Transcript for the Interview with Duane Alexander on the Report on America's Children, 2006

July 14, 2006

Moderator: Each year since 1977 the Federal Interagency Forum on Child and Family Statistics has published a report called "America's Children, Key National Indicators of Well-being". The report highlights critical areas of child well-being. Dr. Duane Alexander, Director of the NICHD, spoke to us about the report's findings. Dr. Alexander, thank you for being with us today.

Dr. Duane Alexander: My pleasure.

Moderator: So how are America's children doing?

Dr. Alexander: Well, this report contains a number of positive developments. One of the most important is that children are exposed to less tobacco smoke than they were a decade ago. Ten years ago 88% of children had a marker in their blood called cotinine that indicates exposure to secondhand tobacco smoke. That's gone in 10 years down from 88% to 59%. Still too high but major improvement. And this reflects their exposure to secondhand smoke as well as smoke themselves.

It's a consequence of several things. Their parents are less likely to smoke in the home, the kids are less likely to smoke themselves, and public laws have outlawed smoking in public places. So all this is combined to reduce the exposure of kids to smoke. This is in combination with the high school seniors being less likely to smoke themselves down from 14% to 12%. This is a significant improvement and continues a long-term trend. This is extremely important from a public health standpoint because avoiding cigarette smoking is one of the best things that people can do to protect their health.

Another positive development recorded in this report is the continued decline of births to teenagers, now at the lowest level ever recorded in the United States. This has been particularly marked in the African American population that had a very high rate to start with. This is an extremely important development from a public health standpoint because teens who give birth to infants and the infants themselves are both at high risk for adverse consequences in terms of poverty, adverse health problems, and other disabilities throughout their lifetime.

Moderator: So I believe the report showed a decline in infant mortality. However, more babies are being born with low birth weights.

Dr. Alexander: These are opposite trends. Lower infant mortality is good. Higher low birth weight rate is not good. What is particularly striking is that we have achieved a lower infant mortality rate in spite of the fact that a cause of infant mortality (low birth weight) is increasing. And it's because of our research and our application of research in improving the survival of the low birth weight and very low birth weight infants that we're able to improve infant mortality at the same time that the low birth rate has gone up.

We really need to focus, though, on the problem of low birth weight. It's gone from 7.9 to 8.1% and that's much too high. Women need to seek care from a healthcare provider as soon as they discover they're pregnant, keep a regular schedule of prenatal visits, and allow us to detect any problems that are occurring with the pregnancy as soon as possible so that we can intervene and try to prevent low birth weight. In addition to the prenatal medical care that they receive, they can also do other things to lower their risk of low birth rate.

Avoiding alcohol, avoiding smoking themselves or secondhand tobacco smoke, all these will reduce their risk of having a low birth weight baby.

Moderator: The report also included some education indicators. What's going on there?

Dr. Alexander: The report's education indicators are mostly positive. Not big changes but slight ones in the right direction. Fourth graders particularly are improving in their reading scores and in their math scores. In fact, the math scores are the highest that we've ever noted in this country. So that's good news. The not so good news is that they're still not as high as they ought to be. So we have a way to go. The changes are occurring, they're in the right direction, but they're slow and we hope that we're gonna continue to see improvement.

Moderator: So why is the America's Children Report so important?

Dr. Alexander: The America's Children Report gives the American people an annual report card on how the country's children are doing. It measures their progress or lack thereof in a wide variety of measures - in education, in health and their general well-being. By doing so each year, it allows us to track progress over time, things that are going well, things that are not going so well. And for those not going so well, what we need to focus on changing so that we improve that status.

Just like the nation's economic indicators which are issued each month provides us a measure of our economic status, the America's Children Report gives us an annual report on how our children are doing and they, after all, are our most valuable asset.

Moderator: Thank you for speaking with us today.

Dr. Alexander: My pleasure. Thank you.

Moderator: And that was Dr. Duane Alexander, Director of the National Institute of Child Health and Human Development, speaking with us today about the new America's Children Report available on line at



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