ps 024 818 title child health usa '95. institution · it is likely that, above and beyond...
TRANSCRIPT
ED 402 048
TITLEINSTITUTION
REPORT NOPUB DATENOTEAVAILABLE FROM
PUB TYPE
EDRS PRICEDESCRIPTORS
DOCUMENT RESUME
PS 024 818
Child Health USA '95.Health Resources and Services Administration(DHHS/PHS), Washington, DC. Maternal and Child HealthBureau.DHHS-HRSA-M-DSEA-96-5; ISBN-0-16-048829-XSep 9679p.; For 1994 edition, see ED 376 387.U.S. Government Printing Office, Superintendent ofDocuments, Mail Stop: SSOP, Washington, DC20402-9328.Statistical Data (110)
MF01/PC04 Plus Postage.Adolescents; Birth Rate; Birth Weight; Child Abuse;*Child Health; Child Neglect; Demography; *HealthConditions; Health Programs; Health Services; InfantMortality; Infants; Mortality Rate; One ParentFamily; Pregnancy; Premature Infants; Public Health;Statistics; Young Children
IDENTIFIERS Death Records; Health Information; Health Policy;*Health Status
ABSTRACTPublished to provide reliable and current data for
public health professionals and other individuals in the public andprivate sector to inform policymaking, this book compiles secondarydata for 50 health status indicators and service needs of America'schildren. The book provides both a graphic and textual summary of thedata and addresses long-term trends where applicable. Some statisticsreveal the extent of progress toward "Healthy People 2000" goals or areduction in the prevalence of unhealthful behaviors, while othersreveal burgeoning or escalating health problems of women, children,and youth. Following an introduction that discusses trends and issuesin children's health, the book has six sections : (1) "AnniversarySection," which summarizes data over the last 60 years; (2)
"Population Characteristics," including children in poverty, workingmothers, child care, school dropouts, and family composition; (3)
"Health Status," discussing the health issue of infants, children,and adolescents; (4) "Health Services and Utilization," includingimmunizations, health care financing, physician and hospital careissues; (5) "State-Specific Data," including mortality, birthweight,perinatal and prenatal care, and children per pediatrician; and (6)"City Data," including infant mortality, birthweight, and prenatalcare. Contains 50 references. (AMC)
***********************************************************************
Reproductions supplied by EDRS are the best that can be madefrom the original document.
***********************************************************************
U.S
. DE
PA
RT
ME
NT
OF
ED
UC
AT
ION
Offi
ce o
f Edu
catio
nal R
esea
rch
and
Impr
ovem
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ED
UC
AT
ION
AL
RE
SO
UR
CE
S IN
FO
RM
AT
ION
CE
NT
ER
(E
RIC
)7(
s,T
his
docu
men
t has
bee
n re
prod
uced
as
ecei
ved
from
the
pers
on o
r or
gani
zatio
nor
igin
atin
g it.
Min
or c
hang
es h
ave
been
mad
e to
impr
ove
repr
oduc
tion
qual
ity.
Poi
nts
of v
iew
or
opin
ions
sta
ted
in th
isdo
cum
ent d
o no
t nec
essa
rily
repr
esen
tof
ficia
l OE
RI p
ositi
on o
r po
licy.
A
CO
*
U.S
. Dep
artm
ent o
f Hea
lth &
Hum
an S
ervi
ces
Pub
lic H
ealth
Ser
vice
Hea
lth R
esou
rces
& S
ervi
ces
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inis
trat
ion
Mat
erna
l & C
hild
Hea
lth B
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uB
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lth U
SA
'95 j
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U.S
. Dep
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lth &
Hum
an S
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ces
Pub
lic H
ealth
Ser
vice
Hea
lth R
esou
rces
& S
ervi
ces
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ion
Mat
erna
l & C
hild
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lth B
urea
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:"::*
::::..
....
Mat
erna
l and
Chi
ld H
ealth
Bur
eau
U.S
. Dep
artm
ent o
f H
ealth
and
Hum
an S
ervi
ces
Publ
ic H
ealth
Ser
vice
Hea
lth R
esou
rces
and
Ser
vice
s A
dmin
istr
atio
n
For
sale
by
the
U.S
. Gov
ernm
ent P
rint
ing
Off
ice
Supe
rint
ende
nt o
f D
ocum
ents
, Mai
l Sto
p: S
SOP,
Was
hing
ton,
DC
204
02-9
328
ISB
N 0
-16-
0488
29-X
4
3
CO
NT
EN
TS
PR
EF
AC
E5
HE
ALT
H S
TA
TU
S22
HE
ALT
H S
ER
VIC
ES
AN
D U
TIL
IZA
TIO
N50
Infa
ntH
ealth
Car
e F
inan
cing
51
INT
RO
DU
CT
ION
6C
ompa
rison
of N
atio
nal
Vac
cina
tion
Cov
erag
e Le
vels
52In
fant
Mor
talit
y R
ates
23Im
mun
izat
ion
Sch
edul
e53
AN
NIV
ER
SA
RY
SE
CT
ION
10In
fant
Mor
talit
y24
Phy
sici
an V
isits
54M
ater
nal M
orta
lity
11N
eona
tal a
nd P
ostn
eona
tal M
orta
lity
25P
lace
of P
hysi
cian
Con
tact
55La
te F
etal
Dea
ths
12M
ater
nal M
orta
lity
26H
ospi
tal U
tiliz
atio
n56
Low
Birt
h W
eigh
t13
Low
Birt
h W
eigh
t27
Ser
vice
Util
izat
ion
by C
hild
ren
With
Infa
nt M
orta
lity
14In
fant
Fee
ding
29C
hron
ic C
ondi
tions
57C
hild
Acc
ess
and
Util
izat
ion
of P
reve
ntiv
eP
OP
ULA
TIO
N C
HA
RA
CT
ER
IST
ICS
... 1
6C
hild
Mor
talit
y30
Den
tal S
ervi
ces
58P
opul
atio
n of
Chi
ldre
n17
Chi
ldho
od D
eath
s D
ue to
Inju
ry31
Pre
nata
l Car
e60
Chi
ldre
n in
Pov
erty
18H
ospi
taliz
atio
n32
Fam
ily C
ompo
sitio
n19
Hos
pita
l Dis
char
ge T
rend
s33
ST
AT
E-S
PE
CIF
IC D
AT
A62
Wor
king
Mot
hers
20Le
ad E
xpos
ure
35In
fant
, Per
inat
al, a
ndC
hild
Car
e20
Ped
iatr
ic A
IDS
36N
eona
tal M
orta
lity
62S
choo
l Dro
pout
s21
Chi
ld A
buse
and
Neg
lect
37P
rena
tal C
are,
Low
Birt
h W
eigh
t and
Den
tal C
arie
s38
Birt
hs to
Wom
en U
nder
18
63A
dole
scen
tC
hild
ren
per
Ped
iatr
icia
n an
dA
dole
scen
t Mor
talit
y40
per
Chi
ld H
ealth
Phy
sici
an64
Ado
lesc
ent D
eath
s D
ue to
Inju
ry41
Med
icai
d R
ecip
ient
s U
nder
21
and
Tee
nage
Pre
gnan
cy a
nd A
bort
ion
Rat
es42
Ped
iatr
icia
ns in
Med
icai
d an
d E
PS
DT
65T
eena
ge S
exua
l Act
ivity
43C
hild
bear
ing
44C
ITY
DA
TA
66A
dole
scen
t AID
S45
Infa
nt M
orta
lity
67A
dole
scen
t AID
S46
Low
and
Ver
y Lo
w B
irth
Wei
ght
68Y
oung
Adu
lt A
IDS
, by
Rac
e/E
thni
city
47P
rena
tal C
are
69S
ubst
ance
Abu
se48
Cig
aret
te S
mok
ing
49R
EF
ER
EN
CE
S70
AC
KN
OW
LED
GM
EN
TS
75
5
k
1
5
PR
EF
AC
E
Chi
ld H
ealth
USA
'95
is th
e se
vent
h an
nual
repo
rt o
n th
e he
alth
sta
tus
and
serv
ice
need
sof
Am
eric
a's
child
ren.
Thi
s bo
ok is
aco
mpi
latio
n of
sec
onda
ry d
ata
for
50 h
ealth
stat
us in
dica
tors
. It p
rovi
des
both
agr
aphi
cal a
nd te
xtua
l sum
mar
y of
the
data
and
addr
esse
s lo
ng-t
erm
tren
ds w
here
appl
icab
le.
Chi
ld H
ealth
USA
is p
ublis
hed
to p
rovi
dere
liabl
e an
d cu
rren
t dat
a fo
r pu
blic
hea
lthpr
ofes
sion
als
and
othe
r in
divi
dual
s in
the
priv
ate
and
publ
ic s
ecto
rs. T
he s
ucci
nct
form
at o
f th
e bo
ok is
inte
nded
to f
acili
tate
the
use
of th
e in
form
atio
n as
a s
naps
hot o
fm
easu
res
of th
e he
alth
of
child
ren
in th
eU
nite
d St
ates
.
Dat
a ar
e pr
esen
ted
for
infa
nts,
chi
ldre
n,ad
oles
cent
s, a
nd w
omen
of
child
bear
ing
age.
In
addi
tion
to h
ealth
sta
tus,
hea
lthse
rvic
es u
tiliz
atio
n an
d po
pula
tion
char
acte
rist
ics
are
addr
esse
d. T
his
info
rmat
ion
prov
ides
the
read
er w
ith a
mul
ti-di
men
sion
al p
ersp
ectiv
e of
the
heal
thof
chi
ldre
n in
the
Uni
ted
Stat
es, i
nac
cord
ance
with
the
Wor
ld H
ealth
Org
aniz
atio
n's
defi
nitio
n of
hea
lth: "
A s
tate
of c
ompl
ete
phys
ical
, men
tal,
and
soci
alw
ell-
bein
g, a
nd n
ot m
erel
y th
e ab
senc
e of
dise
ase
or in
firm
ity."
Bec
ause
199
5 m
arke
d th
e 60
th a
nniv
ersa
ryof
Titl
e V
, the
fir
st s
ectio
n of
Chi
ld H
ealth
USA
'95
is d
evot
ed to
his
tori
cal d
ata
onm
ater
nal m
orta
lity,
late
fet
al d
eath
s, lo
wbi
rth
wei
ght,
and
infa
nt m
orta
lity.
The
seco
nd s
ectio
n pr
esen
ts s
tatis
tics
onpo
pula
tion
char
acte
rist
ics
that
infl
uenc
e th
ew
ell-
bein
g of
chi
ldre
n. T
he th
ird
sect
ion,
entit
led
heal
th s
tatu
s, c
onta
ins
vita
l sta
tistic
san
d he
alth
beh
avio
r in
form
atio
n fo
r in
fant
s,ch
ildre
n, a
nd a
dole
scen
ts. T
he f
ourt
hse
ctio
n co
ntai
ns d
ata
rega
rdin
g he
alth
serv
ices
util
izat
ion.
The
fif
th a
nd s
ixth
sect
ions
con
tain
info
rmat
ion
on s
elec
ted
indi
cato
rs a
t the
sta
te a
nd c
ity le
vels
.T
he B
urea
u is
inde
bted
to th
e N
atio
nal
Cen
ter
for
Hea
lth S
tatis
tics
for
its c
ontin
ued
colla
bora
tion
in p
rodu
cing
this
boo
k. T
hem
any
sour
ces
who
als
o as
sist
ed in
the
colle
ctio
n of
dat
a ar
e lis
ted
in th
e re
fere
nce
sect
ion
begi
nnin
g on
pag
e 70
.
Som
e st
atis
tics
in C
hild
Hea
lth U
SA r
evea
lth
e ex
tent
of
prog
ress
tow
ard
Hea
lthy
Peop
le 2
000
goal
s or
a r
educ
tion
in th
epr
eval
ence
of
unhe
alth
ful b
ehav
iors
, whi
leot
hers
rev
eal b
urge
onin
g or
esc
alat
ing
heal
th p
robl
ems
of w
omen
, chi
ldre
n, a
ndyo
uth.
We
hope
the
info
rmat
ion.
prov
ided
inth
is b
ook
will
be
help
ful t
o po
licy
and
deci
sion
-mak
ers
resp
onsi
ble
for
impl
e-m
entin
g or
exp
andi
ng p
rogr
ams
that
aff
ect
the
heal
th o
f ch
ildre
n in
the
Uni
ted
Stat
es.
Mat
erna
l and
Chi
ld H
ealth
Bur
eau
Hea
lth R
esou
rces
and
Ser
vice
sA
dmin
istr
atio
n
6
INT
RO
DU
CT
ION
The
yea
r 19
95 m
arke
d th
e 60
th a
nniv
ersa
ryof
the
Nat
ion'
s m
ater
nal a
nd c
hild
hea
lthle
gisl
atio
n, T
itle
V o
f th
e So
cial
Sec
urity
Act
. Sig
ned
into
law
in 1
935
by P
resi
dent
Fran
klin
Del
ano
Roo
seve
lt, T
itle
V r
emai
nsth
e lo
nges
t las
ting
publ
ic h
ealth
legi
slat
ion
in th
e hi
stor
y of
the
Uni
ted
Stat
es. H
ow-
ever
, it i
s no
t onl
y lo
ngev
ity th
at m
akes
the
Titl
e V
legi
slat
ion
uniq
ue. E
qual
lyre
mar
kabl
e ar
e its
ori
gins
and
its
lega
cies
.
It is
sig
nifi
cant
that
Titl
e V
was
des
igne
dno
t as
heal
th le
gisl
atio
n, b
ut r
athe
r as
par
t of
the
Soci
al S
ecur
ity A
ct o
f 19
35. T
hem
issi
on o
f T
itle
V w
as th
en, a
nd r
emai
ns to
this
day
"...
to im
prov
e th
e he
alth
and
wel
l-be
ing
of a
ll th
e N
atio
n's
mot
hers
and
child
ren.
.." in
clud
ing
child
ren
with
spe
cial
heal
th c
are
need
s. I
n co
ntra
st to
Med
icai
dor
Med
icar
e, T
itle
V s
tand
s al
one
by it
sem
phas
is o
n a
popu
latio
n-ba
sed
mis
sion
and
scop
e.
Thr
ough
out i
ts h
isto
ry, T
itle
V h
as f
ocus
edon
the
prev
entio
n an
d ea
rly
dete
ctio
n of
dise
ase
and
inju
ry. F
or 6
0 ye
ars,
Titl
e V
prog
ram
s ac
ross
the
coun
try
have
not
onl
ypr
ovid
ed h
ealth
car
e to
wom
en a
nd c
hild
ren,
but h
ave
also
bui
lt sy
stem
s to
link
ser
vice
san
d im
prov
e ac
cess
ibili
ty to
hea
lth c
are;
inte
grat
ed a
nd c
oord
inat
ed h
ealth
with
oth
erso
cial
sys
tem
s; a
nd f
orge
d sy
stem
s th
at a
rece
nter
ed o
n in
divi
dual
s, r
athe
r th
an o
nin
stitu
tions
, in
the
cont
ext o
f th
eir
fam
ily,
cultu
re, a
nd c
omm
unity
.
In th
e 60
yea
rs s
ince
the
pass
age
of th
e T
itle
V le
gisl
atio
n, th
e U
nite
d St
ates
has
witn
esse
d dr
amat
ic im
prov
emen
ts in
the
heal
th o
f its
chi
ldre
n, y
outh
, and
fam
ilies
due
in p
art t
o T
itle
V a
nd o
ther
gov
ernm
ent-
spon
sore
d pu
blic
hea
lth p
rogr
ams
toim
prov
e sa
fety
, san
itatio
n, n
utri
tion,
imm
uniz
atio
ns a
nd a
cces
s to
hea
lth c
are
serv
ices
. Sin
ce 1
935,
the
infa
nt m
orta
lity
rate
has
dec
lined
mor
e th
an s
ix-f
old.
Wom
ento
day
are
78 ti
mes
less
like
ly to
die
fro
mm
ater
nal m
orta
lity
than
thei
r co
unte
rpar
ts o
f60
yea
rs a
go.
In 1
995,
we
cont
inue
d to
see
enc
oura
ging
impr
ovem
ents
in th
e he
alth
indi
cato
rs o
f th
eco
untr
y's
child
ren,
you
th, a
nd f
amili
es.
Dur
ing
the
past
dec
ade,
the
natio
n's
infa
ntm
orta
lity
rate
has
con
tinue
d to
dec
line
slow
ly b
ut s
tead
ily,e
ven
in c
omm
uniti
es
with
som
e of
the
high
est i
nfan
t mor
talit
yra
tes
in th
e U
.S. T
he c
ount
ry's
inte
rnat
iona
lra
nkin
g fo
r in
fant
mor
talit
y, w
hile
stil
ldi
smal
, has
impr
oved
fro
m 2
4th
to 2
2nd
plac
e. T
he p
ropo
rtio
n of
wom
en r
ecei
ving
pren
atal
car
e in
the
firs
t tri
mes
ter
ofpr
egna
ncy
has
cont
inue
d to
clim
b, a
s ha
veth
e pr
opor
tions
of
wom
en b
reas
t-fe
edin
gth
eir
infa
nts,
and
the
prop
ortio
ns o
f ch
ildre
nre
ceiv
ing
the
reco
mm
ende
d im
mun
izat
ions
by th
e ag
e of
3. S
ince
199
1, th
ere
has
been
a sm
all b
ut s
tead
y de
clin
e in
the
birt
h ra
te o
fte
en g
irls
(ag
es 1
5 to
19
year
s)a
tren
ddo
cum
ente
d in
nea
rly
ever
y st
ate.
The
re is
littl
e do
ubt t
hat t
he h
igh
prio
rity
that
gov
ernm
ent-
spon
sore
d m
ater
nal a
ndch
ild h
ealth
pro
gram
s ha
ve g
iven
toco
mba
ting
infa
nt m
orta
lity,
pro
mot
ing
adol
esce
nt h
ealth
, dec
reas
ing
inju
ry,
spea
rhea
ding
an
enha
nced
nat
iona
l eff
ort t
oim
mun
ize
pres
choo
lers
and
fos
teri
nghe
alth
ier
fam
ilies
with
com
mun
ityde
velo
pmen
t and
hea
lth s
ervi
ce s
yste
ms
inte
grat
ion
has
had
a po
sitiv
e im
pact
.
Man
y of
the
effo
rts
to im
prov
e m
ater
nal a
ndch
ild h
eath
out
com
es in
com
mun
ities
natio
nwid
e ha
ve d
epen
ded
on th
e in
nova
tive
part
ners
hips
bet
wee
n m
ater
nal a
nd c
hild
heal
th p
rogr
ams,
pro
fess
iona
l ass
ocia
tions
,bu
sine
sses
, oth
er g
over
nmen
t age
ncie
s,re
ligio
us a
nd o
ther
non
prof
it or
gani
zatio
ns,
and
com
mun
ity le
ader
s. I
n th
e ye
ars
toco
me,
the
linka
ges
betw
een
publ
ic a
ndpr
ivat
e pa
rtne
rs w
ill n
eed
to b
e in
crea
sing
lyst
rong
and
far
-rea
chin
g. O
ther
wis
e, m
any
hard
-won
gai
ns m
ay b
e lo
st, a
nd th
e he
alth
of c
hild
ren
and
fam
ilies
will
suf
fer.
Whi
le th
e st
atis
tical
tren
ds p
rese
nted
in th
isdo
cum
ent r
evea
l are
as o
f pr
ogre
ss, t
hey
also
illu
stra
te th
e ex
tent
to w
hich
som
ehe
ath
risk
s co
ntin
ue to
pla
gue
the
lives
of
child
ren
and
fam
ilies
as
they
pre
pare
toen
ter
the
next
mill
enni
um. I
n th
e U
nite
dSt
ates
toda
y, th
e le
adin
g he
alth
ris
k fo
rbo
th c
hild
ren
and
adul
ts is
nei
ther
a d
isea
seno
r a
med
ical
con
ditio
n. I
t is
pove
rty,
whi
chca
n af
fect
nut
ritio
n, a
cces
s to
hea
lth c
are,
and
livin
g co
nditi
ons
that
are
con
duci
veto
hea
lth. P
over
ty h
as s
tead
ily r
isen
am
ong
child
ren
duri
ng th
e la
st th
ree
deca
des.
Alth
ough
chi
ldre
n un
der
age
18 r
epre
sent
just
26.
2 pe
rcen
t of
the
tota
l U.S
.po
pula
tion,
they
con
stitu
te 3
8.4
perc
ent o
f
the
natio
n's
poor
In
the
Uni
ted
Stat
es, a
child
is b
orn
into
pov
erty
eve
ry 3
2 se
cond
s.A
nd th
en th
ere'
s th
e tr
aged
y of
vio
lenc
e,bo
th a
t hom
e an
d in
soc
iety
. In
1994
, sta
tech
ild p
rote
ctiv
e se
rvic
es in
48
stat
esde
term
ined
that
1,0
12,0
00 c
hild
ren
wer
evi
ctim
s of
chi
ld a
buse
and
neg
lect
. It i
slik
ely
that
, abo
ve a
nd b
eyon
d th
ese
figu
res,
larg
e nu
mbe
rs o
f ca
ses
of a
buse
and
neg
lect
go u
ndet
ecte
d an
d un
repo
rted
. Mor
e th
anha
lf o
f al
l rep
orts
of
child
mal
trea
tmen
tco
me
from
pro
fess
iona
ls: e
duca
tors
, law
enfo
rcem
ent a
nd ju
stic
e of
fici
als,
hea
lthan
d so
cial
ser
vice
pro
fess
iona
ls, a
nd c
hild
care
pro
vide
rs, w
hile
less
than
20
perc
ent
are
repo
rted
by
the
vict
im's
fam
ily. T
hese
stat
istic
s un
ders
core
how
cri
tical
lyim
port
ant i
t is
for
all p
rofe
ssio
nals
who
wor
k w
ith c
hild
ren,
inde
ed f
or a
ll ad
ults
, to
take
res
pons
ibili
ty f
or th
e he
alth
and
wel
l-be
ing
of th
e na
tion'
s m
ost v
ulne
rabl
eci
tizen
s.
Fire
arm
s ar
e th
e se
cond
lead
ing
caus
e of
deat
h du
e to
inju
ry a
mon
g ad
oles
cent
s 15
to19
. It i
s es
timat
ed th
at f
ifte
en c
hild
ren
are
kille
d by
fir
earm
s ea
ch d
ay. I
n th
e la
st te
nye
ars,
the
prop
ortio
n of
ado
lesc
ent d
eath
s
9
7
due
to h
omic
ide
has
incr
ease
d by
50
perc
ent.
In 1
993,
65
perc
ent o
f al
l fir
earm
deat
hs in
15
to 1
9 ye
ar o
lds
wer
e lin
ked
toho
mic
ide,
an
addi
tiona
l 27
perc
ent i
nvol
ved
suic
ide
and
7 pe
rcen
t wer
e un
inte
ntio
nal.
AID
S is
als
o ta
king
a te
rrib
le to
ll on
child
ren,
who
are
incr
easi
ngly
bot
h af
fect
edan
d in
fect
ed b
y H
IV/A
IDS.
Adv
ance
s in
the
know
ledg
e, s
cree
ning
and
ther
apy
for
redu
cing
the
tran
smis
sion
of
the
HIV
vir
usfr
om p
regn
ant w
omen
to th
eir
infa
nts
show
som
e pr
omis
e fo
r st
emm
ing
the
rate
s of
pedi
atri
c A
IDS.
Am
ong
teen
ager
s, th
e pr
opor
tion
of A
IDS
case
s in
teen
gir
ls c
ompa
red
to b
oys
jum
ped
by 2
5 pe
rcen
t jus
t in
the
past
two
year
s(1
993-
1995
). G
irls
now
com
pris
e 35
perc
ent o
f al
l tee
n A
IDS
case
s, a
nd g
irls
are
acqu
irin
g A
IDS
prim
arily
thro
ugh
hete
rose
xual
con
tact
.
AID
S ha
s be
com
e on
e of
the
lead
ing
kille
rsof
wom
en o
f re
prod
uctiv
e ag
e in
the
U.S
.(m
any
of w
hom
wer
e in
fect
ed a
s te
enag
ers)
,an
d w
omen
com
pris
e th
e fa
stes
t gro
win
ggr
oup
to b
ecom
e in
fect
ed w
ith H
IV.
8 Thu
s, it
is c
ritic
al th
at A
IDS
educ
atio
n an
dpr
even
tion
effo
rts
targ
et b
oth
girl
s an
d bo
ys.
Res
earc
hers
est
imat
e th
at e
very
day
appr
oxim
atel
y 3,
000
youn
g pe
ople
bec
ome
regu
lar
smok
ers.
Man
y sm
oker
s st
art t
heir
habi
t as
teen
ager
s, a
nd a
larg
e po
rtio
n of
them
con
tinue
to s
mok
e th
roug
hout
the
rest
of th
eir
lives
. Six
ty-n
ine
perc
ent o
f ad
ult
daily
sm
oker
s re
port
hav
ing
trie
d th
eir
firs
tci
gare
tte b
y ag
e 18
. Eve
ry y
ear,
mor
e th
an40
0,00
0 pe
ople
die
fro
m d
isea
ses
caus
ed b
yto
bacc
o us
e.
