Highlights

America's Children: Key National Indicators of Well-Being, 2023 continues a series of annual reports to the Nation on conditions affecting children in the United States. Highlights from each section follow.

Demographic Background

There were 72.5 million children ages 0–17 in the United States in 2022, a decrease of 0.4 million since 2021. The number of children is projected to increase to 78.2 million in 2050. (POP1)
The percentage of the U.S. population under age 18 has declined in recent decades, from 26% in 2000 to 24% in 2010 and 22% in 2022. By 2050, 20% of the U.S. population is projected to be under age 18, with 22% age 65 and over. (POP2)
Racial and ethnic diversity has grown dramatically in the United States in the last three decades. This growth was first evident among children. This population is projected to become even more diverse in the decades to come. In 1990, 69% of U.S. children were White, non-Hispanic. For 2022, the percentage of children that are White, non-Hispanic is estimated at 49%. By 2050, 39% of U.S. children are projected to be White, non-Hispanic and 31% are projected to be Hispanic (up from 26% in 2022). (POP3)

Family and Social Environment

In 2022, 70% of all children ages 0–17 lived with two parents (65% with two married parents and 5% with two unmarried cohabiting parents), 22% lived with only their mothers, 5% lived with only their fathers, and 4% lived without a parent in the household. The percentage of children living with two unmarried parents is not statistically different from the percentage of children living with only their father. (FAM1.B)
In 2021, the birth rate among unmarried women ages 15–44 was 38 births for every 1,000 women. From 2019 to 2020, birth rates among unmarried women ages 15–44 decreased for each age group. From 2020 to 2021, birth rates continued to decreased for those ages 15–17, 18–19, and 20–24, increased for those ages 25–29 and 35–39, and remained stable for those ages 30–34 and 40–44. (FAM2.A)
In 2021, 41% of births were to unmarried women. Generally, the percentage of births to unmarried women decreased with age—mothers under age 15 were more likely to be unmarried, while mothers ages 35–39 were more likely to be married. (FAM2.B)
In 2019, among children ages 3–5 who were not yet enrolled in kindergarten and who had employed mothers, 58% received center-based care as their primary care arrangement. This percentage was higher than the corresponding percentages whose primary care arrangement was relative care (17%), home-based nonrelative care (10%), multiple nonparental care arrangements for equal amounts of time (2%), or who only received parental care (14%). (FAM3.A)
In 2019, among children ages 3–5 who were not yet in kindergarten and who had employed mothers, 69% were enrolled in center-based care for any amount of time. This percentage was higher than the corresponding percentage in 1995 (61%) but not measurably different from the percentage in 2016 (70%). (FAM3.B)
In 2022, 22% of children were native-born children with at least one foreign-born parent, and 3% were foreign-born children with at least one foreign-born parent. (FAM4)
In 2021, about 21% of school-age children spoke a language other than English at home, and 5% of school-age children spoke a language other than English at home and had difficulty speaking English. (FAM5)
The adolescent birth rate among females ages 15–17 declined from 15 per 1,000 in 2011 to 6 per 1,000 in 2021, a record low for the country. (FAM6)
In 2021, the rate of substantiated victims of child maltreatment was 8.1 per 1,000 children ages 0–17. Children younger than age 1 were at much higher risk for being victims of child maltreatment than were older children. In 2021, there were 25.3 maltreated children per 1,000 children under age 1. (FAM7.A)
Neglect is by far the most common form of maltreatment, with 76% of child maltreatment victims being neglected and 16% physically abused in 2021. (FAM7.B)

Economic Circumstances

In 2021, 15.3% of all children aged 0–17 (11.1 million) lived in poverty, 0.7 percentage points lower than in 2020. (ECON1.A)
In 2021, 7.2% of children aged 0–17 lived below 50% of the poverty line. (ECON1.B)
For all children, the 2021 Supplemental Poverty Measure (SPM) was 5.2%, 10.1 percentage points lower than the official poverty rate of 15.3%. (ECON1.C)
The percentage of children who had at least one parent working year round, full time increased to 77% in 2021 as labor market conditions continued to recover from the COVID-19 pandemic and efforts to contain it. (ECON2)
About 9.3 million children (13% of all children) lived in households that were classified as food insecure in 2021. (ECON3)

