Flourishing and Resilience

Narrative

In addition to traditional measures of health status and risk factors, positive health indicators can be used to help create a more complete picture of child health and well-being.1 The 2011–2012 National Survey of Children’s Health (NSCH) included several such items to contribute to a better understanding of whether U.S. children were “flourishing” or “thriving.” The concept of flourishing is comprised of multiple dimensions of physical health, mental and emotional health, caring, empathy, and resilience.2 Two sets of flourishing items were included in the NSCH: one for children aged 6 months to 5 years and a separate set for children aged 6–17 years based on developmentally relevant milestones and experiences. Four questions were included for younger children focused on curiosity, resilience, attachment to caregivers, and positive affect.3 For parents and caregivers of school-aged children, three items were asked that focused on curiosity, resilience, and self-regulation.4

In 2011–2012, the proportion of children who were reported by their parents and caregivers to usually or always exhibit all age-specific behaviors associated with flourishing varied by age group. Among children aged 6 months to 5 years, 73.2 percent were reported to usually or always exhibit all four flourishing behaviors, while less than half (47.7 percent) of school-aged children were reported to usually or always exhibit the three flourishing behaviors (Figure 1).

Overall Flourishing Behaviors and Characteristics Among Children

Figure 1 Source

Among younger children, the most common behaviors reported were smiling and laughing a lot followed by showing interest and curiosity in new things; more than 80 percent of children aged 6 months to 5 years were reported to always exhibit these behaviors (Figure 2). About one-fifth of children in this age group were reported to never, rarely, or only sometimes bounce back quickly when things did not go their way.

Detailed Flourishing Behaviors and Characteristics Among Children

Figure 2 Source

Difficulties facing challenging situations were common among school-aged children, among whom more than one-third (35.3 percent) were reported to never, rarely, or only sometimes stay calm and in control when faced with a challenge. More than a third (34.8 percent) of this population also exhibited difficulties in finishing tasks and following through with what they said that they would do. The most commonly reported behavior among children in this age group was showing interest and curiosity in learning new things, with 85.0 percent reported to usually or always exhibit this characteristic.

The prevalence of parent-reported flourishing behaviors and characteristics varied by both child and family characteristics. Greater proportions of children living in households with higher incomes and greater parental educational attainment were reported to usually or always exhibit all age-relevant behaviors and characteristics. For example, among children aged 6–17 years, 37.6 percent of those living in a household where neither parent had completed high school usually or always exhibited all three related behaviors compared to 54.9 percent among those living in a household where at least one parent or caregiver had completed college. Among children of all ages, girls were more likely than boys to be reported as meeting all age-specific measures of flourishing: 75.1 versus 71.3 percent, respectively, among younger children and 51.4 versus 44.1 percent, respectively, among school-aged children.

Data Sources

Figure 1. U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau; U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, National Survey of Children’s Health, 2011–2012.

Figure 2. U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau; U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, National Survey of Children’s Health, 2011–2012.

Endnotes

1 Child Trends. Positive Indicators Project. Accessed September 10, 2014.

2 Child and Adolescent Health Measurement Initiative. National Survey of Children’s Health, 2011–2012 Data Resource Center. Accessed September 10, 2014.

3 Child and Adolescent Health Measurement Initiative. National Survey of Children’s Health, 2011–2012 Data Resource Center. Accessed September 10, 2014.

4 Child and Adolescent Health Measurement Initiative. National Survey of Children’s Health, 2011–2012 Data Resource Center. Accessed September 10, 2014.

Data

Statistical Significance Test

Calculate the difference between two estimates:

Calculated Z-Test Result 0.9567433 Not statistically significant

We follow statistical conventions in defining a significant difference by a p-value less than 0.05 where there is a less than 5% probability of observing a difference of that magnitude or greater by chance alone if there were really no difference between estimates. The 95% confidence interval includes a plausible range of values for the observed difference; 95% of random samples would include the true difference with fewer than 5% of random samples failing to capture the true difference.

This website allows comparisons between two estimates using the independent z-test for differences in rates or proportions. This test is appropriate for comparing independent populations across years (e.g., 2011 versus 2012) or subgroups (e.g., Male versus Female) on corresponding measures. To the extent possible, the functionality of this application has limited estimate comparisons based on appropriate use of the independent z-test. However, some tables present subgroup categories within broader categories that will allow comparisons between non-independent populations (e.g., low birth weight and very low birth weight). Users should exercise caution when interpreting these test results, which will frequently overstate statistical significance.

For some tables, the website does not allow for comparisons between two estimates, even though the data represent independent populations. Generally, this is because the standard errors were not publicly available at the time this website was created.

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