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America's Children in Brief: Key National Indicators of Well-Being, 2020

Brief Figures

Figure 1: Percentage of children ages 0–17 in the United States by metropolitan status, 2018
Percentage of children ages 0–17 in the United States by metropolitan status, 2018

NOTE: The income categories were derived from the ratio of a family's income to the family's poverty threshold. In 2016, the poverty threshold for a family of four with two children was $24,339. The source of the calendar year 2013 data for this figure is the portion of the 2014 Current Population Survey (CPS) Annual Social and Economic Supplement (ASEC) sample that received income questions consistent with the 2013 CPS ASEC. Data for calendar year 2014 and onward used the redesigned income questions. Users should use caution when comparing 2013 data to 2014 data.

SOURCE: U.S. Census Bureau, American Community Survey

Figure 2: Percentage of children ages 0–17 in the United States by race, Hispanic origin, and metropolitan status, 2018
Percentage of children ages 0–17 in the United States by race, Hispanic origin, and metropolitan status, 2018

NOTE: NH = non-Hispanic origin; AIAN = American Indian or Alaska Native; and NHPI = Native Hawaiian or Other Pacific Islander. The 1997 U.S. Office of Management and Budget (OMB) standards on race and ethnicity are used to classify persons into one of the following five racial groups: White, Black or African American, Asian, American Indian or Alaska Native, and Native Hawaiian or Other Pacific Islander. Each group is limited to the non-Hispanic population, with the exception of the Hispanic category itself. Federal surveys give respondents the option of reporting more than one race. Therefore, two ways of defining a race group are possible. A group such as Black may be defined as those who report Black and no other race or those who report Black regardless of whether they also report another race. This indicator shows data using the first approach. Those reporting more than one race were classified in the "Two or more races, NH" category. Data on race and Hispanic origin are collected separately. Persons of Hispanic origin may be of any race. The OMB classifies counties as within a metropolitan or a micropolitan statistical area. The remaining counties are not classified and are considered rural in this report. Rural counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas. The U.S. Census Bureau reviewed this data product for unauthorized disclosure of confidential information and has approved the disclosure avoidance practices applied to this release. CBDRB-FY2020-POP001-0123.

SOURCE: U.S. Census Bureau, American Community Survey

Figure 3: Birth rates for females ages 15–19 by race and Hispanic origin and metropolitan status, 2018
Birth rates for females ages 15–19 by race and Hispanic origin and metropolitan status, 2018

NOTE: NH = non-Hispanic origin; AIAN = American Indian or Alaska Native; and NHPI = Native Hawaiian or Other Pacific Islander. Race refers to the mother's race. The 1997 U.S. Office of Management and Budget (OMB) standards on race and ethnicity are used to classify persons into one of the following five racial groups: White, Black or African American, Asian, American Indian or Alaska Native, and Native Hawaiian or Other Pacific Islander. All categories are single race. Included in the total, but not shown separately, are people reporting two or more races. Data on race and Hispanic origin are collected and reported separately. Persons of Hispanic origin may be of any race. The OMB classifies counties as within a metropolitan or a micropolitan statistical area. The remaining counties are not classified and are considered rural in this report. Rural counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas.

SOURCE: National Center for Health Statistics, National Vital Statistics System.

Figure 4: Rate of substantiated maltreatment of children ages 0–17 by metropolitan status, 2018
Rate of substantiated maltreatment of children ages 0–17 by metropolitan status, 2018

