Child Health USA 2003

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Health Status-Infants | Health Status-Children | Health Status-Adolescents |
Health Services Financing and Utilization | State Data | City Data | References | Contributors

Population Characteristics

In this Section:
Population of Children | Foreign-born Population |
Children with Speacial Health Care Needs | Children in Poverty | School Dropouts |
Working Mothers and Childcare | Impact of CSHCN on Parental Employment | Maternal Age

Population Characteristics

Socio-demographic characteristics provide a comprehensive picture of the country's diverse maternal and child population. The population of children ages 21 and below comprises roughly one-third of the U.S. population.

At the national, State, and local levels, policy-makers use population information to systematically address health-related issues of mothers and children. By carefully analyzing and comparing data, health workers can often isolate high-risk populations that require specific interventions. Policy-makers can then tailor programs to meet the needs of those populations. The following section presents data on several population characteristics that have an impact on maternal and child health program development and evaluation. These include age, poverty status, race and ethnicity, living arrangements, child care trends, and school dropout rates. Also presented in this section are descriptions of specific target populations, including the foreign-born population and children with special health care needs.

Population of Children

Age

U.S. Resident Population by Age Group: July 1, 2001 Source (I.1): U.S. Census Bureau [d]

In 2001, the 89 million children through the age of 21 in the United States represented 31.2 percent of the total population, adults ages 22-64 accounted for 56.4 percent, and persons ages 65 and over represented 12.4 percent of the total population. The median age in the United States for all races was 35.6 years.

In the last decade, the number of children under 5 years of age has increased by 0.8 percent, while the number of children ages 5-19 years has increased by 15.1 percent. In the same period, the number of persons ages 65 and over has increased by 10.9 percent.

Race and Ethnicity

Reflecting the trends in the general population, the child population has become increasingly diverse over the past several decades. Since 1980, the percentage of children who are Hispanic or Asian/Pacific Islander has doubled, as the percentage who are White has decreased. Hispanic children represented 9 percent of children in 1980 and 18 percent in 2001; likewise, Asian/Pacific Islander children represented 2 percent in 1980 and 4 percent in 2001. In the same time period, the percentage of children who are White dropped by 16 percent to represent 62 percent of the child population in 2001, while the percentage who are Black has remained stable. These trends are expected to continue.

Percent Distribution of Children Under 18 by Race/Ethnicity: 2001 Source (I.1): U.S. Census Bureau [d]

Children of Foreign-Born Parents

Percent Distribution of Children Under 18, by Nativity of Child and Parents: 2002 Source (I.2): U.S. Census Bureau [d] * Includes children living in households with no parent present and foreign-born children with native parents.

The foreign-born population in the United States has increased substantially since 1970, largely due to immigration from Asia and Latin America. In 2002, nearly 20 percent of children in the U.S., or 14 million children, had at least one foreign-born parent: 15.9 percent were born in the U.S., and 3.7 percent were themselves foreign-born. Most children (76.2 percent) were native-born living in households with native-born parents.¹

Compared to native-born children living with native parents, children living with foreign-born parents were more likely to have family incomes below 200 percent of the Federal poverty level, more likely to live in cities, and more likely to live in two-parent families. They were also more likely to have parents with less than a high school education, although educational attainment varied by region of birth. Those born in Asia and Europe had the highest percentages of high school graduates (86.8 percent and 84 percent, respectively) compared to those born in Latin America, with only 49.1 percent having graduated from high school. Immigrant children and children of foreign-born parents face the challenges of acculturation and have health and psychosocial risks at home and at school.²

Percent Distribution of Children Under 18 by Income and Nativity of Child and Parents: 2002 Source (I.2): U.S. Census Bureau [d] * Federal Poverty Level

Children with Special Health Care Needs

Percent Distribution of Children with Special Health Care Needs Under 18 in U.S. Households: 2001 Source (I.3): U.S. Department of Health and Human Services [d]

Based on the 2001 National Survey of Children with Special Health Care Needs, it is estimated that 12.8 percent of children have special health care needs. Children with special health care needs (CSHCN) are defined by the Maternal and Child Health Bureau as those who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally.

