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Census 2000 counted 72.3 million Americans, or 26% of the U.S. population, under age 1847. In 2001, over 4 million babies were born in the United States48. Racial and ethnic minorities account for almost 40% of all children49. In 1999, almost 17% of children lived in families with incomes below the poverty level compared with 11% of adults50.
In 2002, black children and American Indian or Alaska Native children had death rates about 1.5 to 2 times higher than white children. Black infants were more than twice as likely to die during their first year than white infants51. In 1996, Hispanic children were over twice as likely to report fair or poor health than non-Hispanic white children52.
Quality of health care among children varies by race, ethnicity, and SES53. Differences have been observed in childhood immunization54, management of asthma55, and evaluation and treatment for attention-deficit/hyperactivity disorder56. Access to health care among children also varies by race, ethnicity, and SES. Rates of uninsurance and public coverage57; getting a routine appointment as soon as wanted, receiving needed care, and patient experiences during care58; rating of health care59; and health care utilization and expenditures 60 differ among children by race, ethnicity, and SES.
Many measures of relevance to children are tracked in the NHDR. Findings presented here seek to highlight conditions and topics of particular importance to children's quality of and access to health care including:
- Patient safety
- Health insurance
- Patient-provider communication
In addition, the final section of this chapter, which discusses individuals with special health care needs, focuses on children this year. In that section, data from the 2001 National Survey of Children with Special Health Care Needs are presented to assess disparities among this group of children.