Health Care

In 2021, 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 (8%) compared with Black, non-Hispanic (4%) and White, non-Hispanic (3%) children. (HC1)
Uninsured children ages 0–17 with no usual source of health care increased from 13% in 2020 to 21% in 2021. In 2021, the percentage of uninsured children who had no usual source of health care was 20 percentage points higher than the percentage of children with private health insurance (1%) and 18 percentage points higher than the percentage of children with public health insurance (3%). (HC2)
For children born in 2018, those in families with incomes below the poverty threshold were less likely to have completed the combined 7-vaccine series (60%) compared with those in families with incomes at or above the poverty level (75%). (HC3.A)
In 2020, the percentage of children ages 5–17 years with a dental visit in the past year was 89%, down from 91% in 2019. Children who lacked health insurance coverage in 2020 were less likely to have a dental visit in the past year (63%) compared with children who had private (92%) or public (89%) health insurance coverage. (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 poverty 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 level (8%). (HC4.B)

Physical Environment and Safety

In 2021, about 59% of children lived in counties with measured pollutant concentrations above the levels of one or more of the EPA's National Ambient Air Quality Standards at least once during the year. Ozone is the pollutant most often measured above its current air pollution standard. (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.A)
In 2021, about 7% of children were served by community drinking water systems that did not meet all applicable health-based standards. (PHY3)
In 2017–March 2020, the percentage of children with elevated blood lead levels (at or above 5 micrograms lead per deciliter of blood) was 0.4%, compared with 8.6% in 1999–2002 and 25.6% in 1988–1994. (PHY4)
In 2021, 39% of U.S. households (both owners and renters) with children had one or more of three housing problems: physically inadequate housing, crowded housing, or housing cost burden greater than 30% of household income. This was not statistically significantly different from 2019. (PHY5.A)
In 2021, the rate at which youth were victims of serious violent crimes was 4 per 1,000 youth ages 12–17. (PHY6)
In 2019–2020, falls were the leading cause of injury-related emergency department visits among children ages 1–4 (54 visits per 1,000 children) and among children ages 5–14 (28 visits per 1,000 children). (PHY7.A)
In 2021, 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 2019–2020, being struck by or against an object or person (25 visits per 1,000), motor vehicle traffic-related injuries (21 visits per 1,000), and falls (20 visits per 1,000) were the leading causes of injury-related emergency department visits among adolescents ages 15–19. (PHY8.A)
In 2021, unintentional injuries—the leading cause of injury-related death among adolescents ages 15–19—was 24 per 100,000, up from 22 per 100,000 in 2020. Among males, death rates for homicide (22 per 100,000) were higher than suicide (16 per 100,000). Among females, death rates for suicide (5 per 100,000) were higher than homicide (4 per 100,000). (PHY8.C)

Behavior

In 2022, the percentages of students who reported smoking cigarettes daily in the past 30 days continued to be at historically low levels, with 0.3% of 8th-, 1% of 10th-, and 2% of 12th-grade students reporting use. (BEH1)
Youth binge drinking rates remained steady among 8th, 10th, and 12th graders from 2021 to 2022. (BEH2)
In 2022, illicit drug use in the past 30 days was reported by 7% of 8th graders, 13% of 10th graders, and 22% of 12th graders. The estimates did not significantly change from 2021. Marijuana continues to be the main driver of trends in illicit drug use. (BEH3.A)
In 2022, marijuana use in the past 30 days was reported by 5% of 8th-, 12% of 10th-, and 20% of 12th-grade students. The percentages remained steady compared with those in 2021. (BEH3.B)
The percentage of students reporting ever having had sexual intercourse declined from 54% in 1991 to 46% in 2001 and was relatively stable through 2013 (47%) before decreasing to 30% in 2021. (BEH4.A)
In 2021, the serious violent crime offending rate was 5 crimes per 1,000 youth ages 12–17; there were 122,900 serious violent crimes involving youth. (BEH5.A)

