America's Children: Key National Indicators of Well-Being, 2025 continues a series of annual reports to the Nation on conditions affecting children in the United States. Highlights from each section follow.

Family and Social Environment

• In 2023, the birth rate among unmarried women ages 15–44 was 36 births for every 1,000 women, down from 37 births for every 1,000 women in 2022. From 2022 to 2023, birth rates decreased for those ages 18–19, 25–29, and 30–34, increased for those ages 20–24 and 40–44, and remained stable for those ages 15–17 and 35–39. (FAM1.A)
• In 2023, 40% of births were to unmarried women. Generally, the percentage of births to unmarried women decreased with age—mothers under age 20 were more likely to be unmarried at the time of birth, while mothers age 25 and over were less likely to be unmarried at the time of birth. (FAM1.B)
• The birth rate among female adolescents ages 15–17 declined from 9 per 1,000 in 2016 to 5 per 1,000 in 2023, a record low for the country. (FAM2)
• In 2023, the rate of substantiated child maltreatment was 7 per 1,000 children ages 0–17. The maltreatment rate for children under age 1 was 21 per 1,000, which was more than twice the rate for any other age group. (FAM3.A)
• Neglect was by far the most common form of maltreatment in 2023: nearly three-quarters (74%) of child maltreatment victims were found to have been neglected. (FAM3.B)

Economic Circumstances

• In 2023, 79% of children ages 0–17 had at least one parent who worked year round, full time. This percentage was not significantly different from the percentage in 2022. (ECON1)
• In 2023, 19% of children ages 0–17 (13.8 million children) lived in households classified as food insecure. (ECON2)

Health Care

• In 2023, the percentage of children ages 0–17 without health insurance at the time of interview was 4%. Hispanic children were more likely to be uninsured (7%) compared with Black, non-Hispanic (3%) and White, non-Hispanic (2%) children. (HC1)
• The percentage of uninsured children ages 0–17 with no usual source of health care did not significantly change from 2019 to 2023. In 2023, 24% of uninsured children had no usual source of health care compared with 4% of children with public health insurance and 1% of children with private health insurance. (HC2)
• Among children born in 2020, 68% had received the combined 7-vaccine series (4:3:1:3*:3:1:4) by age 24 months. The percentage who received this vaccine series was lower for those in families with incomes below the poverty threshold (58%) than for those in families with incomes at or above the poverty threshold (71%). (HC3.A)
• The percentage of children ages 5–17 years who had visited the dentist in the past year did not significantly change from 2019 to 2023 (90% in 2023). In 2023, children with family incomes below 100% of the poverty threshold (81%) were the least likely to have visited the dentist in the past year, followed by children with family incomes at 100%–199% of the poverty threshold (86%) and children with family incomes at or above 200% of the poverty threshold (93%). (HC4.A)
• In 2017–March 2020, the percentage of children ages 5–17 with untreated dental caries (i.e., cavities) was 12%. Children in families with incomes below 100% of the poverty threshold were more than two times as likely to have untreated dental caries (19%) compared with children in families with incomes at or above 200% of the poverty threshold (8%). (HC4.B)

Physical Environment and Safety

• In 2022, 54% of children ages 0–17 lived in counties with measured pollutant concentrations above the levels of one or more of the Environmental Protection Agency's Primary National Ambient Air Quality Standards (NAAQS) at least once during the year. (PHY1)
• Overall, the percentage of children ages 4–11 with detectable blood cotinine levels—a chemical marker of recent exposure to secondhand smoke—was 36% in 2017–March 2020. Approximately 58% of Black, non-Hispanic children ages 4–11 had detectable blood cotinine levels, compared with 39% of White, non-Hispanic children and 20% of Mexican American children. (PHY2.B)
• In 2023, 1% of all children ages 0–17 served by community water systems were served by systems that had violations of the disinfection byproducts standard. Exposure to disinfection byproducts may lead to cancer or developmental effects. (PHY3)
• In 2017–March 2020, the percentage of children with elevated blood lead levels (at or above 3.5 micrograms lead per deciliter of blood [µg/dL]) was 1.4%. This percentage was 18.5% in 1999–2002 and 43.0% in 1988–1994.(PHY4.A)
• In 2023, 39% of U.S. households with children ages 0–17 had one or more of the following housing problems: physically inadequate housing, crowded housing, or housing cost burden. This percentage is not statistically different from the percentage in 2021. (PHY5.A)
• In 2023, the serious violent crime victimization rate for youth ages 12–17 was 5 crimes per 1,000. (PHY6)
• In 2021–2022, the leading causes of injury-related emergency department (ED) visits for both children ages 1–4 and 5–14 were falls and being struck by or against an object or person. For children ages 1–4, the rate for falls was 45 visits per 1,000 children and the rate for being struck was 17 visits per 1,000 children. For children ages 5–14, the rate for falls was 24 visits per 1,000 children and the rate for being struck was 18 visits per 1,000 children. (PHY7.A)
• In 2023, the leading injury-related cause of death among children ages 1–4 was drowning (3 per 100,000), whereas motor-vehicle-traffic-related injuries (2 per 100,000) were the leading injury-related cause of death among children ages 5–14. (PHY7.B)
• In 2021–2022, the leading causes of injury-related ED visits among adolescents ages 15–19 were being struck by or against an object or person (20 visits per 1,000), falls (20 visits per 1,000), motor vehicle traffic crashes (17 visits per 1,000), overexertion (12 visits per 1,000), and being cut or pierced from an instrument or object (10 visits per 1,000). (PHY8.A)
• In 2023, unintentional injuries were the leading cause of injury-related death among adolescents ages 15–19 (22 per 100,000). Among males, death rates for homicide (20 per 100,000) were higher than suicide (15 per 100,000). Among females, death rates for suicide (5 per 100,000) were higher than homicide (3 per 100,000). (PHY8.B)