NOTE: The data in this figure are rates of maltreatment based on investigations and assessments by Child Protective Services (CPS) that found the child to be a victim of one or more types of maltreatment. The rates are based on unique counts of victims of maltreatment. A unique count includes each child only one time regardless of the number of times the child was determined to be a victim. Maltreatment includes the dispositions of substantiated or indicated. Data may include state resubmissions and may not match previously published data. Rates are based on the number of states submitting data to the National Child Abuse and Neglect Data System (NCANDS) each year; states include the District of Columbia and the Commonwealth of Puerto Rico. The number of states reporting may vary slightly from year to year: not all states report on all measures, and not all states report in all years. Additional technical notes are available in the annual reports titled Child Maltreatment. These reports are available at https://www.acf.hhs.gov/cb/research-data-technology/statistics-research/child-maltreatment. The Justice for Victims of Trafficking Act of 2015 included an amendment to the Child Abuse Prevention and Treatment Act under Title VIII—Better Response for Victims of Child Sex Trafficking by adding a requirement to collect and report sex trafficking data. States began reporting sex trafficking as a maltreatment type to NCANDS with their Federal fiscal year 2018 data submissions as required by a change in the law. For this first year of reporting, 27 states submitted data about victims of sex trafficking to NCANDS; as a result, sex trafficking rates underrepresent the true national rate, and rates for 2018 are not directly comparable with previous years. The U.S. Office of Management and Budget classifies counties as within a metropolitan or a micropolitan statistical area. The remaining counties are not classified and are considered rural in this report. Rural counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas. Metropolitan status calculations do not include Puerto Rico. Counties were classified based on the county of the child's residence at the time of the alleged abuse. If the child was in out-of-home care at the time of the report, the county of the facility or foster home should be used. This county may or may not be the county where the abuse occurred and may or may not be the county in which the CPS response occurred.

SOURCE: Administration for Children and Families, National Child Abuse and Neglect Data System.

Figure 5: Percentage of substantiated maltreatment of children ages 0–17 by maltreatment type and metropolitan status, 2018
Percentage of substantiated maltreatment of children ages 0–17 by maltreatment type and metropolitan status, 2018

NOTE: This figure represents a duplicated count of maltreatments, based on a unique count of victims. Bars may total to more than 100% because a single child may be the victim of multiple kinds of maltreatment. Substantiated maltreatment includes the dispositions of substantiated or indicated. Additional technical notes are available in the annual reports titled Child Maltreatment. These reports are available at https://www.acf.hhs.gov/cb/research-data-technology/statistics-research/child-maltreatment. The Justice for Victims of Trafficking Act of 2015 included an amendment to the Child Abuse Prevention and Treatment Act under Title VIII—Better Response for Victims of Child Sex Trafficking by adding a requirement to collect and report sex trafficking data. States began reporting sex trafficking as a maltreatment type to NCANDS with their Federal fiscal year 2018 data submissions as required by a change in the law. For this first year of reporting, 27 states submitted data about victims of sex trafficking to NCANDS; as a result, sex trafficking rates underrepresent the true national rate, and rates for 2018 are not directly comparable with previous years. The U.S. Office of Management and Budget classifies counties as within a metropolitan or a micropolitan statistical area. The remaining counties are not classified and are considered rural in this report. Rural counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas. Metropolitan status calculations do not include Puerto Rico. Counties were classified based on the county of the child's residence at the time of the alleged abuse. If the child was in out-of-home care at the time of the report, the county of the facility or foster home should be used. This county may or may not be the county where the abuse occurred and may or may not be the county in which the Child Protective Services response occurred.

SOURCE: Administration for Children and Families, National Child Abuse and Neglect Data System.

Figure 6: Percentage of children ages 0–17 living in poverty by race, Hispanic origin, and metropolitan status, 2018
Percentage of children ages 0–17 living in poverty by race, Hispanic origin, and metropolitan status, 2018

NOTE: NH = non-Hispanic origin and AIAN = American Indian or Alaska Native. In 2018, the poverty threshold for a two-parent, two-child family was $25,465. The 1997 U.S. Office of Management and Budget (OMB) standards on race and ethnicity are used to classify persons into one of the following five racial groups: White, Black or African American, Asian, American Indian or Alaska Native, and Native Hawaiian or Other Pacific Islander. Federal surveys give respondents the option of reporting more than one race. Therefore, two ways of defining a race group are possible. A group such as Black may be defined as those who reported Black and no other race or those who report Black regardless of whether they also report another race. This indicator shows data using the first approach. Included in the total, but not shown separately, are Native Hawaiian or Other Pacific Islander, people reporting some other race, or people reporting two or more races. Data on race and Hispanic origin are collected separately. Persons of Hispanic origin may be of any race. The OMB classifies counties as within a metropolitan or a micropolitan statistical area. The remaining counties are not classified and are considered rural in this report. Rural counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas. The U.S. Census Bureau reviewed this data product for unauthorized disclosure of confidential information and has approved the disclosure avoidance practices applied to this release. CBDRB-FY2020-POP001-0123.