Tee
n sm
okin
g ra
tes
decr
ease
d in
the
late
1970
s, r
emai
ned
rela
tivel
y st
able
dur
ing
the
1980
s, a
nd h
ave
resu
med
a s
tead
y in
crea
seam
ong
8th,
10t
h, a
nd 1
2th
grad
ers
thro
ugho
ut th
e 19
90s.
In
1995
, one
in th
ree
high
sch
ool s
enio
rs s
aid
that
they
had
smok
ed c
igar
ette
s in
the
last
30
days
, and
91
perc
ent o
f 10
th g
rade
rs r
epor
ted
that
ciga
rette
s w
ere
easy
to o
btai
n. T
he C
linto
nA
dmin
istr
atio
n re
spon
ded
in 1
995
bypr
opos
ing
a m
ajor
toba
cco
initi
ativ
e to
redu
ce th
e ac
cess
and
app
eal o
f to
bacc
opr
oduc
ts to
you
th.
Yet
ano
ther
are
a in
whi
ch to
bacc
o us
e ha
spr
oven
neg
ativ
e ef
fect
s is
dur
ing
preg
nanc
y.A
long
with
the
cons
eque
nces
for
the
mot
her's
long
-ter
m h
ealth
, sm
okin
g in
preg
nanc
y, p
artic
ular
ly d
urin
g th
e fi
rst
trim
este
r, is
one
of
the
scie
ntif
ical
lydo
cum
ente
d ri
sk f
acto
rs f
or lo
w b
irth
wei
ght
and
infa
nt m
orta
lity.
Thu
s T
itle
V p
rogr
ams,
in c
onju
nctio
n w
ith o
ther
gov
ernm
ent-
spon
sore
d ac
tiviti
es, h
ave
cont
inue
d to
prom
ote
smok
ing-
cess
atio
n ac
tiviti
es f
orpr
egna
nt w
omen
and
wom
en o
fre
prod
uctiv
e ag
e.
As
we
prep
are
to e
nter
the
21st
cen
tury
, it
may
be
wel
l to
pay
heed
to th
e w
ords
of
Lill
ian
Wal
d, w
ho f
irst
sug
gest
ed th
efo
rmat
ion
of a
chi
ldre
n's
bure
au (
prec
urso
rto
toda
y's
Mat
erna
l and
Chi
ld H
ealth
Bur
eau)
at t
he b
egin
ning
of
this
cen
tury
:
I as
k yo
u to
con
side
r w
heth
er th
is c
all
for
the
child
ren'
s in
tere
st d
oes
not
impl
y th
e ca
ll fo
r ou
r co
untr
y's
inte
rest
.C
an w
e af
ford
not
to ta
ke it
?
The
U.S
. has
mad
e gr
eat p
rogr
ess
inim
prov
ing
mat
erna
l and
chi
ld h
ealth
, yet
it
still
has
man
y ob
ject
ives
to m
eet.
The
roa
dto
mak
ing
child
ren
a na
tiona
l pri
ority
in th
isco
untr
y is
long
, and
the
way
uph
ill. B
ut it
isth
e di
rect
ion
we
mus
t con
tinue
to ta
ke.
10
4
10
AN
NIV
ER
SA
RY
SE
CT
ION
Thi
s is
sue
com
mem
orat
es 6
0 ye
ars
of T
itle
V o
f th
eSo
cial
Sec
urity
Act
, the
long
est l
astin
g pu
blic
hea
lthle
gisl
atio
n in
our
Nat
ion'
s hi
stor
y. T
he g
oal o
f th
eT
itle
V le
gisl
atio
n w
as to
pro
mot
e an
d im
prov
em
ater
nal a
nd c
hild
hea
lth n
atio
nwid
e.
Sinc
e th
e pa
ssag
e of
Titl
e V
, mat
erna
l mor
talit
y ra
tes,
late
fet
al d
eath
rat
es, l
ow b
irth
wei
ght p
erce
ntag
esan
d in
fant
mor
talit
y ra
tes
have
all
dras
tical
lyim
prov
ed. T
itle
V-f
unde
d re
sear
ch, t
rain
ing,
and
dem
onst
ratio
n pr
ogra
ms
cont
inue
to a
ddre
ss th
efi
nanc
ial,
soci
al, b
ehav
iora
l, an
d st
ruct
ural
bar
rier
s to
heal
th c
are
face
d by
man
y w
omen
and
chi
ldre
n.
Pres
ently
, Titl
e V
-sup
port
ed p
rogr
ams
prov
ide
pren
atal
car
e to
mor
e th
an 2
mill
ion
wom
en a
ndpr
imar
y he
alth
car
e to
mor
e th
an 1
1 m
illio
n ch
ildre
n,in
clud
ing
alm
ost 1
mill
ion
child
ren
with
spe
cial
heal
th n
eeds
.
NO
TE
: The
gra
phs
used
in th
is s
ectio
n ar
e of
ten
tren
d da
ta f
rom
1970
for
war
d. E
thni
city
dat
a w
ere
not c
olle
cted
unt
il 19
79. I
nor
der
to p
rese
nt s
tatis
tics
from
197
0 to
199
3, d
ata
mus
t be
cons
iste
nt f
or th
e en
tire
peri
od. T
he a
nniv
ersa
ry p
ages
do
not h
ave
raci
al d
esig
natio
ns b
ecau
se in
the
earl
y ye
ars
cove
red
by th
egr
aphs
, rac
e w
as n
ot r
elia
bly
repo
rted
.
12
11
AN
NIV
ER
SA
RY
SE
CT
ION
Mat
erna
l Mor
talit
y: 1
935-
1993
Sou
rce
(1.1
): N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s
8 7 6 5 4 3 2 1
0
9.2
8.2
`7.8
7.5
1980
1985
1990
1993
1935
194
0 19
45 1
950
1955
196
0 19
65 1
970
1975
198
0 19
85 1
990
1993
Yea
r
* D
ata
valu
es r
epre
sent
ed o
n a
log
scal
e.**
Act
ual d
ata
valu
es.
13
MA
TE
RN
AL
MO
RT
AL
ITY
From
193
5 to
199
3, th
e m
ater
nal m
orta
lity
rate
drop
ped
from
582
mat
erna
l dea
ths
per
100,
000
live
birt
hs to
7.5
. Tho
ugh
all c
ause
s of
mat
erna
lm
orta
lity
decl
ined
dra
mat
ical
ly o
ver
that
per
iod,
the
over
all d
eclin
e w
as la
rgel
y du
e to
mar
ked
decr
ease
s in
mat
erna
l dea
ths
from
infe
ctio
n,to
xem
ia, a
nd h
emor
rhag
e.
Sign
ific
ant i
mpr
ovem
ents
in th
e ca
re o
f w
omen
duri
ng la
bor,
del
iver
y, a
nd th
e po
stpa
rtum
per
iod
have
bee
n m
ade
over
the
last
60
year
s.T
echn
ical
impr
ovem
ents
(in
clud
ing
ster
ilete
chni
ques
) in
the
man
agem
ent o
f va
gina
l and
cesa
rean
del
iver
ies
and
the
adve
nt o
f ef
fect
ive
antib
iotic
s pr
obab
ly a
ccou
nted
for
muc
h of
the
decr
ease
in m
ater
nal m
orta
lity.
It i
s al
so li
kely
that
the
deve
lopm
ent o
f w
idel
y us
ed p
rena
tal
care
pro
toco
ls c
ontr
ibut
ed to
the
decl
ine
inm
orta
lity
from
chr
onic
or
preg
nanc
y-in
duce
dco
nditi
ons.
Alth
ough
mat
erna
l mor
talit
y ha
s de
crea
sed
sign
ific
antly
ove
r th
e pa
st 6
0 ye
ars,
it is
stil
l ase
riou
s pr
oble
m. M
any
of th
ese
deat
hs m
ight
be
prev
enta
ble
if th
e he
alth
car
e sy
stem
wor
ked
mor
e ef
fect
ivel
y.
12
AN
NIV
ER
SA
RY
SE
CT
ION
LA
TE
FE
TA
L D
EA
TH
S
The
rat
e of
fet
al d
eath
s de
crea
sed
from
14.
9pe
r 1,
000
live
birt
hs p
lus
late
fet
al d
eath
s in
1950
to 3
.8 in
199
3. P
art o
f th
e de
clin
e in
the
1950
s an
d 19
60s
was
due
to im
prov
emen
ts in
obst
etri
c te
chni
que.
The
re is
som
e ev
iden
ce th
at la
te f
etal
dea
ths
are
likel
y re
late
d to
mat
erna
l nut
ritio
n.Sm
okin
g du
ring
pre
gnan
cy a
lso
incr
ease
s th
eri
sk o
f la
te f
etal
dea
th. P
rena
tal c
are
that
prom
otes
goo
d nu
triti
on m
ay h
ave
a ro
le in
prev
entin
g la
te f
etal
dea
ths.
U) -c 1.11 a) 0 To
To u_
16 14 12
Late
Fet
al D
eath
s*: 1
950-
1993
Sou
rce
(1.2
): N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s
6
a)
40 0 0
2
3.8
01
1I
II
11
1l
1
1950
1955
1960
1965
1970
1975
1980
1985
1990
1993
Yea
r
* M
ore
than
28
wee
ks
13
AN
NIV
ER
SA
RY
SE
CT
ION
Low
Birt
h W
eigh
t*: 1
950-
1993
Sou
rce
(1.3
): M
ater
nal a
nd C
hild
Hea
lth B
urea
u
10cn E 0 0
8C
019
5019
5519
6019
6519
7019
7519
8019
8519
9019
93
* L
ess
than
2,5
00 g
ram
s (5
.5 lb
s.).
Yea
r
15
LO
W B
IRT
H W
EIG
HT
The
pre
vale
nce
of lo
w b
irth
wei
ght i
n th
e to
tal
popu
latio
n in
crea
sed
from
7.0
% in
195
0 to
8.3
%in
196
5. T
he in
crea
se in
low
bir
th w
eigh
tpr
eval
ence
bet
wee
n 19
50 a
nd 1
965
was
par
tially
attr
ibut
able
to im
prov
ed r
epor
ting,
esp
ecia
lly f
orth
e po
orer
seg
men
ts o
f th
e po
pula
tion.
It
decr
ease
d to
a lo
w o
f 6.
8% in
198
5. H
owev
er,
7.2
the
perc
enta
ge o
f lo
w b
irth
wei
ght b
irth
s ha
sbe
en s
low
ly in
crea
sing
.
14
AN
NIV
ER
SA
RY
SE
CT
ION
Infa
nt M
orta
lity
Rat
es: 1
935-
1993
Sou
rce
(1.4
): M
ater
nal a
nd C
hild
Hea
lth B
urea
u
60
.cu) 5
0
ea 040
0 0 as
30.c its a) as
20 10
0
8.4
5.3
3.1
1935
194
0 19
45 1
950
1955
196
0 19
65 1
970
1975
198
0 19
85 1
990
1993
Yea
r
* N
eona
tal:
less
than
28
days
old
** P
ostn
eona
tal:
28 d
ays
to 1
yea
r ol
d16
INFA
NT
MO
RT
AL
ITY
The
sur
viva
l of
infa
nts
in th
e U
.S. h
as m
arke
dly
impr
oved
ove
r th
e pa
st 6
0 ye
ars.
In
1935
, the
re w
ere
55.7
infa
nt d
eath
s pe
r 1,
000
live
birt
hs; w
hile
in19
93, t
he U
.S. i
nfan
t mor
talit
y ra
te w
as 8
.4.
Adv
ance
s in
pub
lic h
ealth
and
med
ical
pra
ctic
esim
prov
emen
ts in
san
itatio
n, th
e in
itiat
ion
ofch
ildho
od im
mun
izat
ions
, bet
ter
med
ical
trea
tmen
tof
infe
ctio
us a
nd o
ther
illn
esse
s, a
nd im
prov
emen
tsin
mat
erni
ty a
nd n
ewbo
rn c
area
ll ha
ve c
ontr
ibut
edto
the
infa
nt m
orta
lity
decr
ease
.
Alth
ough
the
U.S
. inf
ant m
orta
lity
rate
con
tinue
s to
impr
ove
and
is a
t an
all-
time
low
, the
U.S
. ran
ks o
nly
22nd
am
ong
indu
stri
aliz
ed n
atio
ns.
NE
ON
AT
AL
AN
D P
OST
NE
ON
AT
AL
MO
RT
AL
ITY
Tho
ugh
ther
e ha
ve b
een
subs
tant
ial d
ecre
ases
in b
oth
neon
atal
and
pos
tneo
nata
l mor
talit
y in
the
U.S
. ove
rth
e pa
st 6
0 ye
ars,
the
rela
tions
hip
betw
een
neon
atal
and
post
neon
atal
mor
talit
y ha
s no
t rem
aine
dco
nsta
nt. P
ostn
eona
tal m
orta
lity
decl
ined
mor
era
pidl
y th
an n
eona
tal m
orta
lity
from
the
1940
sth
roug
h th
e m
id 1
960s
due
to im
prov
emen
ts in
livi
ngco
nditi
ons
and
in p
edia
tric
car
e. T
he g
ap b
etw
een
neon
atal
and
pos
tneo
nata
l mor
talit
y ha
s di
min
ishe
dfr
om th
e 19
70s
beca
use
of d
ram
atic
impr
ovem
ents
inpe
rina
tal i
nten
sive
car
e.
15
Phot
o C
ourt
esy
of H
. Arm
stro
ng R
ober
ts
1 '1
16
PO
PU
LAT
ION
CH
AR
AC
TE
RIS
TIC
S
In th
e co
llect
ion
and
pres
enta
tion
of d
ata,
soci
o-de
mog
raph
ic c
hara
cter
istic
s ar
e us
ed to
deve
lop
a co
mpr
ehen
sive
and
acc
urat
e pi
ctur
eof
the
coun
try'
s di
vers
e m
ater
nal a
nd c
hild
popu
latio
n. T
hese
cha
ract
eris
tics
incl
ude
race
and
ethn
icity
, age
, and
pov
erty
sta
tus.
At t
he n
atio
nal,
stat
e, a
nd lo
cal l
evel
s, p
olic
ym
aker
s us
e po
pula
tion
info
rmat
ion
tosy
stem
atic
ally
add
ress
hea
lth-r
elat
ed is
sues
of
mot
hers
and
chi
ldre
n. B
y ca
refu
lly a
naly
zing
and
com
pari
ng d
ata,
hea
lth w
orke
rs c
an o
ften
isol
ate
high
-ris
k po
pula
tions
that
req
uire
spec
ific
inte
rven
tions
. Pol
icy
mak
ers
can
then
deve
lop
effe
ctiv
e pr
ogra
ms
that
mee
t the
nee
dsof
thos
e po
pula
tions
.
The
fol
low
ing
sect
ion
pres
ents
dat
a on
anu
mbe
r of
pop
ulat
ion
char
acte
rist
ics
that
hav
ean
impa
ct o
n m
ater
nal a
nd c
hild
hea
lthpr
ogra
m d
evel
opm
ent a
nd e
valu
atio
n. T
hese
incl
ude
data
on
the
popu
latio
n di
stri
butio
n by
age,
pov
erty
sta
tus,
and
livi
ng a
rran
gem
ents
.D
ata
on s
choo
l dro
pout
rat
es a
nd w
orki
ngm
othe
rs a
nd c
hild
car
e tr
ends
are
als
oin
clud
ed.
U.S
. Res
iden
t Pop
ulat
ion
by A
ge G
roup
: 199
5S
ourc
e (1
1.1)
: U.S
. Bur
eau
of th
e C
ensu
s
Adu
lt22
-64
Yea
rs55
.7%
Eld
erly
4--
<1
Yea
r (1
.5%
)
65+
Yea
rs12
.8%
4--
1-4
Yea
rs (
6.0%
)
Chi
ldre
n31
.6% \V
/ 410
-14
Yea
rs (
7.2°
/0)
4--
15 1
7 Y
ears
(4.
2%)
4--
18-1
9 Y
ears
(2.
7%)
4-5-
9 Y
ears
(7.
3%)
20-2
1 Y
ears
(2.
7%)
19
17
POPU
LA
TIO
N O
F C
HIL
DR
EN
In 1
995,
ther
e w
ere
alm
ost 8
3 m
illio
nch
ildre
n th
roug
h th
e ag
e of
21
in th
eU
nite
d St
ates
, rep
rese
ntin
g 31
.6%
of
the
tota
l pop
ulat
ion.
Bet
wee
n 19
80 a
nd 1
995,
ther
e w
as a
19.1
% in
crea
se in
the
num
ber
of c
hild
ren
unde
r 5
year
s of
age
.
Alth
ough
ther
e w
ere
appr
oxim
atel
y 27
mill
ion
mor
e ch
ildre
n ag
e 21
or
youn
ger
in19
95 th
an in
195
0, th
is a
ge g
roup
isde
clin
ing
rela
tive
to o
ther
age
gro
ups
inth
e po
pula
tion.
In 1
995,
per
sons
age
d 65
and
ove
rre
pres
ente
d 12
.8%
of
the
tota
l pop
ulat
ion.
By
the
year
200
0, th
is g
roup
is e
xpec
ted
tode
crea
se b
y 12
.6%
. The
chi
ld p
opul
atio
nis
exp
ecte
d to
rem
ain
at 3
1.5%
.
18
PO
PU
LAT
ION
CH
AR
AC
TE
RIS
TIC
S
CH
ILD
RE
N I
N P
OV
ER
TY
In 1
994,
ther
e w
ere
14.6
mill
ion
rela
ted
child
ren
unde
r 18
yea
rs o
f ag
e liv
ing
infa
mili
es w
ith in
com
e be
low
the
fede
ral
pove
rty
leve
l. T
his
age
grou
p co
ntai
ns38
.4%
of
all t
he n
atio
n's
poor
.
Bla
ck o
r H
ispa
nic
child
ren
are
mor
e lik
ely
toliv
e in
pov
erty
than
are
whi
te c
hild
ren.
Bet
wee
n 19
80 a
nd 1
994,
the
num
ber
ofch
ildre
n liv
ing
in p
over
ty in
crea
sed
byal
mos
t 3.5
mill
ion.
In
cont
rast
, the
num
ber
of p
erso
ns 6
5 ye
ars
of a
ge a
nd o
ver
livin
g in
pove
rty
decr
ease
d by
0.2
mill
ion.
In 1
994,
a f
amily
of
four
was
con
side
red
tobe
livi
ng in
pov
erty
if it
s an
nual
inco
me
was
belo
w $
15,1
41.*
*
* R
elat
ed c
hild
ren
in a
fam
ily in
clud
e ho
useh
olde
r'sow
n ch
ildre
n an
d al
l oth
er c
hild
ren
in th
e ho
useh
old
who
are
rel
ated
to th
e ho
useh
olde
r by
blo
od,
mar
riag
e, o
r ad
optio
n.
** B
ased
on
the
U.S
. Cen
sus
Bur
eau'
s po
vert
yth
resh
old,
whi
ch is
cal
cula
ted
usin
g th
e C
onsu
mer
Pric
e In
dex
from
the
prev
ious
cal
enda
r ye
ar.
Rel
ated
Chi
ldre
n U
nder
18
Yea
rs o
f Age
* Li
ving
in F
amili
es B
elow
100
% o
f Pov
erty
: 199
4S
ourc
e (1
1.2)
: U.S
. Dep
artm
ent o
f Com
mer
ce
Bla
ckW
hite
65.6
20.6
41.5
10.5
42.1
Bla
ck8
41.1
13.4
Whi
tes
33.0
His
pani
c
43.3
16.3
1959
1970
1980
1994
Yea
rN
ote:
Eth
nici
ty d
ata
are
not a
vaila
ble
prio
r to
197
9.In
clud
es H
ispa
nic
Livi
ng A
rran
gem
ents
of C
hild
ren
Und
er 1
8 Y
ears
of A
ge: 1
970-
1994
Sou
rce
(11.
3): U
.S. B
urea
u of
the
Cen
sus
1970
10.8
With
Mot
her
Onl
y19
80J
18.0
4I
23.5
1994
4-1.
1
Fat
her
Onl
y1.
7 3.2
85.2
Tw
o P
aren
tsI
76.7
I69
.2
I 2.2
Oth
er R
elat
ive
3.1
3.1
0.7
Non
rela
tives
Onl
y0.
61.
0
Per
cent
age
of C
hild
ren
21
19
FAM
ILY
CO
MPO
SIT
ION
In 1
994,
18.
6 m
illio
n ch
ildre
n liv
ed in
fam
ilies
with
onl
y on
e pa
rent
. Thi
s gr
oup
repr
esen
ted
26.7
% o
f ch
ildre
n yo
unge
r th
an 1
8 ye
ars
of a
ge.
Sinc
e 19
70, t
he p
erce
ntag
e of
chi
ldre
n liv
ing
with
sin
gle
pare
nts
has
mor
e th
an d
oubl
ed, f
rom
11.9
% to
26.
7%. A
ris
e in
the
divo
rce
rate
and
the
num
ber
of n
ever
-mar
ried
par
ents
hav
eco
ntri
bute
d to
this
incr
ease
.
In 1
994,
the
vast
maj
ority
of
sing
le-p
aren
tfa
mili
es c
onsi
sted
of
child
ren
livin
g w
ith th
eir
mot
hers
. Of
child
ren
livin
g w
ith o
nly
one
pare
nt, t
he p
ropo
rtio
n liv
ing
with
a s
ingl
e fa
ther
incr
ease
d fr
om 9
.1%
in 1
970
to 1
2.1%
in 1
994.
Whi
te c
hild
ren
are
less
like
ly to
be
livin
g w
ithon
e pa
rent
than
are
bla
ck o
r H
ispa
nic
child
ren.
The
pro
port
ions
livi
ng w
ith o
ne p
aren
t in
1994
wer
e 20
.9%
for
whi
te c
hild
ren,
31.
8% f
orH
ispa
nic
child
ren,
and
57.
1% f
or b
lack
chi
ldre
n.
App
roxi
mat
ely
two-
thir
ds o
f bo
th b
lack
chi
ldre
nan
d H
ispa
nic
child
ren
who
live
with
a s
ingl
em
othe
r ar
e be
low
the
fede
ral p
over
ty le
vel.
Not
e: A
par
ent m
ay b
e a
step
pare
nt o
r pa
rent
by
adop
tion.
20
PO
PU
LIO
N C
HA
RA
CT
ER
IST
ICS
WO
RK
ING
MO
TH
ER
S
In 1
995,
abo
ut 6
2% o
f al
l mot
hers
with
pres
choo
l-ag
ed c
hild
ren
(you
nger
than
6 y
ears
)w
ere
in th
e la
bor
forc
e, a
nea
rly
twof
old
incr
ease
sin
ce 1
970.
Cur
rent
ly, t
here
are
abo
ut 1
0 m
illio
n w
orki
ngw
omen
with
pre
scho
ol-a
ged
child
ren.
Abo
ut 1
2m
illio
n ch
ildre
n yo
unge
r th
an 6
and
28
mill
ion
child
ren
ages
6-1
7 ha
ve m
othe
rs in
the
labo
rfo
rce.
* D
ata
for
1994
and
199
5 ar
e no
t str
ictly
com
para
ble
with
data
for
ear
lier
year
s du
e to
cha
nges
in th
e su
rvey
and
the
estim
atio
n pr
oces
s.
CH
ILD
CA
RE
Mot
hers
in th
e La
bor
For
ce*:
197
0-19
95S
ourc
e (1
1.4)
: U.S
. Bur
eau
of L
abor
Sta
tistic
s
Pla
ce o
f Car
e fo
r P
resc
hool
-Age
dC
hild
ren:
197
7-19
93S
ourc
e (1
1.5)
: U.S
. Bur
eau
of th
e C
ensu
sIn
199
3, 3
out
of
10 c
hild
ren
youn
ger
than
age
5(3
.0 m
illio
n) w
hose
mot
hers
wor
ked
outs
ide
of0
40
the
hom
e sp
ent t
heir
day
s in
non
resi
dent
ial d
ayc
care
cen
ters
.c
30o 02
00 a)
Wom
en w
ho w
ork
full
time
tend
to u
se d
ay c
are
10
cent
ers
whi
le w
omen
who
wor
k pa
rt ti
me
are
a)m
ore
likel
y to
use
in-h
ome
care
.a_
0
The
per
cent
age
of c
hild
ren
rece
ivin
g ch
ild c
are
in th
eir
hom
es d
ecre
ased
fro
m 3
5.7%
to 3
0.7%
from
199
1 to
199
3.
