Yearly report shows the adolescent birth rate falling to an all-time low, highlights other noteworthy findings

A decline in the adolescent birth rate in 2004 to its lowest recorded level is one among many findings in the federal government's annual monitoring report on the well-being of the nation's children and youth. The report covers the most recent years for which data are available and, in the case of adolescent births, reveals a prevalence of: 22.1 births for every 1,000 females between the ages of 15 and 17 years in 2004, down from 22.4 for every 1,000 in 2003. Other noteworthy findings from "America's Children in Brief: Key National Indicators of Well-Being, 2006," reflect changes in the infant mortality rate, prevalence of overweight, and rising math and reading scores among elementary school students.

The new report highlights other national trends in children's health, well-being, and development:

• The infant mortality rate was at its lowest level in 2003 after having risen the previous year

• The percentage of children exposed to secondhand smoke declined in 2005, as did the percentage of high school seniors who reported smoking cigarettes daily in the last 30 days

• Compared to the previous year's statistics, the average score on standardized mathematics tests increased in 2003 for fourth and eighth graders; the average reading score for fourth graders also increased

• The birth rate for unmarried women and the percentage of infants with low birth weight increased in 2004 from the previous year.

"This year's 'America's Children' report includes a number of favorable developments," said Duane Alexander, MD, director of the National Institute of Child Health and Human Development of the National Institutes of Health. "A decline in the adolescent birth rate, and drops in exposure to secondhand smoke and smoking among high school seniors are encouraging news."

Dr. Duane noted that the infant mortality rate declined in 2003 to its previous level after an increase the year before, despite an increase in the rate of low birth weight—a major risk factor for infant death.

The report was compiled by the Federal Interagency Forum on Child and Family Statistics and presents a comprehensive look at critical areas of child well-being, including population and family characteristics, health, behavior and social environment, education, and economic security.

The birth rate for unmarried women between 15 and 44 years old rose—from 45 for every 1,000 unmarried women in 2003 to 46 for every 1,000 in 2004. And the 2003 birth rate for unmarried women was also an increase—from 44 for every 1,000 in 2002. These increases come on the heels of a trend of modest declines between 1994 and 2002.

"The 2004 rate of 46 births per 1,000 unmarried women ages 15 to 44 matches the historic high reported a decade earlier, in 1994," the report stated. "Birth rates for unmarried teenagers have declined steadily since 1994, while rates for unmarried women age 20 and older were higher in 2003 than in 1994."

In 2004, 46% of children between birth and 17 years of age were living in counties in which levels of one or more air pollutants rose above allowable levels—a decline from 65% in 1999.

Fewer children between 4 and 11 years were exposed to secondhand smoke in 2004, compared to the previous time frame for which statistics are available. Cotinine (measured in blood), a breakdown product of nicotine that signals recent exposure to cigarette smoke, was detected in the blood of 88% of children between 1988 and 1994; this percentage declined to 59% in 2001 through 2004.

Although the overall percentage of children with a detectable level of cotinine in blood has declined since 1988, the report notes that levels differ among groups: 61% of white, non-Hispanic children had cotinine in their blood, compared with 81% of black, non-Hispanic children and 41% of Mexican-American children.

The 2003 infant mortality rate returned to the 2001 rate of 6.8 deaths for every 1,000 live births, after increasing to 7.0 in 2002. (That rate represents infant deaths before the first birthday.)

Among infants, the rate of low birth weight (i.e., less than 5 pounds, 8 ounces at birth) increased. In 2004, the rate of low birth weight rose to 8.1 percent, up from 7.9 percent in 2003.

"Recent increases in multiple births, the result of increases in fertility therapy use and older age of childbearing, place infants at high risk for being born too small," the report stated. "These increases have strongly influenced recent upswings in low birth weight and very low birth weight rates; however, low birth weight rates have also been on the rise among infants in singleton deliveries."

The percentage of children between 6 and 17 years who are overweight did not change significantly—from 17% in 2001-2002 to 18% in 2003-2004. The percentage of overweight children has been on an upward trend: In 1976-1980, only 6% of children between 6 and 17 years were overweight; by 1988-1994, 11% were overweight and by 1999-2000, 15% were overweight.

In 2003-2004, 25% of black, non-Hispanic girls were overweight, compared with 16% of white, non-Hispanic girls and 17% of Mexican-American girls.