Smoking is No. 1 health concern for children and adolescents in the United States

It's only natural to for adults to worry about children's health and well-being at school, on the roads and even online.

But adults' No. 1 health concern for children and adolescents in the United States, It's smoking, according to new results from the University of Michigan C.S. Mott Children's Hospital National Poll on Children's Health. Drug abuse ranked No. 2.

The poll, which asked adults to rate 17 different health problems for children living in their communities, also found that childhood obesity now ranks among the public's top three concerns for children's health, ahead of alcohol abuse and teen pregnancy.

Also making the public's overall list of top10 health concerns for kids: Driving accidents, Internet safety, school violence, sexually transmitted infections, and abuse and neglect. The child health issues that didn't make the top 10 list, but were still rated as “big problems” by 6 to 18 percent of adults: Psychological stress, depression, eating disorders, suicide, autism, childhood cancer and food contamination.

“We found that major race/ethnicity groups differ when it comes to the top three health concerns for children as well. While white adults list smoking, drug abuse and alcohol abuse at their top three concerns, black adults rate teen pregnancy, smoking and drug abuse, and Hispanic adults rank smoking, drug abuse and childhood obesity as the three major health problems for children,” says Matthew M. Davis, M.D., M.A.P.P., director of the National Poll on Children's Health, part of the U-M Department of Pediatrics and Communicable Diseases and the Child Health Evaluation and Research (CHEAR) Unit in the U-M Division of General Pediatrics.

To rank the public's top health concerns for children, the National Poll on Children's Health, in collaboration with Knowledge Networks, Inc., conducted a national online survey in March 2007. The survey, administered to a random sample of 2,076 adults who are a part of Knowledge Network's online KnowledgePanelSM, revealed the top 10 out of 17 health concerns for children in the U.S.

Top 10 overall health concerns for children in the U.S.

1. Smoking. Forty percent of adults rate smoking as their top health concern for children. Among black adults, smoking ranks No. 2. Forty-five percent of black adults, however, rate smoking as a big problem.
2. Drug abuse. Adults are more likely to rate drug abuse as a concern based on their children's emotional health. Those who report their child's emotional health as “good,” “fair” or “poor” are more likely to view drug abuse as a major health problem for children compared with parents who rate their child's emotional health as “excellent” or “very good.”
3. Childhood obesity. According to poll results, adults with higher education are more likely to rate childhood obesity as their No. 1 health issue for children than adults with high school education or less. In fact, 40 percent of adults with a college degree view obesity as a top concern, while those with less than a high school education rate it as their No. 10 concern, with 25 percent reporting it as a top concern. The National Poll on Children's Health also found Hispanic adults are more likely to report obesity as a problem, with 42 percent viewing it as a major problem, compared with only 31 percent of white adults and 36 percent of black adults. “These differences somewhat reflect the higher prevalence of obesity among black and Hispanic youth compared with white youth,” notes Davis.
4. Alcohol abuse. “Households with lower incomes – less than $30,000 per year – are significantly more likely to rate alcohol abuse as a problem than families with higher annual incomes,” says Davis. “We also found that alcohol abuse by teens was a bigger concern in households with a single or divorced parent, compared with households with married parents.”
5. Motor vehicle accidents. Driving accidents involving teenagers are a universal concern across all socio-economic groups studied, says Davis.
6. Teen pregnancy. Black adults rate teen pregnancy as the No. 1 health problem for youth, with 51 percent reporting it's a major health concern compared with only 25 percent of white adults. “This difference echoes differences in rates of teen pregnancy by race/ethnicity, which have declined among all teens over the past decade, but remain two time higher among blacks than whites,” says Davis.
7. Internet safety. “Internet safety is a relatively new health concern in relation to other health issues,” says Davis. “Women and black adults are more likely to report it as a major concern.” Thirty-two percent of women and 21 percent of men report they are concerned about Internet safety, while 37 percent of black adults and 25 percent of white adults say it is a big problem.
8. School violence. “School violence didn't rate as high as driving accidents and alcohol use. Yet it still is in the top 10, and that speaks to the current level of concern in the U.S. about this problem,” says Davis. “We measured school violence concerns before the recent tragedy at Virginia Tech, so it is likely that it may rank higher today than it did just a few weeks ago.” Davis also notes that black adults are more than twice as likely as white adults to report school violence as a big problem, ranking it their No. 4 health concern. It also was viewed as a bigger health problem among lower income households.
9. Sexually transmitted infections. Sexually transmitted infections among youth are considered to be a bigger problem by black adults and Hispanics, with 40 percent of black adults and 34 percent of Hispanics adults viewing it as a big problem, compared with only 20 percent of white adults. Households with lower incomes also rate sexually transmitted infections as a greater health concern for children.
10. Abuse and neglect. About 22 percent of survey respondents view abuse and neglect as a health concern for children. “Similar to other health issues in the poll, more black respondents feel abuse and neglect is a big health concern than among Hispanic and white respondents,” says Davis.

Ratings for the top 10 list did not differ between adults who have children in their households, and those who do not. Overall, higher proportions of blacks and Hispanic adults rated all 17 concerns as “big problems” compared with white adults.

“This poll provides us with a detailed picture of what the public views as some of the biggest health concerns for children and adolescents today,” says Davis, associate professor of general pediatrics and internal medicine at the U-M Medical School, and associate professor of public policy at the Gerald R. Ford School of Public Policy. “It also suggests that the government may want to target more investment toward issues such as teen smoking, drug abuse and childhood obesity, in a way that reflects the fact that the public is currently prioritizing these problems as even bigger than other issues on the list.”

The next report from the C.S. Mott Children's Hospital National Poll on Children's Health will be released on May 23.