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America's Children: Key National Indicators of Well-Being, 2021

Health and Safety Figures

Indicator HEALTH1.A: Percentage of infants born preterm and percentage of infants born with low birthweight, 2009–2019
Indicator HEALTH1.A: Percentage of infants born preterm and percentage of infants born with low birthweight, 2009–2019

NOTE: 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. Gestational age is estimated using the obstetric estimate of gestational delivery. Data on low birthweight can be found in table HEALTH1.B.

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

Indicator HEALTH1.B: Percentage of infants born with low birthweight by race and Hispanic origin of mother, 2009 and 2019
Indicator HEALTH1.B: Percentage of infants born with low birthweight by race and Hispanic origin of mother, 2009 and 2019

† Data for Asian, NH and NHOPI, NH groups were not available in 2009.

NOTE: NH = non-Hispanic origin; AIAN = American Indian or Alaska Native; NHOPI = Native Hawaiian or Other Pacific Islander. Starting with 2016 data, race on birth records is available based on the 1997 Office of Management and Budget (OMB) standards and presented as single-race estimates (only one race was reported on the birth certificate). These estimates include separate estimates for Asian, NH and NHOPI, NH groups. Data before 2016 were tabulated according to the 1977 OMB standards and bridged to retain comparability across states as they transitioned from the 1977 standards to those of 1997. Single-race estimates for 2016 and beyond are not completely comparable with bridged-race estimates for earlier years, particularly for smaller race categories. Persons of Hispanic origin may be of any race.

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

Indicator HEALTH2: Death rates among infants by race and Hispanic origin of mother, 2008–2018
Indicator HEALTH2: Death rates among infants by race and Hispanic origin of mother, 2008–2018

NOTE: NH = non-Hispanic origin; AIAN = American Indian or Alaska Native; API = Asian or Pacific Islander; NHOPI = Native Hawaiian or Other Pacific Islander. Infant deaths are deaths before an infant's first birthday. Race refers to the mother's race. For data through 2016, 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. Data from states reporting multiple races were bridged to the single-race categories of the 1977 OMB standards for comparability with other states and for trend analysis. Beginning with 2017 data, the 1997 U.S. OMB standards on race and ethnicity were used to classify persons into one of the following five racial groups: White, Black or African American, Asian, American Indian or Alaska Native, or Native Hawaiian or Other Pacific Islander. All categories are now single race. As a result, data for 2017 and subsequent years are not strictly comparable with earlier data. Data on race and Hispanic origin are collected and reported separately. Persons of Hispanic origin may be of any race.

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

Indicator HEALTH3: Percentage of children ages 4–17 reported by a parent to have serious emotional or behavioral difficulties by age and gender, 2009–2019
Indicator HEALTH3: Percentage of children ages 4–17 reported by a parent to have serious emotional or behavioral difficulties by age and gender, 2009–2019

NOTE: Emotional or behavioral difficulties of children were based on parental responses to the following question on the Strengths and Difficulties Questionnaire123: "Overall, do you think that [child's name] has difficulties in one or more of the following areas: emotions, concentration, behavior, or being able to get along with other people?" Response choices were (1) no, no difficulties; (2) yes, minor difficulties; (3) yes, definite difficulties; and (4) yes, severe difficulties. Children with serious emotional or behavioral difficulties are defined as those whose parent responded "yes, definite difficulties" or "yes, severe difficulties." 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. In 2019, the National Health Interview Survey (NHIS) questionnaire was redesigned, and other changes were made to weighting and design methodology. Therefore, data for 2019 are not strictly comparable with data for earlier years. For more information on the 2019 NHIS redesign, see https://www.cdc.gov/nchs/data/nhis/earlyrelease/EReval202009-508.pdf.

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

Indicator HEALTH4.A: Percentage of youth ages 12–17 who experienced a major depressive episode (MDE) in the past year by age and gender, 2004–2019
Indicator HEALTH4.A: Percentage of youth ages 12–17 who experienced a major depressive episode (MDE) in the past year by age and gender, 2004–2019

NOTE: A major depressive episode (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..

Indicator HEALTH4.B: Percentage of those receiving treatment for depression among youth ages 12–17 with at least one MDE in the past year by gender, 2004–2019
Indicator HEALTH4.B: Percentage of those receiving treatment for depression among youth ages 12–17 with at least one MDE in the past year by gender, 2004–2019

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..

