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America's Children in Brief: Key National Indicators of Well-Being, 2018

Health and Safety Figures

Figure HEALTH1.A: Percentage of infants born preterm and percentage of infants born with low birthweight, 1990–2016
Percentage of infants born preterm and percentage of infants born with low birthweight, 1990–2016

NOTE: Late preterm infants are born at 34–36 weeks of gestation; early preterm infants are born at or 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. Starting with 2007 data, the obstetric estimate (OE) of gestation at delivery replaces the date of the last normal menses (LMP) for estimating the gestational age of a newborn. These methodological changes prevent the direct comparison of trends prior to 2007 with trends from 2007 onwards. Data on preterm births can be found in Table HEALTH1.A, and data on low birthweight can be found in table Table HEALTH1.B.

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

Figure HEALTH1.B: Percentage of infants born with low birthweight by race and Hispanic origin of mother, 1990, 2006, 2016
Percentage of infants born with low birthweight by race and Hispanic origin of mother, 1990, 2006, 2016

NOTE: Race refers to the mother's race. The 1977 U.S. Office of Management and Budget (OMB) Standards for Data on Race and Ethnicity were used to classify persons into one of the following four racial groups: White, Black, American Indian or Alaskan Native, or Asian or Pacific Islander. Although state reporting of birth certificate data is transitioning to comply with the 1997 OMB standard for race and ethnicity statistics, 2006 and 2016 data from states reporting multiple races were bridged to the single-race categories of the 1977 OMB standards for comparability with other states. Data on race and Hispanic origin are collected and reported separately. Persons of Hispanic origin may be any race.

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

Figure HEALTH2: Death rates among infants by race and Hispanic origin of mother, 1999–2015
Death rates among infants by race and Hispanic origin of mother, 1999–2015

NOTE: The abbreviation NH refers to non-Hispanic origin. Infant deaths are deaths before an infant's first birthday. Race refers to mother's race. The 1977 U.S. Office of Management and Budget (OMB) Standards for Data on Race and Ethnicity were used to classify persons into one of the following four racial groups: White, Black, American Indian or Alaskan Native, or Asian or Pacific Islander. Although state reporting of birth certificate data is transitioning to comply with the 1997 OMB standard for race and ethnicity statistics, data from states reporting multiple races were bridged to the single-race categories of the 1977 OMB standards for comparability with other states. Data on race and Hispanic origin are collected and reported separately. Persons of Hispanic origin may be of any race. Trends for the Hispanic population are affected by an expansion in the number of registration areas that included an item on Hispanic origin on the birth certificate.

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

Figure HEALTH3: Percentage of children ages 4–17 reported by a parent to have serious emotional or behavioral difficulties by age and gender, 2005–2016
Percentage of children ages 4–17 reported by a parent to have serious emotional or behavioral difficulties by age and gender, 2005–2016

NOTE: Emotional or behavioral difficulties of children were based on parental responses to the following question on the Strengths and Difficulties Questionnaire:1 "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. Children with serious emotional or behavioral difficulties are defined as those whose parent responded "yes, definite" or "yes, severe." These difficulties may be similar to but do not equate with the Federal definition of serious emotional disturbance, used by the Federal government for planning purposes.

1 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.

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

Figure HEALTH4.A: Percentage of youth ages 12–17 who experienced a Major Depressive Episode (MDE) in the past year by age and gender, 2004–2016
Percentage of youth ages 12–17 who experienced a Major Depressive Episode (MDE) in the past year by age and gender, 2004–2016

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 (DSM-IV).

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

Figure HEALTH4.B: Percentage of receiving treatment for depression among youth ages 12–17 with at least one MDE in the past year by gender, 2004–2016
Percentage of receiving treatment for depression among youth ages 12–17 with at least one MDE in the past year by gender, 2004–2016

NOTE: Treatment is defined as seeing or talking to a medical doctor or other professional and/or using prescription medication in the past year for depression. Respondents with unknown treatment data were excluded.