80 70
2 .5 6
0
0) 5
0
0 40 30 20
Mot
hers
With
Chi
ldre
nA
ged
6-17
5552
7075
iL M
othe
rs W
ith32
Pre
scho
olC
hild
ren
Chi
ld's
Hom
e --
-+
Day
Car
eor
Pre
scho
ol
76 62
1970
1975
1980
1985
1990
1995
Yea
r
30.7
29.9
16.6
15.5
1977
1985
1986
1987
1988
1991
1993
Yea
r
22
7.4
Sta
tus
Sch
ool D
ropo
ut R
ates
for
Ado
lesc
ents
Age
s 16
-24
by R
ace/
Eth
nici
ty: 1
968-
1994
Sou
rce
(11.
6): U
.S. D
epar
tmen
t of E
duca
tion
40 35 30 25 20 15 10
5 0
30.0
His
pani
c
21
SCH
OO
L D
RO
POU
TS
In 1
994,
mor
e th
an 3
mill
ion
16 to
24
year
olds
wer
e ou
t of
scho
ol a
nd h
ad n
otco
mpl
eted
hig
h sc
hool
. Tho
se w
ho h
ave
drop
ped
out o
f hi
gh s
choo
l rep
rese
nt 1
in10
you
ng a
dults
(10
.5%
).
In 1
994,
alm
ost o
ne th
ird
of y
oung
His
pani
cs d
ropp
ed o
ut o
f hi
gh s
choo
l.T
he d
iffe
renc
e be
twee
n th
e dr
opou
t rat
es o
fbl
ack
and
whi
te y
oung
adu
lts h
as n
arro
wed
cons
ider
ably
in th
e la
st 2
5 ye
ars,
as
the
drop
out r
ate
decr
ease
d fa
ster
for
bla
cks
than
for
whi
tes.
12.6
Bla
ck,
Non
-His
pani
c*
7.7
Whi
te,
Non
-His
pani
c*
6870
7274
7678
8082
8486
8890
92**
94*
*Y
ear
Not
e: S
tatu
s ra
tes
mea
sure
the
prop
ortio
n of
the
popu
latio
n w
ho h
ave
not c
ompl
eted
hig
h sc
hool
and
are
not e
nrol
led
at o
ne p
oint
in ti
me,
reg
ardl
ess
of w
hen
they
dro
pped
out
.
23
* Fr
om 1
968-
71, i
nclu
des
pers
ons
of H
ispa
nic
orig
in.
** B
ecau
se o
f ch
ange
s in
dat
a co
llect
ion
proc
edur
es, d
ata
may
not
be
com
para
ble
with
fig
ures
for
ear
lier
year
s.
22
HE
ALT
H S
TA
TU
S
24
The
sys
tem
atic
ass
essm
ent o
f th
e he
alth
sta
tus
ofch
ildre
n en
able
s he
alth
wor
kers
to d
eter
min
e th
eim
pact
of
past
and
cur
rent
hea
lth in
terv
entio
n an
dpr
even
tion
prog
ram
s. P
rogr
am p
lann
ers
and
polic
y m
aker
s id
entif
y tr
ends
by
exam
inin
g an
dco
mpa
ring
dat
a fr
om o
ne y
ear
to th
e ne
xt.
In th
e fo
llow
ing
sect
ion,
hea
lth s
tatu
s in
dica
tors
are
pres
ente
d by
age
gro
up: i
nfan
t, ch
ild, a
ndad
oles
cent
. Tre
nd d
ata
for
the
prec
edin
g 20
yea
rsar
e pr
esen
ted
for
sele
cted
indi
cato
rs.
The
hea
lth s
tatu
s in
dica
tors
in th
is s
ectio
n ar
eba
sed
on v
ital s
tatis
tics
and
natio
nal s
urve
ys.
Popu
latio
n-ba
sed
sam
ples
are
des
igne
d to
yie
ldda
ta th
at a
re r
epre
sent
ativ
e of
the
mat
erna
l and
child
pop
ulat
ion
affe
cted
by,
or
in n
eed
of,
spec
ific
hea
lth s
ervi
ces.
Com
paris
on o
f Nat
iona
l Inf
ant M
orta
lity
Rat
es: 1
992
Sou
rce
(111
.1):
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics
Japa
nH
ong
Kon
gS
inga
pore
Fin
land
Sw
eden
Nor
way
Nor
ther
n Ir
elan
dC
anad
aG
erm
any
Net
herla
nds
Sw
itzer
land
Den
mar
kE
ngla
nd a
nd W
ales
Irel
and
Fra
nce
Sco
tland
Aus
tral
iaS
pain
New
Zea
land
Aus
tria
Italy
Uni
ted
Sta
tes
6.3 6.4
I4.
5I
4.8 4.9
I5.
2
15.
2
5.9 6.0 6.1 6.2 I 6
.5
1 6.
6
I 6.7 6.
8
16.8
16.9 I 7
.2
17.3 17
.5
Dea
ths
Per
1,0
00 L
ive
Birt
hs
23
CO
MPA
RIS
ON
OF
NA
TIO
NA
LIN
FAN
T M
OR
TA
LIT
Y R
AT
ES
Dif
fere
nces
in th
e in
fant
mor
talit
y ra
tes
amon
g in
dust
rial
ized
nat
ions
ref
lect
diff
eren
ces
in th
e he
alth
sta
tus
of w
omen
befo
re a
nd d
urin
g pr
egna
ncy
and
the
qual
ityof
ris
k-ap
prop
riat
e pr
imar
y he
alth
car
eac
cess
ible
to p
regn
ant w
omen
and
thei
rin
fant
s. A
lthou
gh th
e U
nite
d St
ates
has
grea
tly r
educ
ed it
s in
fant
mor
talit
y ra
te s
ince
1965
, the
nat
ion
rank
s lo
wer
than
21
othe
rin
dust
rial
ized
cou
ntri
es.
Sinc
e 19
80, J
apan
has
had
the
low
est i
nfan
tm
orta
lity
rate
in th
e w
orld
. In
1992
, the
ris
kof
a c
hild
dyi
ng in
infa
ncy
(4.5
per
1,0
00 li
vebi
rths
) w
as 5
5% lo
wer
than
that
obs
erve
d in
the
Uni
ted
Stat
es (
8.5
per
1,00
0 liv
e bi
rths
).
I 8.
2
8.5
24
HE
ALT
HT
AT
US
Infa
nt
INFA
NT
MO
RT
AL
ITY
In 1
993,
33,
466
infa
nts
died
bef
ore
thei
r fi
rst
birt
hday
. The
infa
nt m
orta
lity
rate
was
8.4
deat
hs p
er 1
,000
live
bir
ths.
Thi
s fi
gure
repr
esen
ts a
dec
line
of 1
% f
rom
the
rate
of
8.5
for
the
prev
ious
yea
r.
The
rap
id d
eclin
e in
infa
nt m
orta
lity,
whi
chbe
gan
in th
e m
id 1
960s
, slo
wed
for
bot
hbl
acks
and
whi
tes
duri
ng th
e 19
80s.
The
199
3 in
fant
mor
talit
y ra
te f
or b
lack
infa
nts
was
2.4
tim
es th
e ra
te f
or w
hite
infa
nts.
Alth
ough
the
tren
d in
infa
ntm
orta
lity
rate
s am
ong
blac
ks a
nd w
hite
s ha
sbe
en o
n a
cont
inua
l dec
line
thro
ugho
ut th
e20
th c
entu
ry, t
he p
ropo
rtio
nal d
iscr
epan
cybe
twee
n bl
ack
and
whi
te r
ates
has
rem
aine
dun
chan
ged.
35 30 25 20 15 10
5 0
U.S
. Inf
ant M
orta
lity
Rat
es b
y R
ace
of M
othe
r: 1
970-
1993
Sou
rce
(111
.2):
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics
Bla
ck*
All
Rac
es*
Whi
te*
16.5
8.4
6.8
II
II
II
I.I
I ,1
.1.1
.19
70 1
972
1974
197
6 19
78 1
980
1982
198
4 19
86 1
988
1990
199
2 19
93Y
ear
* In
clud
es th
e et
hnic
cla
ssif
icat
ion
of a
ft i
s4,
NE
ON
AT
AL
AN
D P
OST
NE
ON
AT
AL
MO
RT
AL
ITY
Neo
nata
l
In 1
993,
21,
174
infa
nts
youn
ger
than
28
days
died
; put
ting
the
neon
atal
mor
talit
y ra
te a
t52
9.3
deat
hs p
er 1
00,0
00 li
ve b
irth
s. B
oth
the
over
all m
orta
lity
rate
and
rat
es b
yle
adin
g ca
uses
of
mor
talit
y de
crea
sed
from
1991
to 1
993.
Lead
ing
Cau
ses
of N
eona
tal*
Mor
talit
y: 1
993
Sou
rce
(111
.3):
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics
301.
0
145.
1
Bla
cks
have
the
high
est r
ates
of
neon
atal
mor
talit
y in
all
cate
gori
es. D
isor
ders
rel
ated
to s
hort
ges
tatio
n an
d lo
w b
irth
wei
ght a
reth
e pr
imar
y ca
uses
of
neon
atal
mor
talit
y fo
rbl
acks
, whi
le c
onge
nita
l ano
mal
ies
are
the
lead
ing
caus
e fo
r w
hite
s.
Post
neon
atal
In 1
993,
12,
292
infa
nts
28 d
ays
to 1
1 m
onth
sol
d di
ed; t
he p
ostn
eona
tal m
orta
lity
rate
was
Lead
ing
Cau
ses
of P
ostn
eona
tal*
Mor
talit
y: 1
993
Sou
rce
(111
.3):
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics
All
Rac
es**
Bla
ck**
Whi
te**
Con
geni
tal
Ano
mal
ies
Dis
orde
rs R
elat
edto
Sho
rt G
esta
tion
and
Low
Birt
h W
eigh
t
* N
eona
tal:
less
than
28
days
old
** I
nclu
des
His
pani
c
Res
pira
tory
Dis
tres
sS
yndr
ote
Mat
erna
lC
ompl
icat
ions
of P
regn
ancy
25
307.
3de
aths
per
100
,000
live
bir
ths,
ade
crea
se o
f 7.
1 de
aths
per
100
,000
live
bir
ths
from
199
2.
The
pos
tneo
nata
l mor
talit
y ra
te f
or b
lack
s is
at le
ast t
wo
times
that
for
whi
tes
in a
llle
adin
g ca
uses
of
post
neon
atal
mor
talit
y(t
hree
tlim
es g
reat
er w
hen
hom
icid
e is
the
caus
e), w
ith th
e ex
cept
ion
of c
onge
nita
lan
omal
ies.
202.
3
67.8
36.4
V20
317
.0
All
Rac
es**
Bla
ck**
Whi
te**
SID
SC
onge
nita
lA
nom
alie
sIn
june
s
* Po
stne
onat
al: 2
8 da
ys to
less
than
one
yea
r ol
d**
Inc
lude
s H
ispa
nic
27
21.9
1.1-
11.1
Pne
umon
iaH
omic
ide
and
Influ
enza
17.0
7.3
5.2
26
HE
ALT
H S
TA
TU
SIn
fant
MA
TE
RN
AL
MO
RT
AL
ITY
Dur
ing
the
past
sev
eral
dec
ades
, the
re h
asbe
en a
dra
mat
ic d
ecre
ase
in m
ater
nal
mor
talit
y in
the
Uni
ted
Stat
es. S
ince
1980,
how
ever
, the
rat
e of
dec
line
has
slow
ed.
In1993,
ther
e w
ere302
mat
erna
l dea
ths
whi
ch r
esul
ted
from
com
plic
atio
ns d
urin
gpr
egna
ncy,
chi
ldbi
rth,
or
the
post
part
umpe
riod
.
The
mat
erna
l mor
talit
y ra
te f
or b
lack
wom
en(20.5
per
100,
000
live
birt
hs)
ism
ore
than
fou
r tim
es th
e ra
te f
or w
hite
wom
en(4.8
per
100,
000
live
birt
hs).
Reg
ardl
ess
of r
ace,
the
risk
of
mat
erna
lde
ath
incr
ease
s fo
r w
omen
ove
r ag
e30;
wom
en35-39
year
s ol
d ha
ve m
ore
than
twic
e th
e ri
sk o
f m
ater
nal d
eath
than
thos
eag
ed20-24
year
s.
Not
e: 1
970-
1988
dat
a ba
sed
on r
ace
of c
hild
;19
89-1
993
data
bas
ed o
n ra
ce o
f m
othe
r.
70 60
to
50
Zi 00
40
0 0 0 45 3
0a_ 0
20"6 a) E
10
Mat
erna
l Mor
talit
y R
ates
by
Rac
e: 1
970-
1993
Sou
rce
(111
.4):
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics
20.5
7.5
4.8
0i
ii
i,.i,
ii
it.
1970
1972
1974
1976
1978
1980
1982
1984
1986
1988
199
0 19
92 1
993
Yea
r
* In
clud
es th
e et
hnic
cla
ssif
icat
ion
of H
ispa
nic
28
Per
cent
age
of L
ow B
irth
Wei
ght I
nfan
ts b
y R
ace:
197
5-19
93S
ourc
e (1
11.5
): N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s
14.0
13.0
c`i 1
1.0
10.0
9.0
8.0
27
LO
W B
IRT
H W
EIG
HT
In 1
993,
288
,482
bab
ies
(7.2
% o
f al
l liv
ebi
rths
) w
ere
of lo
w b
irth
wei
ght,
wei
ghin
g le
ss th
an 2
,500
gra
ms,
or
5.5
13 3
poun
ds, a
t bir
th.
The
per
cent
age
of lo
w b
irth
wei
ght b
irth
sam
ong
all l
ive
birt
hs r
ose
from
a lo
w o
f6.
8% in
198
5 to
7.2
% in
199
3. F
rom
1992
to 1
993,
rat
es a
mon
g bl
acks
and
His
pani
cs r
emai
ned
stab
le, w
hile
rat
esam
ong
Am
eric
an I
ndia
ns a
nd w
hite
sin
crea
sed.
Am
eric
an In
dian
*
His
pani
cW
hite
*6.
4x'
62 6.0
5.0
4.0
dL\\1
1111
111
1111
111
1975
197
9 19
80 1
981
1982
198
3 19
84 1
985
1986
198
7 19
88 1
989
1990
199
1 19
92 1
993
Yea
r*
Incl
udes
the
ethn
ic c
lass
ific
atio
n of
His
pani
c
29
Low
bir
th w
eigh
t is
the
fact
or m
ost
clos
ely
asso
ciat
ed w
ith n
eona
tal
mor
talit
y. L
ow b
irth
wei
ght i
nfan
ts a
rem
ore
likel
y to
exp
erie
nce
long
-ter
mdi
sabi
litie
s or
to d
ie d
urin
g th
e fi
rst y
ear
of li
fe th
an a
re in
fant
s of
nor
mal
wei
ght.
Fact
ors
asso
ciat
ed w
ith in
crea
sed
risk
of
low
bir
th w
eigh
t inc
lude
pov
erty
, low
leve
l of
educ
atio
nal a
ttain
men
t, an
dm
inor
ity s
tatu
s.
Not
e.' 1
975-
1988
dat
a ba
sed
on r
ace
of c
hild
;19
89-1
993
data
bas
ed o
n ra
ce o
f m
othe
r.
4
OE
111111111111111111.11,L'
9Z
INFA
NT
FE
ED
ING
From
197
1 to
198
2, th
e pe
rcen
tage
of
mot
hers
who
beg
an b
reas
tfee
ding
in th
eho
spita
l inc
reas
ed to
a h
igh
of 6
2%, b
ut th
engr
adua
lly d
eclin
ed to
51.
5% b
y 19
90. S
ince
1991
, how
ever
, the
re h
as b
een
an in
crea
se f
orbl
ack,
His
pani
c, a
nd w
hite
wom
en. T
he to
tal
in-h
ospi
tal b
reas
tfee
ding
rat
e fo
r 19
94 w
as57
.4%
.
With
ste
eper
incr
ease
s in
the
rate
of
brea
stfe
edin
g fo
r bl
ack
wom
en, t
he g
apbe
twee
n br
east
feed
ing
rate
s fo
r bl
ack
and
whi
te w
omen
nar
row
ed s
light
ly in
199
4 bu
t
Tre
nds
in B
reas
tfeed
ing
by R
ace:
197
0-19
94S
ourc
e (1
11.6
): A
bbot
t Lab
orat
orie
s
Q70
70-
Cl) 0
60 50C
D
C/) C13
40
a,30
CD
20L
7072
7476
7880
8284
was
stil
l nea
rly
twic
e as
hig
h fo
r w
hite
wom
en a
s fo
r bl
ack
wom
en. T
he 1
994
rate
sfo
r H
ispa
nic
wom
en a
vera
ged
8.5%
low
erth
an th
ose
for
whi
te w
omen
.
Bre
astf
eedi
ng r
ates
for
wom
en o
f al
l rac
esde
crea
se s
ubst
antia
lly b
etw
een
deliv
ery
and
5to
6 m
onth
s po
stpa
rtum
, the
per
iod
ofbr
east
feed
ing
reco
mm
ende
d as
mos
t cri
tical
for
the
infa
nt's
hea
lth b
y th
e Su
igeo
n G
ener
alof
the
Uni
ted
Stat
es. T
he 1
994
rate
s at
5 to
6m
onth
s po
stpa
rtum
wer
e on
ly 2
3.9%
, 18.
9%an
d 10
.3%
for
whi
te, H
ispa
nic,
and
bla
ckw
omen
res
pect
ivel
y, r
epre
sent
ing
a de
clin
e of
38.4
% a
mon
g w
hite
s, 3
8.9%
am
ong
His
pani
c
rBla
ck
62.3
57.8
57.4
Yea
r86
8890
9294
33.2 r?
1 1
29
His
pani
cs, a
nd 2
2.9%
am
ong
blac
ks f
rom
the
rate
s ju
st a
fter
del
iver
y.
Bre
astf
eedi
ng r
ates
wer
e hi
ghes
t am
ong
wom
en o
ver
30 y
ears
of
age,
col
lege
educ
ated
, rel
ativ
ely
affl
uent
, wom
en n
otpa
rtic
ipat
ing
in th
e W
omen
, Inf
ants
, and
Chi
ldre
n (W
IC)
diet
ary
supp
lem
ent p
rogr
aman
d/or
res
idin
g in
the
wes
tern
Uni
ted
Stat
es.
Wom
en le
ast l
ikel
y to
bre
astf
eed
wer
eyo
unge
r th
an 2
0, e
mpl
oyed
ful
l-tim
e,lo
w-i
ncom
e (
<$1
0,00
0 /y
ear)
, bla
ck,
His
pani
c, a
nd/o
r w
ho li
ved
in th
eso
uthe
aste
rn U
nite
d St
ates
. Als
o w
omen
wer
e le
ss li
kely
to b
reas
tfee
d th
eir
firs
t chi
ld.
Bre
astfe
edin
g R
ates
by
Rac
e: 1
994*
Sou
rce
(111
.6):
Abb
ott L
abor
ator
ies
----
--In
Hos
pita
l70 60 50 40 30 20 10
0
-
33.2
10.3
62.3
5 to
23.9
6 M
onth
s57
.8
18.9
Bla
ckW
hite
*Inc
lude
s ex
clus
ive
and
supp
lem
ente
d br
east
feed
ing.
His
pani
c
30
HE
ALT
H S
TA
TU
SC
hild
CH
ILD
MO
RT
AL
ITY
The
re w
ere
15,7
24 d
eath
s of
chi
ldre
n ag
es1-
14 y
ears
in 1
993.
Inj
ury,
of
any
type
and
rega
rdle
ss o
f in
tent
, was
the
prim
ary
caus
eof
dea
th in
that
age
gro
up. A
mon
g 1-
4 ye
arol
d ch
ildre
n, in
juri
es a
ccou
nted
for
44%
of
all d
eath
s, f
ollo
wed
by
deat
hs d
ue to
cong
enita
l ano
mal
ies
(bir
th d
efec
ts),
mal
igna
nt n
eopl
asm
(tu
mor
s), d
isea
ses
ofth
e he
art,
and
HIV
or
AID
S.
Inju
ries
com
pris
ed 5
2% o
f al
l dea
ths
amon
g5-
14 y
ear
old
child
ren,
fol
low
ed b
ym
alig
nant
neo
plas
m, c
onge
nita
l ano
mal
ies,
dise
ases
of
the
hear
t, an
d H
IV o
r A
IDS.
Chi
ldho
od m
orta
lity
rate
s ha
ve d
eclin
edsu
bsta
ntia
lly o
ver
the
past
sev
eral
dec
ades
.H
owev
er, t
he d
eclin
e ha
s pl
atea
ued
inre
cent
yea
rs a
nd, i
n bo
th a
ge g
roup
s,m
orta
lity
in 1
993
was
slig
htly
hig
her
than
mor
talit
y in
199
2.
Age
s 1
- 4
Inju
ry
Con
geni
tal A
nom
alie
s
Mal
igna
nt N
eopl
asm
s
Dis
ease
s of
the
Hea
rt
HIV
/AID
S
Age
s 5
- 14
Inju
ry
Mal
igna
nt N
eopl
asm
s
Con
geni
tal A
nom
alie
s1
3
Dis
ease
s of
the
Hea
rt0.
8
HIV
/AID
S
Lead
ing
Cau
ses
of D
eath
in C
hild
ren
Age
s 1-
14: 1
993
Sou
rce
(111
.7):
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics
33
1.9
1.3
0.4
29
51
12.2
Age
-Spe
cific
Dea
th R
ate
Per
100
,000
Pop
ulat
ion
In S
peci
fied
Age
Gro
up
32
19.6
Chi
ldho
od D
eath
s D
ue to
Inju
ry b
y C
ause
and
Age
: 199
3S
ourc
e (1
11.8
): N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s
Age
s 1
- 4
Mot
or V
ehic
le C
rash
es
Fire
s an
d B
urns
Dro
wni
ng
Suf
foca
tion
Fire
arm
s
Age
s 5
- 14
Mot
or V
ehic
le C
rash
es
Fire
arm
s
Dro
wni
ng
Fire
s an
d B
urns
Suf
foca
tion
1.4
0.6
1.6
0.8
0.7
2.3
31
CH
ILD
HO
OD
DE
AT
HS
DU
E T
O I
NJU
RY
In19
93, i
njur
ies
caus
ed th
e de
aths
of
3,09
31-
4 ye
ar o
ld c
hild
ren
and
4,50
2 5-
14 y
ear
old
child
ren.
4.8
Am
ong
1-4
year
old
chi
ldre
n, m
otor
veh
icle
37
cras
hes,
fir
e, a
nd d
row
ning
wer
e th
e le
adin
gca
uses
of
inju
ry d
eath
. Mot
or v
ehic
le c
rash
es
3.5
wer
e th
e le
adin
g ca
use
of in
jury
dea
th a
mon
g5-
14 y
ear
old
child
ren,
fol
low
ed b
y fi
rear
man
d dr
owni
ng d
eath
s. A
lmos
t 55%
of
fire
arm
deat
hs a
mon
g 5-
14 y
ear
old
child
ren
wer
eho
mic
ides
.
Age
-Spe
cific
Dea
th R
ate
Per
100
,000
Pop
ulat
ion
In S
peci
fied
Age
Gro
up
5.1
32
HE
ALT
H S
,TU
SC
hild
HO
SPIT
AL
IZA
TIO
N
In 1
993,
ther
e w
ere
3.4
mill
ion
hosp
ital
disc
harg
es o
f ch
ildre
n 1
thro
ugh
21 y
ears
old,
or
four
dis
char
ges
per
100
child
ren
duri
ng th
e ye
ar.
Dis
ease
s of
the
resp
irat
ory
syst
em w
ere
the
maj
or c
ause
of
hosp
italiz
atio
n of
chi
ldre
n1-
9 ye
ars
of a
ge a
nd a
ccou
nted
for
36%
of
thei
r di
scha
rges
.
Hos
pita
l dis
char
ge r
ates
dec
reas
e w
ith a
geun
til a
ge 9
and
then
incr
ease
dur
ing
late
rad
oles
cenc
e.
Whi
le in
juri
es a
re th
e le
adin
g ca
use
of d
eath
for
child
ren
olde
r th
an 1
yea
r, th
is c
ateg
ory
acco
unte
d fo
r on
ly 1
1% o
f th
e ho
spita
ldi
scha
rges
of
child
ren
1-14
yea
rs in
199
3.Pr
egna
ncy
and
child
birt
h re
late
dho
spita
lizat
ions
acc
ount
ed f
or 7
0% o
fdi
scha
rges
of
youn
g w
omen
age
s 15
-21.