Indicator HEALTH5: Percentage of children ages 5–17 with activity limitation resulting from one or more chronic health conditions by gender, selected years 2008–2018
Indicator HEALTH5: Percentage of children ages 5–17 with activity limitation resulting from one or more chronic health conditions by gender, selected years 2008–2018

NOTE: Children are identified as having activity limitation by asking parents whether children receive special education services and whether children are limited in their ability to walk, care for themselves, or participate in other activities. "Activity limitation indicated by participation in special education" 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 also may receive special education services. Chronic health conditions are conditions that once acquired are not cured or have a duration of 3 months or more. In 2019, the National Health Interview Survey (NHIS) questionnaire was redesigned, and other changes were made to weighting and design methodology. As part of the questionnaire redesign, some of the questions previously used to measure activity limitation were dropped from the survey; therefore, 2019 data are not available for this indicator. For more information on the 2019 NHIS redesign, see https://www.cdc.gov/nchs/data/nhis/earlyrelease/EReval202009-508.pdf.

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

Indicator HEALTH6: Average diet quality scoresa using the Healthy Eating Index–2015 for children ages 2–17 by age group, 2017–2018
Indicator HEALTH6: Average diet quality scoresa using the Healthy Eating Index–2015 for children ages 2–17 by age group, 2017–2018

a Calculated using the population ratio method.

NOTE: The Healthy Eating Index–2015 (HEI-2015) is a measure of diet quality with 13 components used to assess how well a set of foods aligns with the key recommendations of the 2015–2020 Dietary Guidelines for Americans. 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. Scores for intakes between the minimum and maximum standards are scored proportionately. Scores for each component are summed to create a total maximum HEI-2015 score of 100 points. Nine of the 13 components assess adequacy components. The remaining four components assess dietary components that should be consumed in moderation. For the adequacy components, higher scores reflect higher intakes. For the moderation components, higher scores reflect lower intakes because lower intakes are more desirable. A higher total score indicates a diet that aligns better with the Dietary Guidelines. HEI-2015 total and component scores reflect usual dietary intakes among children ages 2–17 in the United States, during 2017–2018. The light solid bars represent the maximum scores possible for each component. The dark shaded bars represent the actual scores obtained for each component.

SOURCE: U.S. Department of Agriculture, Center for Nutrition Policy and Promotion; U.S. Department of Health and Human Services, National Cancer Institute; and National Center for Health Statistics, National Health and Nutrition Examination Surveys.

Indicator Health7: Percentage of children ages 6–17 with obesity by race and Hispanic origin, selected years 1999–2002 through 2015–2018
Indicator Health 7 Percentage of children ages 6–17 with obesity by race and Hispanic origin, selected years 1999–2002 through 2015–2018

NOTE: A body mass index (BMI) at or above the 95th percentile is defined as "obesity." Prior to America's Children, 2010, a BMI at or above the 95th percentile of the sex-specific BMI growth charts was termed overweight (https://www.cdc.gov/growthcharts). Estimates of persons with obesity are comparable to estimates of overweight in past reports.140 Data on race are based on the 1997 U.S. Office of Management and Budget standards for data on race and ethnicity. Persons can select one or more of the following five racial groups: White, Black or African American, American Indian or Alaska Native, Asian, or 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 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.

Indicator HEALTH8: Percentage of children ages 0–17 with asthma, 2009–2019
Indicator HEALTH8: Percentage of children ages 0–17 with asthma, 2009–2019

NOTE: Children are identified as ever diagnosed with asthma by asking parents, "Has a doctor or other health professional EVER told you that [child's name] had asthma?" If the parent responds "yes" to this question, they are then asked (1) "Does [child's name] still have asthma?" and (2) "During the past 12 months, has [child's name] had an episode of asthma or an asthma attack?" The question "Does [child's name] still have asthma?" was introduced in 2001 and identifies children who currently have asthma. In 2019, the National Health Interview Survey (NHIS) questionnaire was redesigned, and other changes were made to weighting and design methodology. Therefore, data for 2019 are not strictly comparable with data for earlier years. For more information on the 2019 NHIS redesign, see https://www.cdc.gov/nchs/data/nhis/earlyrelease/EReval202009-508.pdf".

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

123 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.

140 Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2012). Prevalence of obesity and trends in body mass index among U.S. children and adolescents, 1999–2010. Journal of the American Medical Association, 307(5), 483–490.