HEALTH3.A Emotional and behavioral difficulties: Percentage of children ages 4–17 reported by a parent to have serious or minor difficulties with emotions, concentration, behavior, or getting along with other people by selected characteristics, 2001–2019
HEALTH3A Excel Table
HEALTH3A Standard Error Excel Table
| Characteristic | 2001 | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | 2019a |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Serious difficulties | |||||||||||||||||||
| Age and gender | |||||||||||||||||||
| Total ages 4–17 | 5.2 | 5.5 | 4.8 | 5.4 | 4.6 | 5.0 | 5.2 | 5.4 | 5.3 | 6.0 | 5.3 | 5.2 | 5.2 | 5.2 | 5.8 | 5.1 | 5.6 | 5.6 | 5.6 |
| Ages 4–7 | 3.6 | 3.2 | 3.3 | 4.2 | 2.8 | 4.0 | 3.8 | 4.0 | 3.1 | 4.1 | 3.5 | 3.7 | 3.6 | 3.9 | 3.9 | 4.3 | 4.3 | 3.7 | 4.4 |
| Ages 8–10 | 5.9 | 5.9 | 5.5 | 5.8 | 4.8 | 4.9 | 4.4 | 7.1 | 6.3 | 7.2 | 6.2 | 6.3 | 6.9 | 6.6 | 6.0 | 5.4 | 6.5 | 6.2 | 6.8 |
| Ages 11–14 | 6.0 | 6.8 | 4.9 | 6.2 | 4.9 | 5.6 | 6.0 | 5.0 | 5.6 | 6.8 | 5.8 | 5.5 | 5.4 | 6.2 | 7.6 | 5.5 | 6.0 | 6.2 | 5.7 |
| Ages 15–17 | 5.2 | 6.5 | 6.1 | 5.4 | 6.2 | 5.6 | 6.8 | 5.9 | 6.5 | 6.6 | 6.3 | 5.7 | 5.4 | 4.5 | 5.8 | 5.5 | 6.0 | 6.7 | 6.0 |
| Males ages 4–17 | 6.2 | 7.5 | 6.3 | 5.8 | 5.4 | 6.6 | 6.4 | 7.1 | 6.6 | 7.3 | 6.6 | 6.7 | 6.5 | 6.9 | 7.2 | 6.7 | 7.1 | 6.7 | 6.8 |
| Ages 4–7 | 3.8 | 4.3 | 4.8 | 4.0 | 3.0 | 5.3 | 5.1 | 5.4 | 4.1 | 5.0 | 4.9 | 5.0 | 4.5 | 5.4 | 5.4 | 5.9 | 5.2 | 4.1 | 6.3 |
| Ages 8–10 | 8.2 | 8.0 | 7.3 | 7.0 | 5.5 | 6.7 | 6.3 | 10.4 | 8.2 | 9.4 | 8.2 | 7.8 | 8.6 | 8.5 | 7.6 | 7.8 | 8.3 | 7.0 | 7.8 |
| Ages 11–14 | 7.4 | 10.0 | 6.5 | 7.0 | 6.3 | 7.4 | 7.5 | 6.5 | 7.1 | 7.7 | 7.2 | 7.8 | 7.3 | 8.2 | 9.4 | 7.6 | 7.5 | 7.8 | 7.5 |
| Ages 15–17 | 5.6 | 7.6 | 6.9 | 5.6 | 6.9 | 7.1 | 6.9 | 6.7 | 7.7 | 7.6 | 6.6 | 6.2 | 5.7 | 5.7 | 6.2 | 5.4 | 7.8 | 8.2 | 5.6 |
| Females ages 4–17 | 4.1 | 3.5 | 3.3 | 4.8 | 3.8 | 3.3 | 3.9 | 3.6 | 3.9 | 4.8 | 4.0 | 3.8 | 3.9 | 3.5 | 4.4 | 3.5 | 4.1 | 4.5 | 4.4 |
| Ages 4–7 | 3.4 | 2.0 | 1.8 | 4.4 | 2.5 | 2.6 | 2.4 | 2.7 | 2.1 | 3.1 | 2.1 | 2.3 | 2.6 | 2.3 | 2.3 | 2.7 | 3.4 | 3.3 | 2.4 |
| Ages 8–10 | 3.5 | 3.6 | 3.5 | 4.5 | 4.2 | 3.0 | 2.3 | 3.4 | 4.4 | 5.0 | 4.1 | 4.8 | 5.2 | 4.8 | 4.6 | 2.9 | 4.6 | 5.3 | 5.7 |
| Ages 11–14 | 4.6 | 3.5 | 3.2 | 5.3 | 3.4 | 3.8 | 4.5 | 3.4 | 4.1 | 5.8 | 4.5 | 3.2 | 3.5 | 4.0 | 5.6 | 3.1 | 4.4 | 4.6 | 3.9 |
| Ages 15–17 | 4.9 | 5.2 | 5.2 | 5.1 | 5.4 | 3.9 | 6.6 | 5.1 | 5.3 | 5.5 | 5.9 | 5.3 | 5.0 | 3.3 | 5.3 | 5.5 | 4.2 | 5.3 | 6.5 |
| Poverty statusb | |||||||||||||||||||
