Child Health in America: Making a Difference through Advocacy

CHAPTER THREE: The Current Status of Child Health

51 The Current Status of Child Health When Lauren Elizabeth Matthews drew her first breath at 12:05 a.m. on January 1, 2000, she became a citizen of the wealthiest nation the world has ever known. She joined 71 million children and youth aged 0– 18, representing a quarter of the total U.S. population.1 By comparison, youth were more than 35 percent of the population in 1960 during the height of the baby boom.2 Lauren’s life expectancy is 80 years. Pete John San Nicholas, the first American boy born in the millennium, can expect to live 75 years. One hundred years ago, an infant girl could anticipate living only until age 48 and an infant boy until age 47.3 Changing Demographics Lauren and Pete have become part of a wonderfully diverse and culturally rich country. As they grow and go to elementary and middle school, the children in their classes will be drawn from all races and ethnicities. Nationally, 58 percent of their age-mates will be white, 20 percent Hispanic , 15 percent black, and 7 percent other ethnicities.4 As they make their way through school and on to college, they will have the chance to be friends and teammates with children who were born literally all over the world (figure 3.1).5 There is vast economic diversity as well. By contrast to the opportunity that racial and ethnic diversity affords, the huge income differentials among youth have created an ever-widening gap between those who have and those who do not have. Eighteen percent of the nation’s children live in poverty, and that poverty is distributed unequally.6 Thirtyfour percent of black children and 30 percent of Hispanic children come from families whose total income is below poverty (less than $19,307 for a family of four).7 In stark contrast, only 10 percent of white children are poor. At the other end of the income distribution, 29 percent of children live in families with incomes of more than $75,240 for a family of four, and 13 percent of young people enjoy very high annual incomes, of $112,860 or more for a family of four.8 Most American families reside in metropolitan areas: 30 percent in 3 52 Child Health in America central cities and 50 percent in suburbs,9 a profound change from 1900, when the majority of Americans lived in rural environments. In the first half of the twentieth century, families poured into the cities to search for employment; they made their homes in tightly knit, thickly settled neighborhoods. Since 1950 there has been a steady movement out of central cities, with a threefold decline in urban population density.10 At the turn of the millennium, there seems to be a subtler population shift in the making. The original move out of the cities was typified by the flight of white affluent families. The exodus from inner cities now includes families in general. Until a very short time ago, one could expect that poor children would be in inner-city and rural environments and wealthier children would live in suburban settings. In the early twenty- first century, many poor families with children are migrating into small towns and suburban areas.11 States such as Nevada, Arizona, Colorado, Florida, and Georgia are also experiencing a high influx of families.12 Nearly 70 percent of American children live with two parents who are not necessarily their biologic mother and father.13 Because of high rates of divorce,14 many children move between households, often spending time in reconstituted families, bunking with their new stepbrothers and stepsisters. Twenty-six percent of white children, 33 percent of Hispanic children, and 61 percent of black children live in single-parent homes, mostly with their mother.15 Children in single-parent Hispanic and black 10 9 8 7 6 5 4 3 2 1 Millions 12 Rate (per 1,000) 1990s 10 8 6 4 2 0 1980s 1970s 1960s 1950s Year Number 1940s 1930s 1920s 1910s 1900s Rate Figure 3.1. Trends in U.S. Immigration, 1900–1990s Source: U.S. Census Bureau. Statistical Abstract of the United States: The National Data Book (2000). households are nearly five times as likely to be poor as children in twoparent white families (figure 3.2). Two newly emerging phenomena are father-only households and grandparents raising their grandchildren...