7/6/11 10:00 AM
[Transcriptionist's Note: Due to challenges encountered with speakers' speech patterns, this transcript contains a number of (unclear) markings. Overall, this is a useful transcript.]
Moderator: Welcome to America's Children: Key National Indicators of Well-Being, 2011. Please be aware that each of your lines is on "listen only" mode. At the conclusion of the presentation, we will open the floor forquestions. At that time, instructions will be given as to the procedure to follow if you'd like to ask a question. And now, I'll return the floor over to Bob Bock with the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
Robert Bock: Hi. Welcome to the NIH. I'm Bob Bock of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. We are here for the embargoed news briefing of America's Children: Key National Indicators of Well-Being, 2011. The briefing is given under the embargo of midnight, July 8th. That would be first thing Friday morning. And now, I would like to introduce Dr. Alan Guttmacher, director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health.
Dr. Alan Guttmacher: Thank you all for joining us with the National Institutes of Health for this year's audio briefing on America's Children: Key National Indicators of Well-Being, 2011. As you've just heard, I'm Alan Guttmacher, the director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the NIH. We have many interesting developments to report today but before we begin, I'd like to tell you a little bit about the report and its intent. America's Children: Key National Indicators of Well-Being, 2011 is a compendium of federal statistics regarding our nation's children and you. It is compiled and issued by the Federal Interagency Forum on Child and Family Statistics, which is a working group of 22 federal agencies. The Forum collects, analyzes and reports data on issues related to children and families. America's Children: Key National Indicators of Well-Being, 2011 is the 15th in a series. The report is issued each year, and all the statistics in it have been published previously. The rationale behind the report is to include the most recent, reliable federal statistics on children and youth in a single volume. This volume serves as a convenient reference for elected officials, policy makers, educators, the media and anyone interested in the well-being of our nation's young people. The release of the report also serves as a status update on how well the nation's children are doing on a variety of fronts . The report presents 41 key indicators in these important areas: family and social environment, economic circumstances, health care, physical environment and safety, behavior, education, and health. The Forum chose the indicators in the America's Children report because of their critical importance to children. They reflect year-to-year changes, as well as longer- term trends. The Eunice Kennedy Shriver National Institute of Child Health and Human Development—or NICHD—has a strong interest in the report and works together with these other federal agencies on it because of the importance we all place in understanding and improving the health of America's children. I am particularly encouraged by changes in two of the indicators in this year's report. First, the rate of preterm birth has declined for the third year in a row. The rate had reached a high of 12.8 percent in 2006, dropped to 12.7 percent in 2007, then to 12.3 percent in 2008. In 2009, it dropped yet further to 12.2 percent. The change is especially welcome because infants born preterm, that is, less than 37 weeks of gestation, are at higher risk of early death and long-term health and developmental issues than those who are born later in pregnancy. The reasons for the decline aren't yet completely clear and so we continue researching to understand it and hope to reduce the preterm birth rate even further. We are also encouraged by the decline in the adolescent birth rate. In 2009, the rate was 20.1 for 1,000 adolescents ages 15-17, down from 21.7 in 2007 and 22.1 in 2006. Again, the reasons for decline are not completely clear. Compared to infants born to older mothers, infants born to adolescent mothers are at higher risk for low birth weight, either from being born prematurely or from failure to grow appropriately in the womb. Lower birth weight predisposes infants towards serious health problem, serious disability and even death. In addition to the physical problems adolescent child-bearing poses to the infant, it is also associated with long-term difficulties for both mother and child. Children of adolescent mothers are less likely to earn high-school diplomas than are children of older mothers. Adolescents who give birth are less likely to earn high-school diplomas themselves, and the reduced educational attainment limits employment prospects and future earnings. Now, I would like to introduce our other speakers. Joining us in a moment to talk about other health indicators in the America's Children report is Dr. Edward Sondik, director of the National Center for Health Statistics of the Centers for Disease Control and Prevention. Dr. Sondik will also present information on the report's educational indicators for Valena Plisko, associate commissioner at the National Center for Education Statistics, who is unable to join us today. Several other Forum members are joining us by phone, and are available to answer questions as well. With us are Grace Kena, a research scientist from the National Center for Education Statistics of the Institute of Education Sciences at the U.S. Department of Education. We also have Laura Radel, a senior social science analyst, Division of Children and Youth Policy, in the Office of the Assistant Secretary for Planning and Evaluation at the U.S. Department of Health and Human Services. Many of the indicators in the report have also been provided to us by the U.S. Bureau of the Census. Representatives of the Census Bureau who will be available to answer questions are Robert Kominski, associate chief of the Social Economic & Housing Statistics Division, Rose Kreider, demographer in the Fertility and Family Statistics Branch and Suzanne Macartney, analyst in the Poverty Statistics Branch. Now, I would like to turn the mike over to Dr. Sondik of the National Center for Health Statistics. Dr. Sondik?
