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Health and Welfare of America's Kids Looking Up

But several areas leave room for improvement, say federal officials

THURSDAY, July 19, 2001 (HealthDayNews) -- The government's latest snapshot of the welfare of America's children is a pretty picture.

A new report by the Federal Interagency Forum on Child and Family Statistics finds lower teen death rates, fewer children living in poverty and a new low in births to teenage mothers.

"It's a good time to be a child in America," says Tommy Thompson, Secretary of the U.S. Department of Health and Human Services, in a statement released today.

The fifth annual report, which includes figures through 2000, looks at 24 indicators of child health and welfare for the 70.4 million Americans under age 18.

The death rate for children aged 15 to 19 was 71 per 100,000 in 1999, down from 89 per 100,000 in 1991 and an all-time low. Most of the improvement was due to a drop in firearm-related fatalities, which declined to 16 deaths per 100,000 teens from 28 deaths per 100,000 teens in 1994.

The share of children living in families with incomes below the poverty line -- about $17,000 for a family of four -- fell to 16 percent in 1999, a 2 percent drop from the previous year and the lowest level since 1979. The proportion of children with at least one working parent rose from 72 percent in 1994 to 79 percent in 1999.

However, 42 percent of children in households headed by a single woman lived in poverty, a figure that rises to 52 percent for black youths. Still, officials say the economic status of children in single-mother households has improved since 1980, when slightly more than half lived in poverty.

Children from two-parent homes are far less likely to suffer poverty. In 1999, only 8 percent of children in married-couple families were considered poor, the report shows.

The number of children with health insurance rose slightly, from 85 percent to 86 percent between 1989 and 1999, marking the highest coverage level since 1985. On the other hand, officials say some 10 million children still are uninsured.

Births to teen mothers hit their lowest point ever in 1999, falling to 29 per 1,000 girls aged 15 to 17, a 25 percent drop from 1991. Babies born to teen mothers are more likely to grow up in poverty, perform worse in school and face other socioeconomic hurdles than those born to older women are, officials say.

A new indicator found a 20-year surge in the number of high school students enrolled in advanced classes. In 1998, 40 percent had taken at least one advanced math class, and 60 percent had taken one or more advanced science classes. Education officials say students who take advanced courses are more likely to attend and graduate from college.

Richard Wertheimer, senior research associate at Child Trends, a non-profit group that studies child welfare issues, says the picture looks bright for America's youth.

"Things have gotten better. There's no question about that," says Wertheimer, who helped prepare a report released last February that looked at similar trends in the nation's cities.

Wertheimer says much of the gains in the last few years are the result of the strong economy, which has since turned sharply south. "Welfare reform has perhaps had something to do with it as well, since a lot more mothers are working," and thus changing the poverty statistics, he says.

While the impact of that shift isn't clear, some evidence suggests that older children whose mothers have made the jump from welfare to work may be more prone to behavior problems. "It's going to take a few more years of research" to sort these questions out, he says.

Despite the many encouraging trends, several important measures saw little or no positive change, officials say.

The infant mortality rate in 1998 was 7.2 per 1,000 live births, down from the 1990 figure of 8.9 per 1,000 births but unchanged from the previous year. Preliminary data from 1999 show a slight decrease in the infant death rate, to 7.1 per 1,000 live births.

"There are a lot of reasons why we're not leading the world in infant mortality," says Katherine Heck, a statistician at the National Center for Health Statistics who helped coordinate the report. "General preventive access to health care is probably not as good here as it is elsewhere, and not all mothers have good prenatal care."

While fewer high school students reported taking up smoking in 2000 than in previous years, the number who said they used drugs and alcohol held steady, the report says. One in four high school seniors said they used illegal drugs last year, the same as in 1997.

Particularly troubling was the fact that more children have asthma than a decade ago: 5 percent compared with 4 percent, the report says.

"We thought that was an important finding, since it's a chronic disease that can be extremely harmful," Heck says. However, the reasons for the increase aren't clear and likely include not only a real rise in the asthma rate but also more awareness and diagnosis of the condition.

The number of low-weight newborns is also on the rise, most likely because of the increased use of fertility drugs, which lead to multiple births, experts say.

What To Do

For more on the status of America's children, visit the Annie E. Casey Foundation.

To learn more about child health, try the National Institute of Child Health and Human Development.

SOURCES: Interviews with Katherine Heck, M.P.H., health statistician, National Center for Health Statistics, Hyattsville, Md.; Richard Wertheimer, senior research associate, Child Trends, Washington, D.C.; July 2001 America's Children: Key National Indicators of Well-Being
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