Report Gives Mixed Grades on Kids' Health

U.S. children much safer now, but obesity epidemic looms

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HealthDay Reporter

WEDNESDAY, March 24, 2004 (HealthDayNews) -- A 30-year report on the well-being of U.S. children finds marked improvements in safety and education but an overall decline in physical health -- due mainly to surging rates of child obesity.

"The trend toward being overweight among children and young people is very substantial," says report coordinator Kenneth Land, a professor of sociology at Duke University. In fact, increasing obesity levels are undermining hard-fought gains in child health, causing the report's "health index" to drop to levels 15 percent below those seen in 1975.

Highlights from the Index of Child Well-Being, published by Duke University's nonprofit Foundation for Child Development, were presented March 24 in Washington, D.C.

According to Dr. Carden Johnston, president of the American Academy of Pediatrics, very few studies have tried to look at the effect over time of societal trends on the well-being of children. The new index appears to do this, however. "It evaluates the child not only within the context of the individual child, but also within his or her family, the environment, and within society as a whole," Johnston says.

Using data on the lives of U.S. children collected between 1975 and 2003, the Duke team tracked changes in seven categories, including material well-being, health, safety, education, place in community, social relationships and emotional/spiritual well-being.

According to the report, American kids have faced daunting challenges over the past 30 years, from the breakdown of the two-parent family to the crack cocaine epidemic of the late 1980s, to the popularity in the 1990s of the video game, and high-calorie, high-fat fast foods.

Those challenges have taken their toll.

In terms of physical health, steady advances in vaccination and health care have been undermined by soaring obesity rates. "Activity patterns have changed -- kids today after school are more likely to go home and play video games and sip soft drinks, eat snacks, than 20 or 25 years ago," Land says.

The traditional family dinner may also be under attack as overstressed, overworked parents find it harder to gather everyone around the table each evening. "If there is a family dinner, it's more likely now to be a dinner of processed foods or prepared foods from the supermarket or fast food restaurants," Land says. In the meantime, kids are left free to snack their way through the day.

Youngsters' emotional health may be suffering as well. Index scores for child spiritual or emotional well-being were lowest in the late 1980s and early 1990s, a time of economic recession, crack cocaine and major changes in the workforce that put stresses on the family.

"For that period of time, the suicide rate among adolescents and teenagers was increasing and reached a high plateau," Land points out. However, "since about 1993-1994 it has shown some decreases, indicative of an improving emotional well-being among kids."

Children may be looking elsewhere for support when they don't find it within the weakened family unit, Land says. Indeed, ratings for "connection to community" have risen steadily among U.S. teens throughout the 1990s and as children increased their participation in school, sports or the workforce.

A sharp rise in child safety is another encouraging trend. Death rates among U.S. children fell by half between 1975 and 2002, and despite recent media attention on child abductions, children are actually much safer today than they were in generations past. The easing of the crack epidemic was a major factor in reducing crime and drug abuse, Land says, but parents are also becoming more vigilant in keeping their kids from harm's way.

"Parents have become more intense about monitoring their children's activities to reduce their exposure to the risks of various types of violent crimes," Land says.

Overall, children's well-being is improving, albeit slowly, the researchers conclude. Tallying changes in health, education, safety and other categories, they estimate an overall five-point, 30-year increase in child well-being from the base score of 100 they started with in 1975. More and more children now get college degrees, and -- obesity aside -- 83.5 percent are now in "very good or excellent" health, up from 78 percent in 1975.

Still, problems remain. Poverty rates have only declined slightly over the past 30 years, and by 2002 one in every six American children still lived below the poverty line.

Land warns that history might also repeat itself someday. "Everyone knows, of course, that we are in a period of slow growth or no growth of jobs and incomes. Should this economic environment continue for an extended period of time -- five to 10 years -- we could potentially be in a situation like the early 1980s," he says. "We could be upsetting the apple cart for a generation of young children now forming families, having kids and rearing them."

Johnston agrees. "If the macroeconomic situation is not right and parents lose their jobs, they are under stress, and with stress the outcomes are worse," he says. "You end up with more child abuse, more neglect, not as much reading to the child, less time for education."

And Land says its time to tackle the problem of childhood obesity "head-on."

"We can be much more vigorous and intensive," he says, "getting the message out there about the impact of dietary patterns on weight, obesity and health."

More information

Learn more about raising healthy, happy kids from the National Institute of Child and Human Development or the American Academy of Pediatrics.

SOURCES: Kenneth Land, Ph.D., professor, sociology, Duke University, Durham, N.C.; Carden Johnston, M.D, president, American Academy of Pediatrics, Chicago; Index of Child Well-Being, Foundation for Child Development, Duke University

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