Dr. Edward Sondik: Thank you, Dr. Guttmacher. This annual report, we feel, is an important tool for monitoring the well-being of our nation's children. The several sections of the report reflect that wellness has many dimensions and each of them is critical to a child's well-being. The multiple perspectives give us a comprehensive picture of the nation's children. I'm going to focus largely, but not exclusively on health, and let me begin with some good news. Injury-related death, the leading cause of death among teens, dropped by 10 percent among older teens aged 15-19, from 44 deaths per 100,000 teens in 2008, to 39 deaths per 100,000 in 2009. Decline… uh… One of the major reasons for this decline was the decline in motor-vehicle accidents, which actually has been going on now for some time: That's very good news. But on the other side of the ledger, tobacco continues to be a health concern for America's teens and, of course, adults. It, of course, has long-term disease consequences and premature death. In 2010, 3 percent of 8th-grade students reported smoking cigarettes daily, in the past thirty days. That's 1/3 the percentage in the peak year of 1996, so… considerable progress. For 10th graders, 7 percent reported daily smoking in 2009, which is almost 1/3 the peak. And for 12th graders, 11 percent reported daily smoking in 2009, which is less than half the percentage in 1997 when 25 percent of 12th graders reported daily smoking. So, the progress is good. But, on the other hand, if we look at the last several years, what was seen is a relatively flat trend, so this is a significant challenge. Another challenge has to do with alcohol. One of the behaviors we track is binge drinking along with illicit drug use. We define "binge drinking" as five or more alcoholic beverages in a row within a two-week period. The data shows the drop in the percentage of 12th graders who reported binge drinking: That's positive, but it's from 25 percent in 2009 to 23 percent in 2010. There was no significant change in the percentage of 8th and 10th graders who reported binge drinking. With respect to illicit drug use, 8th graders showed a significant use of illicit drugs in, I'm sorry, significant increase in the use of illicit drugs in thirty days, from 8 percent in 2009 up to 10 percent in 2010. Now, let me turn to a very prevalent disease among children, asthma. In fact, 10 percent of children under age 18 had asthma in 2009. That figure varies greatly among racial and ethnic groups. In 2009, about 17 percent of black, non-Hispanic children were reported to currently have asthma compared with 9 percent of whites, non-Hispanic and 8 percent of Hispanic children. In short, the rate among the black population is about twice that in the white and non-Hispanic...and Hispanic populations. But that single figure of 8 percent for the Hispanic population really hides some other very important facts. In fact, one of them is that 16 percent of Puerto Rican children were reported to have asthma compared with 7 percent of children of Mexican origin. The trends in asthma show that it increased. The percentage of children who report now having asthma—this is overall children—increased from 8.8 in 2001 up to 9.6 in 2009. The report includes several indicators on babies. Dr. Guttmacher has already mentioned the decrease in pre-term births, which, of course, is a very, very positive development. The report also gives the percentage of infants born to single women. When we consider all births, in 2009, 41 percent of all births were to unmarried women. Up slightly from 40.6 percent in 2008, more than double the percentage in 1980, which was 18.4 percent. However, the rate at which the group of unmarried women are having babies actually decreased from 53 births for every 1,000 unmarried women in 2008, down slightly to 51 births in 2009. So, in short, while unmarried women had slightly fewer babies in 2009, they accounted for slightly greater percentage of birth. From a statistical point of view, these infants are at risk for low birth weight and are more likely to live in poverty. Lastly, I'm very pleased to tell you about the report's special feature this year on adoption. The section includes a wide range of information that we believe will be very important for researchers, and the public, and policy makers. We think the data and the sources will be extremely important as resources. So, to go into the data, from about 2.5 percent of U.S. children, ages 18—0-18—joined their families through adoption. This includes adoptions from foster care, from private domestic adoptions, international adoptions and step-parent adoptions. Of all these adoptions, 21.5 percent of adopted children were a different race than their adopted parent, though this percentage varied by state, from a low of 8.4 percent in West Virginia to over 40 percent in Alaska and New Hampshire. The report also shows that some measures of children's well-being were different for adopted children. For example, 