| Below 100% poverty | 7.4 | 9.2 | 6.4 | 7.2 | 7.1 | 6.6 | 7.0 | 9.7 | 8.2 | 10.1 | 7.6 | 7.9 | 7.8 | 7.6 | 7.6 | 7.3 | 8.3 | 8.2 | 8.6 |
| 100%–199% poverty | 6.7 | 6.3 | 5.2 | 5.8 | 4.8 | 5.6 | 7.3 | 5.8 | 6.5 | 5.7 | 5.4 | 5.8 | 5.1 | 5.8 | 6.8 | 6.2 | 7.3 | 7.1 | 5.1 |
| 200% poverty and above | 4.0 | 4.3 | 4.2 | 4.7 | 3.8 | 4.2 | 3.9 | 4.0 | 3.7 | 4.6 | 4.4 | 4.0 | 4.2 | 4.1 | 4.8 | 3.9 | 4.2 | 4.4 | 5.0 |
| Race and Hispanic originc | |||||||||||||||||||
| White, non-Hispanic | 5.3 | 5.6 | 5.2 | 6.0 | 4.8 | 5.5 | 5.6 | 5.8 | 5.4 | 6.7 | 5.9 | 5.5 | 6.0 | 5.9 | 6.2 | 5.4 | 6.4 | 6.3 | 6.5 |
| Black, non-Hispanic | 5.6 | 8.5 | 4.7 | 5.8 | 5.1 | 4.5 | 5.9 | 7.1 | 6.2 | 6.1 | 6.4 | 5.8 | 5.2 | 4.7 | 6.5 | 6.9 | 5.4 | 5.2 | 5.4 |
| Hispanic | 3.9 | 3.7 | 3.7 | 3.3 | 4.0 | 3.6 | 3.7 | 3.0 | 4.1 | 4.2 | 3.9 | 4.2 | 3.6 | 4.5 | 6.0 | 4.0 | 5.7 | 5.0 | 4.6 |
| Family structured | |||||||||||||||||||
| Two parents | 4.0 | 4.2 | 4.0 | 4.4 | 3.7 | 4.0 | 4.2 | 4.1 | 4.1 | 4.4 | 3.9 | 4.2 | 4.2 | 4.4 | 4.3 | 4.1 | 4.1 | 4.0 | 4.6 |
| Mother only | 8.1 | 9.2 | 7.0 | 7.8 | 6.9 | 7.8 | 7.1 | 8.0 | 8.2 | 9.6 | 8.3 | 8.0 | 8.1 | 7.1 | 9.9 | 7.9 | 8.9 | 9.5 | 7.9 |
| Father only | 5.0 | 5.4 | 3.6 | 5.3 | 4.2 | 4.8 | 5.5 | 5.5 | ‡ | 5.1 | ‡ | 5.5 | 3.1 | 3.6 | 3.5 | 4.0 | 7.1 | 7.4 | 4.2 |
| No parents | 10.6 | 9.6 | 8.8 | 9.4 | 9.8 | 7.0 | 11.5 | 13.1 | 7.3 | 12.5 | 10.1 | 6.0 | 7.8 | 9.8 | 9.6 | 8.6 | 11.3 | 10.0 | 8.6 |
| Minor difficulties | |||||||||||||||||||
| Age and gender | |||||||||||||||||||
| Total ages 4–17 | 17.1 | 18.0 | 15.4 | 15.4 | 16.2 | 15.5 | 14.4 | 14.4 | 13.7 | 16.1 | 14.4 | 14.1 | 13.0 | 15.0 | 15.8 | 15.3 | 15.9 | 18.1 | 21.6 |
| Ages 4–7 | 14.9 | 15.2 | 13.8 | 12.2 | 14.0 | 13.9 | 12.5 | 11.0 | 11.6 | 14.2 | 11.1 | 12.9 | 11.4 | 12.5 | 13.1 | 13.6 | 14.1 | 16.2 | 21.9 |
| Ages 8–10 | 18.1 | 20.2 | 15.5 | 16.4 | 18.4 | 14.4 | 16.4 | 17.1 | 15.6 | 16.9 | 16.3 | 14.6 | 13.3 | 16.9 | 16.4 | 16.6 | 16.9 | 18.0 | 21.0 |
| Ages 11–14 | 18.7 | 19.4 | 16.0 | 17.3 | 17.0 | 15.8 | 15.8 | 16.7 | 14.3 | 17.4 | 16.1 | 14.3 | 15.3 | 16.9 | 16.6 | 15.0 | 16.9 | 20.2 | 21.8 |
| Ages 15–17 | 17.1 | 17.5 | 16.4 | 15.9 | 15.7 | 18.0 | 13.1 | 13.2 | 14.0 | 16.1 | 14.7 | 15.2 | 11.9 | 13.8 | 17.7 | 16.7 | 15.9 | 18.0 | 21.6 |
| Males ages 4–17 | 20.1 | 20.1 | 17.3 | 17.2 | 17.9 | 16.9 | 16.1 | 16.7 | 16.3 | 18.0 | 16.4 | 16.3 | 14.8 | 17.5 | 17.6 | 17.1 | 17.7 | 20.6 | 24.8 |
| Ages 4–7 | 16.9 | 18.3 | 15.8 | 15.2 | 15.3 | 15.5 | 13.3 | 12.0 | 13.8 | 15.2 | 12.4 | 15.6 | 14.0 | 16.0 | 16.5 | 14.5 | 15.6 | 18.4 | 25.4 |
