An Index of Child Well-Being for States, the Nation and Low-Income ChildrenKristin A. Moore, Laura Lippman, Christina Theokas, Margot Bloch & Sharon Vandivere Child TrendsBill OHare Annie E. Casey FoundationUtilizing the National Survey of Childrens HealthFunded by the Annie E. Casey Foundation

Research QuestionsCan an index of child well-being be developed from one micro dataset rather than by aggregating across multiple macro datasets?Can an index be developed that represents and is balanced across all domains of child well-being?Can an index be developed that represents childrens normative development at different stages of development?Can the National Survey of Childrens Health (NSCH) support robust state indices for low-income children?

PurposesTo develop an index of child well-being and an index of contextual well-being at the micro level for the nation, and for states and for low-income children by state.To distinguish between child outcomes and childrens contexts.To develop indices for each stage of child development.To introduce a new source of state level child well-being data, the National Survey of Childrens Health (NSCH), To explore whether composite indices are valid, reliable and descriptive, and what value is added by using micro data compared with aggregate data.

National Survey of Childrens Health (NSCH) Sponsored by the Maternal and Child Health Bureau, U.S. Department of Health and Human ServicesNationally representative data collected from all 50 states and the District of ColumbiaInterviews completed from 2003 to 2004N= 102,353 children ages 0-17, with approximately 2,000 children per state

Data Base

The index is comprised of 7 domains:4 Child Well-Being DomainsPhysical Health, Psychological Health, Social Health and Educational Achievement & Cognitive Development3 Contextual Well-Being DomainsFamily Context, Community Context and Sociodemographic ContextEach domain has 4-15 indicators organized into 4 subdomains.Indicators dichotomized using a conceptual threshold of well-being.Subdomains dichotomized and summed to produce overall domain scores.Method

CHILD WELL-BEING

PHYSICAL HEALTHHealth StatusLimiting ConditionsHealth Risk BehaviorsHealth Promoting BehaviorsPSYCHOLOGICAL HEALTHInternalizing Problems Externalizing ProblemsSelf-EsteemCoping SkillsSOCIAL HEALTHParent-Child RelationshipActivity EngagementPositive Social BehaviorsNegative Social BehaviorsEDUCATIONAL ACHIEVEMENT & COGNITIVE DEVELOPMENTSchool Problems Learning DifficultiesCognitive DevelopmentAchievement

CONTEXTUAL WELL-BEING

FAMILY CONTEXTParental EngagementGuardian FunctioningHome EnvironmentHealth CoverageCOMMUNITY CONTEXTNeighborhood: Supportive EnvironmentNeighborhood: Support for ParentingSafe NeighborhoodSafe SchoolSOCIODEMOGRAPHIC CONTEXTSocioeconomic Well-BeingHuman CapitalFamily StructureFamily Size

Index Domains and SubdomainsNote: For a complete list of the 69 indicators please see the authors.

Summary scores calculated for child well-being and contextual well-being separately for each child.Indices developed separately for 6-11 and 12-17 year olds to represent child development stages.Child well-being and contextual well-being indices calculated for states, the nation and low-income children (

Macro indices capture trends in well-being by aggregating population-based rates.As a result, macro indices reflect average social conditions that many children do not experience.By using individual child-level data, micro indices present a picture of the circumstances actually experienced by individual children.Based on NSCH data for 2003-2004, about 1/4 of teens fare well in all four domains of well-being, and 1/8 are not faring well in any domain. Micro vs. Macro Indices

Micro data present a picture of the actual circumstances experienced by individual children*Score of 75+ in a domain# of Domains in which Children are Faring Well*

Chart1

8.515.8619.2725.1231.25

12.4119.0320.8925.0222.64

Ages 6-11

Ages12-17

0

1

2

3

4

Cumulative Child Well-Being Across Domains

Summary Scores by Domain

&LSummary Domain Scores of Child Well-Being and the Condition of ChildrenAges 6-11 & 12-17NSCH 2003National Estimates

&R&D

Summary Scores by Domain

5.313.97

18.217.34

16.2714.13

20.1719.43

40.0545.13

12-17

6-11

# of Sub-Domains

Psychological Health Summary Scores

Cumulative well-being

2.11.55

11.759.54

21.7121.58

31.7233.34

32.7234

12-17

6-11

# of Sub-Domains

Social Health Summary Scores

4.712.12

13.8210.04

22.5522.87

26.7624.77

32.1640.19

12-17

6-11

# of Sub-Domains

Educational Achievement & Cognitive Development Summary Scores

8.555.78

30.7823.32

30.3734.24

19.8525.5

7.4511.17

12-17

6-11

# of Sub-Domains

Family Context Summary Scores

21.7919.08

20.6520.71

26.1624.91

20.7622.3

10.6513.01

12-17

6-11

# of Sub-Domains

Community Context Summary Scores

5.392.54

19.6711.97

32.0827.58

30.5834.42

12.2923.49

12-17

6-11

# of Sub-Domains

Physical Health Summary Scores

3.493.85

16.9716.17

22.6422.84

28.4326.45

28.4630.68

12-17

6-11

# of Sub-Domains

Sociodemographic Context Summary Scores

&L*Note: Children are considered to fare 'well' in a domain if they receive a score of 3 or higher. Domains scores range 0-4.