29 percent of adopted children were recorded to have one or more moderate-to-severe health problems, compared with 12 percent of children overall. The percentage was higher for children adopted from foster care than for children adopted from other sources. That is, 45 percent of children ages 12-17 who were foster-care adoptees had one or more moderate-to-severe health problems compared with 29 percent of 12-to-17-year-olds adopted privately within the U.S., and 27 percent adopted internationally. But again, that compares with 12 percent of children overall who would have moderate or severe health problems. There's a great deal more information about children who joined their families through adoption including other measures of well-being. One last example; when compared to all children, adopted children ages birth to five were more likely to be read to every day, 68 percent, than were children in this age group over the entire population at 48 percent. You may want to take a look at figures special, 1.D on page 72 of the report to find this and other measures of well-being. Laura Radel from the U.S. Department of Health and Human Services—the Assistant Secretary for Planning and Evaluation's Office—is also on the phone to answer your questions. Her office is one of those that sponsored the key survey in this, but not the only one, the National Survey of Adoptive Parents. Now, let me turn to education. I've been asked by Valena Plisko—from the National Center for Education Statistics—who couldn't be here today, to present some of the information on the report's education indicator. So, the highlights of this are that... uhh… let me get right into it: Early family reading is one of the topics. Early education experiences of young children, such as being read to daily, encourage the development of essential skills and help prepare them for success in school. Yes, I just mentioned one of these indicators, but for adoptive parents. In 2007, 55 percent of children ages 3-5 who were not yet in kindergarten were read to daily by a family member. Children living in a family below poverty were less likely to be read to daily than children in other households, 40 percent, compared with rates of 50-64 percent in the higher family income groups. Turning to math and reading, with respect to mathematics: In 2009, the average mathematics score of 4th graders was unchanged from 2007, but higher than the average in 1990. For 8th graders, the average score was higher than the scores in all the previous assessments. And for 12th graders, the score in 2009 was higher than the most recent score from 2005. Also reading— the average reading score for 8th graders improved from the 2007 score. The 2009 average reading scores of 4th graders and 12 graders did not change from those in the most recent years. Another important measure is high-school completion. The percentage of young adults ages 18-24 with a high-school diploma or equivalent credential is a measure of the extent to which young adults have completed a basic pre-requisite for many entry-level jobs, and for higher education. In 2009, 90 percent of young adults had attained such a credential. This percentage was higher than it was in 1980 when it was 84 percent. Youth, neither enrolled in school nor working, are young people who are at risk of limiting their future employment and earning prospects. So, we look at the percentage of 16-to-19-year-olds who are not enrolled in school and not working. In 2009, 9 percent of teenagers ages 16-19 were neither enrolled in school nor working. Black and Hispanic youth were more likely than white youth to be in this situation. Continuing along the educational progression, college enrollment: The report looks at immediate college enrollment following high school. In 2009, 70 percent of recent high-school completers had enrolled in college the October immediately after completing high school. The rate had increased from 49 percent in 1980, but has fluctuated from year to year so that's up from 1980, from 49 to 70 percent in 2009. So, to recap, the indicators of educational well-being present a mixed picture overall, with improvements noted in some areas but continuing challenges in others. In terms of year-to-year change from the last report, we see the math performance of 12th graders improving and high-school completion and immediate college enrollments of young adults improving. We also continue to see persistent long-term challenges for educating our children and youth including lower participation of poor children in reading-rich environments and generally lower educational performance and attainment by blacks and Hispanics and please keep in mind that many of these indicators, in fact, as I see it from the NCHS—National Center for Health Statistics—point of view, all of the indicators are really inter-related. Looking at one, we have to consider all of the others, particularly in looking at how to change these indicators. With that, Dr. Guttmacher...?