Behavior

• In 2024, 5% of 8th-graders used any nicotine products and 6% vaped nicotine; 11% of 10th-graders used any nicotine products and 10% vaped nicotine; and 16% of 12th-graders used any nicotine products and 15% vaped nicotine. (BEH1)
• Youth binge drinking rates remained steady among 8th-, 10th-, and 12th-graders from 2023 to 2024. (BEH2)
• In 2024, illicit drug use in the past 30 days was reported by 5% of 8th-graders, 10% of 10th-graders, and 17% of 12th-graders. These estimates were not significantly different from those in 2023 for 8th- and 10th-graders. For 12th-graders, the estimate reflects a significant decrease compared with 2023 (20%). (BEH3.A)
• In 2024, marijuana use in the past 30 days was reported by 4% of 8th-graders, 10% of 10th-graders, and 16% of 12th-graders. Rates remained stable compared with 2023. (BEH3.B)
• The percentage of high school students who reported ever having had sexual intercourse decreased from 38% in 2019 to 32% in 2023. (BEH4.A)
• Among sexually active high school students, the percentage who reported they or their partner used a condom the last time they had intercourse peaked at 63% in 2003, decreased to 52% in 2021, and remained stable through 2023. (BEH4.B)
• Among sexually active high school students, the percentage who used birth control pills to prevent pregnancy before the last time they had sexual intercourse (not counting emergency contraception such as Plan B or the "morning after" pill) was 21% in 2021 and remained stable through 2023, ranging from 10% in 9th grade to 24% in 12th grade. (BEH4.C)
• In 2023, the serious violent crime offending rate for juveniles ages 12–17 was 6 crimes per 1,000; there were 162,100 serious violent crimes involving juvenile offenders. (BEH5.A)

Education

• In 2024, 9% of youth ages 16–19 were neither enrolled in school nor working. This rate has remained between 8% and 9% since 2000, with the exception of 2020 (when the rate was 10%). (ED1)
• In 2023, nearly two-thirds (66%) of children ages 3–5 were developmentally on track and ready for school. Percentages varied by developmental domain—from 68% for motor development to 89% for health—and by race/ethnicity, ranging from 60% for Black, non-Hispanic and Hispanic children to 70% for White, non-Hispanic children. These measures show no significant difference from the prior year. (ED2.A)

Health

• The percentage of infants born preterm varied year-to-year from 2013 to 2023 but was about 10% throughout the period. In 2023, infants of Black, non-Hispanic women (15%) were the most likely to be born preterm, followed by infants of Native Hawaiian or Other Pacific Islander, non-Hispanic (13%) and American Indian or Alaska Native, non-Hispanic (12%) women. Infants of Hispanic (10%); White, non-Hispanic (9%); and Asian, non-Hispanic (9%) women were the least likely to be born preterm. (HEALTH1.A)
• In 2023, 9% of infants were born with low birthweight. Infants of Black, non-Hispanic women were the most likely to have low birthweight (15%), compared with infants of Asian, non-Hispanic (9%); American Indian or Alaska Native, non-Hispanic (9%); Native Hawaiian or Other Pacific Islander, non-Hispanic (9%); Hispanic (8%); and White, non-Hispanic (7%) women. (HEALTH1.B)
• After a long-term downward trend since 1995, the infant mortality rate was stable from 2020 to 2021 (5 deaths per 1,000 live births) and then increased in 2022 to 6 per 1,000. In 2022, infant mortality rates continued to be the highest for infants of Black, non-Hispanic women (11 per 1,000) and lowest for infants of Asian, non-Hispanic women (4 per 1,000). (HEALTH2)
• In 2022, 7% of children ages 4–17 were reported by parents to have serious emotional or behavioral difficulties. This percentage was higher for male children (8%) than for female children (6%). (HEALTH3)
• In 2022–2023, 14% of children ages 5–17 had disability. The likelihood of disability increased with decreasing poverty status—children with family incomes below 100% of the poverty threshold were the most likely to have disability (20%), followed by children with family incomes at 100%–199% of the poverty threshold (15%) and children with family incomes at or above 200% of the poverty threshold (11%). (HEALTH4)
• In August 2021–August 2023, 22% of children ages 6–11 and 23% of adolescents ages 12–17 had obesity. (HEALTH5)
• In 2024, among children ages 0–17, 7% currently had asthma, and 4% had one or more asthma attacks in the past year. (HEALTH6)
• The prevalence of current asthma in 2024 was highest among Black, non-Hispanic children ages 0–17 (10%), followed by children who were Hispanic (7%); White, non-Hispanic (6%); and Asian, non-Hispanic (4%). (HEALTH6)