SOURCE: U.S. Census Bureau, American Community Survey

Figure 7: Percentage of children ages 0–17 in food-insecure households by metropolitan status, 2017–2018
Percentage of children ages 0–17 in food-insecure households by metropolitan status, 2017–2018

NOTE: Food-insecure households are those in which either adults or children or both were "food insecure," meaning that, at times, they were unable to acquire adequate food for active, healthy living because the household had insufficient money and other resources for food. The U.S. Office of Management and Budget classifies some counties as within a metropolitan statistical area. The remaining counties are considered nonmetropolitan. Nonmetropolitan counties include counties in micropolitan statistical and rural areas.

SOURCE: U.S. Census Bureau, Current Population Survey Food Security Supplement; tabulated by the U.S. Department of Agriculture, Economic Research Service and Food and Nutrition Service.

Figure 8: Percentage of children ages 0–17 by health insurance coverage status at the time of interview and metropolitan status, 2018
Percentage of children ages 0–17 by health insurance coverage status at the time of interview and metropolitan status, 2018

NOTE: A child was considered uninsured if he or she did not have any private health insurance, Medicare, Medicaid, Children's Health Insurance Program (CHIP), a state-sponsored or other government-sponsored health plan, or a military plan. A child also was defined as uninsured if he or she had only Indian Health Service coverage or had only a private plan that paid for one type of service, such as accidents or dental care. Private health insurance includes children covered by any comprehensive private insurance plan (including health maintenance organizations and preferred provider organizations). These plans include those obtained through an employer, purchased directly, purchased through local or community programs, or purchased through the Health Insurance Marketplace or a state-based exchange. Public health insurance includes children who do not have private coverage, but who have Medicaid or other state-sponsored health plans, including CHIP. The U.S. Office of Management and Budget classifies counties as within a metropolitan or a micropolitan statistical area. The remaining counties are not classified and are considered rural in this report. Rural counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas.

SOURCE: National Center for Health Statistics, National Health Interview Survey.

Figure 9: Percentage of children ages 5–17 with a dental visit in the past year by metropolitan status, 2018
Percentage of children ages 5–17 with a dental visit in the past year by metropolitan status, 2018

NOTE: Children were identified as having a dental visit in the past year by asking parents, "About how long has it been since your child last saw a dentist?" Parents were directed to include all types of dentists, such as orthodontists, oral surgeons, and all other dental specialists, as well as dental hygienists. The U.S. Office of Management and Budget classifies counties as within a metropolitan or a micropolitan statistical area. The remaining counties are not classified and are considered rural in this report. Rural counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas.

SOURCE: National Center for Health Statistics, National Health Interview Survey.

Figure 10: Percentage of households with children ages 0–17 that have housing problems by metropolitan status, 2017
Percentage of households with children ages 0–17 that have housing problems by metropolitan status, 2017

NOTE: The U.S. Office of Management and Budget classifies counties as within a metropolitan or a micropolitan statistical area. The remaining counties are not classified and are considered rural in this report. Rural counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas. Principal cities of metropolitan areas also are identified.

SOURCE: U.S. Census Bureau and the U.S. Department of Housing and Urban Development, American Housing Survey. Tabulated by U.S. Department of Housing and Urban Development.

Figure 11: Percentage of households with children ages 0–17 that have moderate or severe housing cost burdens by metropolitan status, 2017
Percentage of households with children ages 0–17 that have moderate or severe housing cost burdens by metropolitan status, 2017

NOTE: The U.S. Office of Management and Budget classifies counties as within a metropolitan or a micropolitan statistical area. The remaining counties are not classified and are considered rural in this report. Rural counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas. Principal cities of metropolitan areas also are identified.

SOURCE: U.S. Census Bureau and the U.S. Department of Housing and Urban Development, American Housing Survey. Tabulated by U.S. Department of Housing and Urban Development.

Figure 12: Death rates among children ages 1–4 by selected leading causes of death and metropolitan status, 2018
Death rates among children ages 1–4 by selected leading causes of death and metropolitan status, 2018

NOTE: Underlying causes of death are based on the International Classification of Diseases, 10th revision. Unintentional injuries is another term for accidents. Unintentional injury deaths are identified by codes V01–X59 and Y85–Y86. Cancer (malignant neoplasms) deaths are identified by codes C00–C97. Birth defect (congenital malformations, deformations, and chromosomal abnormalities) deaths are identified by codes Q00–Q99. Homicide deaths are identified by codes U01–U02, X85–Y09, and Y87.1. The U.S. Office of Management and Budget classifies counties as within a metropolitan or a micropolitan statistical area. The remaining counties are not classified and are considered rural in this report. Rural counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas.