Dr. Guttmacher: Now, we'd like to open this to questions from those of you on the line. You just state who you are and what your question is: We'll get it to the right person to answer it
Moderator: At this time, we will open the phone for questions. If you would like to ask for questions, please press the "star" key followed by the "one" key, that's "star, one" on your touch tone phone now. Again, if you would like to ask a question, please press "star, one". Our first question comes from Val Willingham with CNN.
Val Willingham: Yes, actually I have two small questions. I just want to check one statistic that Dr. Sondik says: Are you telling me that 41 percent of all children born in this country are born to unmarried mothers?
Dr. Sondik: Yes. That's a succinct answer: That's yes. One of the things that I find fascinating about this is how much this has changed over, in my view—at my advanced age—a relatively short period of time. In looking at it—I think I quoted from 1980—and it's really… it's quite a significant change. We've also seen, and I didn't mention this, but the teen-birth figures have also declined tremendously and despite a little blip a few years ago, they continue on this downwards trend so we're seeing significant social changes taking place right in front of us.
Mr. Willingham: In the other question I have was in reference to the accidents/teen driving. Do you credit that to the laws that are popping up all over the country? The states that are making more stringent laws for children, for teens?
Dr. Sondik: Speaking from NCHS, it's hard for me to credit it to anything in particular but these are the facts. Maybe one of the other panel members would want to comment.
Dr. Guttmacher: Yeah, I think there is speculation—this is Alan Guttmacher—there's speculation but no clear data which would prove that it's one [indiscernible] versus something else.
Dr. Sondik: I have no data for the following statement, but I'm always impressed with the advances in safety, in cars. Which, speaking as a lay person as far as that goes, I would think it's something that one has to think of. I passed an accident this morning on the beltway so, in my mind...
Dr. Guttmacher: One, yes, this is Alan Guttmacher again… One might want to look, for instance—Dr. Sondik mentioned—the proportion of 12th grader who binge drink, or were reported having five or more alcoholic beverages in a row in the past two weeks, fell from 25 percent in 2009 to 23 percent, so the trend there as well that may be playing a role here but...
Dr. Sondik: A combination of factors.
Dr. Guttmacher: Yes.
Mr. Willingham: Okay, all right. Thank you, gentlemen. I appreciate it.
Moderator: Thank you. Our next question comes from Caroline Helwig with Medscape.
Caroline Helwig: Hi, talking about the adopted children and their moderate-to-severe health problems, do these percentages reflect mental and physical health problems?
Laura Radel: They do. This is Laura Radel. They reflect a variety of health conditions. There are some 16 health conditions that are included in the data. There is a table listing specific health conditions on page 186 of the volume. The most common medical issues are moderate-to-severe health problems in adopted children are mostly mental health items, but other items such as asthma and a variety of factors, conditions also affect adopted children.
Ms. Helwig: Okay, and also, would you please spell your name for me?
Ms. Radel: R-a-d-e-l.
Ms. Helwig: R-a-d-e-l, and Laura?
Ms. Radel: My first name is Laura, L-a-u-r-a.
Ms. Helwig: What's your title, Laura?
Ms. Radel: Mm-hmm?
Ms. Helwig: What is your title again?
Ms. Radel: Senior Social Science analyst.
Ms. Helwig: Senior Social Science analyst for...?
Ms. Radel: With the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services.
Respondent: Thank you.
Moderator: Thank you. Our next question comes from Heidi Splete with Pediatric News.
Heidi Splete: Hi. Thank you for taking my call. There are a lot of numbers here but I was wondering whether anyone could comment on what would be the take-home message from this report for pediatricians? Maybe things that they might want to keep in mind based on these numbers, or any actions that they could be taking to help get the numbers continuing to go in the right direction?