Age
s 1-
4D
isea
ses
of th
e R
espi
rato
ry S
yste
mD
isea
ses
of th
e D
iges
tive
Sys
tem
Infe
ctio
us a
nd P
aras
itic
Dis
ease
sIn
jury
Dis
ease
s of
the
Ner
vous
Sys
tem
and
Sen
se O
rgan
s
Age
s 5-
9D
isea
ses
of th
e R
espi
rato
ry S
yste
mIn
jury
Dis
ease
s of
the
Dig
estiv
e S
yste
mIn
fect
ious
and
Par
asiti
c D
isea
ses
End
ocrin
e, N
utrit
iona
l, an
d M
etab
olic
Dis
ease
s, a
nd Im
mun
ity D
isor
ders
Age
s 10
-14
Inju
ryD
isea
ses
of th
e R
espi
rato
ry S
yste
mM
enta
l Dis
orde
r'sD
isea
ses
of th
e D
iges
tive
Sys
tem
Infe
ctio
us a
nd P
aras
itic
Dis
ease
s
Age
s 15
-19
Pre
gnan
cy /C
hild
birt
hIn
jury
Men
tal D
isor
ders
Dis
ease
s of
the
Dig
estiv
e S
yste
mD
isea
ses
of th
e R
espi
rato
ry S
yste
m
Age
s 20
-21
Pre
gnan
cy /C
hild
birt
hIn
jury
Men
tal D
isor
ders
Dis
ease
s of
the
Dig
estiv
e S
yste
mD
isea
ses
of th
e G
enito
urin
ary
Sys
tem
61
51
3951
1
1 21
62 62
I5159
101
I 70
58 54
39 38--
I 28
Maj
or C
ause
s of
Hos
pita
lizat
ion,
by
Age
: 199
3S
ourc
e (1
11.9
): N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s
121
118
34
258
Num
ber
of H
ospi
tal D
isch
arge
s(I
n T
hous
ands
)
457
582
33
Dis
char
ge R
ate
of P
atie
nts
1-14
Yea
rs O
ld fo
r S
elec
ted
Dia
gnos
es: 1
980-
1993
Sou
rce
(111
.10)
: Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics
180
a)
140
0 0 0 0 0_
20
Dis
ease
s of
the
Res
pira
tory
sys
tem
Inju
ry
Dis
ease
s of
the
Dig
estiv
e S
yste
m
79.7
29.7
28.7
II
II
IIII
I1
III
1980
198
1 19
82 1
983
1984
198
5 19
86 1
987
1988
198
9 19
90 1
991
1992
199
3Y
ear
35
HO
SPIT
AL
DIS
CH
AR
GE
TR
EN
DS
Sinc
e 19
80, t
here
has
bee
n a
55%
dec
reas
ein
ove
rall
hosp
ital d
isch
arge
rat
es f
orch
ildre
n ag
ed 1
-14
year
s.
Bet
wee
n 19
80 a
nd 1
993,
ther
e w
as a
54%
decl
ine
in th
e ho
spita
l dis
char
ge r
ate
for
dise
ases
of
the
resp
irat
ory
syst
em in
child
ren
aged
1-1
4 ye
ars.
Thr
ee d
iagn
ostic
cat
egor
ies
(dig
estiv
edi
seas
e, r
espi
rato
ry d
isea
se, a
nd in
jury
)ac
coun
ted
for
51%
of
the
disc
harg
es o
fch
ildre
n ag
ed 1
-14
year
s in
199
3.
4to
96
rrA
VE
LE
AD
EX
POSU
RE
Red
uctio
ns in
chi
ldho
od le
ad e
xpos
ure
are
am
ajor
pub
lic h
ealth
suc
cess
sto
ry. T
hepe
rcen
tage
of
child
ren
with
ele
vate
d bl
ood
lead
leve
ls d
eclin
ed s
ubst
antia
lly f
rom
197
6to
199
1, a
nd a
vera
ge b
lood
lead
leve
lsdr
oppe
d fr
om 1
5 m
icro
gram
s pe
r de
cilit
er(.
1.g/
dL)
to .6
gg/
dL. D
espi
te th
is s
ucce
ss, 1
.7m
illio
n A
mer
ican
chi
ldre
n st
ill h
ave
elev
ated
bloo
d le
ad le
vels
. Thi
s is
abo
ut 9
% o
f al
lch
ildre
n un
der
6 ye
ars
old.
Nat
iona
lly, a
bout
36%
of
the
child
ren
in th
e U
.S. w
ho a
re p
oor,
blac
k, a
nd li
ve in
inne
r ci
ties,
hav
e el
evat
ed
bloo
d le
vels
. Thi
s co
mpa
res
to a
bout
4%
of
non-
His
pani
c w
hite
chi
ldre
n w
ho a
re n
eith
erpo
or n
or li
ve in
the
inne
r ci
ty.
The
mos
t ser
ious
rem
aini
ng s
ourc
es o
f le
adex
posu
re a
re d
eter
iora
ted
lead
-bas
ed p
aint
inol
der
hous
ing,
as
wel
l as
dust
and
soi
lco
ntam
inat
ed b
y le
aded
pai
nt a
nd r
esid
ues
from
pas
t aut
o em
issi
ons
of le
aded
gas
olin
e.T
he E
nvir
onm
enta
l Pro
tect
ion
Age
ncy
initi
ated
a p
hase
-out
of
lead
ed f
uel i
n th
e19
70s.
The
man
ufac
ture
of
resi
dent
ial p
aint
with
lead
was
pha
sed
out o
ver
seve
ral d
ecad
esan
d fi
nally
elim
inat
ed in
197
8.
35
The
Cen
ters
for
Dis
ease
Con
trol
and
Prev
entio
n (C
DC
) is
cur
rent
ly u
pdat
ing
its19
91 g
uide
lines
on
lead
scr
eeni
ng a
ndtr
eatm
ent o
f ch
ildre
n w
ith le
ad p
oiso
ning
.A
lthou
gh d
ata
indi
cate
that
lead
exp
osur
e ha
ssu
bsta
ntia
lly d
eclin
ed, c
hild
ren
in in
ner
citie
sco
ntin
ue to
be
disp
ropo
rtio
nate
ly a
ffec
ted.
The
new
gui
delin
es w
ill h
elp
impr
ove
the
use
of s
cree
ning
tool
s, e
xpan
d pr
even
tion
activ
ities
am
ong
child
ren
who
nee
d th
emm
ost,
and
help
ass
ure
that
pre
vent
ion
appr
oach
es a
re a
ppro
pria
te to
loca
l con
ditio
ns.
Per
cent
age
of C
hild
ren
1-5
Yea
rs O
ld W
ith E
leva
ted*
Blo
od L
ead
Leve
ls:
Mea
n B
lood
Lea
d Le
vels
(.1
g/dL
) in
Chi
ldre
n A
ges
1-5,
1976
-199
1by
Rac
e/E
thni
city
: 197
6-19
91S
ourc
e (1
11.1
1):
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics
Sou
rce
(111
.1 1
): N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
sN
HA
NE
S II
:19
76-1
981
20.2
NH
AN
ES
III P
hase
I:
1988
-199
1-o
88.2
NH
AN
ES
II: 1
976-
1980
NH
AN
ES
Ill P
hase
!:19
88-1
991
052
.613
.70 ca "C
". a) a)
24.7
04.
10.
4
(> =
30)
Non
-His
pani
c W
hite
Non
-His
pani
c B
lack
Rac
e/E
thni
city
5.6
(> =
10)
(> =
15)
(> =
20)
(> =
25)
Blo
od L
ead
Leve
l (ig
/dL)
*Ele
vate
d bl
ood
lead
leve
l: at
or
mor
e th
an 1
0 lig
/dL
37
36
HE
ALT
H S
TA
TU
SC
hild
PED
IAT
RIC
AID
S
As
of D
ecem
ber
31, 1
995,
6,9
48 c
ases
of
AID
S in
child
ren
youn
ger
than
13
year
s ol
d ha
d be
en r
epor
ted
in th
e U
.S. T
his
tota
l inc
lude
s 80
0 ne
wly
rep
orte
dca
ses
in 1
995.
Pedi
atri
c ca
ses
of A
IDS
repr
esen
t app
roxi
mat
ely
1.4%
of
all c
ases
rep
orte
d. T
he m
ajor
ity o
f pe
diat
ric
AID
S ca
ses
resu
lt fr
om tr
ansm
issi
on b
efor
e or
dur
ing
birt
h, w
ith a
dis
prop
ortio
nate
num
ber
of c
ases
occu
rrin
g in
bla
ck a
nd H
ispa
nic
child
ren.
NO
TE
S:
Peri
nata
l Tra
nsm
issi
on -
Chi
ld's
bio
logi
c m
othe
r ha
d:In
ject
ing
drug
use
Sex
with
inje
ctin
g dr
ug u
ser
Sex
with
bis
exua
l mal
eSe
x w
ith p
erso
n w
ith h
emop
hilia
Sex
with
tran
sfus
ion
reci
pien
t with
HIV
infe
ctio
nSe
x w
ith p
erso
n w
ith H
IV in
fect
ion,
ris
k no
t spe
cifi
edR
ecei
pt o
f bl
ood
tran
sfus
ion,
blo
od c
ompo
nent
s, o
r tis
sue
Has
HIV
infe
ctio
n, r
isk
not s
peci
fied
Rec
eipt
of
Blo
od/B
lood
Com
pone
nts:
Rec
eive
d cl
ottin
g fa
ctor
for
hem
ophi
lia/c
oagu
latio
n di
sord
erR
ecei
ved
bloo
d tr
ansf
usio
n, b
lood
com
pone
nts,
or
tissu
e
Ped
iatr
ic A
IDS
Cas
es b
y R
ace/
Eth
nici
ty a
nd E
xpos
ure
Cat
egor
y: 1
981-
1995
Sou
rce
(111
.12)
: Cen
ters
for
Dis
ease
Con
trol
and
Pre
vent
ion
Whi
te,
Non
-His
pani
c(1
,270
)
Bla
ck,
Non
-His
pani
c(3
,974
)
His
pani
c(1
,629
)
Asi
an/
Pac
ific
Isla
nder
(39)
Am
eric
an In
dian
/A
lask
a N
ativ
e
(21)
Unk
now
n
(15)
338
14 MI.
115
67
AIM
II 1,
487
126
918
AIM
3,7
92
16 2
25
!12
11
20 1
38
Per
inat
al T
rans
mis
sion
Rec
eipt
of B
lood
/Blo
od C
ompo
nent
s
Ris
k no
t rep
orte
d/id
entif
ied
Num
ber
of C
ases
Per
cent
age
of C
hild
Abu
se a
nd N
egle
ct V
ictim
s, b
y T
ype
of M
altr
eatm
ent:
1994
Sou
rce
(111
.13)
: Nat
iona
l Cen
ter
on C
hild
Abu
se a
nd N
egle
ct
E 0 a) a)
53
Neg
lect
Phy
sica
lA
buse
Oth
erS
exua
lE
mot
iona
lU
nkno
wn
Med
ical
Abu
seM
altr
eatm
ent
Neg
lect
Not
e: B
ecau
se s
ome
stat
es r
epor
t mor
e th
an o
ne ty
pe o
f abu
se, t
he to
tal d
oes
not e
qual
100
%.
33
37
CH
ILD
AB
USE
AN
D N
EG
LE
CT
Inve
stig
atio
ns b
y st
ate
child
pro
tect
ive
serv
ices
agen
cies
in 4
8 st
ates
det
erm
ined
that
1,0
12,0
00ch
ildre
n w
ere
vict
ims
of s
ubst
antia
l or
indi
cate
dch
ild a
buse
and
neg
lect
in 1
994.
Abo
ut 2
7% o
f al
l vic
tims
of c
hild
mal
trea
tmen
tw
ere
3 ye
ars
old
or y
oung
er, a
nd a
noth
er 2
0%w
ere
betw
een
the
ages
of
4 an
d 6.
Jus
t ove
ron
e-fi
fth
of v
ictim
s w
ere
yout
h ag
es 1
3-18
.
Typ
es o
f m
altr
eatm
ent c
hild
ren
suff
ered
wer
ene
glec
t 53%
, phy
sica
l abu
se 2
6%, s
exua
l abu
se14
%, a
nd o
ther
type
s of
mal
trea
tmen
t inc
ludi
ngm
edic
al n
egle
ct a
nd e
mot
iona
l mal
trea
tmen
t(2
7%).
For
ty-t
hree
sta
tes
repo
rted
that
1,1
11ch
ildre
n di
ed a
s a
resu
lt of
mal
trea
tmen
t in
1994
.
In 1
994,
sta
te c
hild
pro
tect
ive
serv
ices
age
ncie
sre
ceiv
ed a
nd r
efer
red
for
inve
stig
atio
n an
estim
ated
2 m
illio
n re
port
s al
legi
ng th
em
altr
eatm
ent o
f 2.
9 m
illio
n ch
ildre
n. M
ore
than
half
of
all r
epor
ts a
llegi
ng m
altr
eatm
ent (
53%
)ca
me
from
pro
fess
iona
ls, i
nclu
ding
edu
cato
rs, l
awen
forc
emen
t and
just
ice
offi
cial
s, m
edic
alpr
ofes
sion
als,
soc
ial s
ervi
ce p
rofe
ssio
nals
and
child
car
e pr
ovid
ers.
Onl
y on
e in
fiv
e re
port
sca
me
from
eith
er th
e vi
ctim
or
a fa
mily
mem
ber
of th
e vi
ctim
.
38
HE
ALT
H S
TA
TU
SC
hild
DE
NT
AL
CA
RIE
S
From
198
8 to
199
1, o
n th
e av
erag
e, c
hild
ren
2-4
year
s of
age
had
1.2
dec
ayed
and
fill
edpr
imar
y su
rfac
es. O
nly
25%
of
child
ren
ages
5-17
with
at l
east
one
per
man
ent t
ooth
acco
unte
d fo
r ab
out 8
0% o
f th
e gr
oup
with
fille
d pe
rman
ent t
eeth
.
Dif
fere
nces
in c
arie
s pr
eval
ence
wer
e fo
und
amon
g ra
cial
and
eth
nic
subp
opul
atio
ns, a
nd
Per
cent
age
of C
hild
ren
Age
s 2-
4 w
ith D
enta
l Car
ies
in P
rimar
y T
eeth
, by
Rac
e/E
thni
city
: 198
8-19
91S
ourc
e (1
11.1
4): N
atio
nal I
nstit
utes
of H
ealth
13
22
cari
es p
atte
rns
for
the
prim
ary
and
perm
anen
tte
eth
diff
ered
als
o. M
exic
an-A
mer
ican
child
ren
ages
2-4
had
the
high
est p
reva
lenc
eof
car
ies
in th
eir
prim
ary
teet
h (3
2.3%
),co
mpa
red
to 2
2% o
f no
n-H
ispa
nic
blac
kch
ildre
n an
d 13
% o
f no
n-H
ispa
nic
whi
tech
ildre
n. M
exic
an-A
mer
ican
s al
so h
ad th
ehi
ghes
t mea
n nu
mbe
r of
fill
ed d
ecay
edsu
rfac
es o
n pr
imar
y te
eth.
The
se s
tatis
tics
dem
onst
rate
that
Mex
ican
-Am
eric
an c
hild
ren
are
rece
ivin
g de
ntal
car
e, b
ut th
e hi
gh c
arie
s
32.3
Non
-His
pani
c W
hite
Non
-His
pani
c B
lack
Mex
ican
-Am
eric
ans
Rac
e/E
thni
city
prev
alen
ce s
ugge
sts
an a
ppar
ent l
ack
ofca
ries
pre
vent
ion
in th
is s
ubpo
pula
tion.
Mex
ican
-Am
eric
an c
hild
ren
ages
5-1
7 al
soha
d th
e hi
ghes
t pre
vale
nce
of c
arie
s in
perm
anen
t tee
th (
48.6
%)
com
pare
d to
44.
3%of
non
-His
pani
c w
hite
s an
d 39
.4%
of
non-
His
pani
c bl
acks
.
Per
cent
age
of C
hild
ren
Age
s 5-
17 w
ith D
enta
l Car
ies
in P
erm
anen
t Tee
th, b
y R
ace/
Eth
nici
ty: 1
988-
1991
Sou
rce
(111
.14)
: Nat
iona
l Ins
titut
es o
f Hea
lth
44.3
39.4
48.6
Non
-His
pani
c W
hite
Non
-His
pani
c B
lack
Mex
ican
-Am
eric
ans
Rac
e/E
thni
city
40
IP
6E
40
HE
ALT
H S
TA
TU
SA
dole
scen
t
AD
OL
ESC
EN
T M
OR
TA
LIT
Y
In 1
993,
ther
e w
ere
14,9
97 d
eath
s of
ado
lesc
ents
aged
15-
19 y
ears
. In
that
age
gro
up, i
njur
y w
asth
e le
adin
g ca
use
of d
eath
. The
12,
047
inju
ryde
aths
acc
ount
ed f
or 8
0% o
f al
l dea
ths
amon
g15
-19
year
old
s in
199
3. M
alig
nant
neo
plas
m(t
umor
) w
as th
e ne
xt le
adin
g ca
use
of d
eath
,ac
coun
ting
for
4.8%
of
all d
eath
s am
ong
15-1
9ye
ar o
lds.
Mor
talit
y am
ong
teen
ager
s de
clin
edsu
bsta
ntia
lly b
etw
een
1960
and
the
earl
y 19
80s.
The
re w
as a
mod
erat
e in
crea
se in
mor
talit
y am
ong
15-1
9 ye
ar o
lds
in th
e m
id to
late
198
0s. T
hede
ath
rate
am
ong
that
age
gro
up h
as b
een
stab
lesi
nce
then
.
Mot
or v
ehic
les
and
fire
arm
s w
ere
the
lead
ing
caus
es o
f in
jury
mor
talit
y am
ong
15-1
9 ye
ar o
lds
in 1
993.
Eac
h ca
tego
ry a
ccou
nted
for
appr
oxim
atel
y 40
% o
f al
l inj
ury
deat
hs a
mon
gte
enag
ers.
The
nex
t thr
ee le
adin
g ca
uses
of
inju
ryde
aths
uffo
catio
n, d
row
ning
, and
poi
soni
ngea
ch a
ccou
nted
for
2%
to 3
% o
f al
l inj
ury
deat
hsam
ong
15-1
9 ye
ar o
lds.
Mot
or v
ehic
le m
orta
lity
amon
g te
enag
ers
has
decl
ined
by
appr
oxim
atel
y15
% o
ver
the
past
dec
ade.
Con
vers
ely,
ado
lesc
ent
mor
talit
y fr
om f
irea
rms
has
mor
e th
an d
oubl
edov
er th
at s
ame
peri
od.
Lead
ing
Cau
ses
of D
eath
in A
dole
scen
ts 1
5-19
Yea
rs o
f Age
: 199
3
Mor
talit
yA
ges
15 -
19
Uni
nten
tiona
l Inj
ury
Sou
rce
(111
.15)
: Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics
69.8
Mal
igna
nt N
eopl
asm
s42
Dis
ease
s of
the
Hea
rt2
1
Con
geni
tal A
nom
alie
s1.
3
Pne
umon
iaan
d In
fluen
za0.
4
Inju
ry M
orta
lity
Age
s 15
- 1
9
Mot
or V
ehic
le C
rash
es28
.2
Fire
arm
s27
.8
Suf
foca
tion
27
Dro
wni
ng2.
4
Poi
soni
ng2.
1
Dea
thR
ate
Per
100
,000
Pop
ulat
ion
42In
Spe
cifie
d A
ge G
roup
41
Mot
or V
ehic
le C
rash
es a
nd F
irear
ms
Mor
talit
y A
mon
g A
dole
scen
ts, A
ges
15-1
9: 1
993
AD
OL
ESC
EN
T D
EA
TH
S D
UE
TO
IN
JUR
YS
ourc
e (1
11.1
6): N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s
Mot
or V
ehic
le T
raffi
c M
orta
lity,
by
Typ
e of
Per
son
Inju
red
Occ
upan
t
Ped
estr
ian
1.6
Mot
orcy
clis
t1.
4
Ped
al c
yclis
t0.
5 -
Fire
arm
Mor
talit
y, b
y In
tent
Hom
icid
e
Sui
cide
Uni
nten
tiona
l1
9
Unk
now
n0.
5
74
Dea
th R
ate
Per
100
,000
Pop
ulat
ion
In S
peci
fied
Age
Gro
up
In 1
993,
mot
or v
ehic
le tr
affi
c cr
ashe
s ca
used
the
deat
h of
4,8
76 1
5-19
yea
r ol
ds. A
lmos
t90
% o
f th
ose
deat
hs w
ere
of m
otor
veh
icle
24.7
occu
pant
s, e
ither
pas
seng
ers
or th
e dr
iver
.D
eath
s of
ped
estr
ians
, mot
orcy
clis
ts, a
nd p
edal
cycl
ists
acc
ount
ed f
or th
e re
mai
nder
of
mot
orve
hicl
e m
orta
lity
amon
g te
enag
ers.
Dat
a fr
omth
e N
atio
nal H
ighw
ay T
raff
ic S
afet
yA
dmin
istr
atio
n su
gges
t tha
t alc
ohol
was
invo
lved
in 2
0-25
% o
f m
otor
veh
icle
dea
ths
amon
g te
enag
ers.
In 1
993,
4,7
94 1
5-19
yea
r ol
ds w
ere
kille
d by
fire
arm
s in
the
U.S
. Hom
icid
e ac
coun
ted
for
3,11
8 or
65%
of
fire
arm
dea
ths
amon
gte
enag
ers.
App
roxi
mat
ely
27%
of
fire
arm
18.1
deat
hs w
ere
suic
ide,
whi
le 7
% w
ere
cons
ider
edto
be
unin
tent
iona
l. O
ver
the
past
dec
ade,
the
prop
ortio
n of
fir
earm
dea
ths
due
to h
omic
ide
has
incr
ease
d by
app
roxi
mat
ely
50%
.
43
42
HE
ALT
H S
AT
US
Ado
lesc
ent
TE
EN
PR
EG
NA
NC
Y A
ND
AB
OR
TIO
N R
AT
ES
In 1
991,
ther
e w
ere
997,
190
preg
nanc
ies
amon
gw
omen
less
than
20
year
s of
age
. Pre
gnan
cyou
tcom
es in
clud
ed 5
31,5
91 li
ve b
irth
s (5
3.3%
)an
d 32
6,62
0 in
duce
d ab
ortio
ns (
32.8
%).
Al t
houg
h th
e nu
mbe
r of
abo
rtio
ns a
mon
gfe
mal
es le
ss th
an 2
0 in
crea
sed
shar
ply
from
1975
to 1
980,
the
rate
has
dec
reas
ed s
tead
ilyfr
om 1
980-
1991
. For
the
firs
t tim
e si
nce
1986
,th
ere
was
a s
mal
l but
ste
ady
decl
ine
in th
e te
enbi
rth
rate
fro
m 1
991
to 1
993.
Thi
s tr
end
has
been
doc
umen
ted
in n
earl
y ev
ery
stat
e.
Res
earc
hers
con
sist
ently
fin
d fo
ur b
road
fac
tors
that
pre
dict
sex
ual i
nter
cour
se a
t an
earl
y ag
e,ad
oles
cent
pre
gnan
cy, a
nd n
onm
arita
lch
ildbe
arin
g am
ong
teen
ager
s: e
arly
sch
ool
failu
re, e
arly
beh
avio
r pr
oble
ms,
pov
erty
, and
fam
ily p
robl
ems/
fam
ily d
ysfu
nctio
n.
NO
TE
: Dat
a re
pres
ent a
wom
an's
age
at t
he ti
me
apr
egna
ncy
ende
d. M
ore
preg
nanc
ies
wer
e ex
peri
ence
d by
teen
ager
s th
an w
ere
repo
rted
bec
ause
mos
t of
the
19-y
ear-
olds
who
bec
ame
preg
nant
had
thei
r bi
rths
or
abor
tions
at a
ge 2
0 an
d th
us w
ere
not c
ount
ed.
Abo
rtio
n T
rend
s A
mon
g W
omen
Les
s T
han
20 Y
ears
of A
ge*:
197
5-19
91S
ourc
e (1
11.1
7): T
he A
lan
Gut
tmac
her
Inst
itute
460,
120
342,
040
416,
170
363,
150
326,
620
1975
1980
1985
1990
1991
* In
clud
es w
oms
<_1
4Y
ear
SEX
UA
L A
CT
IVIT
Y
The
num
ber
of s
tude
nts
repo
rtin
g ev
er h
avin
gha
d se
xual
inte
rcou
rse
incr
ease
d w
ith a
ge.
Mal
es in
all
grad
es h
ad th
e hi
ghes
tpr
eval
ence
of
sexu
al e
xper
ienc
e.
Ove
r 50
% o
f st
uden
ts in
12t
h gr
ade
repo
rted
havi
ng h
ad s
exua
l int
erco
urse
dur
ing
the
prec
edin
g th
ree
mon
ths.
The
pre
vale
nce
rate
of s
exua
l act
ivity
incr
ease
d si
gnif
ican
tly f
rom
grad
es 9
thro
ugh
12 a
mon
g fe
mal
es, w
hile
itin
crea
sed
sign
ific
antly
fro
m g
rade
s 10
thro
ugh
12 a
mon
g m
ales
.