SOURCE: National Center for Health Statistics, National Vital Statistics System.

Figure 13: Death rates among children ages 5–14 by selected leading causes of death and metropolitan status, 2018
Death rates among children ages 5–14 by selected leading causes of death and metropolitan status, 2018

‡ Reporting standards not met; the number of deaths is too few to calculate a reliable rate.

NOTE: Underlying causes of death are based on the International Classification of Diseases, 10th revision. Unintentional injuries is another term for accidents. Unintentional injury deaths are identified by codes V01–X59 and Y85–Y86. Cancer (malignant neoplasms) deaths are identified by codes C00–C97. Suicide deaths are identified by codes U03, X60–X84, and Y87.0. Most suicides in the 5–14 age group are among those ages 10–14. Birth defect (congenital malformations, deformations, and chromosomal abnormalities) deaths are identified by codes Q00–Q99. Homicide deaths are identified by codes U01–U02, X85–Y09, and Y87.1. The U.S. Office of Management and Budget classifies counties as within a metropolitan or a micropolitan statistical area. The remaining counties are not classified and are considered rural in this report. Rural counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas.

SOURCE: National Center for Health Statistics, National Vital Statistics System.

Figure 14: Death rates among adolescents ages 15–19 by selected leading causes of death and metropolitan status, 2018
Death rates among adolescents ages 15–19 by selected leading causes of death and metropolitan status, 2018

NOTE: Underlying causes of death are based on the International Classification of Diseases, 10th revision. Unintentional injuries is another term for accidents. Unintentional injury deaths are identified by codes V01–X59 and Y85–Y86. Suicide deaths are identified by codes U03, X60–X84, and Y87.0. Homicide deaths are identified by codes U01–U02, X85–Y09, and Y87.1. Cancer (malignant neoplasms) deaths are identified by codes C00–C97. Heart disease deaths are identified by codes I00–I09, I11, I13, and I20–I51. The U.S. Office of Management and Budget classifies counties as within a metropolitan or a micropolitan statistical area. The remaining counties are not classified and are considered rural in this report. Rural counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas.

SOURCE: National Center for Health Statistics, National Vital Statistics System.

Figure 15: Percentage of 8th-, 10th-, and 12th-grade students who reported smoking cigarettes daily in the past 30 days by metropolitan status, 2019
Percentage of 8th-, 10th-, and 12th-grade students who reported smoking cigarettes daily in the past 30 days by metropolitan status, 2019

NOTE: Daily cigarette smoking is defined as the use of one or more cigarettes per day in the past 30 days. The U.S. Office of Management and Budget classifies some counties as within a metropolitan statistical area. The remaining counties are considered nonmetropolitan. Nonmetropolitan counties include counties in micropolitan statistical and rural areas.

SOURCE: National Institute on Drug Abuse, Monitoring the Future Survey.

Figure 16: Percentage of 8th-, 10th-, and 12th-grade students who reported having five or more alcoholic beverages in a row in the past 2 weeks by metropolitan status, 2019
Figure 16: Percentage of 8th-, 10th-, and 12th-grade students who reported having five or more alcoholic beverages in a row in the past 2 weeks by metropolitan status, 2019

NOTE: Binge drinking is defined as having five or more alcoholic beverages in a row in the past 2 weeks. The U.S. Office of Management and Budget classifies some counties as within a metropolitan statistical area. The remaining counties are considered nonmetropolitan. Nonmetropolitan counties include counties in micropolitan statistical and rural areas.

SOURCE: National Institute on Drug Abuse, Monitoring the Future Survey.

Figure 17: Percentage of young adults ages 18–24 who have completed high school by metropolitan status, 2010 and 2018
Percentage of young adults ages 18–24 who have completed high school by metropolitan status, 2010 and 2018

NOTE: Diploma equivalents include alternative credentials obtained by passing examinations such as the General Educational Development (GED) test. This figure excludes those still enrolled in high school or enrolled in a lower education level. The U.S. Office of Management and Budget classifies some counties as within a metropolitan statistical area. The remaining counties are considered nonmetropolitan. Nonmetropolitan counties include counties in micropolitan statistical and rural areas. Total includes those whose household metropolitan status was "not identified," which is not separately shown.

