US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau.
JAMA Pediatr. 2022 Jul 1;176(7):e220056. doi: 10.1001/jamapediatrics.2022.0056. Epub 2022 Jul 5.
Ensuring the well-being of the 73 million children in the United States is critical for improving the nation's health and influencing children's long-term outcomes as they grow into adults.
To examine recent trends in children's health-related measures, including significant changes between 2019 and 2020 that might be attributed to the COVID-19 pandemic.
DESIGN, SETTING, AND PARTICIPANTS: Annual data were examined from the National Survey of Children's Health (2016-2020), a population-based, nationally representative survey of randomly selected children. Participants were children from birth to age 17 years living in noninstitution settings in all 50 states and the District of Columbia whose parent or caregiver responded to an address-based survey by mail or web. Weighted prevalence estimates account for probability of selection and nonresponse. Adjusted logistic regression models tested for significant trends over time.
Diverse measures pertaining to children's current health conditions, positive health behaviors, health care access and utilization, and family well-being and stressors.
A total of 174 551 children were included (annual range = 21 599 to 50 212). Between 2016 and 2020, there were increases in anxiety (7.1% [95% CI, 6.6-7.6] to 9.2% [95% CI, 8.6-9.8]; +29%; trend P < .001) and depression (3.1% [95% CI, 2.9-3.5] to 4.0% [95% CI, 3.6-4.5]; +27%; trend P < .001). There were also decreases in daily physical activity (24.2% [95% CI, 23.1-25.3] to 19.8% [95% CI, 18.9-20.8]; -18%; trend P < .001), parent or caregiver mental health (69.8% [95% CI, 68.9-70.8] to 66.3% [95% CI, 65.3-67.3]; -5%; trend P < .001), and coping with parenting demands (67.2% [95% CI, 66.3-68.1] to 59.9% [95% CI, 58.8-60.9]; -11%; trend P < .001). In addition, from 2019 to 2020, there were increases in behavior or conduct problems (6.7% [95% CI, 6.1-7.4] to 8.1% [95% CI, 7.5-8.8]; +21%; P = .001) and child care disruptions affecting parental employment (9.4% [95% CI, 8.0-10.9] to 12.6% [95% CI, 11.2-14.1]; +34%; trend P = .001) as well as decreases in preventive medical visits (81.0% [95% CI, 79.7-82.3] to 74.1% [95% CI, 72.9-75.3]; -9%; trend P < .001).
Recent trends point to several areas of concern that can inform future research, clinical care, policy decision making, and programmatic investments to improve the health and well-being of children and their families. More analyses are needed to elucidate varying patterns within subpopulations of interest.
确保美国 7300 万儿童的福祉对于改善美国的健康状况和影响儿童成长为成年人的长期结果至关重要。
研究与儿童健康相关的措施的最新趋势，包括可能归因于 COVID-19 大流行的 2019 年至 2020 年之间的重大变化。
设计、地点和参与者：对国家儿童健康调查（2016-2020 年）的年度数据进行了检查，这是一项基于人群的、具有全国代表性的随机选择儿童的调查。参与者是居住在所有 50 个州和哥伦比亚特区的非机构环境中的出生至 17 岁的儿童，其父母或照顾者通过邮件或网络对基于地址的调查做出了回应。加权流行率估计数考虑了选择和无回应的可能性。调整后的逻辑回归模型测试了随时间的显著趋势。
与儿童当前健康状况、积极的健康行为、医疗保健的获得和利用以及家庭福祉和压力源有关的各种措施。
共有 174551 名儿童被纳入（年度范围为 21599 至 50212）。在 2016 年至 2020 年期间，焦虑症的发病率有所增加（7.1%[95%CI，6.6-7.6]至 9.2%[95%CI，8.6-9.8]；增加 29%；趋势 P < 0.001），抑郁症的发病率也有所增加（3.1%[95%CI，2.9-3.5]至 4.0%[95%CI，3.6-4.5]；增加 27%；趋势 P < 0.001）。每日体育活动的比例也有所下降（24.2%[95%CI，23.1-25.3]至 19.8%[95%CI，18.9-20.8]；减少 18%；趋势 P < 0.001），父母或照顾者的心理健康（69.8%[95%CI，68.9-70.8]至 66.3%[95%CI，65.3-67.3]；减少 5%；趋势 P < 0.001），以及应对育儿需求的能力（67.2%[95%CI，66.3-68.1]至 59.9%[95%CI，58.8-60.9]；减少 11%；趋势 P < 0.001）。此外，从 2019 年到 2020 年，行为或行为问题的发生率有所增加（6.7%[95%CI，6.1-7.4]至 8.1%[95%CI，7.5-8.8]；增加 21%；P = 0.001），儿童保育中断影响父母就业（9.4%[95%CI，8.0-10.9]至 12.6%[95%CI，11.2-14.1]；增加 34%；趋势 P = 0.001），而预防性医疗访问的次数有所减少（81.0%[95%CI，79.7-82.3]至 74.1%[95%CI，72.9-75.3]；减少 9%；趋势 P < 0.001）。
最近的趋势表明了一些令人担忧的领域，这些领域可以为未来的研究、临床护理、政策决策和计划投资提供信息，以改善儿童及其家庭的健康和福祉。需要进行更多的分析来阐明感兴趣的亚人群中的不同模式。