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

Figure HEALTH5: Percentage of children ages 5–17 with activity limitation resulting from one or more chronic health conditions by gender, 2000–2016
Percentage of children ages 5–17 with activity limitation resulting from one or more chronic health conditions by gender, 2000–2016

NOTE: Children are identified as having activity limitation by asking parents (1) whether children receive special education services and (2) whether they are limited in their ability to walk, care for themselves, or participate in other activities. "Activity limitation indicated by participation in special education" only includes children identified solely by their use of special education services. "Activity limitation indicated by all other limitations" includes limitations in self-care, walking, or other activities; children in this category may also receive special education services. Chronic health conditions are conditions that once acquired are not cured or have a duration of 3 months or more.

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

Figure HEALTH6: Average diet quality scores using the Healthy Eating Index-2015 for children ages 2–17 by age groups, 2013–2014
Average diet quality scores using the Healthy Eating Index-2015 for children ages 2–17 by age groups, 2013–2014

NOTE: The Healthy Eating Index-2015 (HEI-2015) is a dietary assessment tool comprising 13 components designed to measure quality in terms of how well diets align with the recommendations of the 2015 Dietary Guidelines for Americans and the USDA Food Patterns. The HEI-2015 has 13 components and intakes equal to or better than the standards set for each component are assigned a maximum score. Maximum HEI-2015 component scores range from 5 to 10 points, which is reflected in the shading of the bars. Scores for intakes between the minimum and maximum standards are scored proportionately. Scores for each of the 13 components are summed to create a total maximum HEI-2015 score of 100. Nine of the thirteen components assess adequacy of the diet. The remaining four components assess dietary components that should be consumed in moderation. For the adequacy components, higher scores reflect higher intakes that meet or exceed the standards. For the moderation components, higher scores reflect lower intakes because lower intakes are more desirable. A higher total score indicates a higher quality diet. The HEI-2015 component scores are averages across all children and reflect usual dietary intakes. Starting with America's Children 2018 report, the average diet quality scores for children have been updated using the HEI-2015 which reflects the key recommendations in the 2015–2020 Dietary Guidelines for Americans.

SOURCE: National Center for Health Statistics, National Health and Nutrition Examination Survey and U.S. Department of Agriculture, Center for Nutrition Policy and Promotion and the U.S. Department of Health and Human Services, Healthy Eating Index-2015.

Figure HEALTH7: Percentage of children ages 6–17 with obesity by race and Hispanic origin, selected years 1976–1980 through 2013–2016
Percentage of children ages 6–17 with obesity by race and Hispanic origin, selected years 1976–1980 through 2013–2016

NOTE: Previously a body mass index (BMI) at or above the 95th percentile of the sex-specific BMI growth charts was termed overweight (https://www.cdc.gov/growthcharts). Beginning with America's Children 2010, a BMI at or above the 95th percentile is termed obese to be consistent with other National Center for Health Statistics publications. Estimates of persons with obesity are comparable to estimates of overweight in past reports. From 1976 to 1994, the 1977 U.S. Office of Management and Budget (OMB) Standards for Data on Race and Ethnicity were used to classify persons into one of the following four racial groups: White, Black, American Indian or Alaskan Native, or Asian or Pacific Islander. For 1999–2014, the revised 1997 OMB standards were used. Persons could select one or more of five racial groups: White, Black or African American, American Indian or Alaska Native, Asian, and Native Hawaiian or Other Pacific Islander. Included in the total, but not shown separately, are American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and "Two or more races." Beginning in 1999, those in each racial category represent those reporting only one race. Data from 1999 onward are not directly comparable with data from earlier years. Data on race and Hispanic origin are collected separately but are combined for reporting. Persons of Mexican origin may be of any race. From 1976 to 2006, the National Health and Nutrition Examination Survey (NHANES) sample was designed to provide estimates specifically for persons of Mexican origin. Beginning in 2007, NHANES allows for reporting of both total Hispanics and Mexican Americans; however, estimates reported here are for Mexican Americans to be consistent with earlier years.

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

Figure HEALTH8: Percentage of children ages 0–17 with asthma, 1997–2016
Percentage of children ages 0–17 with asthma, 1997–2016

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 answers YES to this question, they are then asked (1) "Does your child still have asthma?" and (2) "During the past 12 months, has your child had an episode of asthma or an asthma attack?" The question "Does your child still have asthma?" was introduced in 2001 and identifies children who currently have asthma.

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