The Kids Are All Right

By Jeffrey Kluger

Parents have never lacked for reasons to lie awake at night. They worry endlessly about keeping their kids healthy and safe and fret about such persistent problems as teen drug use, dropout rates, pregnancy and crime. How, they wonder, will their under-18s ever become tomorrow's thirtysomethings?

Perhaps they ought to start sleeping better. According to a sweeping U.S. government study conducted by 20 federal departments and agencies and released last week, the kids are actually doing just fine. By almost any important measure, the report was bursting with good news: teen birthrates are at record lows; teen crime rates are plummeting; kids are swearing off cigarettes (the smoking rate for high school seniors is the lowest it has been in 29 years), staying in school (87% of young Americans now earn high school diplomas) and getting much of the basic health care they need (immunization rates are high, for example, with 90% of kids getting vaccinated against hepatitis B and a record 81% against chicken pox).

"There are a lot of favorable developments," says Duane Alexander, director of the National Institute of Child Health and Human Development, which contributed to the report. The survey used 25 health and social indicators to evaluate the approximately 73 million under-18 Americans, and on the whole, the investigators declared themselves exceedingly pleased. For all the heat generated by the number of Americans without health insurance, fully 88% of kids do have coverage. What's more, 83% of children are considered in good or excellent health, and 81% of kids under 7 live in homes in which no one regularly smokes anymore.

Domestic life is becoming more stable too. Currently, 68% of children live with two married parents. While that's down from 77% a generation ago, it's a figure that has at least stayed steady for nearly a decade, suggesting that the long demographic decline of the two-parent household may have been arrested. And even in an economy that has been shedding jobs faster than it has been replacing them, in 89% of those two-parent households at least one parent is working full time. In addition, kids have been doing a better job of staying out of trouble. The number of violent crimes committed by teenagers plummeted 78% from 1993 to 2002--and the number of teen victims fell commensurately.

"Over the last decade, 4.2 million serious crimes against youth did not occur that would have [otherwise] occurred," says Lawrence Greenfeld of the U.S. Department of Justice.

But not all the news is good. The rates of infant mortality and low-birthweight babies both ticked up, a bad-health bellwether that always catches the eye of epidemiologists. "As a pediatrician, I can tell you that this is a major cause of concern," says Alexander. It's possible that the reason is merely better prenatal care that's enabling more sickly babies to survive through birth but not a great deal longer.

The researchers were worried too about the exploding rate of childhood obesity; 16% of kids are now considered overweight, nearly three times the percentage in 1980. "This predisposes children to a lot of health problems when they become adults," says Edward Sondik, director of the National Center for Health Statistics.

Even the good numbers tell only part of the story. If 88% of kids have adequate health insurance, that means 12%--or a whopping 8.8 million--don't. "There's really no reason for kids not to be covered," says Emil Parker, director of the health division of the nonprofit Children's Defense Fund. "Kids are the least expensive group to cover because they're generally healthy."

Children are slipping through other cracks in the government's optimistic report. The infant-mortality rate, for example, is twice as high among blacks as among whites. Children living in poverty are at greater risk for violent crime. And while the U.S. may boast of soaring high-school-graduation rates, children in poor families are still six times as likely as those in wealthier families to drop out. "So much of this is driven by child poverty," says Parker. "In 2002, more than 12 million children were poor, and those figures were up from both 2000 and 2001."

To be sure, nobody, including the Children's Defense Fund, denies that the thrust of the survey is welcome news. It's far too early to say that no child is being left behind, but it seems that more and more are being brought along.