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Social and Economic Factors

Community and Family Safety

Child Victimization*
Number of children who were victims of maltreatment that was either substantiated or indicated per 1,000 children
HHS, Children’s Bureau, Child Maltreatment report, 2019

Economic Resources

Children in Poverty
Percentage of children younger than 18 years who live in households below the poverty threshold
U.S. Census Bureau, American Community Survey, 2019
Children in Poverty Racial Disparity
Ratio of the racial/ethnic group with the highest childhood poverty rate (varies by state) to the non-Hispanic white rate
U.S. Census Bureau, American Community Survey, 2015-2019
High-speed Internet
Percentage of households with children under age 18 that have a broadband internet subscription and a computer, smartphone or tablet
U.S. Census Bureau, American Community Survey, 2019
Students Experiencing Homelessness
Percentage of public school students who lack a fixed, regular and adequate nighttime residence
U.S. Department of Education, National Center for Homeless Education, Federal Data Summary, 2019
WIC Coverage
Percentage of children ages 1-4 eligible for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) who received WIC benefits in an average month
USDA, WIC Eligibility and Coverage Rates, 2018

Education

Early Childhood Education
Percentage of children ages 3-4 who are enrolled in nursery school, preschool or kindergarten
U.S. Census Bureau, American Community Survey, 2019
Fourth Grade Reading Proficiency
Percentage of fourth grade public school students who scored proficient or above on the reading assessment
U.S. Department of Education, National Center for Education Statistics, National Assessment of Educational Progress, 2019
High School Graduation
Percentage of high school students who graduated with a regular high school diploma within four years of starting ninth grade
U.S. Department of Education, National Center for Education Statistics, Common Core of Data, 2019
High School Graduation Racial Disparity
Difference in the high school graduation rate between white students and the racial/ethnic group with the lowest rate (varies by state)
U.S. Department of Education, National Center for Education Statistics, Common Core of Data, 2019

Social Support and Engagement

Adverse Childhood Experiences
Percentage of children ages 0-17 who experienced two or more of the following: parental divorce or separation; living with someone who had an alcohol or drug problem; neighborhood violence victim or witness; living with someone who was mentally ill, suicidal or severely depressed; domestic violence witness; parent served jail time; being treated or judged unfairly due to race/ethnicity; or death of parent
HHS, HRSA, MCHB, National Survey of Children's Health, 2019-2020
Foster Care Instability
Percentage of children in foster care with three or more placements within 12 months
HHS, Children's Bureau, Child Welfare Outcomes report, 2019
Neighborhood Amenities
Percentage of children ages 0-17 with access to a park or playground; recreation center, community center or boys' and girls' club; library or bookmobile; and sidewalks or walking paths
HHS, HRSA, MCHB, National Survey of Children's Health, 2019-2020
Reading, Singing or Storytelling
Percentage of children ages 0-5 whose family members read, sang or told stories to them every day during the past week
HHS, HRSA, MCHB, National Survey of Children's Health, 2019-2020

Physical Environment

See list of measures here.

Clinical Care

Access to Care

ADD/ADHD Treatment
Percentage of children ages 3-17 who currently have ADD or ADHD and are taking medication and received behavioral treatment
HHS, HRSA, MCHB, National Survey of Children's Health, 2019-2020
Pediatricians
Number of pediatricians per 100,000 children ages 0-21
HHS, CMS, National Plan and Provider Enumeration System, September 2020
Uninsured Children
Percentage of children younger than 19 years not covered by private or public health insurance
U.S. Census Bureau, American Community Survey, 2019

Preventive Clinical Care

Childhood Immunizations
Percentage of children who received by age 35 months all recommended doses of the combined seven-vaccine series: diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine; measles, mumps and rubella (MMR) vaccine; poliovirus vaccine; Haemophilus influenzae type b (Hib) vaccine; hepatitis B (HepB) vaccine; varicella vaccine; and pneumococcal conjugate vaccine (PCV)
CDC, National Immunization Survey-Child (Birth Cohort), 2016-2017
HPV Vaccination
Percentage of adolescents ages 13-17 who have received all recommended doses of the human papillomavirus (HPV) vaccine
CDC, National Immunization Survey-Teen, 2019
Preventive Dental Care
Percentage of children ages 1-17 who had one or more preventive dental care visits during the past 12 months
HHS, HRSA, MCHB, National Survey of Children's Health, 2019-2020
Well-child Visit
Percentage of children ages 0-17 who received one or more preventive visits in the past 12 months
HHS, HRSA, MCHB, National Survey of Children's Health, 2019-2020