SOURCE: U.S. Census Bureau, Current Population Survey, School Enrollment Supplement.

Figure 18: Death rates among infants by race and Hispanic origin of mother and metropolitan status, 2017–2018
Death rates among infants by race and Hispanic origin of mother and metropolitan status, 2017–2018

‡ Reporting standards not met; the number of deaths is too few to calculate a reliable rate.

NOTE: NH = non-Hispanic origin. Infant deaths are deaths before an infant's first birthday. Among Native Hawaiian or Other Pacific Islander infants, the number of infant deaths is generally too small to meet reliability standards and therefore are not shown. Race refers to the mother's race. The 1997 U.S. Office of Management and Budget (OMB) standards on race and ethnicity are used to classify persons into one of the following racial groups: White, Black or African American, Asian, and American Indian or Alaska Native. All categories are single race. Included in the total, but not shown separately, are people reporting two or more races. Data on race and Hispanic origin are collected and reported separately. Persons of Hispanic origin may be of any race. The OMB classifies counties as within a metropolitan or a micropolitan statistical area. The remaining counties are not classified and are considered rural in this report. Rural counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas.

SOURCE: National Center for Health Statistics, National Vital Statistics System.

Figure 19 Percentage of youth ages 12–17 who experienced a major depressive episode (MDE) in the past year by gender and metropolitan status, 2018
Figure 19 Percentage of youth ages 12–17 who experienced a major depressive episode (MDE) in the past year by gender and metropolitan status, 2018

NOTE: MDE is defined as a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities plus at least four additional symptoms of depression (such as problems with sleep, eating, energy, concentration, and feelings of self-worth) as described in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. The U.S. Office of Management and Budget classifies counties as within a metropolitan or a micropolitan statistical area. The remaining counties are not classified and are considered rural in this report. Rural counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas.

SOURCE: Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health.

Figure 20 Percentage of those receiving treatment for depression among youth ages 12–17 with at least one major depressive episode (MDE) in the past year by metropolitan status, 2018
Figure 20 Percentage of those receiving treatment for depression among youth ages 12–17 with at least one major depressive episode (MDE) in the past year by metropolitan status, 2018

NOTE: MDE is defined as a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities plus at least four additional symptoms of depression (such as problems with sleep, eating, energy, concentration, and feelings of self-worth) as described in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. The U.S. Office of Management and Budget classifies counties as within a metropolitan or a micropolitan statistical area. The remaining counties are not classified and are considered rural in this report. Rural counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas.

SOURCE: Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health.

Figure 21 Percentage of children ages 6–17 with obesity by metropolitan status, 2013–2018
Figure 21 Percentage of children ages 6–17 with obesity by metropolitan status, 2013–2018

NOTE: Obesity for children and adolescents is defined as a body mass index (BMI) at or above the sex- and age-specific 95th percentile from the 2000 Centers for Disease Control and Prevention Growth Charts (https://www.cdc.gov/growthcharts/). BMI is a measure of body fat based on height and weight. It is calculated as a person's weight in kilograms divided by the square of height in meters. The U.S. Office of Management and Budget classifies some counties as within a metropolitan statistical area. The remaining counties are considered nonmetropolitan. Nonmetropolitan counties include counties in micropolitan statistical and rural areas.

SOURCE: National Center for Health Statistics, National Health and Nutrition Examination Survey.

Figure 22 Percentage of children ages 0–17 who currently have asthma by metropolitan status, 2016–2018
Figure 22 Percentage of children ages 0–17 who currently have asthma by metropolitan status, 2016–2018

NOTE: Children are identified as ever diagnosed with asthma by asking parents "Has a doctor or other health professional EVER told you that your child has asthma?" If the parent answered YES to this question, they were then asked "Does your child still have asthma?" The question "Does your child still have asthma?" was introduced in 2001 and identifies children who currently have asthma. The U.S. Office of Management and Budget classifies some counties as within a metropolitan statistical area. The remaining counties are considered nonmetropolitan. Nonmetropolitan counties include counties in micropolitan statistical and rural areas.

SOURCE: National Center for Health Statistics, National Health Interview Survey.