugars, and were lacking in vegetables, fruits, and whole grains; they were adequate in total grains. Federal diet quality standards for total fruit, whole fruit, and milk were met or exceeded only for children ages 2–5.36
32 Preterm births are births less than 37 weeks gestation. Low birthweight infants weigh less than 2,500 grams, or 5 lbs. 8 oz. at birth.
33 Institute of Medicine, Committee on Understanding Premature Birth and Assuring Healthy Outcomes and Board on Health Sciences Policy. (2005). Preterm birth: Causes, consequences, and prevention. R.E. Behrman and A.S. Butler. (Eds). Washington, DC: The National Academies Press. Retrieved from http://www.iom.edu/Reports/2006/Preterm-Birth-Causes-Consequences-and-Prevention.aspx.
34 Race refers to mother's race.
35 Goodman, R. (1999). The extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden. Journal of Child Psychology and Psychiatry, 40, 791–799.
36 The Healthy Eating Index-2005 measures how well diets meet the 2005 Dietary Guidelines for Americans. Guenther, P.M., Reedy, J., and Krebs-Smith, S.M. (2008). Development of the Healthy Eating Index-2005. Journal of the American Dietetic Association, 108(11), 1896–1901.