2020 Capital Kids Report

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Beyond the classroom: Greater Washington can do more to help young people flourish

Data on child well-being beyond measures of education are sparse for the Greater Washington region.

The well-being of children and youth is multi-dimensional. While strong educational preparation is a necessary ingredient for success, young people also need good physical health, social and emotional well-being, safety, and stability in order to thrive.

Across the region, available data identify several areas of progress and highlight groups of children and youth at risk of poor outcomes.  For some issues, such as improving healthy birth outcomes, aggregate data may obscure substantial inequities across racial and ethnic groups.  At the same time, data on some key indicators are missing, preventing us from providing a full portrait of child and youth well-being region-wide (see box at the end of the section).

Region-wide, more children have health insurance than in 2009.

Health insurance coverage is associated with children getting more timely care and with enhanced well-being in other dimensions of their development.45 Rising rates of insurance in the region are consistent with national trends following implementation of the Affordable Care Act.46

  • Across all jurisdictions for which multi-year data were available rates of uninsured children decreased from 2009 to 2017 (see Figure 12). This translates to about 23,000 more area children and youth with health insurance coverage in 2017 compared to 2009.
  • The percentage of children without health insurance in 2017 ranged from 1 percent (District of Columbia) to 8 percent (Montgomery County).

Figure 12. Percentage of children under age 19 without health insurance, by jurisdiction, 2009 and 2017

Overall, rates of low birthweight and infant mortality are down, but disparities by race and ethnicity persist.

Growth and development are rapid in the early years of a child’s life, and development builds on itself, underscoring the critical importance of a healthy start to life. Key indicators of a poor start include low birthweight and infant mortality status. On both measures, while the region shows encouraging progress, there are race-based disparities in birth outcomes. In particular, research shows that health care delivered to Black mothers and their infants is likely to be of poorer quality than the care provided to White mothers and infants.47

  • As of 2016, in the Greater Washington region as a whole, the rate of low birthweight live births (less than 2500 grams) was 7.6 percent—down from 8.2 percent in 2010.
  • The percentage of low birthweight live births varied within the District from 7 percent in Wards 2, 3, and 6 to 14 percent in Wards 7 and 8, with an average of 10.2 percent (see Figure 13).48
  • Low birthweight live births in the District were most prevalent for Black mothers (13 percent), occurring at almost double the rates for other racial and ethnic groups (7 percent for White and 8 percent for Hispanic mothers).
  • In Prince George’s County, which has the second-highest percentage of low birthweight births in the Greater Washington region (9.7 percent overall), Black mothers (12.1 percent) had higher rates of low birthweight live births than White mothers (6 percent) and Hispanic mothers (7 percent).

Figure 13. Percentage of infants with low birthweight, by D.C. Ward, 2016

Similar patterns are found for infant mortality across the Greater Washington region.

  • Rates of infant mortality across the jurisdictions followed similar patterns as low birth weight, except in Fairfax County; there, the rate for White infants (3.8 deaths per 1,000 live births) is closer to the rate for Black infants (4.5 deaths per 1,000 live births).
    • In Prince George’s County, the infant mortality rate for Black infants (12 deaths per 1,000 live births) is more than double the rate for Hispanic infants (5 deaths per 1,000 live births).
    • Infant mortality for White infants is highest in Loudoun County, where the rate is 4.7 deaths per 1,000 live births; however, the rate for Black infants is almost double at 8.6 deaths per 1,000 live births.
    • Arlington County has the region’s largest racial difference between White and Black infant mortality, with a rate of 12.3 for Black infants and 1.0 for White infants.
    • In Alexandria, the mortality rates for Black infants is 8.0 compared to 1.3 for White infants.
    • Rates of infant mortality in the District of Columbia for Black infants (11.5 deaths per 1,000 live births) are five times higher than for White infants (2.6 deaths per 1,000 live births).
  • Rates of infant mortality are down in all District of Columbia wards, although Wards 1, 5, 7, and 8 are still above the national average for 2016 (5.87 percent; see Figure 14).49
  • Rates of infant mortality are four times higher in Ward 7 and over six times higher in Ward 8 than in Ward 2. Wards 7 and 8 are vastly different from Ward 2 in their socioeconomic composition.50

Figure 14. Infant mortality rate per 1,000 live births, by D.C. Ward, 2016

Smaller percentages of parents report reading to their young children and sharing family meals together than in past years.