8.515.8619.2725.1231.25

12.4119.0320.8925.0222.64

Ages 6-11

Ages12-17

0

1

2

3

4

Cumulative Child Well-Being Across Domains

24.7334.5727.5613.14

27.8138.0724.819.3

Ages 6-11

Ages12-17

0

1

2

3

Distribution of Children Faring Well* in Zero to Three Domains of Contextual Conditions

Child Well-Being and Contextual Well-Being Index scores for individual children range from 0 to 100. Children in our sample represent the full range.Mean Child Well-Being score for children ages 6-17 in the U.S.= 67.9Mean Contextual Well-Being score for children ages 6-17 in the U.S.= 53.8Mean Child Well-Being score for low-income children (

Child Well-Being is Lower for Teens

Chart5

70.519765.326

66.083256.1821

71.102367.8597

72.17470.3024

72.719366.9597

Ages 6-11

Ages 12-17

Mean Score

Mean Scores on Child Well-Being Index by Age

Gender 6-11

Means and Standard Errors of Child Well-Being by Gender

Children Ages 6-11

National Survey of Children's Health 2003

National Estimates

Sample limited to children enrolled in school or home-schooled.

GENDER

MALEFEMALESig.t-valueEffect Size (Eta squared)

N=15,86715,201

DOMAINMeanSEMeanSE

PHYSICAL HEALTH65.610.3766.570.37-3.27

PSYCH-OLOGICAL HEALTH69.690.4572.580.45***-4.560.00067

SOCIAL HEALTH71.290.3773.090.37***-3.410.00037

EDUCATIONAL ACHIEVEMENT & COGNITIVE DEVELOPMENT69.520.4076.050.38***-11.790.00445

FAMILY CONTEXT53.930.3752.530.39**2.590.00022

COMMUNITY CONTEXT47.350.4647.400.47

SOCIO-DEMOGRAPHIC CONTEXT66.180.4565.770.48

CHILD WELL-BEING69.030.2972.070.28***-7.550.00183

CONTEXTUAL WELL-BEING55.820.3155.230.31

CONDITION OF CHILDREN62.420.2663.650.25***-3.420.00038

* p

Contextual Well-Being Varies Less by Child Age Than Child Well-Being

Chart4

70.519765.326

55.531652.1751

Ages 6-11

Ages 12-17

Mean Score

Mean Scores on Child Well-Being Index and Contextual Well-Being Index by Age

Gender 6-11

Means and Standard Errors of Child Well-Being by Gender

Children Ages 6-11

National Survey of Children's Health 2003

National Estimates

Sample limited to children enrolled in school or home-schooled.

GENDER

MALEFEMALESig.t-valueEffect Size (Eta squared)

N=15,86715,201

DOMAINMeanSEMeanSE

PHYSICAL HEALTH65.610.3766.570.37-3.27

PSYCH-OLOGICAL HEALTH69.690.4572.580.45***-4.560.00067

SOCIAL HEALTH71.290.3773.090.37***-3.410.00037

EDUCATIONAL ACHIEVEMENT & COGNITIVE DEVELOPMENT69.520.4076.050.38***-11.790.00445

FAMILY CONTEXT53.930.3752.530.39**2.590.00022

COMMUNITY CONTEXT47.350.4647.400.47

SOCIO-DEMOGRAPHIC CONTEXT66.180.4565.770.48

CHILD WELL-BEING69.030.2972.070.28***-7.550.00183

CONTEXTUAL WELL-BEING55.820.3155.230.31

CONDITION OF CHILDREN62.420.2663.650.25***-3.420.00038

* p

Child Well-Being is Higher for Girls

Chart12

63.432267.2778

55.355957.0181

66.745269.0035

69.069871.5692

62.557771.5202

MALE

FEMALE

Mean Score

Mean Scores on Child Well-Being Index by Gender: Children Ages 12-17

Gender 6-11

Means and Standard Errors of Child Well-Being by Gender

Children Ages 6-11

National Survey of Children's Health 2003

National Estimates

Sample limited to children enrolled in school or home-schooled.