Based on this definition, the survey estimated that 9.4 million children in the United States have special health care needs. The survey identified CSHCN as those children who have a condition that has lasted or is expected to last at least 1 year, and which results in at least one of five consequences: the need for prescription medication; the need for more medical, mental health, or educational services than other children of the same age; the need for emotional, behavioral, or developmental counseling; a limitation in the child’s ability to do the things most children of the same age do; or the need for special therapy, such as physical, occupational, or speech therapy. Of these five criteria, the need for prescription drugs was the most common, reported for 74.3 percent of CSHCN, followed by the need for extra medical care, which was cited by 45.6 percent of CSHCN.

Percent Distribution of Children with Special Health Care Needs by Type of Special Need: 2001 Source (I.3): U.S. Department of Health and Human Services [d]

Children in Poverty

In 2001, there were 11 million related children³ under 18 years of age living in families with incomes below the Federal poverty threshold (e.g., $18,104 for a family of four)⁴. Children living below the poverty level comprised 15.8 percent of all related children living in families, with children under six more likely (18.2 percent) to live in poverty. The rate for 2001 is the lowest childhood poverty rate in the past two decades.

Related Children Under 18 Living in Families Below 100% of Poverty Level, by Race/Ethnicity: 1970-2001 Source (I.4): U.S. Census Bureau [d] * Hispanic ethnicity not reported prior to 1979.

Poverty affects living conditions and access to health care and nutrition, all of which contribute to health status. Black and Hispanic children were particularly vulnerable. A much higher proportion of Black (30.0 percent) and Hispanic (27.4 percent) related children under age 18 were poor than were related White children (12.8 percent).

Of the 11 million related children living in poverty, just over 50 percent lived in homes headed by a single mother, 40.5 percent lived in homes headed by married parents, and 8.6 percent lived in families headed by a single father. Children living in single-parent families are nearly five times as likely to be poor as are children living in married-couple families.

Related Children Under 18 Living in Families Below 100% of Poverty Level, by Household Status: 2001 Source (I.4): U.S. Census Bureau [d]

School Dropouts

As of October 2001, there were approximately 3,774,000 high school dropouts⁵ between the ages of 16 and 24 in the United States. This translates into a total dropout rate of 10.7 percent for youth in this age group, a rate that has remained fairly stable since 1992.

Since 1970, Hispanic students have had the highest dropout rates, representing well over a quarter of Hispanic young adults. The high Hispanic dropout rate (27 percent) is partly driven by the significantly higher dropout rate among foreign-born Hispanics of 43.4 percent in 2001. The corresponding rates for White and Black students were 7.3 percent and 10.9 percent, respectively. Although the gap in the dropout rate between Blacks and Whites narrowed between the 1970s and 1980s, the gap has remained constant since 1990.

Dropout Rates Among High School Students Ages 16-24, by Race/Ethnicity: 1991-2001 Source (I.5): U.S. Department of Education [d] * Because of changes in data collection precedures beginning in 1992, data may not be comparable with figures for earlier years.

According to the National Center for Education Statistics, students who drop out of high school are more likely to be unemployed and earn less when employed, compared to students who complete high school.

Working Mothers

In 2001, 64 percent of mothers with pre-school aged children (younger than 6 years) were in the labor force (either employed or looking for work), with 60 percent actually employed. Of those mothers, 70 percent worked full-time and 30 percent worked part-time. Of women with children ages 6-17, 78 percent were in the labor force in 2001 and 75 percent were actually employed. Of employed mothers, 78 percent worked full-time and 23 percent worked part-time.