CO
ND
OM
USE
Mor
e th
an 5
0% o
f se
xual
ly a
ctiv
e 9t
hth
roug
h 12
th g
rade
rs r
epor
ted
cond
om u
sedu
ring
last
sex
ual i
nter
cour
se. M
ales
wer
e
Per
cent
age
of H
igh
Sch
ool S
tude
nts
Who
Hav
e E
ver
Had
Sex
ual I
nter
cour
se, b
y G
rade
: 199
3S
ourc
e (1
11.1
8): C
ente
rs fo
r D
isea
se C
ontr
ol a
nd P
reve
ntio
n
43.5
59.5
55.1
70.2
66.3
31.6
Mal
eF
emal
e
47.4
44.9
9th
Gra
de10
th G
rade
11th
Gra
de12
th G
rade
43
sign
ific
antly
mor
e lik
ely
than
fem
ales
to h
ave
repo
rted
that
a c
ondo
m w
as u
sed.
Whi
le s
exua
l act
ivity
incr
ease
d by
gra
de f
oral
l stu
dent
s, c
ondo
m u
se d
ecre
ased
by
grad
e.O
nly
46.5
% o
f se
xual
ly a
ctiv
e 12
th g
rade
rsre
port
ed c
ondo
m u
se, c
ompa
red
with
61.
6%of
sex
ually
act
ive
9th
grad
ers.
Sex
ual A
ctiv
ity a
nd C
ondo
m U
se in
Hig
h S
choo
l Stu
dent
s: 1
993
Sou
rce
(111
.18)
: Cen
ters
for
Dis
ease
Con
trol
and
Pre
vent
ion
61.6
54.7
Sex
ually
Act
ive*
Con
dom
Use
**
55.3
53.0
46.5
9th
Gra
de10
th G
rade
11th
Gra
de12
th G
rade
* S
exua
l int
erco
urse
dur
ing
the
3 m
onth
s pr
eced
ing
the
surv
ey.
** A
mon
g se
xual
ly a
ctiv
e st
uden
ts a
t las
t sex
ual i
nter
cour
se.
45
44
HE
ALT
H S
TA
TU
SA
dole
scen
t
AD
OL
ESC
EN
T C
HIL
DB
EA
RIN
G
In 1
994,
the
live
birt
h ra
te p
er 1
,000
wom
en w
as 1
.4 f
or te
enag
ers
aged
10-
14,
37.6
for
thos
e 15
-17,
and
91.
5 fo
r th
ose
18-1
9 ye
ars
old.
In 1
994,
ther
e w
ere
69,0
28 li
ve b
irth
sam
ong
blac
k fe
mal
es y
oung
er th
an 1
8ye
ars
of a
ge, w
hich
rep
rese
nted
10.
8% o
fal
l bir
ths
to b
lack
wom
en. T
here
wer
e13
2,36
6 bi
rths
to w
hite
fem
ales
und
er 1
8,w
hich
rep
rese
nted
4.2
% o
f al
l bir
ths
tow
hite
wom
en.
In 1
994,
app
roxi
mat
ely
59 m
illio
n w
omen
wer
e of
chi
ldbe
arin
g ag
e (1
5-44
yea
rs)
inth
e U
nite
d St
ates
.
1.4
Tot
al*
Whi
te*
Bla
ck*
Live
Birt
hs b
y A
ge a
nd R
ace
of M
othe
r: 1
994
Sou
rce
(111
.19)
: Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics
76.3
91.5
148.
3
*Inc
lude
s th
e et
hnic
cla
ssif
icat
ion
of H
ispa
nic
18 -
19
Ado
lesc
ent A
IDS
Cas
es b
y R
ace/
Eth
nici
ty a
nd E
xpos
ure
Cat
egor
yfo
r A
ges
13-1
9: 1
981-
1995
Sou
rce
(111
.20)
: Cen
ters
for
Dis
ease
Con
trol
and
Pre
vent
ion
Ris
k N
ot R
epor
ted/
Rec
eipt
of
Iden
tifie
dr
Blo
od/B
lood
Com
pone
nts
2953
4
Whi
te,
Non
-His
pani
c(8
38)
Bla
ck,
Non
-His
pani
c(1
,040
)
His
pani
c(4
37)
Asi
an/
Pac
ific
Isla
nder
(22)
Am
eric
anIn
dian
/A
lask
a N
ativ
e(1
5)
Inje
ctin
g D
rug
Use
(ID
U)
219
106
104
3612
072
76
49
Het
eros
exua
lE
Men
Hav
ing
i Sex
With
Men
7215
4
329
282
133
2 R
isk
Not
Rep
orte
d/Id
entif
ied
14 R
ecei
pt o
f Blo
od/B
lood
Com
pone
nts
2 ID
U4
Men
Hav
ing
Sex
With
Men
7 R
ecei
pt o
f Blo
od/B
lood
Com
pone
nts
2 ID
U1
Het
eros
exua
l Con
tact
5 M
en H
avin
g S
ex W
ith M
en
45
AD
OL
ESC
EN
T A
IDS
As
of D
ecem
ber
31, 1
995,
2,3
54 c
ases
of
AID
S w
ere
repo
rted
in a
dole
scen
ts a
ged
13-1
9 ye
ars.
Thi
s to
tal
incl
udes
405
new
ly r
epor
ted
case
s in
199
5.
Whi
tes
com
pris
ed 3
6% o
f th
e A
IDS
case
s am
ong
adol
esce
nts.
Of
thes
e, 6
4% w
ere
expo
sed
to H
IVpr
imar
ily th
roug
h re
ceip
t of
clot
ting
fact
or f
orhe
mop
hilia
/coa
gula
tion
diso
rder
or
as a
res
ult o
fbl
ood
tran
sfus
ions
. Eig
htee
n pe
rcen
t of
whi
tes
aged
13-1
9 ye
ars
wer
e ex
pose
d to
HIV
thro
ugh
mal
e-to
-mal
e se
xual
con
tact
.
Fort
y-fo
ur p
erce
nt o
f ad
oles
cent
AID
S ca
ses
wer
eam
ong
blac
k, n
on-H
ispa
nics
. Tw
enty
-sev
en p
erce
ntof
bla
cks
aged
13-
19 w
ere
expo
sed
to H
IV th
roug
hm
ale-
to-m
ale
sexu
al c
onta
ct.
NO
TE
S:
Rec
eipt
of B
lood
/Blo
od c
ompo
nent
s:R
ecei
ved
clot
ting
fact
or fo
r he
mop
hilia
/coa
gula
tion
diso
rder
Rec
eive
d bl
ood
tran
sfus
ion,
blo
od c
ompo
nent
s, o
r tis
sue
The
cat
egor
y "M
en W
ho H
ave
Sex
with
Men
" in
clud
es m
en w
ho h
ave
sex
with
men
and
als
o in
ject
dru
gs
Rac
e is
unk
now
n fo
r tw
o pe
rson
s in
this
age
gro
up; b
oth
are
in th
e ca
tego
ry"R
isk
Not
Rep
orte
d/Id
entif
ied"
Het
eros
exua
l con
tact
incl
udes
sex
with
: an
inje
ctin
g dr
ug u
ser;
a p
erso
nw
ith h
emop
hilia
; a tr
ansf
usio
n re
cipi
ent i
nfec
ted
with
HIV
; an
HIV
-infe
cted
per
son,
ris
k no
t spe
cifie
d; a
bis
exua
l mal
e (f
emal
es o
nly)
On
Janu
ary
1, 1
993,
the
AID
S c
ase
defin
ition
for
adul
ts a
nd a
dole
scen
ts,
aged
13
year
s an
d ol
der,
was
exp
ande
d to
incl
ude
HIV
-infe
cted
per
sons
with
CD
4 co
unts
of l
ess
than
or
equa
l to
200
cells
/AL
or a
CD
4 pe
rcen
tage
of le
ss th
an o
r eq
ual t
o 14
, and
per
sons
dia
gnos
ed w
ith p
ulm
onar
ytu
berc
ulos
is, r
ecur
rent
pne
umon
ia, a
nd in
vasi
ve c
ervi
cal c
ance
r.
Num
ber
of C
ases
BE
ST
CO
PY
AV
MB
LE
46
HE
ALT
H S
AT
US
Ado
lesc
ent
AD
OL
ESC
EN
T A
IDS
Mal
es c
ompr
ised
65%
of
the
2,35
4 A
IDS
case
sam
ong
adol
esce
nts
aged
13-
19 y
ears
. The
seyo
ung
men
wer
e ex
pose
d to
HIV
pri
mar
ilyth
roug
h re
ceip
t of
clot
ting
fact
or f
orhe
mop
hilia
/coa
gula
tion
diso
rder
or
as a
res
ult o
fbl
ood
tran
sfus
ions
. Thi
rty-
eigh
t per
cent
of
mal
esag
ed 1
3-19
yea
rs w
ere
expo
sed
to H
IV th
roug
hse
xual
con
tact
with
oth
er m
ales
.
Thi
rty-
five
per
cent
of
adol
esce
nt A
IDS
case
sw
ere
amon
g fe
mal
es. O
f th
ose,
54%
acq
uire
dH
IV in
fect
ion
thro
ugh
hete
rose
xual
con
tact
.T
wen
ty-f
our
perc
ent h
ad s
ex p
artn
ers
who
wer
ein
ject
ing
drug
use
rs, w
hile
16%
wer
e in
ject
ing
drug
use
rs th
emse
lves
.N
OT
ES
:R
ecei
pt o
f Blo
od/B
lood
com
pone
nts:
Rec
eive
d cl
ottin
g fa
ctor
for
hem
ophi
lia/c
oagu
latio
n di
sord
erR
ecei
ved
bloo
d tr
ansf
usio
n, b
lood
com
pone
nts,
or
tissu
e
The
cat
egor
y "M
en W
ho H
ave
Sex
with
Men
" in
clud
es m
en w
hoha
ve s
ex w
ith m
en a
nd a
lso
inje
ct d
rugs
Het
eros
exua
l con
tact
incl
udes
sex
with
: an
inje
ctin
g dr
ug u
ser;
ape
rson
with
hem
ophi
lia; a
tran
sfus
ion
reci
pien
t inf
ecte
d w
ith H
IV;
an H
1V-in
fect
ed p
erso
n, r
isk
not s
peci
fied;
a b
isex
ual m
ale
(fem
ales
onl
y)
On
Janu
ary
1, 1
993,
the
AID
S c
ase
defin
ition
for
adul
ts a
ndad
oles
cent
s, a
ged
13 y
ears
and
old
er, w
as e
xpan
ded
to in
clud
eH
IV-in
fect
ed p
erso
ns w
ith C
D4
coun
ts o
f les
s th
an o
r eq
ual t
o 20
0ce
lls/id
, or
a C
D4
perc
enta
ge o
f les
s th
an o
r eq
ual t
o 14
, and
pers
ons
diag
nose
d w
ith p
ulm
onar
y tu
berc
ulos
is, r
ecur
rent
pneu
mon
ia, a
nd in
vasi
ve c
ervi
cal c
ance
r.
Ado
lesc
ent A
IDS
Cas
es b
y G
ende
r an
d E
xpos
ure
Cat
egor
yfo
r A
ges
13-1
9: 1
981-
1995
Sou
rce
(11.
21):
Cen
ters
for
Dis
ease
Con
trol
and
Pre
vent
ion
Ris
k N
otR
ecei
pt o
fR
epor
ted/
Blo
od/B
lood
Iden
tifie
dC
ompo
nent
s
Mal
es(1
,534
)
Fem
ales
(820
)
Tot
al(2
,354
)
Inje
ctin
g D
rug
Use
(ID
U)
Het
eros
exua
lM
en H
avin
g
578
Sex
With
Men
109
712
97 3
8
179
69 1
3244
0
288
48
781
229
478
578
Num
ber
of C
ases
You
ng A
dult
AID
S C
ases
by
Rac
e/E
thni
city
and
Exp
osur
e C
ateg
ory
for
Age
s 20
-24:
198
1-19
95S
ourc
e (1
11.2
2): C
ente
rs fo
r D
isea
se C
ontr
ol a
nd P
reve
ntio
n
Whi
te,
Non
-His
pani
c(7
,423
)
Bla
ck,
Non
-His
pani
c(7
,384
)
His
pani
c(3
,926
)
Asi
an/
Pac
ific
Isla
nder
(125
)
Am
eric
anIn
dian
/A
lask
a N
ativ
e(6
8)
Unk
now
n(2
9)
253
523
Ris
k N
ot R
epor
ted/
Iden
tifie
dR
ecei
pt o
f Blo
od/B
lood
Com
pone
nts
Inje
ctin
g D
rug
Use
(ID
U)
Het
eros
exua
l Con
tact
849
663
Men
Hav
ing
Sex
With
Men
5,13
5
943
114
1 26
51,
545
262
92 1
,100
612
3,51
7
1,86
0
7 R
isk
Not
Rep
orte
d/Id
entif
ied
16 B
lood
/Blo
od P
rodu
cts
4 ID
U11
Het
eros
exua
l Con
tact
87 M
en H
avin
g S
ex W
ith M
en
6 R
isk
Not
Rep
ort/I
dent
ified
8 B
lood
/Blo
od P
rodu
cts
12 ID
U8
Het
eros
exua
l Con
tact
34 M
en H
avin
g S
ex W
ith M
en
5 R
isk
Not
Rep
orte
d/Id
entif
ied
4 B
lood
/Blo
od P
rodu
cts
3 ID
U4
Het
eros
exua
l Con
tact
13 M
en H
avin
g S
ex W
ith M
enN
umbe
r of
Cas
es49
47
YO
UN
G A
DU
LT
AID
S
As
of D
ecem
ber
31, 1
995,
18,
955
case
s of
AID
Sw
ere
repo
rted
in y
oung
adu
lts a
ged
20-2
4 ye
ars.
Thi
s to
tal i
nclu
des
2;43
2 ne
wly
rep
orte
d ca
ses
in19
95.
Acr
oss
all r
acia
l/eth
nic
grou
ps, m
en w
ho h
ave
sex
with
men
is th
e m
ajor
exp
osur
e ca
tego
ry a
ssoc
iate
dw
ith k
now
n A
IDS
case
s in
you
ng a
dults
. You
ngad
ult w
omen
(24
% o
f kn
own
AID
S ca
ses
in th
is a
gegr
oup)
are
exp
osed
to H
IV p
rim
arily
thro
ugh
inje
ctin
g dr
ug u
se (
31%
) or
thro
ugh
sex
with
an
inje
ctin
g dr
ug u
ser
(25%
).
Due
to th
e lo
ng la
tenc
y pe
riod
(m
edia
n of
10
year
s to
seve
re o
ppor
tuni
stic
infe
ctio
ns),
the
maj
ority
of
youn
g ad
ults
with
AID
S w
ere
mos
t lik
ely
infe
cted
duri
ng a
dole
scen
ce.
NO
TE
S:
Rec
eipt
of B
lood
/Blo
od c
ompo
nent
s:R
ecei
ved
clot
ting
fact
or fo
r he
mop
hilia
/coa
gula
tion
diso
rder
Rec
eive
d bl
ood
tran
sfus
ion,
blo
od c
ompo
nent
s, o
r tis
sue
The
cat
egor
y "M
en W
ho H
ave
Sex
with
Men
" in
clud
es m
en w
ho h
ave
sex
with
men
and
als
o in
ject
dru
gs
Het
eros
exua
l con
tact
incl
udes
sex
with
: an
inje
ctin
g dr
ug u
ser;
a p
erso
nw
ith h
emop
hilia
; a tr
ansf
usio
n re
cipi
ent i
nfec
ted
with
HIV
; an
HIV
- in
fect
edpe
rson
, ris
k no
t spe
cifie
d; a
bis
exua
l mal
e (f
emal
es o
nly)
On
Janu
ary
1, 1
993,
the
AID
S c
ase
defin
ition
for
adul
ts a
nd a
dole
scen
ts,
aged
13
year
s an
d ol
der,
was
exp
ande
d to
incl
ude
H /V
- in
fect
ed p
erso
nsw
ith C
D4
coun
ts o
f les
s th
an o
r eq
ual t
o 20
0 ce
lls/4
1, o
r a
CD
4 pe
rcen
tage
of le
ss th
an o
r eq
ual t
o 14
, and
per
sons
dia
gnos
ed w
ith p
ulm
onar
ytu
berc
ulos
is, r
ecur
rent
pne
umon
ia, a
nd in
vasi
ve c
ervi
cal c
ance
r.
48
HE
ALT
H S
TA
TU
SA
dole
scen
t
SUB
STA
NC
E A
BU
SE
Dru
g us
e am
ong
U.S
. sec
onda
ry s
choo
lst
uden
ts r
ose
agai
n in
199
5, c
ontin
uing
atr
end
that
beg
an in
199
1 am
ong
8th
grad
est
uden
ts, a
nd in
199
2, a
mon
g 10
th a
nd 1
2th
grad
ers.
Bel
iefs
abo
ut th
e ha
rmfu
lnes
s of
drug
s ha
ve p
rove
n to
be
impo
rtan
tde
term
inan
ts o
f us
e.
75
Alth
ough
alc
ohol
use
rat
es d
ecre
ased
stea
dily
fro
m 1
987
to 1
993,
use
has
incr
ease
d fo
r th
e pa
st tw
o ye
ars.
Alc
ohol
isst
ill th
e m
ost w
idel
y us
ed s
ubst
ance
am
ong
12th
gra
ders
. In
1995
, ove
r 51
% o
f 12
thgr
ader
s re
port
ed u
sing
alc
ohol
with
in th
e 30
days
pri
or to
the
surv
ey.
Long
-Ter
m T
rend
s in
Thi
rty-
Day
Pre
vale
nce
of U
se o
fV
ario
us T
ypes
of D
rugs
for
Tw
elfth
Gra
ders
: 197
5-19
95
Sou
rce
(111
.23)
: The
Mon
itorin
g th
e F
utur
e S
tudy
, Uni
vers
ity o
f Mic
higa
n
Alc
ohol
Mar
ijuan
a
51.0
_51.
3
12 -
0
Ce .c " 6
"6 cp4
21.2
CU a)
28
7577
7981
8385
8789
9193
95Y
ear
1.8
0
In 1
995,
the
use
of m
ariju
ana
cont
inue
d th
est
rong
res
urge
nce
that
beg
an in
the
earl
y19
90s.
The
per
cent
age
of 1
2th
grad
ers
repo
rtin
g da
ily u
se in
crea
sed
from
1.9
% to
4.6%
bet
wee
n 19
92 a
nd 1
995.
The
use
of
coca
ine
cont
inue
d to
incr
ease
slig
htly
.
Long
-Ter
m T
rend
s in
Thi
rty-
Day
Pre
vale
nce
of D
aily
Use
of .
Var
ious
Typ
es o
f Dru
gs fo
r T
wel
fth G
rade
rs: 1
975-
1995
Sou
rce
(111
.23)
: The
Mon
itorin
g th
e F
utur
e S
tudy
, Uni
vers
ity o
f Mic
higa
n
Mar
ijuan
a
7577
79
Alc
ohol
Coc
aine
II
IL
8183
85
Yea
r
8789
2.5
_102
9193
95
NO
TE
: As
of 1
993,
hal
f of
the
surv
eys
incl
uded
a n
ew q
uest
ion
on a
lcoh
ol: "
On
how
man
y oc
casi
ons,
if a
ny, h
ave
you
had
an a
lcoh
olic
beve
rage
to d
rink
mor
e th
an ju
st a
few
sip
s?"
By
1994
, all
of th
e su
rvey
s in
corp
orat
ed th
is q
uest
ion.
The
syn
tax
befo
re 1
993
was
, "O
n ho
w m
any
occa
sion
s, if
any
, hav
e yo
u ha
dal
coho
l to
drin
k?"
50
CIG
AR
ET
TE
SM
OK
ING
Tre
nds
in T
hirt
y D
ay P
reva
lenc
e
The
Uni
vers
ity o
f M
ichi
gan'
s In
stitu
te f
orSo
cial
Res
earc
h ha
s fo
und
that
cig
aret
tesm
okin
g ro
se a
gain
in 1
995
amon
g A
mer
ican
yout
h. T
his
is th
e fo
urth
yea
r in
a r
ow th
atci
gare
tte s
mok
ing
incr
ease
d fo
r 8t
h an
d 10
thgr
ader
s, a
nd th
e th
ird
year
in a
row
for
hig
hsc
hool
sen
iors
. One
in th
ree
high
sch
ool
seni
ors
said
that
they
had
sm
oked
cig
aret
tes
30 d
ays
prio
r to
the
surv
ey.
Incr
ease
d sm
okin
g ra
tes
will
hav
e se
vere
,lif
elon
g co
nseq
uenc
es f
or th
is g
ener
atio
nbe
caus
e a
larg
e pr
opor
tion
of th
ose
who
initi
ate
smok
ing
in a
dole
scen
ce w
ill c
ontin
ueto
sm
oke
for
the
rest
of
thei
r liv
es. H
undr
eds
of th
ousa
nds
of e
ach
grad
uatin
g cl
ass
may
die
prem
atur
ely
as a
res
ult o
f ci
gare
ttesm
okin
g.
Long
-Ter
m T
rend
s in
Thi
rty-
Day
Pre
vale
nce
of C
igar
ette
Sm
okin
g fo
r 8t
h, 1
0th,
and
12t
h G
rade
rs, 1
975-
1995
Sou
rce
(111
.24)
: The
Mon
itorin
g th
e F
utur
e S
tudy
, The
Uni
vers
ity o
f Mic
higa
n
40
le 3
0a) V ti5
20
0 a) rn t 10
/1".
114%
12th
Gra
de -
--44
iii,;,
.,/00
/ 33.
5
27.9
0'
7577
79
10th
Gra
de
8th
Gra
de19
.1
,,,,
8183
8587
8991
9395
Yea
r
51
49
Tre
nds
in A
ttitu
des
Am
ong
Am
eric
an y
outh
, bot
h di
sapp
rova
lan
d pe
rcei
ved
risk
of
ciga
rette
sm
okin
g ha
vebe
en d
eclin
ing
over
the
past
sev
eral
yea
rs,
whi
le th
e pr
eval
ence
of
smok
ing
has
incr
ease
d. T
hree
-fou
rths
(76
%)
of 8
thgr
ader
s sa
y th
ey c
an g
et c
igar
ette
s fa
irly
easi
ly; b
y 10
th g
rade
, ove
r 90
% s
ayci
gare
ttes
are
easi
ly a
ttain
able
.
Tre
nds
in A
ttitu
des
Abo
ut S
mok
ing
One
or
Mor
e P
acks
of
Cig
aret
tes
Per
Day
for
10th
Gra
ders
: 199
1-19
95S
ourc
e (1
11.2
4): T
he M
onito
ring
the
Fut
ure
Stu
dy, T
he U
nive
rsity
of M
ichi
gan
7978
8989
90
MIN
Per
ceiv
ed R
isk
ME
M D
isap
prov
alP
erce
ived
Ava
ilabi
lity
91
1991
1992
1993
Yea
r
1994
1995
50
HE
ALT
H S
ER
VIC
ES
AN
D U
TIL
IZA
TIO
N
Phot
o C
ourt
esy
of B
ruce
Str
ombe
rg/T
he C
hild
ren'
s H
ospi
tal o
f Ph
ilade
lphi
a
'1 '
The
ava
ilabi
lity
of a
nd a
cces
s to
qua
lity
heal
th c
are
dire
ctly
aff
ect t
he h
ealth
of
mot
hers
and
chi
ldre
n; e
spec
ially
thos
e at
hig
hri
sk d
ue to
med
ical
or
low
soc
io-e
cono
mic
stat
us. T
o da
te, t
here
is n
o un
iver
sal h
ealth
care
cov
erag
e fo
r w
omen
and
chi
ldre
n in
the
Uni
ted
Stat
es. I
t is
estim
ated
that
ove
r 14
%of
chi
ldre
n yo
unge
r th
an 1
8 ha
d no
hea
lthin
sura
nce
cove
rage
in 1
994.
As
stat
es im
plem
ent a
ltern
ativ
e se
rvic
ede
liver
y en
viro
nmen
ts s
uch
as M
edic
aid
man
aged
car
e, m
onito
ring
and
qua
lity
assu
ranc
e w
ill b
ecom
e in
crea
sing
lyim
port
ant.
The
fol
low
ing
sect
ion
pres
ents
bot
h na
tiona
lan
d st
ate
data
on
the
utili
zatio
n of
hea
lthse
rvic
es w
ithin
the
mat
erna
l and
chi
ldpo
pula
tion.
The
mos
t cur
rent
dat
a ar
esu
mm
ariz
ed b
y so
urce
of
paym
ent,
type
of
care
, and
pla
ce o
f se
rvic
e de
liver
y. D
ata
are
stra
tifie
d by
age
, eth
nici
ty, a
nd in
com
e.
