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

A group of teenagers outdoors, several children on a playground, and a child standing with a horse

This year's America's Children in Brief: Key National Indicators of Well-Being continues two decades of collaboration by agencies across the Federal Government to advance our understanding of our Nation's children and what may be needed to bring them a better tomorrow. Data used in this report were collected before the COVID-19 pandemic. While many of the data surveys reflected in this report have adapted to address data needs related to the pandemic, these data were not available for inclusion at the time of publication.
Office of the Chief Statistician, U.S. Office of Management and Budget


The Federal Interagency Forum on Child and Family Statistics (Forum) was chartered in 1997 by Executive Order No. 13045. The Forum fosters collaboration among 23 Federal agencies that produce and use statistics on children and families and seeks to improve these Federal data. Each year, the Forum publishes a report compiling measures of well-being drawn from the most reliable Federal statistics.

Conceptual Framework for Key National Indicators

The Forum has identified 41 indicators that describe the well-being of children. These indicators span seven domains: Family and Social Environment, Economic Circumstances, Health Care, Physical Environment and Safety, Behavior, Education, and Health. The indicators also must meet the following criteria:

  • Easy to understand by broad audiences
  • Objectively based on reliable data
  • Balanced, so that no single area dominates the report
  • Measured regularly so that they can be updated and show trends
  • Representative of large segments of the population

Pending data availability, the Forum updates all 41 indicators annually on its website ( and alternates publishing a detailed report, America's Children: Key National Indicators of Well-Being, with a summary version, America's Children in Brief, which highlights selected indicators.

America's Children in Brief, 2020

This year's America's Children in Brief highlights selected indicators by metropolitan status to give the reader a closer look at how well-being is influenced by the type of community in which children and their families live. The Brief also provides a snapshot of the overall well-being of America's children through the At-a-Glance summary table displaying the most recent data for all 41 indicators.
The focus on metropolitan status is motivated by the long-standing recognition that there are substantial differences across communities and such differences may influence child well-being in diverse ways. Underlying characteristics of communities that affect child well-being reported in this Brief include the following types of factors:110

  • Demographic characteristics of the population. The age, race, and ethnic composition of communities differ by metropolitan status.
  • Physical characteristics of natural and built environments. Living environments influence the health and well-being of children and families in many ways, and living environments vary substantially by metropolitan status. Differences in housing types, conditions, and costs in different communities affect the prevalence of housing problems among the children and families who live there.
  • Economic activity and conditions. The level of economic vitality in a community affects the employment opportunities of parents. The concentration of firms, labor markets, and consumer markets varies by metropolitan status, providing different levels and types of advantages to the children and families who dwell in them.
  • Social and cultural factors. Social and cultural factors that influence support networks, behavior, and perceived choices vary by geography. For instance, behavioral risk factors such as smoking prevalence or substance use often differ significantly by metropolitan status.
  • Community institutions, resources, and services. Community institutions that can directly influence child well-being include the proximity of hospitals and clinics, the availability of good schools and public parks, and the presence of cultural and religious institutions that enrich children's lives and development. These community resources vary across the spectrum of metropolitan status.
  • Health and wellness. Community conditions can influence a child's health, and health in childhood can affect other outcomes. For example, asthma is more prevalent in older and denser housing and areas with worse air quality, which vary by metropolitan status. Chronic conditions such as childhood asthma can impact school attendance, which can impact educational achievement.

Discussions of the geographic classifications, race and ethnicity measures, and statistical significance analyses used in this report follow.

Geographic Classifications

Classifying counties into "standard metropolitan areas" was introduced around 1950. The U.S. Office of Management and Budget (OMB) develops definitions for these areas to provide a nationally consistent set of delineations for collecting, tabulating, and publishing Federal statistics for geographic areas. Although some of the definitions and terminology have changed since they were first introduced, the OMB's Standards for Delineating Metropolitan and Micropolitan Statistical Areas have the same goals today as in the past.11 The general concept of a metropolitan statistical area is an area containing a large population nucleus and adjacent communities that have a high degree of integration with that nucleus. The concept of a micropolitan statistical area closely parallels that of the metropolitan statistical area but contains a smaller nucleus.

  • Metropolitan statistical areas contain a large (at least 50,000 residents) urbanized area and adjacent counties with a high degree of economic integration (as measured by commuting to work) with that core.
  • Nonmetropolitan counties are those not classified as within a metropolitan statistical area. Nonmetropolitan areas include counties in micropolitan statistical areas and rural counties.
    • Micropolitan statistical areas as defined by the OMB contain an urban cluster with 10,000 to 49,999 residents. Adjacent counties with a high degree of economic integration (as measured by commuting to work) with that core are also classified as part of the micropolitan statistical area. Approximately 85% of micropolitan statistical areas comprise only one county.12
    • Counties that are not classified by the OMB as within a metropolitan or a micropolitan statistical area are classified as "rural counties" for this report. Rural counties may include small urban areas, as well as completely rural areas.

