Federal Government Releases Annual Interagency Report on Health, Well-Being of America’s Children

The economic "boom" of the mid-1990s "has created a generation of children who are better off" than their older siblings, according to a number of health indicators in the annual report compiled by the Federal Interagency Forum on Child and Family Statistics,a consortium of government agencies including 10 cabinet-level departments, the Washington Post reports (Cooper, Washington Post, 7/19). The report, called "America's Children: Key National Indicators of Wellbeing in 2001," examines various health factors for these children, finding the following:

• Health Status: In 1998, 83% of children were reported by their parents to be in good health, compared with 82% in 1997. However, child health "varies by family income." Seventy percent of children in families with annual incomes below the federal poverty line were in "very good" or "excellent health" in 1998, compared with 87% of children in families living at or above the poverty line.
• Insurance Rates: Eighty-six percent of children had health coverage in 1999, an increase from 85% in 1998. Ten million children lacked insurance during 1999, the lowest rate of uninsurance since 1995. The percentage of children covered by private insurance increased to 69% in 1999, up from 66% in 1994. In 1999, 23% of children were covered through public health programs, up from 11% in 1987. In 1999, 91% of white children had insurance, compared to 82% of black children and 73% of Hispanic children.
• Access to Health Care: Seven percent of children lacked a "usual" source of care in 1998, a rate that has remained relatively stable since 1993. Compared with children who had private insurance, children with public insurance were "more likely" and uninsured children were "much more likely" to lack a usual source of care. Children living below the poverty line also were less likely to have a usual source of care compared with children in families with higher annual incomes.
• Childhood Immunization: Seventy-eight percent of children ages 19 to 35 months received the recommended combined series of vaccines in 1999. Rates for the full series were higher among white children than among black or Hispanic children.
• Asthma: The rate of children with asthma increased from 3% in 1981 to 5% in 1998. Black children had the highest rates of asthma, at 7%, compared with 5% of white and Hispanic children. Seven percent of children living below the poverty line had asthma, compared with 5% of children living at or above the poverty line.
• Adolescent Births: Between 1991 and 1999, the teen birth rate declined from 39 births to 29 births per 1,000 women ages 15-17. "[S]ubstantial racial and ethnic disparities" exist in teen birth rates -- the rate in 1999 was 61 births for Hispanic teenagers, 54 births for blacks, 41 births for American Indians/Alaska Natives, 17 births for whites and 12 births per 1,000 Asian/Pacific Islander teenagers. The "steepest decline" in the teen birth rate during the mid-1990s occurred for first births. The teen pregnancy rate -- defined as the sum of births, abortions and fetal losses per 1,000 teens -- declined by one-fifth during 1990-1997, to reach a record low of 64 pregnancies per 1,000 teenagers in 1997.
• Low Birthweight: The percentage of infants born weighing less than 2,500 grams (about 5.5 lbs.) increased slightly, from 7.5% in 1997 to 7.6% in 1998 and 1999, following a pattern of increasing "slowly but steadily since 1984." The rate for blacks rose from 13.1% in 1997 to 13.2% in 1998 and 1999, the rate for whites rose from 5.6% in 1990 to 6.6% in 1998 and 1999 and the rate for American Indian/Alaska Natives increased to 7.1% in 1999, though the report did not give a number for previous years. Hispanics' rate of low birthweight remained steady at 6.4% from 1997 to 1999, and the rate for Asian/Pacific Islanders remained at 7.4% in 1998 and 1999.
• Infant Mortality: The infant mortality rate remained the same between 1997 and 1998 at 7.2 deaths per 1,000 live births. Rates continued to decrease for Hispanics in 1998, but increased for blacks, Asian/Pacific Islanders and American Indian/Alaska Natives. Rates for 1998 were 13.8 deaths for blacks, 9.3 deaths for American Indian/Alaska Natives, 6 deaths for whites, 5.8 deaths for Hispanics and 5.5 deaths per 1,000 live births for Asian/Pacific Islanders.

Reactions
"It's a good time to be a child in America," HHS Secretary Tommy Thompson said of the report. He added that HHS has made more than $17.1 million in grants to help 49 communities develop and implement abstinence-only education programs to "bolster the downward trend in the teen pregnancy rate" (Piccolo, Washington Times, 7/19). Dr. Duane Alexander, director of the National Institute of Child Health and Human Development, said, "These findings represent important victories for children and adolescents. Children are less likely to live in poverty, more likely to have a parent working full-time and more likely to have health insurance" (Lewin, New York Times, 7/19). But the Post reports that the advantages seen now "could be swiftly eliminated by economic recession" (Washington Post, 7/19). Margaret Simms, research director at the Joint Center for Political and Economic Studies, said, "It's a cautionary tale of progress. Economic expansion is not enough to put all families on equal footing" (McQueen, AP/Boston Globe, 7/19). The report is available online.