52
Hea
lth In
sura
nce
Cov
erag
e: 1
994
Sou
rce
(IV
A):
Em
ploy
ee B
enef
it R
esea
rch
Inst
itute
Chi
ldre
n U
nder
18
Yea
rs o
f Age
*
4--
No
Cov
erag
e 14
.4%
Priv
ate
Insu
ranc
e18
.7%
1,
Pub
lic A
ssis
tanc
e 25
.2%
Priv
ate
Insu
ranc
e 66
.2%
Chi
ldre
n U
nder
18
Yea
rs o
f Age
in P
over
ty*
4No
Cov
erag
e 22
.3%
4--
Pub
lic A
ssis
tanc
e 64
.9%
51
HE
AL
TH
CA
RE
FIN
AN
CIN
G
A 1
996
repo
rt f
rom
the
Em
ploy
ee B
enef
itR
esea
rch
Inst
itute
indi
cate
d th
at 1
4.4%
, or
10.0
mill
ion
child
ren
youn
ger
than
18
year
sof
age
, had
no
insu
ranc
e co
vera
ge in
199
4.
Som
e 25
.2%
of
child
ren
wer
e pu
blic
lyin
sure
d, p
rim
arily
thro
ugh
Med
icai
d, a
nd66
.2%
wer
e co
vere
d by
pri
vate
insu
ranc
e.
Of
child
ren
youn
ger
than
18
who
se f
amili
esliv
ed in
pov
erty
, 64.
9% w
ere
publ
icly
insu
red
and
18.7
% h
ad p
riva
te c
over
age.
How
ever
,22
.3%
of
child
ren
in p
over
ty h
ad n
o he
alth
cove
rage
in 1
994.
* D
etai
ls m
ay a
dd to
mor
e th
an 1
00%
bec
ause
indi
vidu
als
may
rec
eive
cov
erag
e fr
om m
ore
than
one
sou
rce.
53
52
HE
ALT
H S
ER
VIC
ES
AN
D U
TIL
IZA
TIO
N
VA
CC
INA
TIO
N C
OV
ER
AG
E L
EV
EL
S
The
Nat
iona
l Im
mun
izat
ion
Surv
ey is
a s
ingl
esu
rvey
pro
vidi
ng s
tate
and
nat
iona
l est
imat
es o
fva
ccin
atio
n co
vera
ge le
vels
am
ong
child
ren
aged
19-3
5 m
onth
s. A
ll ch
ildre
n in
clud
ed in
the
surv
eyw
ere
born
aft
er O
ctob
er 1
990.
CD
C im
plem
ente
dth
e N
IS in
Apr
il 19
94 a
s on
e el
emen
t of
the
five
-par
t Chi
ldho
od I
mm
uniz
atio
n In
itiat
ive.
Vac
cina
tion
cove
rage
est
imat
es a
re th
e hi
ghes
tev
er r
ecor
ded
in th
e U
nite
d St
ates
. How
ever
,m
ore
than
one
mill
ion
child
ren
still
lack
one
or
mor
e do
ses
of th
e re
com
men
ded
vacc
ines
.C
over
age
for
the
Hep
atiti
s B
vac
cine
was
not
inco
rpor
ated
into
the
vacc
inat
ion
sche
dule
unt
il19
90.
Cov
erag
e le
vels
var
ied
subs
tant
ially
nat
ion-
wid
e.St
ates
in th
e M
iddl
e A
tlant
ic, S
outh
Atla
ntic
, and
Wes
t Nor
th C
entr
al r
egio
ns (
with
the
exce
ptio
n of
Sout
h D
akot
a an
d N
ebra
ska)
had
the
high
est
cove
rage
leve
ls (
>75
%),
whi
le M
ount
ain
and
Paci
fic
stat
es (
with
the
exce
ptio
n of
Ari
zona
and
Col
orad
o) h
ad th
e lo
wes
t cov
erag
e le
vels
(61-
74%
).
94 DT
P*
*
Vac
cina
tion
Cov
erag
e Le
vels
Am
ong
Chi
ldre
n A
ged
19-3
5 M
onth
s,by
Sel
ecte
d V
acci
nes:
199
4-19
95*
84
Sou
rce
(IV
.2):
Cen
ters
for
Dis
ease
Con
trol
and
Pre
vent
ion
9089
42
Pol
iovi
rus
Hib
***
MM
R**
**H
epat
itis
B
Typ
e of
Imm
uniz
atio
n
*Dat
a ar
e fr
om A
pril
1994
thro
ugh
Mar
ch 1
995
**D
TP:
Dip
hthe
ria
and
Tet
anus
toxo
ids
and
pert
ussi
s va
ccin
e, 2
3 do
ses
***H
ib:
Hae
mop
hilu
s in
fuen
zae
type
b 2
3 do
ses
****
MM
R: m
easl
es-m
umps
-rub
ella
ZI
dose
54
Rec
omm
ende
d C
hild
hood
Imm
uniz
atio
n S
ched
ule,
Uni
ted
Sta
tes,
199
5*
Vac
cine
Rou
tinel
y re
com
men
ded
age
for
vacc
inat
ion;
sha
ded
bar
indi
cate
s ac
cept
able
age
ran
geB
irth
I_ 2
mos
4 m
os6
mos
12 m
oss
15 m
os18
mos
4-6
yrs
11-1
2 yr
14-1
6 yr
s
Hep
atiti
s B
1
Dip
hthe
ria, T
etan
us, P
ertu
ssis
2
H. I
nflu
enza
e ty
pe b
3
Pol
io
Mea
sles
, Mum
ps, R
ubel
la4
HB
-1
HB
-2H
B-3
DT
P o
rD
TaP
DT
P
HiB
DT
P
HiB
DT
P
HiB
..
DT
Por
DT
aP a
t 15+
mos
Td
1 HiB
OP
VI
OP
VO
PV
OP
VI
MM
RM
MR
orM
MR
I
App
rove
d by
the
Adv
isor
y C
omm
ittee
on
Imm
unZ
atio
n P
ract
ices
(A
CIP
), th
e C
omm
ittee
on
Infe
ctio
us D
isea
ses
(CO
ID),
the
Am
eric
an A
cade
my
ofP
edia
tric
s (A
AP
), th
e A
AP
Exe
cutiv
e B
oard
, and
the
Com
mis
sion
on
Pub
lic H
ealth
and
Sci
entif
ic A
ffairs
(C
oPH
SA
), A
mer
ican
Aca
dem
y of
Fam
ilyP
hysi
cian
s (A
AF
P).
All
preg
nant
wom
en s
houl
d be
scr
eene
d fo
r H
BaA
g in
an e
arly
pre
nata
l vis
it; in
fant
s bo
rn to
HB
aAg-
posi
tive
mot
hers
shou
ldre
ceiv
eim
mun
opro
phyl
axis
for
hepa
titis
B w
ith 0
.5 m
l Hep
atiti
s B
Imm
une
Glo
bulin
(HB
IG)
with
in 1
2 ho
urs
of b
irth,
and
0.5
ml o
f 'ei
ther
Mer
ck S
harp
e &
Doh
me
vacc
ine
(Rec
ombi
vax
HB
) or
of S
mith
Klin
e B
eech
am v
acci
ne (
Eng
erix
-B)
at a
sepa
rate
site
.In
thes
e in
fant
s, th
e se
cond
dos
e of
vacc
ine
is r
ecom
men
ded
at 1
mon
th o
f age
and
the
third
dos
e at
6 m
onth
s of
age
. For
infa
nts
of H
BaA
g-ne
gativ
e m
othe
rs, t
he s
econ
d do
se o
f Hep
atiti
s B
vacc
ine
may
be
adm
inis
tere
d be
twee
n1
and
4m
onth
s of
age
, pro
vide
d at
leas
t one
mon
th h
asel
apse
d si
nce
rece
ipt o
f the
firs
t dos
e. T
he th
ird d
ose
is r
ecom
men
ded
betw
een
6 an
d 15
mon
ths
of a
ge.
BE
ST C
OPY
AV
AIL
AB
LE
2 T
he fo
urth
dos
e of
DT
P m
ay b
e ad
min
iste
red
as e
arly
as 1
2 m
onth
s of
age
, pro
vide
d at
leas
t 6 m
onth
s ha
veel
apse
d si
nce
DT
P3.
Com
bine
d D
TP
-Hib
pro
duct
sm
ay b
e us
ed w
hen
thes
e tw
o va
ccin
es a
re to
be
adm
inis
tere
d si
mul
tane
ousl
y.D
TaP
(di
phth
eria
and
teta
nus
toxo
ids
and
acel
lula
r pe
rtus
sis
vacc
ine)
islic
ense
d fo
r us
e fo
r th
e 4t
h an
d/or
5th
dos
e of
DIP
vacc
ine
in c
hild
ren
15 m
onth
s of
age
or
olde
r an
dm
ay b
e pr
efer
red
for
thes
e do
ses
in c
hild
ren
in th
isag
e gr
oup.
3 T
hree
H. i
nflu
enza
e ty
pe b
con
juga
te v
acci
nes
are
avai
labl
e fo
r us
e in
infa
nts;
HbO
C [H
ib T
ITE
R]
(Led
erle
Pra
xis)
; PR
P-T
[Act
HIB
; Om
niH
IB] (
Pas
teur
Mer
ieus
,di
strib
uted
byS
mith
Klin
eB
eech
am;
4
53
Con
naug
ht);
and
PR
P-O
MP
[Ped
vaxH
lB)
(Mer
ckS
harp
& D
ohm
e).
Chi
ldre
n w
ho h
ave
rece
ived
PR
P-O
MP
at 2
and
4 m
onth
s of
age
do
not r
equi
re a
dose
at 6
mon
ths
of a
ge. A
fter
the
prim
ary
infa
nt H
ibco
njug
ate
vacc
ine
serie
s is
com
plet
ed, a
ny li
cens
edH
ib c
onju
gate
vac
cine
may
be
used
as
a bo
oste
rdo
se a
t age
12-
15 m
onth
s.
The
sec
ond
dose
of M
MR
vac
cine
sho
uld
be a
d-m
inis
tere
d E
ITH
ER
at 4
-6 y
ears
of a
ge O
R a
t 11-
12ye
ars
of a
ge.
5 V
acci
nes
reco
mm
ende
d in
the
seco
nd y
ear
of li
fe(1
2-15
mon
ths
of a
ge)
may
be
give
n at
eith
er o
ne o
ftw
o vi
sits
.
54
HE
ALT
H S
ER
VIC
ES
UT
ILIZ
AT
ION
PHY
SIC
IAN
VIS
ITS
In 1
994,
nea
rly
20.7
% o
f ch
ildre
n yo
unge
rth
an 2
0 ye
ars
of a
ge, o
r 15
.5 m
illio
nch
ildre
n, w
ere
not s
een
by a
phy
sici
an in
the
past
yea
r. I
n al
l age
gro
ups,
a h
ighe
rpe
rcen
tage
of
blac
k ch
ildre
n th
an w
hite
child
ren
had
not b
een
seen
by
a ph
ysic
ian
inth
e pa
st y
ear.
Dur
ing
1994
, 7.8
% o
f w
hite
, 9.4
% o
f bl
ack,
and
7.8%
of
His
pani
c or
igin
chi
ldre
n ag
es1-
4 w
ere
not s
een
by a
phy
sici
an.
9.4
Per
cent
age
of C
hild
ren
with
No
Phy
sici
an V
isits
in th
e P
ast Y
ear,
by A
ge a
nd R
ace/
Eth
nici
ty: 1
994
Sou
rce
(IV
.3):
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics
38.6
MIN
Whi
teB
lack
His
pani
c
22.4
22.
3
31.5
26.6
28.9
1-4
5-9
Age 56
10-1
415
-19
Pla
ce o
f Phy
sici
an C
onta
ct b
y A
ge a
nd P
over
ty S
tatu
s: 1
994
Sou
rce
(IV
.4):
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics
Und
er 5
Yea
rs
belo
wpo
vert
y le
vel
abov
epo
vert
y le
vel
5 -1
4 Y
ears be
low
pove
rty
leve
l
abov
epo
vert
y le
vel
Oth
er
1 1
1.3
114
4'
Tel
epho
neH
ospi
tal
MD
Offi
ce
3.0
.5.4
.7
4.4
1.8
5 .4
2.2
Phy
sici
an C
onta
cts
Per
Chi
ld57
55
PLA
CE
OF
PHY
SIC
IAN
CO
NT
AC
T
Am
ong
child
ren
who
saw
a p
hysi
cian
duri
ng th
e pa
st y
ear,
chi
ldre
n yo
unge
r th
an5
year
s ol
d av
erag
ed m
ore
phys
icia
nco
ntac
ts th
an s
choo
l-ag
e ch
ildre
n.
Chi
ldre
n w
hose
fam
ily in
com
e w
as a
bove
the
pove
rty
leve
l use
d m
ore
phys
icia
nse
rvic
es th
an c
hild
ren
in p
over
ty.
Chi
ldre
n in
pov
erty
wer
e m
ore
likel
y to
see
phys
icia
ns in
hos
pita
ls a
nd o
ther
pla
ces
and
less
like
ly to
see
phy
sici
ans
in o
ffic
es th
anch
ildre
n ab
ove
pove
rty.
How
ever
, fro
m 1
993
to 1
994,
the
num
ber
ofph
ysic
ian
cont
acts
per
chi
ld in
a p
hysi
cian
'sof
fice
incr
ease
d fo
r ch
ildre
n ag
ed 1
-14
year
sin
pov
erty
, whi
le it
dec
reas
ed f
or c
hild
ren
youn
ger
than
5 y
ears
old
in p
over
ty.
56
HE
ALT
H S
ER
VIC
ES
AN
D U
TIL
IZA
TIO
N
HO
SPIT
AL
UT
ILIZ
AT
ION
In 1
994,
chi
ldre
n yo
unge
r th
an a
ge 1
8 in
fam
ilies
with
inco
mes
less
than
$20
,000
aver
aged
1.5
tim
es m
ore
hosp
ital d
ays
per
1,00
0 ch
ildre
n th
an c
hild
ren
from
hig
her
inco
me
fam
ilies
.
Reg
ardl
ess
of in
com
e st
atus
, bla
ck c
hild
ren
youn
ger
than
18
year
s of
age
had
the
high
est
num
ber
of h
ospi
tal d
ays
per
1,00
0 ch
ildre
n.
*Oth
er in
clud
es:
Indi
an (
Am
eric
an)
Esk
imo
Ale
utC
hine
seFi
lipin
oH
awai
ian.
Kor
ean
Vie
tnam
ese
Japa
nese
Asi
an I
ndia
nSa
moa
nG
uam
ania
nO
ther
Asi
an P
acif
ic I
slan
ders
Oth
er R
ace
Mul
tiple
Rac
eU
nkno
wn
Hos
pita
l Util
izat
ion
by In
com
e an
d R
ace:
199
4S
ourc
e (I
V.5
): N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s
Whi
teB
lack
All
Rac
es
Oth
er*
331.
4
164.
3
94.5
Und
er $
20,0
00
Inco
me
58
Ove
r $2
0,00
0
Per
cent
age
of E
PS
DT
* C
hild
ren
Who
Rec
eive
d P
reve
ntiv
e D
enta
l Ser
vice
s:19
92-1
993
Sou
rce
(IV
.6):
Offi
ce o
f Ins
pect
or G
ener
al
33.7
30.0
1992
1993
22.0
22.2
19.7
19.5
18.1
16.0
0.3
0.4
All
ages
< 1
yea
r1-
5 ye
ars
6-14
yea
rs15
-20
year
s
Age
gro
up*E
arly
and
Per
iodi
c Sc
reen
ing,
Dia
gnos
is, a
nd T
reat
men
t
59
57
AC
CE
SS A
ND
UT
ILIZ
AT
ION
OF
PRE
VE
NT
IVE
DE
NT
AL
SE
RV
ICE
S
Few
chi
ldre
n re
ceiv
e E
PSD
T d
enta
l ser
vice
s; th
eex
tent
of
the
prob
lem
var
ies
sign
ific
antly
fro
mst
ate
to s
tate
. In
1993
, onl
y 1
in 5
(4.
2 m
illio
nou
t of
21.2
mill
ion)
elig
ible
Med
icai
d-en
rolle
dch
ildre
n re
ceiv
ed p
reve
ntiv
e de
ntal
ser
vice
s.T
his
was
a 2
.3%
dec
reas
e fr
om th
e 19
92 r
ate
of1
in 4
.5 c
hild
ren.
In 1
993,
thre
e fo
urth
s of
the
stat
es p
rovi
ded
prev
entiv
e de
ntal
ser
vice
s to
few
er th
an 3
0pe
rcen
t of
all e
ligib
le c
hild
ren,
whi
le n
one
of th
est
ates
pro
vide
d se
rvic
es to
50
perc
ent.
The
Dep
artm
ent o
f H
ealth
and
Hum
an S
ervi
ces'
Hea
lthy
Peop
le 2
000
Obj
ectiv
e is
"to
incr
ease
toat
leas
t 90
perc
ent t
he p
ropo
rtio
n of
all
child
ren
ente
ring
sch
ool p
rogr
ams
for
the
firs
t tim
e w
hoha
ve r
ecei
ved
an o
ral h
ealth
scr
eeni
ng, r
efer
ral,
and
follo
w-u
p fo
r ne
cess
ary
diag
nost
ic,
prev
entiv
e, a
nd tr
eatm
ent s
ervi
ces.
"
The
pro
port
ion
of e
ligib
le M
edic
aid-
enro
lled
child
ren
rece
ivin
g pr
even
tive
dent
al s
ervi
ces
decr
ease
d fo
r al
l age
gro
ups
from
199
2 to
199
3.A
lthou
gh th
e A
mer
ican
Aca
dem
y of
Ped
iatr
icD
entis
ts r
ecom
men
ds th
at d
entis
ts e
xam
ine
all
child
ren
befo
re th
eir
firs
t bir
thda
y, o
nly
a sm
all
frac
tion
of M
edic
aid
child
ren
rece
ive
thes
ese
rvic
es.
58
HE
ALT
H S
ER
VIC
ES
AN
D U
TIL
IZA
TIO
N
SER
VIC
E U
TIL
IZA
TIO
N B
YC
HIL
DR
EN
WIT
H C
HR
ON
ICC
ON
DIT
ION
S
Phys
icia
n U
tiliz
atio
n
In 1
994,
chi
ldre
n w
ho w
ere
limite
d in
activ
ities
had
thre
e tim
es a
s m
any
phys
icia
n co
ntac
ts a
s ch
ildre
n w
ithou
tch
roni
c co
nditi
ons.
The
num
ber
ofph
ysic
ian
cont
acts
per
per
son
for
ages
15
to24
rem
aine
d st
able
fro
m 1
993
to 1
994,
whi
le it
dec
reas
ed f
or a
ll ot
hers
.
Hos
pita
l Util
izat
ion
Chi
ldre
n w
ith c
hron
ic c
ondi
tions
spe
ndab
out 1
0 tim
es a
s m
any
days
in th
e ho
spita
las
chi
ldre
n w
ithou
t act
ivity
lim
itatio
ns.
Phy
sici
an U
tiliz
atio
n by
Chi
ldre
n w
ith C
hron
icA
ctiv
ity L
imita
tions
,by
Age
: 199
4S
ourc
e (I
IV.7
): N
atio
nal C
ente
rfo
r H
ealth
Sta
tistic
s
Hos
pita
l Util
izat
ion
byC
hild
ren
with
Chr
onic
Act
ivity
Lim
itatio
ns,
by A
ge: 1
994
(Exc
ludi
ng D
eliv
erie
s)S
ourc
e (I
V.7
): N
atio
nal C
ente
rfo
r H
ealth
Sta
tistic
s
19.8
9.3
2.9
6.3
With
Lim
itatio
nsW
ithou
t Lim
itatio
ns
9.9
3.4
Und
er 5
4.1
0.3
5-14
Age
0.9
Und
er 5 60
15-2
4
With
Lim
itatio
nsW
ithou
t Lim
itatio
ns
0 07
5-14
Age
1.4
0.10
15-2
4
I
61
t,t
59
Phot
o C
ourt
esy
of th
e H
ospi
tal f
or S
ick
Chi
ldre
n
60
HE
ALT
H S
ER
VIC
ES
AN
D U
TIL
IZA
TIO
N
PRE
NA
TA
L C
AR
E
Ear
ly P
rena
tal C
are
Ove
rall,
80%
of
all m
othe
rs r
ecei
ved
pren
atal
care
in th
e fi
rst t
rim
este
r of
pre
gnan
cy in
199
4.
The
re is
sub
stan
tial r
acia
l dis
pari
ty in
the
timel
yre
ceip
t of
pren
atal
car
e. I
n 19
94, 8
3% o
f w
hite
mot
hers
, as
com
pare
d to
68%
of
blac
k m
othe
rs,
rece
ived
ear
ly p
rena
tal c
are.
Wom
en y
oung
er th
an 2
0 ye
ars
of a
ge a
re le
sslik
ely
than
old
er w
omen
to r
ecei
ve e
arly
pren
atal
car
e.
No
Pren
atal
Car
e
Eve
ry y
ear
from
198
3 to
199
1, 6
% o
f in
fant
sw
ere
born
to m
othe
rs w
ho in
itiat
ed c
are
duri
ngth
e th
ird
trim
este
r or
rec
eive
d no
pre
nata
l car
e.H
owev
er, t
hat f
igur
e dr
oppe
d to
4%
in 1
994.
Reg
ardl
ess
of a
ge, b
lack
wom
en a
re le
ss li
kely
to r
ecei
ve p
rena
tal c
are
than
are
whi
te w
omen
.
Ris
k fa
ctor
s fo
r no
t rec
eivi
ng p
rena
tal c
are
incl
ude
bein
g le
ss th
an 1
8 ye
ars
of a
ge,
unm
arri
ed s
tatu
s, lo
w e
duca
tiona
l atta
inm
ent
and
bein
g in
a m
inor
ity g
roup
.
Per
cent
age
of W
omen
with
Ear
ly P
rena
tal C
are,
by
Age
and
Rac
e of
Mot
her:
199
4S
ourc
e (I
V.8
): N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s
r_ W
hite
rBla
ck
62.9
154.4
68.8
76.9
86.5
< 1
818
-19
20-2
425
-29
30-3
4A
ge o
f Mot
her
Per
cent
age
of W
omen
with
No
Pre
nata
l Car
e, b
y A
ge a
nd R
ace
of M
othe
r: 1
994
35-3
940
+
Corn a) C
I_
Whi
teB
lack
3.4
Sou
rce
(IV
.8):
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics
4.0
3.4
3.6
3.7
< 1
818
-19
20-2
425
-29
30-3
4
nA
ge o
f Mot
her
35-3
940
+
62
ST
AT
E-S
PE
CIF
IC D
AT
A
Infa
nt a
nd N
eona
tal M
orta
lity
Rat
es, b
y R
ace
of M
othe
r an
d S
tate
, 199
3, a
nd P
erin
atal
Mor
talit
y R
ates
,by
Rac
e of
Mot
her
and
Sta
te: 1
992
Sou
rce
(V.1
): N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s
Sta
te
Infa
nt M
orta
lity'
All*
Whi
teB
lack
Per
inat
al M
orta
lity
Y
All*
Whi
teB
lack
Neo
nata
l Mor
talit
y
All*
Whi
teB
lack
Infa
nt M
orta
lity'
Per
inat
al M
orta
lity
2N
eona
tal M
orta
lity
Sta
teA
ll*W
hite
Bla
ckA
ll*W
hite
Bla
ckA
ll*W
hite
Bla
ck
UN
ITE
D S
TA
TE
S8.
46.
816
.58.
57.
215
.45.
34.
310
.7N
EV
AD
A6.
76.
214
.06.
15.
611
.53.
43.
3**
ALA
BA
MA
10.3
7.9
15.1
11.0
8.4
16.1
6.6
5.0
9.8
NE
W H
AM
PS
HIR
E5.
65.
7**
5.7
5.5
**3.
63.
7**
ALA
SK
A8.
26.
3**
6.3
5.7
**4.
63.
7**
NE
W J
ER
SE
Y8.
36.
117
.58.
66.
816
.55.
54.
211
.2
AR
IZO
NA
7.6
6.9
22.1
7.6
7.1
11.8
4.9
4.5
13.3
NE
W M
EX
ICO
8.4
7.3
**6.
15.
9**
4.6
4.3
**
AR
KA
NS
AS
10.0
9.1
13.4
9.7
8.2
14.4
5.8
5.1
8.7
NE
W Y
OR
K8.
46.
615
.49.
98.
117
.05.
74.
610
.3
CA
LIF
OR
NIA
6.8
6.3
15.6
7.3
6.9
14.6
4.2
3.8
9.7
NO
RT
H C
AR
OLI
NA
10.5
7.7
17.1
10.6
7.9
16.8
7.3
5.2
12.3
CO
LOR
AD
O7.
97.
417
.07.
47.
113
.54.
24.
08.
5N
OR
TH
DA
KO
TA
7.9
7.9
**7.
77.
3**
4.6
4.8
**
CO
NN
EC
TIC
UT
7.1
5.8
15.6
8.4
6.9
17.9
5.0
4.1
11.6
OH
IO9.
27.
617
.98.
87.
714
.86.
05.
011
.5
DE
LAW
AR
E8.
85.
719
.98.
76.
814
.46.
44.
