Children's health improved in last decade

WASHINGTON, July 12 (UPI) -- Overall, the health of American children has improved over the past decade, the federal government announced in a new report released Friday, but children living below the poverty line still lag behind in many key areas.

Infant mortality has declined significantly in the United States over the last decade, more than 80 percent of parents rate the health of their children as good or excellent, and teen births dropped to a record low, according to the report prepared by 12 governmental agencies, including the National Institutes of Health in Bethesda, Md., and the Centers for Disease Control and Prevention in Atlanta.

"More things are improving than are going in the wrong direction," Duane Alexander, director of the National Institute of Child Health and Human Development, told United Press International. "Overall, for many of these indices, they are the best they've ever been," he added.

"The major trends of things improving for kids in the '90s is nothing new," said Bill O'Hare, national coordinator of Kids Count, part of the Annie E. Casey Foundation, a charity focused on helping disadvantaged children.

The booming economy during the late 1990s was responsible for many of the improvements in children's health, O'Hare told UPI, so the slumping economy now raises concern that some of the improvements may fade.

States are cutting their budgets, which also could affect children's health negatively, O'Hare said. "Some of the progress in the '90s was due to social programs ... and these may be in jeopardy as states try to cut state programs to balance their budgets."

One factor that may keep children's health from starting a downward spiral is "increased attention to children and family issues that didn't exist 10 years ago," he said. If the government and non-governmental sources continue that focus, it could curtail some of the impact of the faltering economy, he said.

Alexander noted the biggest impact from the economy would be if parents delayed seeking medical help for their kids or failed to get the recommended childhood vaccines. "That would certainly be a serious concern," he said. However, he noted, "We have a safety net." There is a federal program covering the cost of children's vaccines for parents who cannot afford them, and health insurance for children is available through state programs called Children's Health Insurance Programs or CHIP.

O'Hare said he feared CHIP may be something states decide to cut or reduce, or state governments may cut back on outreach programs intended to enroll kids in CHIP because they cannot afford to increase the rolls.

According to the report, infant mortality dropped from 9.2 deaths per 1,000 live births in 1990 to 7.0 deaths in 1999, the most recent year for which data are available. This is a 20 percent reduction that Alexander attributed primarily to reductions in deaths from respiratory distress syndrome and sudden infant death syndrome.

Deaths from each of these causes was reduced by more than half over the decade due to new treatments for respiratory distress syndrome and campaigns to promote putting babies to sleep on their backs, which reduces the chance of sudden infant death syndrome, Alexander said at a news briefing announcing the report.

There also were declines in mortality in children ranging in age from one year to 14 years, said Edward Sondik, director of the CDC's National Center for Health Statistics. Most deaths in this age group are due to vehicle crashes, and more than 45 percent of the children who died in such incidents were not restrained. Proper use of child safety seats and seatbelts could reduce the number and severity of injuries significantly, the report said.

Although infant mortality declined, Alexander said he still has concerns about the high prevalence of low birth weight in the United States. More than 7 percent of infants are underweight at birth, defined as being less than 5.5 pounds, and this puts them at a high risk of death and long-term disability, he said. One reason is the increase over the past several years in twin, triplet and higher-order multiple births, the report said.

"The other big concern is the health disparities that we see" between races and income levels, Alexander continued. The rate of mortality among African American infants is about 2.5 times greater than the rate among white babies. This rate also is higher among infants born in poverty, he said.

Although 82 percent of parents rated the health of their children as good or excellent in 2000, among families living below the poverty line, this figure drops to 70 percent, Sondik said.

There also are gaps for immunization. Approximately 76 percent of children had received the recommended vaccines for diphtheria, tetanus, pertussis, polio, measles and flu. Among children living in poverty, however, the level dropped to 71 percent.

Alexander noted the gaps between poverty children and more affluent kids "are in many instances narrowing but are certainly still present and need to be addressed."

One method to reduce the disparity between the poor and the rich is improved access to CHIP, O'Hare said. The states need more outreach programs and must make sure those programs are not cut. "That could help the poverty kids," he said.

Teen births also dropped to record low levels in 2000, Sondik said. "The percentage of teens having babies is at a record low and that portends a better future ... both for those teen mothers if they delay those pregnancies as well as their children," he said.

The rate for teen births was 27 per 1,000 girls between the ages of 15 years to 17 years -- which still amounted to more than 157,000 children born to teen moms during 2000.