Education

Approximately 85% of children ages 3–5 who were not yet in kindergarten were read to three or more times per week by a family member in 2019. This rate was higher than the rate in 1993 (78%), although it fluctuated in the intervening years. (ED1)
At both Grades 4 and 8, the average mathematics scores in 2022 were higher than in 1990, but the Grade 4 and Grade 8 2022 average mathematics scores in 2022 were lower than in 2019. (ED2.A)
At Grades 4 and 8, the average reading scores in 2022 were lower than the scores in 2019 and not measurably different from the scores in 1992. (ED2.C)
In 2017–18, about 23% of public high school students were enrolled in geometry, 20% were enrolled in algebra II, 16% were enrolled in advanced mathematics, 5% were enrolled in calculus, and 5% were enrolled in Advanced Placement mathematics. (ED3)
In 2017–18, about 30% of public high school students were enrolled in biology, 20% were enrolled in chemistry, 11% percent were enrolled in physics, and 6% percent were enrolled in Advanced Placement science. (ED3)
In 2021, some 94% of young adults ages 18–24 had completed high school with a diploma or an alternative credential such as a General Educational Development (GED) certificate. The high school completion rate has increased since 2000, when it was 86%. (ED4)
In 2022, 9% of youth ages 16–19 were neither enrolled in school nor working, little changed from the prior year. (ED5)
During the 2021–22 school year, 20% of youth ages 16 to 19 were both enrolled in school and employed. Young women were more likely to be employed and enrolled in school (23%) than were young men (18%). The proportion of youth both enrolled in school and employed is about 2.0 percentage points higher than in 2010. (ED5)
In the 2021–22 school year, 60% of youth ages 16 to 19 were enrolled in school and not employed, while 20% of youth were both enrolled in school and employed. (ED5)
In 2021, some 62% of high school completers enrolled in a 2-year or 4-year college in the fall immediately following their graduation from high school. (ED6)

Health

In 2021, 10.5% of infants were born preterm, slightly higher than the percentage in 2011 (9.8%). (HEALTH1.A)
In 2021, 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 Native Hawaiian or Other Pacific Islander, non-Hispanic (9%); Asian, non-Hispanic (9%); American Indian or Alaska Native, non-Hispanic (8%); Hispanic (8%); and White, non-Hispanic (7%) women. (HEALTH1.B)
Despite the decline in infant mortality rates from 2010 (6 per 1,000) to 2020 (5 per 1,000), racial and ethnic disparities persist. In 2020, infant mortality rates were highest for infants born to Black, non-Hispanic mothers (10 per 1,000) and lowest for infants born to Asian, non-Hispanic mothers (3 per 1,000). (HEALTH2)
In 2019, 6% of parents reported that their child ages 4–17 had serious emotional or behavioral difficulties. Parents were more likely to report serious emotional or behavioral difficulties for boys (7%) than for girls (4%). (HEALTH3)
In 2019, 4 out of 10 children ages 4–17 with serious emotional or behavioral difficulties used special education services for an emotional or behavioral problem. (HEALTH3)
In 2021, more than 1 in 5 adolescents experienced a major depressive episode (MDE) in the past year, including nearly 30% of adolescent girls. (HEALTH4.A)
In 2020–2021, 12.7% of children ages 5–17 had disability. Children with family incomes below poverty (18%) and those with family incomes at 100%–199% of the poverty level (15%) were more likely to report disability than children with family incomes at or above 200% of the poverty level (11%). (HEALTH5)
During 2019–2020, overall the total diets of children and adolescents did not align with the 2015–2020 Dietary Guidelines for Americans. (HEALTH6)
In 2017–March 2020, 21% of children ages 6–11 and 22% of adolescents ages 12–17 had obesity. (HEALTH7)
In 2021, among children ages 0–17, 6% of children were reported to currently have asthma, and 3% of children had one or more asthma attacks in the past year. (HEALTH8)
In 2021, 13% of Black, non-Hispanic children were reported to currently have asthma compared with 5% of Hispanic; 6% of White, non-Hispanic; and 3% of Asian, non-Hispanic children. (HEALTH8)

Federal Interagency Forum on Child and Family Statistics