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

NOTE: The 1997 U.S. Office of Management and Budget 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, and Native Hawaiian or Other Pacific Islander. All categories are single race. 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.

NOTE: NH = non-Hispanic origin; AIAN = American Indian or Alaska Native; and API = Asian or Pacific Islander. Infant deaths are deaths before an infant's first birthday. Race refers to mother's race. For data through 2015, 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 2016 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, and Native Hawaiian or Other Pacific Islander. All categories are now single race. As a result, data for 2016 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. 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.

NOTE: Emotional or behavioral difficulties of children were based on parental responses to the following question on the Strengths and Difficulties Questionnaire: "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.

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

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..

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 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.

NOTE: The Healthy Eating Index–2015 (HEI–2015) is a dietary assessment tool with 13 components designed to measure quality in terms of 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 thirteen 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 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 diet that aligns better with the Dietary Guidelines. HEI–2015 total and component scores reflect usual dietary intakes among children in the United States. 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: National Center for Health Statistics, National Health and Nutrition Examination Surveys 2015–2016; 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.

NOTE: Previously a body mass index (BMI) at or above the 95th percentile of the sex-specific BMI growth charts was termed overweight (http://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.¹⁵³ 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.

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.