GENDER

MALEFEMALESig.t-valueEffect Size (Eta squared)

N=15,86715,201

DOMAINMeanSEMeanSE

PHYSICAL HEALTH65.610.3766.570.37-3.27

PSYCH-OLOGICAL HEALTH69.690.4572.580.45***-4.560.00067

SOCIAL HEALTH71.290.3773.090.37***-3.410.00037

EDUCATIONAL ACHIEVEMENT & COGNITIVE DEVELOPMENT69.520.4076.050.38***-11.790.00445

FAMILY CONTEXT53.930.3752.530.39**2.590.00022

COMMUNITY CONTEXT47.350.4647.400.47

SOCIO-DEMOGRAPHIC CONTEXT66.180.4565.770.48

CHILD WELL-BEING69.030.2972.070.28***-7.550.00183

CONTEXTUAL WELL-BEING55.820.3155.230.31

CONDITION OF CHILDREN62.420.2663.650.25***-3.420.00038

* p

Child Well-Being Varies by Race/Ethnicity and is Lowest for Black ChildrenNote: Other Race includes Asian, Native American, Alaska Native, Native Hawaiian and Pacific Islanders

Chart11

68.112357.401964.957268.125960.6693

59.760547.765555.749357.414149.0361

69.656561.634367.175769.749666.1367

72.735864.305871.437473.930264.3502

70.296355.90265.466471.409663.1543

WHITE (NON HISPANIC)

BLACK (NON HISPANIC)

MULTIRACIAL

OTHER

HISPANIC

Mean Score

Mean Scores on Child Well-Being Index by Race/Ethnicity: Children Ages 12-17

Gender 6-11

Means and Standard Errors of Child Well-Being by Gender

Children Ages 6-11

National Survey of Children's Health 2003

National Estimates

Sample limited to children enrolled in school or home-schooled.

GENDER

MALEFEMALESig.t-valueEffect Size (Eta squared)

N=15,86715,201

DOMAINMeanSEMeanSE

PHYSICAL HEALTH65.610.3766.570.37-3.27

PSYCH-OLOGICAL HEALTH69.690.4572.580.45***-4.560.00067

SOCIAL HEALTH71.290.3773.090.37***-3.410.00037

EDUCATIONAL ACHIEVEMENT & COGNITIVE DEVELOPMENT69.520.4076.050.38***-11.790.00445

FAMILY CONTEXT53.930.3752.530.39**2.590.00022

COMMUNITY CONTEXT47.350.4647.400.47

SOCIO-DEMOGRAPHIC CONTEXT66.180.4565.770.48

CHILD WELL-BEING69.030.2972.070.28***-7.550.00183

CONTEXTUAL WELL-BEING55.820.3155.230.31

CONDITION OF CHILDREN62.420.2663.650.25***-3.420.00038

* p

WYWVWIWAVTVAUTTXTNSDSCRIPAOROKOHNYNVNMNJNHNENDNCMTMSMOMNMIMEMDMALAKYKSINILIDIAHIGAFLDEDCCTCOCAAZARALAK70 to 7565 to 7060 to 6555 to 6050 to 55Child Well-Being Varies by State

Child Well-Being for Low-Income Children Also Varies by State

Contextual Well-Being Varies by State*Note the ranges of contextual well-being mean scores differ from child well-being mean scores.Mean Contextual Well-Being Score

Child and contextual well-being is lower for teens than for children ages 6-11.Child well-being is higher for girls than for boys.Child well-being is lower for Blacks and Hispanics when compared to other racial/ethnic groups.State child well-being indices range from 64 to 74.State indices of contextual well-being range from 42 to 61.State indices of child well-being for low-income children range from 55 to 70.Summary of Results Based on the NSCH Micro Data

Some domains are more comprehensive than others due to limitations in the dataset.All indicators are not available for children of all ages.The data are based on parent-reports and therefore have gaps and are subject to social desirability.Objective assessments, such as weight or academic achievement, are missing. Limitations

The NSCH enables index development across all domains of child well-being by developmental stage, and by state, and for low-income children by state and the nation.Separating contextual indicators from well-being indicators clarifies levels of well-being for child outcomes versus context.An index, even limited to child well-being, masks variations of well-being by domain, but provides a simple reporting tool.Micro indices add to existing indices of child well-being by representing the actual cumulative circumstances experienced by individual children. Macro and micro indices, however, both need better data and theory.Conclusions

For more information please contact Laura Lippman at:

llippman@childtrends.orgwww.childtrends.orgwww.aecf.org/kidscount