214
.5O
KLA
HO
MA
8.8
8.3
16.4
9.0
8.6
12.5
4.5
3.9
10.9
DIS
TR
ICT
OF
CO
L17
.4**
20.6
17.5
**20
.012
.2**
14.5
OR
EG
ON
7.2
7.0
**6.
56.
4**
3.7
3.6
**
FLO
RID
A8.
66.
615
.39.
07.
414
.25.
64.
210
.0P
EN
NS
YLV
AN
IA8.
66.
619
.79.
27.
816
.95.
84.
712
.5
GE
OR
GIA
10.4
7.2
16.3
10.8
7.3
16.7
6.8
4.5
10.9
RH
OD
E IS
LAN
D7.
37.
1**
8.2
7.6
**4.
94.
9**
HA
WA
II7.
23.
8**
5.7
5.0
**5.
3**
**S
OU
TH
CA
RO
LIN
A10
.16.
715
.710
.77.
416
.26.
84.
410
.9
IDA
HO
7.2
7.0
**7.
98.
0**
3.6
3.6
**S
OU
TH
DA
KO
TA
9.5
7.6
**8.
98.
3**
4.9
4.2
**
ILLI
NO
IS9.
97.
119
.69.
97.
817
.46.
34.
612
.5T
EN
NE
SS
EE
9.4
6.7
17.9
8.6
6.5
15.2
5.5
3.8
11.0
IND
IAN
A9.
28.
018
.39.
58.
418
.45.
54.
911
.1T
EX
AS
7.5
6.5
14.6
7.4
6.7
12.1
4.5
4.0
8.5
IOW
A6.
96.
422
.97.
67.
3**
4.1
3.8
**.
UT
AH
6.0
6.0
**6.
06.
1**
3.0
3.1
**
KA
NS
AS
8.8
7.5
23.5
7.8
7.2
14.1
5.5
4.7
14.5
VE
RM
ON
T6.
76.
7**
7.0
7.1
**4.
64.
5**
KE
NT
UC
KY
8.2
7.6
14.3
7.5
7.0
12.6
5.1
4.7
8.7
VIR
GIN
IA8.
76.
714
.98.
36.
215
.05.
84.
410
.2
LOU
ISIA
NA
10.8
7.4
15.6
9.1
7.4
11.7
6.8
4.5
10.0
WA
SH
ING
TO
N6.
46.
017
.8. 6
.36.
015
.53.
23.
19.
2
MA
INE
6.8
6.9
**6.
86.
5**
4.4
4.5
**W
ES
T V
IRG
INIA
8.6
8.1
**8.
78.
7**
5.8
5.7
**
MA
RY
LAN
D9.
86.
317
.69.
97.
315
.66.
84.
312
.2W
ISC
ON
SIN
7.9
7.0
16.0
7.5
6.8
12.1
4.7
4.2
9.1
MA
SS
AC
HU
SE
TT
S6.
25.
711
.47.
16.
612
.34.
54.
08.
7W
YO
MIN
G7.
97.
9**
7.3
7.1
**4.
64.
71r
*
MIC
HIG
AN
9.5
7.1
18.8
8.6
6.9
15.9
6.2
4.6
12.5
MIN
NE
SO
TA
7.5
7.1
14.1
7.2
6.7
16.4
4.6
4.4
7.8
* R
ates
incl
ude
race
s ot
her
than
bla
ck a
nd w
hite
.
MIS
SIS
SIP
PI
11.5
8.4
14.7
12.3
8.2
16.8
7.1
5.3
9.1
** F
ewer
than
20
deat
hs, r
ates
not
sho
wn.
MIS
SO
UR
I8.
47.
114
.88.
06.
814
.05.
24.
48.
91.
Rat
es a
re d
eath
s le
ss th
an o
ne y
ear
per
1,00
0 liv
e bi
rths
in s
peci
fied
grou
p.
MO
NT
AN
A7.
46.
9**
7.0
6.8
**4.
54.
4**
2. R
ates
are
feta
l dea
ths
28 w
eeks
and
infa
nt d
eath
s <
7 d
ays
per
1,00
0 liv
e
NE
BR
AS
KA
9.1
8.3
26.2
6.8
6.4
**5.
34.
8**
birt
hs a
nd s
peci
fied
feta
l dea
ths.
3. R
ates
are
dea
ths
unde
r 28
day
s pe
r 1,
000
live
birt
hs in
spe
cifie
d gr
oup.
BE
ST
CO
PY
AV
AIL
AB
LE64
63
Per
cent
age
of L
ow B
irth
Wei
ght*
Infa
nts,
Wom
en R
ecei
ving
Firs
t Trim
este
r P
rena
tal C
are,
and
Birt
hs to
Wom
en U
nder
18,
by R
ace
of M
othe
r an
d S
tate
: 199
3S
ourc
e (V
.2):
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics
Sta
te
Per
cent
age
Low
Birt
h W
eigh
t
All
Whi
teB
lack
Per
cent
age
With
Ear
ly P
rena
tal C
are
All
Whi
teB
lack
Per
cent
age
of B
irths
to W
omen
<18
All
Whi
te B
lack
His
pani
cS
tate
Per
cent
age
Low
Birt
h W
eigh
t
All
Whi
teB
lack
Per
cent
age
With
Ear
ly P
rena
tal C
are
All
Whi
teB
lack
Per
cent
age
of B
irths
to W
omen
<18
All
Whi
teB
lack
His
pani
c
UN
ITE
D S
TA
TE
S7.
26.
013
.378
.981
.866
.05.
14.
010
.57.
2M
ON
TA
NA
6.0
5.9
**80
.582
.776
.64.
53.
6**
**
ALA
BA
MA
8.7
6.6
12.6
80.1
86.8
67.6
7.5
5.0
12.4
5.3
NE
BR
AS
KA
5.9
5.5
12.0
83.2
84.7
66.6
3.5
2.9
10.4
7.5
ALA
SK
A4.
94.
59.
483
.385
.985
.63.
92.
95.
3**
NE
VA
DA
7.4
6.5
15.4
73.1
74.8
58.7
5.1
4.5
11.3
6.6
AR
IZO
NA
6.7
6.4
13.4
69.9
71.5
64.5
5.9
5.6
10.5
8.8
NE
W H
AM
PS
HIR
E5.
04.
9**
88.5
88.6
74.0
2.0
2.0
****
AR
KA
NS
AS
8.2
6.9
12.5
73.8
78.4
58.5
7.5
5.5
14.2
4.5
NE
W J
ER
SE
Y.
7.6
6.1
13.5
81.6
86.1
62.9
3.3
2.0
8.7
6.6
CA
LIF
OR
NIA
6.0
5.4
12.6
76.8
76.7
74.3
4.8
4.8
7.9
6.6
NE
W M
EX
ICO
7.3
7.3
12.5
63.9
66.8
59.3
7.4
7.5
11.6
10.5
CO
LOR
AD
O8.
48.
014
.979
.580
.567
.44.
74.
59.
510
.4N
EW
YO
RK
7.7
6.2
13.0
74.6
79.3
59.0
3.8
2.9
7.4
6.4
CO
NN
EC
TIC
UT
6.9
6.0
12.3
88.0
90.0
74.3
3.4
2.7
7.3
10.8
NO
RT
H C
AR
OLI
NA
8.6
6.6
13.4
80.7
86.8
66.7
6.1
4.0
11.0
5.2
DE
LAW
AR
E7.
85.
814
.282
.286
.567
.95.
13.
311
.39.
5N
OR
TH
DA
KO
TA
5.3
5.3
**82
.884
.186
.52.
92.
3**
**
DIS
TR
ICT
OF
CO
L.14
.65.
716
.754
.981
.150
.58.
11.
49.
75.
8O
HIO
7.5
6.3
13.9
83.7
86.6
68.9
5.2
4.0
11.6
9.0
FLO
RID
A7.
56.
112
.180
.284
.167
.45.
53.
811
.24.
8O
KLA
HO
MA
6.7
6.1
12.3
74.3
77.4
58.9
6.3
5.2
11.7
8.9
GE
OR
GIA
8.7
6.3
13.0
78.7
84.7
68.4
6.7
4.5
11.0
5.5
OR
EG
ON
5.2
5.1
11.4
79.5
80.0
68.2
4.6
4.4
13.2
7.7
HA
WA
II6.
85.
211
.974
.578
.771
.03.
41.
3**
6.5
PE
NN
SY
LVA
NIA
7.4
6.0
14.6
80.8
84.9
58.7
4.2
3.0
11.0
11.7
IDA
HO
5.3
5.2
**78
.078
.577
.84.
84.
7**
8.3
RH
OD
E IS
LAN
D6.
55.
910
.889
.290
.876
.34.
33.
69.
39.
2
ILLI
NO
IS8.
15.
915
.379
.383
.664
.85.
33.
312
.46.
4S
OU
TH
CA
RO
LIN
A
SO
UT
H D
AK
OT
A
9.3
5.5
6.7
5.3
13.6 **
73.5
79.9
82.5
83.4
59.1
80.3
6.6
3.9
4.2
2.7
10.5 **
4.5 **
IND
IAN
A7.
06.
212
.979
.181
.162
.85.
14.
112
.76.
9T
EN
NE
SS
EE
8.8
7.0
14.4
81.2
85.4
68.2
6.5
4.9
11.7
4.9
IOW
A5.
75.
512
.686
.887
.472
.33.
83.
512
.87.
4T
EX
AS
7.1
6.2
13.1
71.9
72.7
65.1
6.6
6.1
10.8
8.5
KA
NS
AS
6.6
6.0
12.8
83.7
85.2
71.5
4.5
3.8
11.7
8.1
UT
AH
5.9
5.9
8.7
85.7
86.6
72.7
3.9
3.8
7.2
9.3
KE
NT
UC
KY
7.1
6.6
12.5
81.2
82.7
66.5
6.5
5.9
13.0
5.0
VE
RM
ON
T5.
75.
6**
85.1
85.4
**2.
62.
6**
**LO
UIS
IAN
A9.
36.
213
.577
.485
.966
.48.
14.
512
.94.
1V
IRG
INIA
7.3
5.6
12.3
82.8
87.4
70.1
4.1
2.7
8.5
3.9
MA
INE
5.4
5.4
**88
.088
.287
.73.
43.
3**
**W
AS
HIN
GT
ON
5.2
4.9
11.3
80.7
81.8
70.4
4.0
3.8
8.8
7.9
MA
RY
LAN
D8.
55.
913
.785
.391
.273
.54.
22.
28.
53.
9W
ES
T V
IRG
INIA
7.2
7.0
12.1
79.2
79.9
60.6
6.6
6.4
11.6
**
MA
SS
AC
HU
SE
TT
TS
6.2
5.7
10.6
88.0
89.7
77.2
3.0
2.5
6.7
9.9
WIS
CO
NS
IN6.
15.
213
.782
.286
.060
.93.
82.
513
.59.
2M
ICH
IGA
N7.
65.
914
.381
.885
.667
.04.
83.
211
.18.
7W
YO
MIN
G7.
37.
3**
81.2
81.9
71.7
4.8
4.7
**8.
4M
INN
ES
OT
A5.
55.
011
.982
.985
.657
.03.
02.
312
.79.
2
MIS
SIS
SIP
PI
10.1
6.7
13.7
74.9
84.9
64.5
9.5
5.3
13.9
***
Les
s th
an 2
,500
gra
ms
(5 lb
. 8 o
z.).
MIS
SO
UR
I7.
56.
313
.481
.585
.164
.85.
44.
012
.47.
5**
Few
er th
an 2
0 oc
curr
ence
s.
65
64
ST
AT
E-S
PE
CIF
IC D
AT
A
Num
ber
of C
hild
ren
Und
er A
ge 1
8 pe
r P
edia
tric
ian,
199
4, a
nd N
umbe
r of
Chi
ldre
n pe
r C
hild
Hea
lth P
hysi
cian
, 199
4S
ourc
e (V
.3):
Am
eric
an A
cade
my
of P
edia
tric
s
Tot
al N
umbe
r of
Chi
ldre
n pe
rC
hild
ren
per
Sta
teC
hild
ren
Und
er A
ge 1
8P
edia
tric
ian
1C
hild
Hea
lth P
hysi
cian
2
UN
ITE
D S
TA
TE
S67
,351
,411
1,68
91,
206
ALA
BA
MA
1,11
5,65
32,
412
1,57
3
ALA
SK
A19
2,37
72,
346
1,38
2
AR
IZO
NA
1,08
0,98
91,
982
1,35
0
AR
KA
NS
AS
648,
132
2,73
51,
439
CA
LIF
OR
NIA
8,36
4,37
71,
582
1,13
9
CO
LOR
AD
O95
7,84
91,
797
1,16
7
CO
NN
EC
TIC
UT
757,
880
1,06
791
2
DE
LAW
AR
E17
5,81
01,
465
1,07
3
DIS
TR
ICT
OF
CO
L.11
1,28
643
738
4
FLO
RID
A3,
109,
531
1,52
61,
066
GE
OR
GIA
1,89
5,63
82,
064
1,46
0
HA
WA
II30
1,58
11,
228
963
IDA
HO
334,
001
4,75
52,
092
ILLI
NO
IS3,
065,
261
1,64
71,
198
IND
IAN
A1,
521,
948
2,78
81,
541
IOW
A73
4,92
53,
343
1,68
7
KA
NS
AS
684,
462
2,50
11,
420
KE
NT
UC
KY
994,
253
2,12
81,
347
LOU
ISIA
NA
1,26
8,04
82,
104
1,51
2
MA
INE
314,
764
2,19
31,
310
MA
RY
LAN
D1,
236,
265
935
786
MA
SS
AC
HU
SE
TT
S1,
375,
134
918
805
MIC
HIG
AN
2,54
1,93
32,
187
1,57
9
MIN
NE
SO
TA
1,23
0,44
92,
110
1,16
7
MIS
SIS
SIP
PI
778,
188
3,10
31,
883
MIS
SO
UR
I1,
364,
012
1,89
31,
428
BE
ST C
OPY
AV
AIL
AB
LE
66
Sta
te
Tot
al N
umbe
r of
Chi
ldre
n U
nder
Age
18
Chi
ldre
n pe
rP
edia
tric
ian.
'C
hild
ren
per
Chi
ld H
ealth
Phy
sici
an2
MO
NT
AN
A23
6,50
73,
362
1,68
9
NE
BR
AS
KA
441,
162
2,45
61,
305
NE
VA
DA
357,
758
2,96
41,
869
NE
W H
AM
PS
HIR
E28
6,05
51,
727
1,18
8
NE
W J
ER
SE
Y1,
871,
014
1,03
288
1
NE
W M
EX
ICO
487,
416
2,04
31,
319
NE
W Y
OR
K4,
393,
891
954
827
NO
RT
H C
AR
OLI
NA
1,71
7,46
71,
857
1,25
4
NO
RT
H D
AK
OT
A17
5,10
72,
793
1,31
6
OH
IO2,
901,
507
1,82
81,
317
OK
LAH
OM
A87
3,13
13,
004
1,75
4
OR
EG
ON
790,
254
2,34
71,
440
PE
NN
SY
LVA
NIA
2,87
3,17
51,
668
1,15
5
RH
OD
E IS
LAN
D22
8,65
01,
222
1,00
9
SO
UT
H C
AR
OLI
NA
980,
696
2,35
61,
433
SO
UT
H D
AK
OT
A20
6,55
73,
968
1,60
6
TE
NN
ES
SE
E1,
297,
351
1,74
61,
221
TE
XA
S5,
258,
335
2,32
01,
577
UT
AH
692,
455
2,57
81,
809
VE
RM
ON
T14
8,47
71,
442
1,00
0
VIR
GIN
IA1,
620,
367
1,59
31,
111
WA
SH
ING
TO
N1,
402,
142
1,95
11,
143
WE
ST
VIR
GIN
IA45
4,07
12,
264
1,36
7
WIS
CO
NS
IN1,
350,
783
2,23
81,
350
WY
OM
ING
142,
377
4,18
81,
796
I. P
edia
tric
ians
are
con
side
red
to b
e in
dire
ct p
atie
nt c
are
if th
eir
maj
or p
rofe
ssio
nal a
ctiv
ity is
offic
e-ba
sed,
or
if th
ey a
re fu
ll-tim
e ho
spita
l sta
ff m
embe
rs.
2. T
he n
umbe
r of
chi
ld h
ealth
pro
vide
rs is
cal
cula
ted
by a
ddin
g th
e to
tal n
umbe
r of
pedi
atric
ians
to o
ne-f
ourt
h of
the
fam
ily/g
ener
al p
ract
ition
ers.
65
Med
icai
d R
ecip
ient
s U
nder
Age
21
and
Per
cent
age
of P
edia
tric
ians
Cur
rent
lyP
artic
ipat
ing
in M
edic
aid
and
the
Ear
ly a
nd P
erio
dic
Scr
eeni
ng, D
iagn
osis
and
Tre
atm
ent P
rogr
am(E
PS
DT
), 1
993
Sou
rce
(V.4
): A
mer
ican
Aca
dem
y of
Ped
iatr
ics
Sta
te
Med
icai
d
Rec
ipie
nts
Und
er A
ge 2
1
Per
cent
age
of P
edia
tric
ians
Cur
rent
ly P
artic
ipat
ing
in M
edic
aid
Per
cent
age
of P
edia
tric
ians
Cur
rent
ly P
artic
ipat
ing
in E
PS
DT
Med
icai
dP
erce
ntag
e of
Ped
iatr
icia
nsR
ecip
ient
sC
urre
ntly
Par
ticip
atin
gS
tate
Und
er A
ge 2
1in
Med
icai
d
Per
cent
age
of P
edia
tric
ians
Cur
rent
ly P
artic
ipat
ing
in E
PS
DT
UN
ITE
D S
TA
TE
S17
,634
,534
85.1
56.9
MO
NT
AN
A47
,177
100.
087
.1A
LAB
AM
A28
1,99
188
.457
.8N
EB
RA
SK
A97
,166
98.1
90.0
ALA
SK
A38
,586
81.4
78.5
NE
VA
DA
49,5
7894
.662
.5A
RIZ
ON
A25
6,50
277
.264
.9N
EW
HA
MP
SH
IRE
41,5
0694
.587
.3A
RK
AN
SA
S17
3,91
895
.891
.5N
EW
JE
RS
EY
408,
850
82.4
47.3
CA
LIF
OR
NIA
2,49
6,22
478
.161
.6N
EW
ME
XIC
O14
5,68
491
.887
.1C
OLO
RA
DO
161,
221
84.6
70.9
NE
W Y
OR
K1,
474,
713
80.3
35.7
CO
NN
EC
TIC
UT
167,
594
87.0
447
NO
RT
H C
AR
OLI
NA
478,
765
92.6
79.3
DE
LAW
AR
E42
,816
89.8
40.5
NO
RT
H D
AK
OT
A30
,887
89.7
76.4
DIS
TR
ICT
OF
CO
L.62
,543
79.1
25.5
OH
IO83
2,48
488
.064
.6F
LOR
IDA
995,
422
83.1
49.2
OK
LAH
OM
A21
4,41
288
.872
.0G
EO
RG
IA52
5,16
884
.436
.9O
RE
GO
N18
5,46
394
.688
.5H
AW
AII
58,6
6585
.875
.7P
EN
NS
YLV
AN
IA63
9,62
387
.770
.1ID
AH
O60
,357
94.8
81.6
RH
OD
E IS
LAN
D*
45,7
7090
.690
.0IL
LIN
OIS
778,
662
84.5
41.6
SO
UT
H C
AR
OLI
NA
253,
593
93.4
64.3
IND
IAN
A31
5,79
495
.253
.4S
OU
TH
DA
KO
TA
39,8
5196
.795
.4IO
WA
149,
855
94.8
66.3
TE
NN
ES
SE
E47
0,65
789
.971
.6K
AN
SA
S13
4,52
880
.770
.9T
EX
AS
1,42
9,38
078
.745
.7K
EN
TU
CK
Y30
4,40
789
.227
.4U
TA
H89
,029
94.2
81.1
LOU
ISIA
NA
433,
958
87.9
35.9
VE
RM
ON
T39
,523
100.
076
.4M
AIN
E82
,749
97.4
89.2
VIR
GIN
IA31
8,89
280
.154
.8M
AR
YLA
ND
234,
309
75.1
73.5
WA
SH
ING
TO
N33
4,58
089
.584
.1
MA
SS
AC
HU
SE
TT
S37
6,19
892
.168
.7W
ES
T V
IRG
INIA
185,
819
97.9
74.3
MIC
HIG
AN
624,
531
92.0
26.9
WIS
CO
NS
IN22
7,01
997
.362
.7M
INN
ES
OT
A22
3,04
292
.177
.9W
YO
MIN
G27
,933
92.3
95.4
MIS
SIS
SIP
PI
267,
998
90.6
53.7
MIS
SO
UR
I32
4,91
280
.660
.7*N
umbe
r of
Med
icai
d re
cipi
ents
und
er a
ge 2
1 is
for
FY
198
9.
66
CIT
Y D
AT
A
How
doe
s th
e he
alth
of
infa
nts
and
child
ren
inA
mer
ica'
s ci
ties
com
pare
to th
at o
f ch
ildre
nna
tionw
ide?
Thi
s se
ctio
n in
clud
es d
ata
on in
fant
mor
talit
y, lo
w b
irth
wei
ght a
nd p
rena
tal c
are
for
wom
en a
nd c
hild
ren
who
res
ide
in th
e na
tion'
sce
ntra
l citi
es w
ith p
opul
atio
ns o
ver
100,
000.
In 1
993,
nea
rly
one
thir
d of
bir
ths
in th
e U
.S.
wer
e to
res
iden
ts o
f ce
ntra
l citi
es w
ithpo
pula
tions
ove
r 10
0,00
0. O
ver
64%
of
thos
ebi
rths
wer
e to
whi
tes,
whi
le a
ppro
xim
atel
y 29
%w
ere
to b
lack
s.
As
the
follo
win
g da
ta in
dica
te, t
he h
ealth
sta
tus
of c
hild
ren
livin
g in
U.S
. citi
es w
ith p
opul
atio
nsov
er 1
00,0
00 is
infe
rior
to th
at o
f ch
ildre
n in
the
natio
n as
a w
hole
. Low
er r
ates
of
acce
ss to
pren
atal
car
e co
mbi
ned
with
hig
her
rate
s of
low
birt
h w
eigh
t con
trib
ute
to th
e ci
ty in
fant
mor
talit
y ra
te o
f 9.
9 de
aths
per
1,0
00 li
ve b
irth
s;th
e na
tiona
l rat
e is
8.5
. The
cha
lleng
e fo
r he
alth
serv
ice
prov
ider
s an
d sp
ecia
l ini
tiativ
es w
ill b
eto
elim
inat
e th
ese
disp
ariti
es b
y im
prov
ing
the
heal
th s
tatu
s of
chi
ldre
n in
the
natio
n's
citie
s.
68
Infa
nt M
orta
lity
Rat
es in
U.S
. Citi
es W
ith O
ver
100,
000
Pop
ulat
ion:
198
7-19
93S
ourc
e (V
I.1):
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics
14 12 10
8 6 4 2
FC
ities
9.9
67
INFA
NT
MO
RT
AL
ITY
In 1
993,
11,
925
infa
nts
born
to r
esid
ents
of
U.S
. citi
es w
ith o
ver
100,
000
popu
latio
ndi
ed in
the
firs
t yea
r of
life
. The
city
infa
ntm
orta
lity
rate
was
9.9
dea
ths
per
1,00
0 liv
ebi
rths
, 17%
hig
her
than
the
rate
of
8.5
for
the
natio
n as
a w
hole
. For
199
2, th
e in
fant
mor
talit
y ra
te w
as 1
0.1
per
1,00
0 liv
ebi
rths
. The
199
3 ra
te o
f 9.
9 pe
r 1,
000
live
birt
hs r
epre
sent
s a
decl
ine
of 2
%.
8.5
Alth
ough
infa
nt m
orta
lity
in c
ities
has
stea
dily
dec
lined
, it h
as r
outin
ely
been
high
er in
citi
es th
an in
the
natio
n as
aw
hole
. Bet
wee
n 19
87 a
nd 1
993,
infa
ntm
orta
lity
in c
ities
dec
lined
app
roxi
mat
ely
18%
, fro
m 1
2.1
to 9
.9. T
he d
eclin
ena
tionw
ide
in th
e sa
me
peri
od w
as a
lmos
t17
%, f
rom
10.
1 to
8.4
per
1,0
00 li
ve b
irth
s.
0I
II
I1
11
1987
1988
1989
1990
1991
1992
1993
Yea
r4
68
CIT
Y D
AT
A
LO
W A
ND
VE
RY
LO
W B
IRT
H W
EIG
HT
In 1
993,
104
,714
bab
ies
(8.7
% o
f al
l liv
ebi
rths
) bo
rn to
res
iden
ts o
f U
.S. c
ities
with
popu
latio
ns o
ver
100,
000
wer
e of
low
bir
thw
eigh
t, w
eigh
ing
less
than
2,5
00 g
ram
s, o
r5.