Dr. Guttmacher: This is Alan Guttmacher. In some ways, I think, the take-home message is that childhood is a dynamic phenomenon. And that some of the things that pediatricians are perhaps taught in training to focus on, become over time—and over the time of their practice lives— less common, less crucial to the lives of children and there are other things which therefore become more prominent. So, I don't think there's one single—especially if you look at things one year to the next—there's rarely a dramatic change from one year to the next, but I think the trends over time suggest (if one looks over a great period of time—several decades) that infectious diseases were a much larger part of a pediatrician's practice and focus. And now, if you look at the lives of children, while infectious diseases still play an important role, the role of injury becomes much, much more important in life: Not so much the injury itself that's more common, it's just that the other scourges of childhood have become less common so that things like injury have become something that pediatricians need to focus on. One statistic in the report that, I think, does bear some attention from pediatricians is on page 23 (I believe), and has to do with immunization rates which actually fell from the previous year. The reason for that probably is primarily due to the (indiscernable) vaccine shortage but that certainly bears attention since immunization in children, we know is usually important to their well-being and something that in recent years, we've not received some slow but fairly steady decline in the rates of immunizations.
Dr. Sondik: This is Ed Sondik. I would just add to that...some of the figures that pop out to me that I think would be important to pediatricians would be these behaviors that we focus on every year from cigarettes, to alcohol, to drug use. I think that's particularly important. I also think things that are not in the health section of this [report] are important. For example, reading to children: So, this is perhaps advice to [give] parents in understanding how the children are actually being cared for. I think that's important. I think the multiple sections of this report really have a great deal to offer. As someone said, I think it was you on the phone, there are a lot numbers here and I think they tell a story. We try not to put together the story explicitly, but I think there are many, many stories in this, with implications for children themselves, for parents, and for the pediatricians.
Mr. Splete: Thank you.
Moderator: To have your question answered immediately, please press "star one" now. Again, to ask a question, press "star one". Our next question comes from Cheryl Wetzstein with the Washington Times.
Wetzstein: Good morning. I'm looking at the smoking statistics and it seems like there is really nothing significant that's happened from year to year and I wondered, is there an expectation that by re-packaging the cigarettes with the graphics and all the messages on it, is there going to be—do you think—a correlation or a change in smoking behavior among young people after a campaign like that really rolls out and gets into the country?
Dr. Sondik: I think the people to ask...the person to ask on this is not me who is looking at the numbers. I think our colleagues here in the NIH and the CDC are really the people to talk to as well as the FDA. They put together this campaign really carefully, and I'm sure they have very specific expectations for the reaction by all the age groups.
Dr. Guttmacher: It's an interesting challenge, though I always think of at this time, there's a difference in the challenge between getting adults to quit smoking and having a fewer percentage smoking… compared with children. And the challenge is that adults hear these messages and they hear them for years and they understand them and they make choices. Children, on the other hand, it's a new—it's a completely new decade of children, if you will, every decade and that means that we really need to keep up the effort and tailor the effort to the current medias, to the current way that children look at the world. And I think that is really a tough challenge, and I think the lack of progress over the last several years reflects the difficulty in getting the message and then the behavior, getting it across to them.
Wetzstein: Excellent. Thank you very much.
Moderator: Once again, if you would like to ask a question, please press "star, one" now. There are no other questions at this time.
Mr. Bock: Hi. This is Bob Bock, the NICHD press officer. I would just like to add a little something to help the reporters that called in: This is background for their stories. We've spoken about the indicator on binge drinking in 12th graders: You may be interested to know that the National Institute of Alcohol Abuse and Alcoholism, one of our sister agencies here at the NIH, has information that may be useful to you. They have an underage drinking research initiative, and that can be accessed on their website, which is www.niaaa.nih.gov. Once again, www.niaaa.nih.gov. Thank you. Oh, also, another useful reference would be the website at the Federal Intragency Forum, which is http://www.childstats.gov. And, if there are no more questions, then I guess we will conclude our briefing...
Dr. Sondik: Bob… Uh… Sources that are used! And that list, I think, is really very, very valuable. It's hard to come by all of this information in one spot. And, I think the reporters might find it very useful.
Mr. Bock: If there are no more questions, we will conclude our briefing.
END OF AUDIO.