Quality of Care

Adequate Insurance
Percentage of children ages 0-17 who were continuously insured in the past year with adequate coverage based on the following criteria: the benefits meet the child’s needs, the insurance allows the child to see needed providers and the insurance either has no or reasonable out-of-pocket expenses
HHS, HRSA, MCHB, National Survey of Children's Health, 2019-2020
Developmental Screening
Percentage of children ages 9-35 months whose parent completed a standardized developmental screening tool in the past 12 months
HHS, HRSA, MCHB, National Survey of Children's Health, 2019-2020
Medical Home
Percentage of children ages 0-17 who received coordinated, ongoing and comprehensive care within a medical home, including having: a personal doctor or nurse, a dedicated source for sick care, family-centered care as well as referrals and effective care coordination when needed
HHS, HRSA, MCHB, National Survey of Children's Health, 2019-2020

Behaviors

Nutrition and Physical Activity

Breastfed
Percentage of infants exclusively breastfed for six months
CDC, National Immunization Survey-Child (Birth Cohort), 2017
Food Sufficiency
Percentage of children ages 0-17 whose household could always afford to eat good nutritious meals in the past 12 months
HHS, HRSA, MCHB, National Survey of Children's Health, 2019-2020
Physical Activity
Percentage of children ages 6-17 who were physically active at least 60 minutes every day in the past week
HHS, HRSA, MCHB, National Survey of Children's Health, 2019-2020
Soda Consumption*
Percentage of high school students who reported drinking a can, bottle or glass of soda or pop two or more times per day in the past week
CDC, Youth Risk Behavior Surveillance System, 2019

Sexual Health

Dual Contraceptive Nonuse*
Percentage of sexually active high school students who reported not using both a condom during last sexual intercourse and birth control pills; an intrauterine device or implant; or a shot, patch or birth control ring before last sexual intercourse
CDC, Youth Risk Behavior Surveillance System, 2019
Teen Births
Number of births per 1,000 females ages 15-19
CDC WONDER, Natality Public Use Files, 2019

Sleep Health

Adequate Sleep
Percentage of children age 6-17 who sleep recommended age-appropriate hours on most weeknights
HHS, HRSA, MCHB, National Survey of Children's Health, 2019-2020
Sleep Position
Percentage of women with a recent live birth who reported their infants are usually placed on their backs to sleep
CDC, Pregnancy Risk Assessment Monitoring System, 2019

Tobacco Use - Youth

Electronic Vapor Product Use*
Percentage of high school students who reported using an electronic vapor product in the past 30 days
CDC, Youth Risk Behavior Surveillance System, 2019
Tobacco Use
Percentage of children ages 12-17 who used a tobacco product in the past month
SAMHSA, National Survey on Drug Use and Health, 2018-2019

Health Outcomes

Behavioral Health

Alcohol Use
Percentage of children ages 12-17 who reported drinking alcohol in the past month
SAMHSA, National Survey on Drug Use and Health, 2018-2019
Anxiety
Percentage of children ages 3-17 who currently have anxiety problems
HHS, HRSA, MCHB, National Survey of Children's Health, 2019-2020
Depression
Percentage of children ages 3-17 who currently have depression
HHS, HRSA, MCHB, National Survey of Children's Health, 2019-2020
Flourishing
Percentage of children ages 6 months-5 years who show affection, resilience, interest and curiosity in learning, and smile and laugh a lot; and children ages 6-17 who show self-regulation, interest and curiosity in learning, and work to finish tasks
HHS, HRSA, MCHB, National Survey of Children's Health, 2019-2020
Illicit Drug Use
Percentage of children ages 12-17 who reported using illicit drugs, including marijuana, in the past month
SAMHSA, National Survey on Drug Use and Health, 2018-2019
Teen Suicide*
Number of deaths by suicide per 100,000 adolescents ages 15-19
CDC WONDER, Multiple Cause of Death Files, 2017-2019

Mortality

Child Mortality
Number of deaths per 100,000 children ages 1-19
CDC WONDER, Multiple Cause of Death Files, 2017-2019
Infant Mortality
Number of infant deaths (before age 1) per 1,000 live births
CDC WONDER, Linked Birth/Infant Death Files, 2017-2018
Neonatal Mortality*
Number of deaths during first 28 days of life (0-27 days) per 1,000 live births
CDC WONDER, Linked Birth/Infant Death Files, 2017-2018

Physical Health

Asthma
Percentage of children ages 0-17 who currently have asthma
HHS, HRSA, MCHB, National Survey of Children's Health, 2019-2020
High Health Status*
Percentage of children ages 0-17 whose health is very good or excellent
HHS, HRSA, MCHB, National Survey of Children's Health, 2019-2020
Low Birthweight
Percentage of infants weighing less than 2,500 grams (5 pounds, 8 ounces) at birth
CDC WONDER, Natality Public Use Files, 2019
Low Birthweight Racial Disparity
Ratio between low birthweight rates among births to mothers in the racial/ethnic group with the highest rate (varies by state) and births to non-Hispanic white mothers
CDC WONDER, Natality Public Use Files, 2019
Overweight or Obesity
Percentage of children ages 10-17 who are overweight or obese for their age based upon reported height and weight
HHS, HRSA, MCHB, National Survey of Children's Health, 2019-2020

* Not included in composite measures.
‡ Data appearing in this edition are the same that appeared in the last edition.

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