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

Highlights

America's Children: Key National Indicators of Well-Being, 2021 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 72.8 million children ages 0–17 in the United States in 2020, a decrease of 1.3 million since 2010. The number of children is projected to increase to 78.2 million in 2050. (POP1)
  • Racial and ethnic diversity have grown dramatically in the United States in the last 3 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 2020, the percentage of children who are White, non-Hispanic is estimated at just under 50%. 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 2020). (POP3)

Family and Social Environment

  • In 2020, about 70% of all children ages 0–17 lived with two parents (67% with two married parents and 4% with two unmarried cohabiting parents), 21% lived with only their mothers, 5% lived with only their fathers, and 4% lived without a parent in the household. (FAM1.A)
  • In 2019, the birth rate among unmarried women ages 15–44 was 40 births for every 1,000 women, down from 50 per 1,000 in 2009. Generally, the percentage of births to unmarried women decreased with age; mothers under age 15 were more likely to be unmarried, whereas mothers ages 35–39 were more likely to be married.(FAM2)
  • 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 only parental care (14%). (FAM3)
  • In 2019, about 23% of school-age children spoke a language other than English at home, and 4% 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 20 per 1,000 in 2009 to 7 per 1,000 in 2019, a record low for the country. (FAM6)
  • In 2019, the rate of substantiated victims of child maltreatment was 8.9 per 1,000 children ages 0–17. Neglect is by far the most common form of maltreatment, with 75% of child maltreatment victims being neglected and 18% physically abused. (FAM7)

Economic Circumstances

  • In 2019, 14.4% of all children ages 0–17 (10.5 million) lived in poverty, 1.8 percentage points lower than in 2018. For all children, the 2019 supplemental poverty measure (SPM) was 12.5%, 1.9 percentage points lower than the official poverty rate of 14.4%. (ECON1)
  • The percentage of children who had at least one parent working year-round, full time increased to 80% in 2019. (ECON2)
  • About 10.7 million children (14.6% of all children) lived in households that were classified as food insecure in 2019. (ECON3)

Health Care

  • In 2019, the percentage of children ages 0–17 without health insurance at the time of interview was 5%. Hispanic children were more likely to be uninsured (7%) compared with White, non-Hispanic (4%) and Black, non-Hispanic (3%) children in 2019. (HC1)
  • In 2019, about 3% of children ages 0–17 had no usual source of health care. Children with no health insurance (18%) were more likely to have no usual source of care compared with children who had private (2%) or public (3%) health insurance. (HC2)
  • For children born in 2016, those in families with incomes below the poverty threshold had lower vaccination coverage of 61% compared with 73% for those in families with incomes at or above the poverty level. (HC3.A)
  • In 2019, vaccination coverage for adolescents ages 13–17 years for one dose (or more) of human papillomavirus (HPV) vaccine was 72% and up-to-date (UTD) coverage was 54%. Since 2011, vaccination coverage for adolescents ages 13–17 years has steadily increased for two of the routinely recommended vaccinations for adolescents, Tdap and MenACWY. (HC3.B)
  • In 2019, the percentage of children ages 5–17 years with a dental visit in the past year was 91%. Children who lacked health insurance coverage were less likely to have a dental visit in the past year (66%) compared with children who had private (93%) or public (92%) health insurance coverage. (HC4.A)
  • In 2017–2018, 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 twice as likely to have untreated dental caries (19%) compared with children in families with incomes at or above 200% of the poverty level (7%). (HC4.B)

Physical Environment and Safety

  • In 2019, about 51% of children lived in counties with measured pollutant concentrations above the levels of one or more 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 2017–2018. Approximately 57% of Black, non-Hispanic children ages 4–11 had detectable blood cotinine levels compared with 39% of White, non-Hispanic children and 22% of Mexican American children. (PHY2)
  • In 2019, about 2% of all children 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 2019, 38% 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 is a statistically significant decrease from 2017 levels. (PHY5)
  • In 2019, the rate at which youth were victims of serious violent crimes was 6 per 1,000 youth ages 12–17. (PHY6)
  • In 2017–2018, falls were the leading cause of injury-related emergency department visits among children ages 1–4 (65 visits per 1,000 children) and among children ages 5–14 (33 visits per 1,000 children). (PHY7.A)
  • In 2019, the leading injury-related cause of death among children ages 1–4 was drowning (2 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 2017–2018, being struck by or against an object or person (26 visits per 1,000) was the leading cause of injury-related emergency department visits among adolescents ages 15–19. (PHY8.A)
  • In 2019, unintentional injuries were the leading cause of injury-related death among both male (23 per 100,000) and female (10 per 100,000) adolescents ages 15–19. Among males, death rates were similar for suicide (16 per 100,000) and homicide (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 2019, the percentages of students who reported smoking cigarettes daily in the past 30 days continued to be at historically low levels with 1% of 8th-, 1% of 10th-, and 2% of 12th-grade students reporting use. (BEH1)
  • Youth binge drinking rates remained unchanged among 8th, 10th, and 12th graders from 2018 to 2019. (BEH2)
  • In 2019, illicit drug use in the past 30 days was reported by 9% of 8th graders, 20% of 10th graders, and 24% of 12th graders. These estimates were not significantly different from 2018. Marijuana continues to be the main driver of trends in illicit drug use. (BEH3)
  • 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 38% in 2019. (BEH4)
  • In 2019, the serious violent crime offending rate was 6 crimes per 1,000 youth ages 12–17; there were 146,000 serious violent crimes involving youth. (BEH5)

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 2019 were higher than in 1990. The Grade 4 2019 average mathematics score was higher than the 2017 average score, but the Grade 8 2019 average mathematics score was lower than the 2017 average score. The average reading scores in 2019 at Grades 4 and 8 were lower than the scores in 2017 but higher than the scores in 1992. (ED2)
  • 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. During the same period, about 30% of public high school students were enrolled in biology, 20% were enrolled in chemistry, 11% were enrolled in physics, and 6% were enrolled in Advanced Placement science. (ED3)
  • In 2019, 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 2020, 10% of youth ages 16–19 were neither enrolled in school nor working, an increase from the prior year. (ED5)
  • In 2019, some 66% 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

  • The percentage of infants born preterm varied year-to-year from 2009 to 2019, but was about 10% throughout the period. In 2019, 8% of infants were born with low birthweight. Infants born to Black, non-Hispanic women were the most likely to have low birthweight (14%) compared with infants born to Asian, non-Hispanic (9%); American Indian or Alaska Native, non-Hispanic (8%); Native Hawaiian or Other Pacific Islander, non-Hispanic (8%); Hispanic (8%); and White, non-Hispanic (7%) women. (HEALTH1)
  • In 2019, 6% of parents reported that their child 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, about 16% of the population ages 12–17 had a major depressive episode (MDE) during the past year, a higher prevalence than that reported in each year between 2004 (9%) and 2014 (11%). (HEALTH4)
  • During 2017–2018, the average Total HEI-2015 scores for ages 2–5, 6–11, and 12–17 were 61, 53, and 51, respectively, out of 100. Overall, the total diets of children and adolescents did not align with the 2015–2020 Dietary Guidelines for Americans. (HEALTH6)
  • In 2019, among children ages 0–17, 7% of children were reported to currently have asthma, and 3% of children had one or more asthma attacks in the past year. In 2019, 14% of Black, non-Hispanic children were reported to currently have asthma compared with 7% of Hispanic; 6% of White, non-Hispanic; and 4% of Asian, non-Hispanic children. (HEALTH8)