5 po
unds
, at b
irth
. The
199
3 pe
rcen
tage
of
city
infa
nts
with
low
bir
th w
eigh
t was
20%
high
er th
an th
e na
tiona
l per
cent
age
of 7
.2%
.
Infa
nts
with
bir
th w
eigh
ts le
ss th
an 1
,500
gram
s (v
ery
low
bir
th w
eigh
t, ap
prox
imat
ely
3 lb
s. 5
oz.
) w
ere
at h
ighe
st r
isk
of p
oor
outc
ome.
The
199
3 ve
ry lo
w b
irth
wei
ght
perc
enta
ge o
f 1.
7% in
citi
es w
asap
prox
imat
ely
25%
hig
her
than
the
natio
nal
perc
enta
ge o
f 1.
3%.
Lik
e th
e na
tion
as a
who
le, p
erce
ntag
es o
fci
ty in
fant
s w
ith lo
w b
irth
wei
ght a
nd v
ery
low
bir
th w
eigh
t hav
e no
t dec
lined
in r
ecen
tye
ars.
Thu
s, th
e ga
p in
low
and
ver
y lo
wbi
rth
wei
ght b
etw
een
citie
s an
d th
e na
tion
over
all h
as n
ot n
arro
wed
.
10-
8 6 4 2 0'
2.0
1.5
1.0
0.5 0
FC
ities
Per
cent
age
of L
ow B
irth
Wei
ght I
nfan
ts in
U.S
. Citi
esW
ith O
ver
100,
000
Pop
ulat
ion:
198
7-19
93S
ourc
e (V
l.2):
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics
LNat
iona
l
8.7
7.2
1987
1988
1989
1990
1991
1992
1993
Per
cent
age
of V
ery
Low
Birt
h W
eigh
t Inf
ants
in U
.S. C
ities
With
Ove
r 10
0,00
0 P
opul
atio
n: 1
987-
1993
Sou
rce
(Vl.2
): N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
sF
Citi
es
Nat
iona
l
1.7
1.3
1987
1988
1989
719
9019
9119
9219
93
Per
cent
age
of P
regn
ant W
omen
Rec
eivi
ng F
irst T
rimes
ter
Pre
nata
l Car
ein
U.S
. Citi
es W
ith O
ver
100,
000
Pop
ulat
ion:
198
7-19
93S
ourc
e (V
I.3):
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics
r Nat
iona
l
80 -
1.1-
2 it ,t
c_ 6
0.5
co C Ho o rr
40cm
0 rc
*go
20
0
)77
1
Citi
es
69
PRE
NA
TA
L C
AR
E
Wom
en in
U.S
. citi
es a
re le
ss li
kely
to b
egin
pren
atal
car
e in
the
firs
t thr
ee m
onth
s of
preg
nanc
y th
an a
re w
omen
nat
ionw
ide.
Sin
ce71
.119
87, t
he g
ap in
pre
nata
l car
e be
twee
n ci
ties
and
the
natio
n ha
s no
t nar
row
ed.
1987
1988
1989
1990
1991
1992
1993
Per
cent
age
of P
regn
ant W
omen
Rec
eivi
ng N
o P
rena
tal C
are
in U
.S. C
ities
With
Ove
r 10
0,00
0 P
opul
atio
n: 1
987-
1993
Sou
rce
(VI.3
): N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s
8
cr;
6a)
2cc
cz c p24
cd o
ea)z
a.2
FC
ities
Nat
iona
l
6.1
) 3.
8
019
8719
8819
8919
9019
9119
9219
93
In 1
993,
71.
1% o
f pr
egna
nt w
omen
livi
ng in
U.S
. citi
es r
ecei
ved
pren
atal
car
e in
the
firs
ttr
imes
ter
of p
regn
ancy
, com
pare
d to
77.
1% o
fpr
egna
nt w
omen
nat
ionw
ide.
The
per
cent
age
of p
regn
ant w
omen
livi
ng in
U.S
. citi
es r
ecei
ving
no
pren
atal
car
ede
crea
sed
slig
htly
, fro
m 6
.3%
to 6
.1%
bet
wee
n19
92 to
199
3. T
he p
erce
ntag
e of
wom
enre
ceiv
ing
no p
rena
tal c
are
is o
ver
60%
hig
her
amon
g w
omen
livi
ng in
citi
es th
an a
mon
g th
eov
eral
l U.S
. pop
ulat
ion.
70
RE
FE
RE
NC
ES
-.7
I. H
IST
OR
ICA
L D
AT
A
(I.1
) N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s (1
970,
1975
, 198
0, 1
990,
199
3 H
ealth
US
1995
)(1
935,
194
0, 1
945,
195
0, 1
955,
196
0, 1
965
Vita
l Sta
tistic
s of
the
Uni
ted
Stat
es, V
olum
eII
Mor
talit
y, P
art A
)
(I.2
) N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s (1
950,
1960
, 197
5, 1
980,
198
5, 1
983
Hea
lth U
S19
95)
(195
5, 1
965
Hea
lth U
S 19
76-7
7)
(I.3
) N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s (1
970,
1975
, 198
0, 1
985,
199
0, 1
993
Hea
lth U
S19
95)
(195
0, 1
955,
196
70, 1
965
Vita
lSt
atis
tics
of th
e U
nite
d St
ates
, Vol
ume
I,N
atal
ity)
(I.4
) N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s (1
950,
1960
, 197
0, 1
980,
198
5, 1
990,
199
3 H
ealth
US
1995
) (1
935,
194
0, 1
945,
195
5, 1
965,
1975
Vita
l Sta
tistic
s of
the
Uni
ted
Stat
es,
Vol
ume
II M
orta
lity,
Par
t A)
72
II. P
OPU
LA
TIO
N C
HA
RA
CT
ER
IST
ICS
(H.1
)U
.S. B
urea
u of
the
Cen
sus.
(19
95).
U.S
. Pop
ulat
ion
Est
imat
es b
y A
ge,
Sex,
Rac
e, a
nd H
ispa
nic
Ori
gin,
1990
-199
5. (
Popu
latio
n Pa
per
Lis
ting
No.
41)
.
(II.
2)U
.S. D
epar
tmen
t of
Com
mer
ce,
Bur
eau
of th
e C
ensu
s. (
1994
).C
urre
nt P
opul
atio
n Su
rvey
(Se
ries
P-60
-189
).
(11.
3)Sa
lute
r, A
. (19
94).
Mar
ital S
tatu
san
d L
ivin
g A
rran
gem
ents
. Cur
rent
Popu
latio
n R
epor
ts (
Seri
esP-
20-4
84).
Was
hing
ton,
D.C
.B
urea
u of
the
Cen
sus.
(11.
4)U
.S. B
urea
u of
Lab
or S
tatis
tics.
(199
4). C
urre
nt P
opul
atio
n Su
rvey
.U
npub
lishe
d D
ata.
(11.
5)U
.S. B
urea
u of
the
Cen
sus.
Who
'sM
indi
ng th
e Pr
esch
oole
rs?
(199
3).
Cur
rent
Pop
ulat
ion
Rep
orts
,H
ouse
hold
Eco
nom
ics
Stud
ies
(Ser
ies
P-70
, for
thco
min
g, 1
996)
.
(II.
6)U
.S. D
epar
tmen
t of
Edu
catio
n.(1
995)
. Off
ice
of E
duca
tiona
lR
esea
rch
and
Impr
ovem
ent.
Dig
est
of E
duca
tion
Stat
istic
s.
HI.
HE
AL
TH
ST
AT
US
(III
.1)
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics.
(199
0 an
d un
publ
ishe
d). V
ital
Stat
istic
s of
the
Uni
ted
Stat
es, 1
987
and
1992
. Vol
ume
II, M
orta
lity,
Par
tA
. Was
hing
ton,
D.C
.: Pu
blic
Hea
lthSe
rvic
e.
(III
.2)
Gar
dner
, P. a
nd H
udso
n, B
.L.
(199
3). A
dvan
ce R
epor
t of
Fina
lM
orta
lity
Stat
istic
s, 4
4 (7
), (
Supp
l.).
Hya
ttsvi
lle, M
d.: N
atio
nal C
ente
r fo
rH
ealth
Sta
tistic
s.
(III
.3)
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics.
(199
6). V
ital S
tatis
tics
of th
e U
nite
dSt
ates
, 199
2.II
Mor
talit
y, P
art
A. W
ashi
ngto
n, D
.C.:
Publ
ic H
ealth
Serv
ice.
(III
.4)
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics.
(199
5). A
dvan
ce R
epor
t of
Fina
lM
orta
lity
Stat
istic
s, 1
993.
Mon
thly
Vita
l Sta
tistic
s R
epor
t, 44
(7)
, (Su
ppl.)
.H
yatts
ville
, Md.
: Pub
lic H
ealth
Serv
ice.
Als
o un
publ
ishe
d da
ta.
(III
.5)
Ven
tura
, S.J
., M
artin
, J.A
., &
Taf
fel,
S.M
. (19
94).
Adv
ance
Rep
ort o
fFi
nal N
atal
ity S
tatis
tics,
199
3.M
onth
ly V
ital
Rep
ort,
44
71
(3),
(Su
ppl.)
. Hya
ttsvi
lle, M
d.:
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics.
(III
.6)
Ros
s Pr
oduc
ts D
ivis
ion,
Abb
ott L
abo-
rato
ries
. (19
94).
Mot
hers
' Sur
vey
(111
.7)
Gar
dner
, P.,
and
Hud
son,
B.L
.(1
993)
. Mon
thly
Vita
l Sta
tistic
sR
epor
t, 44
(7)
; (Su
ppl.)
. Hya
ttsvi
lle,
Md.
: Nat
iona
l Cen
ter
for
Hea
lthSt
atis
tics.
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics.
(199
6). 1
993
Det
ail M
orta
lity
File
.U
npub
lishe
d D
ata.
(111
.8)
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics.
(199
6). 1
993
Det
ail M
orta
lity
File
.U
npub
lishe
d D
ata.
(III
.9)
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics.
(199
3). N
atio
nal H
ospi
tal D
isch
arge
Surv
ey. U
npub
lishe
d da
ta.
(III
.10)
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics.
(199
3). N
atio
nal H
ospi
tal D
isch
arge
Surv
ey. U
npub
lishe
d da
ta.
(III
.11)
Her
shov
itz, J
.M. (
1995
). C
DC
'sE
ffor
ts to
Elim
inat
e C
hild
hood
Lea
dPo
ison
ing
as a
Maj
or P
ublic
Hea
lthPr
oble
m. U
npub
lishe
d. C
ente
rs f
orD
isea
se C
ontr
ol a
nd P
reve
ntio
n.
73
72
RE
FE
RE
NC
ES
(III
. 11)
Pir
kle,
J.,
Bro
dy, D
., G
unte
r, E
.,K
ram
er, R
., Pa
scha
l, D
., R
egal
, K.,
& M
atte
, T. (
1994
). T
he D
eclin
e in
Blo
od L
ead
Lev
els
in th
e U
nite
dSt
ates
: The
Nat
iona
l Hea
lth a
ndN
utri
tion
Exa
min
atio
n Su
rvey
s(N
HA
NE
S). J
ourn
al o
f th
eA
mer
ican
Med
ical
Ass
ocia
tion,
272
,28
4-29
1.
(III
.12)
Cen
ters
for
Dis
ease
Con
trol
and
Prev
entio
n. (
1995
). H
IV/A
IDS
Surv
eilla
nce
Rep
ort,
Yea
r-en
dE
ditio
n, 7
(2)
. (N
atio
nal C
ente
r fo
rH
IV, S
TD
, TB
Pre
vent
ion)
. Atla
nta,
Ga.
: Pub
lic H
ealth
Ser
vice
.
(III
.13)
Nat
iona
l Cen
ter
on C
hild
Abu
se a
ndN
egle
ct. (
1996
). C
hild
Mal
trea
tmen
t 199
4: R
epor
ts f
rom
the
Stat
es to
the
Nat
iona
l Cen
ter
onC
hild
Abu
se a
nd N
egle
ct (
DH
HS
Publ
icat
ion)
. Was
hing
ton,
D.C
.: U
.S.
Gov
ernm
ent P
rint
ing
Off
ice.
(III
.14)
Kas
te, L
.M.,
Selw
itz, R
.H.,
Old
akow
ski,
R.J
., B
rune
lle, J
.A.,
Win
n, D
.M.,
& B
row
n, L
.J. (
1996
).C
oron
a] C
arie
s in
the
Prim
ary
and
Perm
anen
t Den
titio
n of
Chi
ldre
n an
d
Ado
lesc
ents
1-1
7 Y
ears
of
Age
:U
nite
d St
ates
, 198
8-19
91. J
ourn
al o
fD
enta
l Res
iden
cy, 7
5, 6
31-6
41.
Roc
kvill
e, M
d.: N
atio
nal I
nstit
utes
of
Hea
lth. N
atio
nal I
nstit
ute
of D
enta
lR
esea
rch,
Div
isio
n of
Epi
dem
iolo
gyan
d O
ral D
isea
se P
reve
ntio
n.
(III
.15)
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics.
(199
6). 1
993
Det
ail M
orta
lity
File
.U
npub
lishe
d D
ata.
(III
.16)
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics.
(199
6). 1
993
Det
ail M
orta
lity
File
.U
npub
lishe
d D
ata.
.
Hen
shaw
, S. U
.S. T
eena
ge P
regn
ancy
Stat
istic
s (1
996)
. New
Yor
k: T
heA
lan
Gut
tmac
her
Inst
itute
.U
npub
lishe
d da
ta.
Ven
tura
, S.J
., T
affe
l, S.
M.,
Mos
her,
W.,
Wils
on, J
., &
Hen
shaw
, S.
(199
5). T
rend
s in
Pre
gnan
cies
and
Preg
nanc
y R
ates
: Est
imat
es f
or th
eU
nite
d St
ates
, 198
0-92
. Mon
thly
Vita
l Sta
tistic
s R
epor
t, 43
(11
)(S
uppl
.). H
yatts
ville
, Md.
: Nat
iona
lC
ente
r fo
r H
ealth
Sta
tistic
s.
(III
.18)
Cen
ters
for
Dis
ease
Con
trol
and
Prev
entio
n. (
1995
). Y
outh
Ris
kB
ehav
ior
Surv
eilla
nce:
Uni
ted
Stat
es, 1
993.
Mor
bidi
ty a
ndM
orta
lity
Wee
kly
Rep
ort S
urve
illan
ceSu
mm
ary,
45
(55-
1).
(III
.19)
Ven
tura
, S.J
., M
artin
, J.A
., &
Taf
fel,
S.M
. (19
94).
Adv
ance
Rep
ort o
fFi
nal N
atal
ity S
tatis
tics,
199
3.M
onth
ly V
ital S
tatis
tics
Rep
ort,
44(3
), (
Supp
l.). H
yatts
ville
, Md.
:N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s.
(III
.20)
Cen
ters
for
Dis
ease
Con
trol
and
Prev
entio
n. (
1995
). (
Div
isio
n of
HIV
/AID
S Pr
even
tion,
Sur
veill
ance
Bra
nch,
Nat
iona
l Cen
ter
for
HIV
,ST
D, T
B P
reve
ntio
n). P
ublic
Hea
lthSe
rvic
e. U
npub
lishe
d D
ata.
(III
.21)
Cen
ters
for
Dis
ease
Con
trol
and
Prev
entio
n. (
1995
). (
Div
isio
n of
HIV
/AID
S Pr
even
tion,
Sur
veill
ance
Bra
nch,
Nat
iona
l Cen
ter
for
HIV
,ST
D, T
B P
reve
ntio
n). P
ublic
Hea
lthSe
rvic
e. U
npub
lishe
d D
ata.
74
(111
.22)
Cen
ters
for
Dis
ease
Con
trol
and
Prev
entio
n. (
1995
). H
IV/A
IDS
Surv
eilla
nce
Rep
ort,
Yea
r-en
dE
ditio
n, 7
(2)
. (N
atio
nal C
ente
r fo
rH
IV, S
TD
, TB
Pre
vent
ion)
. Atla
nta,
Ga.
: Pub
lic H
ealth
Ser
vice
.
(111
.23)
The
Uni
vers
ity o
f M
ichi
gan
Inst
itute
for
Soci
al R
esea
rch.
(19
95).
The
Mon
itori
ng th
e Fu
ture
Stu
dy,
1975
-199
5. (
Nat
iona
l Ins
titut
e on
Dru
g A
buse
, Nat
iona
l Ins
titut
es o
fH
ealth
). R
ockv
ille,
Md.
: Pub
licH
ealth
Ser
vice
.
(111
.24)
The
Uni
vers
ity o
f M
ichi
gan
Inst
itute
for
Soci
al R
esea
rch.
(19
95).
The
Mon
itori
ng th
e Fu
ture
Stu
dy,
1975
-199
5. (
Nat
iona
l Ins
titut
e on
Dru
g A
buse
, Nat
iona
l Ins
titut
es o
fH
ealth
). R
ockv
ille,
Md.
: Pub
licH
ealth
Ser
vice
.
IV H
EA
LT
H S
ER
VIC
ES
AN
D U
TIL
IZA
TIO
N
(IV
.1)
Fron
stin
, P. a
nd R
heem
, E. (
1996
).So
urce
s of
Hea
lth I
nsur
ance
and
Cha
ract
eris
tics
of th
e U
nins
ured
:A
naly
sis
of th
e M
arch
199
5 C
urre
ntPo
pula
tion
Surv
ey. (
App
endi
x to
EB
RI
Issu
e B
rief
No.
170
).W
ashi
ngto
n, D
.C.:
Em
ploy
ee B
enef
itR
esea
rch
Inst
itute
.
(IV
.2)
Cen
ters
for
Dis
ease
Con
trol
and
Prev
entio
n. (
1996
). N
atio
nal,
Stat
e,an
d U
rban
Are
a V
acci
natio
nC
over
age
Lev
els
Am
ong
Chi
ldre
nA
ged
19-3
5 M
onth
s: U
nite
d St
ates
,A
pril
1994
-Mar
ch 1
995,
Nat
iona
lIm
mun
izat
ion
Surv
ey, U
nite
d St
ates
,A
pril-
Dec
embe
r 19
94, 4
5 (7
).
(IV
.3)
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics.
(199
4). N
atio
nal H
ealth
Int
ervi
ewSu
rvey
, 199
3. P
ublic
Hea
lth S
ervi
ce.
Unp
ublis
hed
Dat
a.
(IV
.4)
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics.
(199
4). N
atio
nal H
ealth
Int
ervi
ewSu
rvey
, 199
3. P
ublic
Hea
lth S
ervi
ce.
Unp
ublis
hed
Dat
a.
75
73
(IV
.5)
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics.
(199
4). N
atio
nal H
ealth
Int
ervi
ewSu
rvey
, 199
3. P
ublic
Hea
lth S
ervi
ce.
Unp
ublis
hed
Dat
a.
(IV
.6)
Off
ice
of I
nspe
ctor
Gen
eral
. (19
96).
Chi
ldre
n's
Den
tal S
ervi
ces
Und
erM
edic
aid:
Acc
ess
and
Util
izat
ion.
(DH
HS
Publ
icat
ion
No.
0E1-
09-9
3-00
240)
.
(IV
.7)
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics.
(199
4). N
atio
nal H
ealth
Int
ervi
ewSu
rvey
, 199
3. P
ublic
Hea
lth S
ervi
ce.
Unp
ublis
hed
Dat
a.
(IV
.8)
Ven
tura
, S.J
., M
artin
, J.A
., &
Taf
fel,
S.M
. (19
94).
Adv
ance
Rep
ort o
fFi
nal N
atal
ity S
tatis
tics,
199
3.M
onth
ly V
ital S
tatis
tics
Rep
ort,
44(3
) (S
uppl
.). H
yatts
ville
, Md.
:N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s.
74
RE
FE
RE
NC
ES
V. S
TA
TE
-SPE
CIF
IC D
AT
A
(V.1
)N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s.(1
996)
. Adv
ance
Rep
ort o
f Fi
nal
Mor
talit
y St
atis
tics,
199
3. M
onth
lyV
ital S
tatis
tics
Rep
ort,
44 (
7)(S
uppl
.). H
yatts
ville
, Md.
: Nat
iona
lC
ente
r fo
r H
ealth
Sta
tistic
s.
(V.2
)V
entu
ra, S
.J.,
Mar
tin, J
.A.,
& T
affe
l,S.
M. (
1994
). A
dvan
ce R
epor
t of
Fina
l Nat
ality
Sta
tistic
s, 1
993.
Mon
thly
Vita
l Sta
tistic
s R
epor
t, 44
(3)
(Sup
pl.)
. Hya
ttsvi
lle, M
d.:
Nat
iona
l Cen
ter
for
Hea
lth S
tatis
tics.
(V.3
)B
roth
erto
n, S
.E. (
1996
). P
hysi
cian
Wor
kfor
ce R
atio
s fo
r C
hild
Hea
lth,
1994
. Elk
Gro
ve V
illag
e, I
ll.:
Am
eric
an A
cade
my
of P
edia
tric
s,D
ivis
ion
of H
ealth
Pol
icy
Res
earc
h.
(V.4
)Y
udko
wsk
y, B
.K. a
nd T
ang,
S.
(199
5). M
edic
aid
Stat
e R
epor
ts, F
Y19
93. E
lk G
rove
Vill
age,
Ill.
:A
mer
ican
Aca
dem
y of
Ped
iatr
ics,
Div
isio
n of
Hea
lth P
olic
y R
esea
rch.
Am
eric
an A
cade
my
of P
edia
tric
s.(1
994)
. Ped
iatr
icia
n Pa
rtic
ipat
ion
inM
edic
aid:
A 1
993
Surv
ey o
f A
AP
Mem
bers
.
VI.
CIT
Y D
AT
A
(VI.
1) N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s.(1
996)
. 199
3 D
etai
l Mor
talit
y an
dN
atal
ity F
iles.
Unp
ublis
hed
data
.
(VI.
2) N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s.(1
996)
. 199
3 D
etai
l Nat
ality
File
.U
npub
lishe
d da
ta.
(VI.
3) N
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s.(1
996)
. 199
3 D
etai
l Nat
ality
File
.U
npub
lishe
d da
ta.
G6
75
AC
KN
OW
LED
GE
ME
NT
S
AC
KN
OW
LE
DG
EM
EN
TS
The
Hea
lth R
esou
rces
and
Ser
vice
sA
dmin
istr
atio
n's
Mat
erna
l and
Chi
ld H
ealth
Bur
eau
expr
esse
s gr
atitu
de f
or th
e w
ork
ofM
ater
nal a
nd C
hild
Hea
lth I
nfor
mat
ion
Res
ourc
e C
ente
r st
aff
in p
repa
ring
this
repo
rt f
or p
ublic
atio
n. S
arah
Pfa
u, L
ori
Whi
teha
nd, a
nd g
raph
ics
cons
ulta
nt M
olly
Pick
ett m
ade
valu
able
con
trib
utio
ns to
the
form
at, t
ext,
and
prod
uctio
n of
Chi
ld H
ealth
USA
'95.
Staf
f at
oth
er n
on-g
over
nmen
t org
aniz
atio
nsw
ho p
rovi
ded
data
and
ass
ista
nce
incl
ude:
Gin
ger
Mag
gio,
Uni
vers
ity o
f M
ichi
gan
Inst
itute
for
Soc
ial R
esea
rch;
Kri
stin
Moo
re,
Chi
ld T
rend
s, I
nc.;
Edi
na R
heem
, Em
ploy
eeB
enef
it R
esea
rch
Inst
itute
; Jef
frey
Wys
ong,
Abb
ott L
abor
ator
ies;
and
Bet
h Y
udko
wsk
y;A
mer
ican
Aca
dem
y of
Ped
iatr
ics.
In a
dditi
on, t
his
repo
rt w
ould
not
hav
e be
enpo
ssib
le w
ithou
t the
con
trib
utio
ns o
f th
eN
atio
nal C
ente
r fo
r H
ealth
Sta
tistic
s, th
eU
.S. B
urea
u of
the
Cen
sus,
the
Cen
ters
for
Dis
ease
Con
trol
and
Pre
vent
ion,
the
U.S
. Bur
eau
of L
abor
Sta
tistic
s, th
e U
.S.
Dep
artm
ent o
f E
duca
tion,
the
Nat
iona
lC
ente
r on
Chi
ld A
buse
and
Neg
lect
, and
the
Nat
iona
l Cen
ter
for
Env
iron
men
tal
Hea
lth.
77
\-Lit - -
161.4114.
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U.S
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F H
EA
LT
H A
ND
HU
MA
N S
ER
VIC
ES
Publ
ic H
ealth
Ser
vice
Hea
lth R
esou
rces
and
Ser
vice
s A
dmin
istr
atio
nM
ater
nal a
nd C
hild
Hea
lth B
urea
u
DH
HS
Publ
icat
ion
No.
HR
SA-M
-DSE
A-9
6-5
Sept
embe
r 19
96
79
Mat
erna
l and
Chi
ld H
ealth
Bur
eau
BE
ST
CO
PY
AV
AIL
AB
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(9/92)
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