| Ages 8–10 | 21.9 | 23.0 | 17.8 | 18.0 | 22.2 | 15.9 | 18.1 | 20.0 | 19.4 | 19.3 | 19.7 | 17.7 | 14.8 | 20.2 | 18.1 | 19.5 | 20.4 | 19.9 | 25.9 |
| Ages 11–14 | 22.7 | 20.2 | 18.1 | 18.8 | 18.6 | 17.8 | 19.1 | 20.7 | 17.0 | 22.1 | 17.9 | 16.5 | 18.0 | 19.7 | 18.8 | 17.8 | 18.4 | 22.9 | 25.2 |
| Ages 15–17 | 19.0 | 19.0 | 17.4 | 17.1 | 16.4 | 18.4 | 14.0 | 14.2 | 15.9 | 15.1 | 16.4 | 15.5 | 11.3 | 14.1 | 16.9 | 17.4 | 16.8 | 21.3 | 22.3 |
| Females ages 4–17 | 14.0 | 15.9 | 13.4 | 13.4 | 14.4 | 14.0 | 12.6 | 12.0 | 11.0 | 14.1 | 12.3 | 11.9 | 11.2 | 12.3 | 14.0 | 13.4 | 14.1 | 15.5 | 18.3 |
| Ages 4–7 | 12.6 | 12.0 | 11.9 | 9.1 | 12.7 | 12.1 | 11.6 | 10.0 | 9.1 | 13.2 | 9.8 | 9.9 | 8.7 | 8.8 | 9.7 | 12.6 | 12.7 | 13.9 | 18.4 |
| Ages 8–10 | 14.1 | 17.1 | 12.9 | 14.7 | 14.7 | 12.7 | 14.6 | 14.0 | 11.7 | 14.5 | 12.6 | 11.4 | 11.8 | 13.6 | 14.7 | 13.7 | 13.3 | 15.9 | 15.4 |
| Ages 11–14 | 14.5 | 18.6 | 13.8 | 15.7 | 15.4 | 13.8 | 12.3 | 12.4 | 11.5 | 12.4 | 14.3 | 12.0 | 12.4 | 14.0 | 14.3 | 12.0 | 15.3 | 17.5 | 18.3 |
| Ages 15–17 | 15.1 | 15.9 | 15.3 | 14.6 | 14.9 | 17.6 | 12.2 | 12.2 | 12.1 | 17.2 | 13.0 | 14.8 | 12.6 | 13.4 | 18.4 | 16.1 | 15.0 | 14.6 | 20.8 |
| Poverty statusb | |||||||||||||||||||
| Below 100% poverty | 20.3 | 21.2 | 17.4 | 18.1 | 19.4 | 17.1 | 17.7 | 16.1 | 18.1 | 20.7 | 18.4 | 16.2 | 16.8 | 17.3 | 19.5 | 18.1 | 18.2 | 18.2 | 21.5 |
| 100%–199% poverty | 18.9 | 19.4 | 17.8 | 17.3 | 17.6 | 16.7 | 16.3 | 15.5 | 14.5 | 15.6 | 14.7 | 15.1 | 13.7 | 15.2 | 17.3 | 16.4 | 15.8 | 19.3 | 22.9 |
| 200% poverty and above | 15.7 | 16.7 | 13.9 | 13.9 | 14.8 | 14.4 | 12.7 | 13.5 | 11.9 | 14.6 | 12.7 | 12.9 | 11.3 | 13.9 | 14.0 | 13.9 | 15.3 | 17.6 | 21.2 |
| Race and Hispanic originc | |||||||||||||||||||
| White, non-Hispanic | 16.6 | 18.2 | 15.6 | 16.0 | 16.5 | 16.3 | 15.2 | 14.7 | 13.8 | 16.4 | 15.0 | 15.5 | 14.0 | 16.5 | 17.3 | 16.6 | 16.9 | 19.6 | 23.9 |
| Black, non-Hispanic | 22.7 | 22.4 | 17.2 | 16.6 | 18.4 | 14.3 | 16.5 | 18.3 | 17.8 | 18.6 | 16.2 | 16.1 | 16.0 | 17.0 | 19.1 | 19.1 | 16.5 | 18.5 | 22.4 |
| Hispanic | 15.1 | 14.5 | 14.0 | 13.0 | 14.8 | 13.6 | 12.1 | 11.7 | 12.0 | 14.0 | 12.4 | 10.3 | 10.6 | 11.2 | 10.3 | 15.0 | 13.7 | 15.7 | 20.6 |
| Family structured | |||||||||||||||||||
| Two parents | 15.0 | 15.3 | 14.1 | 13.5 | 14.4 | 13.9 | 12.2 | 13.0 | 11.9 | 13.8 | 11.8 | 12.2 | 10.8 | 13.1 | 13.1 | 12.5 | 19.0 | 21.0 | 19.6 |
| Mother only | 22.9 | 23.9 | 19.0 | 19.6 | 20.6 | 18.4 | 19.5 | 16.7 | 17.3 | 21.0 | 19.7 | 17.8 | 18.0 | 18.8 | 21.1 | 21.4 | 18.0 | 15.2 | 24.0 |
| Father only | 19.1 | 22.7 | 12.8 | 19.0 | 19.9 | 19.0 | 18.2 | 16.6 | 17.5 | 16.9 | 18.9 | 16.0 | 12.2 | 16.9 | 22.7 | 18.4 | 14.4 | 16.8 | 25.2 |
