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The health of the current child population
has important implications for the future health of the
overall United States population as today’s children grow
into adults. A number of childhood health issues—including
weight, smoking, oral health, and vaccination coverage—can
affect health throughout the lifespan. In 2005, approximately
25 percent of the United States population was under 18
years of age. The health and well-being of these children,
as well as that of our country, depend on preventive services
such as prenatal care and immunization, as well as the promotion
of healthy life choices. These measures help assure that
children are born healthy and maintain good health as they grow up.
Good health begins even before birth.
Timely prenatal care is an important preventive strategy
that can help protect the health of both mother and child.
Entry into prenatal care during the first trimester has
been improving, reaching 83.9 percent of pregnant women
in 2004. A small proportion of women (3.6 percent) goes
without prenatal care until the third trimester, or forgoes
it entirely. This is more common among Black and Hispanic
women, as well as those who are younger, unmarried, and
less educated.
Several other indicators of maternal health
are presented in Child Health USA. One of these
is maternal age, which can affect the health of both infant
and mother. In 2004, births to 15- to 19-year-old women
reached a record low, while births to older women (35 years
and older) increased. Parental employment and child care
can also affect the health and well-being of a family. In
2005, 70.5 percent of women with children under 18 years
of age were in the labor force (either employed or looking
for work). Of mothers with preschool-aged children (younger
than 6 years), 62.8 percent were in the labor force and
58.5 percent were employed. In the same year, 60 percent
of children under 6 years of age required at least one weekly
nonparental child care arrangement.
After the health of the mother and the
family, Child Health USA presents data regarding
the health of infants and young children. Healthy birth
weight is an important indicator of infant health, and evidence
is currently emerging that birth weight affects children
into adulthood, as well. Despite high rates of prenatal
care utilization, preliminary data in 2004 indicate that
8.1 percent of infants were born at low birth weight (less
than 2,500 grams, or 5 pounds 8 ounces) that year, which
is the highest rate recorded in the last 3 decades. Although
the increase in multiple births, which are more likely to
result in low birth weight, are on the rise, the low birth
weight rate among singleton births is rising as well. Very
low birth weight (less than 1,500 grams, or 3 pounds 4 ounces)
is also on the rise, representing 1.5 percent of live births
in 2004. This has increased from a rate of approximately
1 percent in 1980. Children born at very low birth weight
are significantly more likely to die in the first year of
life than babies of normal birth weight, and those who survive
are at particularly high risk for severe physical, developmental,
and cognitive problems. Although rates of maternal and infant
mortality have dropped dramatically in the past century,
the United States still has one of the highest rates of
infant death in the industrialized world (6.9 deaths per
1,000 live births in 2004).
Breastfeeding can also support the health
of infants and mothers. Breastfeeding rates have increased
steadily since the beginning of the last decade. In 2004,
70.3 percent of mothers reported ever breastfeeding their
infant. However, the rate declined dramatically as infant
age increased: 36.2 percent of mothers reported breastfeeding
their infant at 6 months of age. The rate of exclusive breastfeeding
at 6 months was even lower (14.1 percent).
Vaccination is a preventive health measure
that protects the health of children into adulthood. Vaccines
are available for a number of public health threats, including
measles, mumps, rubella (German measles), polio, diphtheria,
tetanus, pertussis (whooping cough), and H. Influenzae
type b (a meningitis bacterium). In 2004, 80.9 percent of
children aged 19 to 35 months had received the recommended
series of vaccines; 76.0 percent of children in this age
group received the recommended series plus the varicella
(chicken pox) vaccine.
Oral health becomes an important factor
in overall child health status as soon as the first tooth
appears. In 2003, the parents of 68.4 percent of children
reported that their children’s teeth were in excellent or
very good condition. Non-Hispanic White children were most
likely to have teeth in excellent or very good condition,
while Hispanic children were least likely. In 2004, 72.3
percent of children had seen a dentist in the past year.
Physical activity and healthy weight are
other important factors in overall health that begin in
early childhood. In 2003, 14.8 percent of children aged
10 to 17 years were classified as overweight. Results from
the 2005 National Youth Risk Behavior Surveillance show
that 35.8 percent of high school students met the currently
recommended levels of physical activity, and 54.2 percent
of students were enrolled in a physical education class
on one or more days a week. Enrollment in weekly physical
activity classes was higher in the younger grades (71.5
percent of 9th graders) than in the older grades (38.8 percent
of 12th graders).
The period of adolescence introduces additional
health issues that need to be monitored and addressed. In
2005, 46.8 percent of high school students reported ever
having sexual intercourse. Among 9th grade students, more
males were currently sexually active (24.5 percent) than
females (19.5 percent). However, by 12th grade, females
were more likely to be currently sexually active (51.7 percent)
than males (47.0 percent). With sexual activity comes the
risk of sexually transmitted infections (STIs). Adolescents
(ages 15 to 19 years) and young adults (ages 20 to 24 years)
are at much higher risk of contracting STIs than are older
adults. Chlamydia continues to be the most common STI in
adolescents and young adults, with rates of 1,579 and 1,660
cases per 100,000, respectively, in 2004. Gonorrhea followed
in prevalence with overall rates of 427 and 498 per 100,000
adolescents and young adults, respectively. Although specific
statistics are yet unavailable, genital human papillomavirus
(HPV) is believed to be the most common STI in the United
States. A vaccine for HPV was recently approved by the Food
and Drug Administration (FDA) for use in females aged 9
to 26 years.
Mental health is another issue that increasingly
affects children as they grow older. In 2004, 22.5 percent
of youth aged 12 to 17 years received mental health treatment
or counseling in the past year, which includes treatment
or counseling for emotional or behavioral problems not caused
by drug or alcohol use. The rate in 2004 represented a significant
increase over the previous year (20.6 percent). Depression
was the leading reason reported for mental health treatment
among this age group.
A number of other issues are interconnected
with mental health, including violence and substance abuse.
Results from the 2005 Youth Risk Behavior Surveillance indicate
that 18.5 percent of high school students had carried a
weapon (such as a gun, knife, or club) at some point during
preceding 30 days. Among males, non-Hispanic Whites and
Hispanics were more likely than non-Hispanic Blacks to carry
a weapon. Among females, non-Hispanic Blacks were more likely
to carry a weapon than their non-Hispanic White and Hispanic
counterparts. With regard to substance abuse, 10.6 percent
of adolescents aged 12 to 17 years reported using illicit
drugs in the past month in 2004. Alcohol was the most commonly
used drug among adolescents, with 17.6 percent reporting
past-month use in 2004, while marijuana was the most commonly
used illicit drug (7.6 percent).
The health status and health services
utilization indicators reported in Child Health USA
can help policymakers and public health officials analyze
the current health climate and determine what programs might
be needed to further improve the public’s health. These
indicators can also help identify positive health outcomes,
which may allow lessons to be learned from the experiences
of programs that have achieved success. The health of our
children and adolescents relies on effective public health
efforts that include providing access to knowledge, skills,
and tools; providing drug-free alternative activities; identifying
risk factors and linking people to appropriate services;
building community supports; and supporting approaches that
promote policy change. Such preventive efforts and health
promotion activities are vital to the continued improvement
of the health and well-being of America’s children and families. |