Percent of Mothers in the Work Force: 1980-2001 Source (I.6): U.S. Department of Labor [d] * Data for 1995 and later are not strictly comparable with data for earlier years due to changes in the survey and estimation process.

Child Care

The issue of child care is essential to working parents. The 2001 National Household Education Survey collected information about types of child care arrangements. In 2001, 61 percent of children through age 6 spent time in the care of an individual other than a parent. Overall, 23 percent were cared for by a relative, 16 percent by a non-relative in a home, and 34 percent received care in a center-based program.⁶ Older children, ages 3 to 6, were more likely to receive center-based care than were children under 3 years of age. Only 17 percent of children under 3 received care in a center-based program, compared to 56 percent of children ages 3 to 6.

Analysis of the National Household Education Survey also revealed variations by race and ethnicity. A comparison of child care arrangements for children through age 6 across racial and ethnic groups revealed that Hispanic children were least likely to be enrolled in a center-based program and most likely to receive only parental care. Slightly more than half (53 percent) of Hispanic children were in the care of a parent, compared to 38 percent of non-Hispanic White and 26 percent of non-Hispanic Black children. The percentage of children receiving care in center-based programs was highest for non-Hispanic Black (41 percent) and lowest for Hispanic (20 percent) children.

Child Care Arrangement Among Children Through Age 6, by Race/Ethnicity: 2001* Source (I.7): U.S. Department of Education [d] * Some Children participate in more than one type of arrangement.

Children with Special Health Care Needs

Impact on Parental Employment

The medical needs of a child with special health care needs (CSHCN) can often affect the employment of a parent, as a parent may reduce work hours or stop working entirely in order to care for a child. Analysis of the 2001 National Survey of Children with Special Health Care Needs showed that 16.8 percent of parents reported having to cut back on work and another 13.2 percent stopped working due to their children’s needs. Since giving up a job affects a family’s income, it is not surprising that parents of CSHCN in lower-income families are those most likely to have stopped working.

Children with Special Health Care Needs and Parental Employment, by Income: 2001 Source (I.8): U.S. Department of Health and Human Services [d] * Federal poverty level.

Time Spent Providing Care

Time Spent Per Week Providing, Arranging, or Coordinating Care for Children with Special Health Care Needs: 2001 Source (I.8): U.S. Department of Health and Human Services [d]

Caring for CSHCN may require families to spend time either providing direct care or coordinating care for their child. In the 2001 National Survey of Children with Special Health Care Needs, more than half (57.5 percent) of families reported spending an hour or less per week in these activities. Just over one-fifth (20.2 percent) indicated spending 6 or more hours each week providing, arranging, or coordinating care for CSHCN.

The time burden was greatest on low-income families. The families of more than one-quarter of poor children spent at least 11 hours a week providing, arranging, or coordinating their children’s care, compared to the 6 percent of families with incomes of 400 percent of poverty or more.

Maternal Age

The overall birth rate declined to 64.8 per 1,000 women in 2002, the lowest level since national health data have been available. The birth rates among older mothers ages 35-44 increased, while rates for women in their twenties and early thirties declined. Birth rates for teenagers have fallen steadily in the past decade and reached a record low in 2002.

Among 2002 births, approximately 11 percent were to women under 19, over half to women in their twenties, one third to women in their thirties, and about 3 percent to women in their forties and early fifties.

Among both Black and non-Hispanic White women, about half of births in 2002 were to women in their twenties. However, non-Hispanic White births were more likely to be to women in their thirties, forties and early fifties, while the proportion of births that were to teens was about twice as large among Blacks than among non-Hispanic Whites.

Percent Distribution of Births by Maternal Age and Race: 2002* Source (I.9): National Center for Health Statistics [d] * Prelimnary data

Footnotes

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Home | Table of Contents | Preface | Introduction | Population Characteristics |
Health Status-Infants | Health Status-Children | Health Status-Adolescents |
Health Services Financing and Utilization | State Data | City Data | References | Contributors