When possible, indicator data in this report are presented for three categories: metropolitan areas, micropolitan areas, and rural counties. In some cases, limited sample sizes or number of cases or issues with data reliability required that data be limited to two categories: metropolitan areas and nonmetropolitan areas comprising micropolitan areas and rural counties.

Race and Ethnicity

Every effort is made to include data breakouts by race and ethnicity for regular indicators in the full America's Children report and for selected indicators in this year's Brief. Unless otherwise noted, data by race and ethnicity in this report have implemented the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity (hereafter referred to as standards on race and ethnicity) issued in 1997 by the OMB ( The 1997 standards on race and ethnicity allow for observer or proxy identification of race but clearly state a preference for self-classification. Data on race and Hispanic origin are collected separately. Persons of Hispanic origin may be of any race. Data in this report are generally presented for the following six race and Hispanic origin groups: American Indian or Alaska Native, non-Hispanic; Asian, non-Hispanic; Black or African American, non-Hispanic; Native Hawaiian or Other Pacific Islander, non-Hispanic; White, non-Hispanic; and Hispanic or Latino. On the charts, shortened labels often are used because of limited space.

The 1997 standards on race and ethnicity also offer an opportunity for respondents to select more than one of the five race groups, leading to many possible multiple-race categories. These standards allow for two basic ways of defining a race group. A group such as Black may be defined as those who reported Black and no other race (the race-alone or single-race concept) or those who reported Black regardless of whether they also reported another race (the race-alone or-in-combination concept). In this report, indicators present data using the first approach (single race). Use of the single-race population does not imply that it is the preferred method of presenting or analyzing data. Generally, a small percentage of people report two or more races. When possible, estimates for this group are shown separately. All groups not shown separately are included in the totals.

Statistical Significance

Most data in this report are estimates based on a sample of the population and are therefore subject to sampling error. Differences between estimates are tested for statistical significance at either the 0.05 or 0.10 cutoff level, according to agency standards; all differences discussed in the report are statistically significant according to the standards of the agency responsible for the data. Agency details about statistical reporting standards for indicators included in the America's Children report and standard error tables for select indicators are available online at

For Further Information on the Forum

The Forum's website ( also includes this additional information:

  • Detailed data for indicators discussed in this Brief as well as trend data and other America's Children indicators not discussed here.
  • Data source descriptions and agency contact information.
  • America's Children reports from 1997 to the present and other Forum reports.
  • Links to Forum agencies, their online data tools, and various international data sources.
  • Forum news and information on the Forum's overall structure and organization.

1 National Center for Health Statistics. (2001). Health, United States, 2001: With urban and rural chartbook. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. Retrieved from

2 Agency for Healthcare Research and Quality. (2017). National healthcare quality and disparities report chartbook on rural health care (AHRQ 17(18)-0001-2-E). Rockville, MD: U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality. Retrieved from

3 Meit, M., Knudson, A., Gilbert, T., Yu, A., Tanenbaum, E., Ormson, E., . . . & Popat, S. (2014). The 2014 update of the rural-urban chartbook. Rural Health Reform Policy Research Center. Retrieved from

4 U.S. Census Bureau. (2016). Measuring America: Our changing landscape [Infographic]. U.S. Census Bureau.

5 Parker, K., Horowitz, J., Brown, A., Fry, R., Cohn, D. & Igielnik, R. (2018). What unites and divides urban, suburban and rural communities. Pew Research Center. Retrieved from

6 Holder, K. A., Fields, A., & Lofquist, D. (2016). Rurality matters. Random Samplings, U.S. Census Bureau. 2016.

7 Semega, J., Kollar, M., Creamer, J., & Mohanty, A. (2019). Income and poverty in the United States: 2018 (Current Population Reports P60-266). Washington, DC: U.S. Census Bureau. Retrieved from

8 National Center for Health Statistics. (2019). 2018 National Health Interview Survey (NHIS): Summary health statistics.

9 Strosnider, H., Kennedy, C., Monti, M., & Yip, F. (2017). Rural and urban differences in air quality, 2008–2012, and community drinking water quality, 2010–2015—United States. MMWR Surveillance Summaries, 66(13), 1–10. Retrieved from

10 National Advisory Committee on Rural Health and Health Care Services. (2015). Mortality and life expectancy in rural America: Connecting the health and human service safety nets to improve health outcomes over the life course. Retrieved from

11 2010 Standards for Delineating Metropolitan and Micropolitan Statistical Areas, 75 Fed. Reg. 37246 (proposed June 28, 2010). Retrieved from

12 U.S. Office of Management and Budget. (2013). Revised delineations of metropolitan statistical areas, micropolitan statistical areas, and combined statistical areas, and guidance on uses of the delineations of these areas (OMB Bulletin No. 13-01). Washington, DC: Author. Retrieved from