Child Well-Being in the U.S.: Developing a Measurement Tool for Understanding and Tracking Progress”

American society and investments in both the public and private sectors show a concern for young children and their well-being, a concern that has resulted in some very hopeful advances. In health, infant death rates have been declining steadily, smoking during pregnancy is increasingly rare, and vaccination rates have been rising. In terms of education, there has been a significant increase in both preschool and kindergarten rates, from nearly half of children in a full-day kindergarten in 1995 to xx.x percent in 2008.   In addition to these important signs of progress, there have been a number of innovative local programs, such as the Olds Nurse Partnership, the Abecedarian Project and others, that are internationally studied and replicated as “best practices” to set children on a trajectory of success.
Yet, recent international comparisons show us that our honest efforts to support every child to live to their full potential are not achieving impressive results for all children. According to the OECD’s 2009 publication Doing Better for Children, the U.S.:
  • While U.S. average family income for children under 18 is six times higher than the average for the 30 OECD countries, child poverty rates are among the highest, with more than one in five children living in a poor household.
  • U.S. incidence of low birth weight children is among the highest of OECD countries; at 8.1 percent, the rate is nearly double that of Iceland, Finland, Sweden, and South Korea.
  • The U.S. ranks #29 out of 30 OECD countries on teen births. Only Mexico has a higher rate.
  • The average educational achievement of 15 year-olds compares poorly to other OECD countries on PISA, the international standardized exam (7th worst) and the U.S. has larger gaps between good and poor school performers than all but five other OECD countries.
These facts are evidence of massive underperformance in child well-being as compared with other nations, virtually all of which have lower per capita incomes. While the rate of poverty among the elderly today in the U.S. (ck year) is about 10 percent, and among adults 18-64 is 12 percent, poverty for children under 18 is 19 percent, and the highest rates of poverty are observed in families with children under the age of three— where more than one in five (22 percent) live in households below the federal poverty rate. (see Table x) Looking at change over time, while there has been some improvement in child poverty rates over the last decade, we find ourselves in the same place today as we were in 1998, with 19 percent of children under 18 living in families at or below the federal poverty rate (ck). There was progress in the early part of the 21st Century, with a decrease in the child poverty rate to 16 percent in both 2000 and 2001, but it began to increase steadily after 2001 to its present level today.  Our best efforts have done little to change the fundamental trajectory.
Table x: The Highest Rates of Poverty are Among Children Under 3
AGE GROUP                                                % IN POVERTY
Under 3                                                                       22%
Under 18                                                                     19%
Adults 18-64                                                               12%
Elderly  65+                                                                 10%
Source: Natl Center for Children in Poverty using official federal poverty guildlines of the U.S. Dept of Health and Human Services.
The analysis that follows looks closely at the challenges of measuring child well-being in an affluent-country context. It assesses existing aggregate measures of child well-being to see if they are adequate for understanding and tracking progress and enabling comparisons between important population groups, such as by sub-national geographies or by racial and ethnic background.   It explores whether the American Human Development Index is a suitable proxy for child well-being in the U.S. and after concluding that this Index suffers from some critical weaknesses for this purpose, proposes a framework for an index of child well-being and the indicators on which it could be based. This index would focus on children under the age of five and offer the possibility of disaggregation to the level of the states and by racial and ethnic background.

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