| No parents | 24.0 | 29.6 | 22.1 | 22.9 | 22.5 | 22.1 | 19.9 | 24.7 | 19.7 | 24.1 | 21.2 | 22.7 | 23.8 | 21.2 | 24.1 | 26.2 | 21.5 | 30.7 | 34.4 |
| ‡ Reporting standards not met; estimate is considered unreliable. | |||||||||||||||||||
| a In 2019, the 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/nhis/2019_quest_redesign.htm. | |||||||||||||||||||
| b Missing family income data were imputed for 15%–25% of children ages 4–17 for the years 2001–2019. | |||||||||||||||||||
| c The revised 1997 U.S. Office of Management and Budget standards for race were used for the 2001–2013 race-specific estimates. A person's race is described by one or more of five racial groups: White, Black or African American, American Indian or Alaska Native, Asian, or Native Hawaiian or Other Pacific Islander. Data on race and Hispanic origin are collected separately but combined for reporting. 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 due to the small sample size for each group. Persons of Hispanic origin may be of any race. | |||||||||||||||||||
| d "Two parents" includes two married or unmarried parents. The terms "mother" and "father" can include biological, adoptive, step, or foster relationships. "No parents" can include children cared for by other relatives or a legal guardian. In 2019, family structure was categorized based on a series of questions that establish presence of parents, marital status of parent, and relationship to other adults in the household. Family structure could not be determined for about 7% of sample children in 2019. | |||||||||||||||||||
| NOTE: Emotional or behavioral difficulties of children were based on parental responses to the following question on the Strengths and Difficulties Questionnaire1 in the Sample Child Survey: "Overall, do you think that (child) 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" 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. Children with minor emotional or behavioral difficulties are defined as those whose parent responded "yes, minor difficulties." Starting in 2019, questions based on the Strength and Difficulties Questionnaire are included in the 3-year rotating core. For more information on the 2019 NHIS redesign, see: https://www.cdc.gov/nchs/nhis/2019_quest_redesign.htm. | |||||||||||||||||||
| SOURCE: National Center for Health Statistics, National Health Interview Survey. | |||||||||||||||||||
| 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. | |||||||||||||||||||