Children thrive on the time they spend interacting with the people closest to them. Two traditional indicators of family time together that benefit children’s development—reading to young children and sharing meals as a family—suggest that some families may struggle to spend time together. This may reflect parents’ long or nontraditional work hours, lengthy commutes, or lack of awareness that these activities are important to their children’s development. A child’s experience of being read to promotes not only early literacy, but also positive social and emotional development.51

Trends in parents reading to their children region-wide include:

  • Forty-two percent of parents in the Greater Washington region report reading to their young children (birth through age 5) every day, higher than the 38 percent of parents nationally who report reading to their children. This high level of reading in the region may be attributed to parents’ high levels of education, and to local efforts to promote reading.
  • Nevertheless, the percentage of parents in the region reading to their children declined across most jurisdictions from 2007 to 2017. This decline mirrors a national trend during the same timeframe; in 2007, 48 percent of parents reported reading to their young children, but by 2017, this number had decreased to 38 percent.
    • Large decreases of 10 to 15 percentage points in family members reading daily to young children were found across most jurisdictions.
    • The largest decrease was found in Fairfax County. In 2007, 56 percent of young children had a family member who read to them each day, but the rate dropped to 41 percent by 2017.
    • By contrast, in the District of Columbia, 49 percent of young children had a family member who read to them each day in 2007, a rate that increased to 52 percent by 2017.

Sharing family meals is associated with many benefits. Research has shown that children who frequently eat meals with their family members are more likely to succeed academically, avoid risky behaviors (including substance abuse), maintain positive family relationships, and develop healthier nutrition habits.52, 53

Figure 15. Percentage of children ages 0-17 whose family eat a meal together every day of the week, 2007 and 2017

  • Nationally, 43 percent of parents reported in 2017 that their families share daily meals together, a rate that is higher than that seen in the Greater Washington region (see Figure 15).
  • In the Greater Washington region in 2017, 39 percent of children shared meals with family members every day, down from 43 percent in 2007.
    • The largest drop was in the District of Columbia, where in 2017, 40 percent of parents reported having family meals every day, down from 48 percent in 2007.
    • In both Fairfax County and in Alexandria City, 41 percent of parents reported having family meals every day in 2017, down from 44 percent in 2007.
    • Loudoun County was the only location in the area where a decrease was not found. In both 2007 and in 2017, 41 percent of families in Loudoun County shared meals together.

Limited data on adolescents’ health-related behaviors suggest declines in substance use, but also in physical activity.

Much of the data on adolescents’ health-related behaviors are limited to two jurisdictions in the region: Washington, D.C. and Fairfax County. These are the only two local jurisdictions included in the federal Youth Risk Behavior Survey (YRBS). We report the data for these two locales but strongly recommend against drawing region-wide conclusions.

More youth use alcohol than any other age-restricted or illegal substance. In addition to the health damage caused by alcohol itself, other types of risky behavior, such as drug use and unprotected sex, are associated with teens’ heavy drinking. Among U.S. teens, binge drinking, or consuming multiple drinks in rapid succession (“drinking to get drunk”), is a common type of alcohol use.54

  • Binge drinking appears to have declined since 2011 in the District of Columbia and in Fairfax County. While data on binge drinking and a few other risk behaviors are only available in these two jurisdictions within the Greater Washington area, statewide data also reflect declines in Maryland and Virginia.
    • In Fairfax County, the number of students reporting any binge drinking in the past 30 days dropped from 11 to 7 percent from 2010 to 2017.
    • In the District of Columbia, reports of binge drinking dropped from 13 to 8 percent.
  • Even larger decreases were found in the percentage of high school students who reported having one drink on at least one day in the past 30 days.
    • In the District of Columbia, high schoolers who reported drinking decreased from 33 percent in 2011 to 21 percent in 2017.
    • In Fairfax County, the percentage of high schoolers who reported drinking decreased from 21 percent in 2010 to 15 percent in 2017.

Youth tobacco use has undergone substantial changes in recent years with an increased use in e-cigarettes (vaping) as compared to conventional cigarettes.55 Unfortunately, many young people took up the habit before recently discovered links between the use of e-cigarettes and severe, acute health problems became known.56, 57 Nevertheless, most smokers still begin using tobacco in their teens, and many become addicted to nicotine, which is a potent toxin available in many forms. Although some vaping products are nicotine-free, the data available on their use unfortunately do not distinguish between those that contain nicotine and those that do not. Many such products combine nicotine with flavorings that may cause some young users to believe the products are less harmful than they actually are.58

Figure 16. Percentage of high school students who reported they used an electronic vapor product on at least 1 day in the past 30 days, 2015 and 2017

As is noted above, young people today are considerably more likely to use e-cigarettes (vaping) than to smoke conventional cigarettes. This is true for the two Greater Washington area jurisdictions for which YRBS data are available. However, rates of smoking e-cigarettes and conventional cigarettes are down overall, despite an increase in smoking e-cigarettes in Fairfax County.

  • In 2017, 11 percent of high school students in the District of Columbia reported that they had used an electronic vaping product within the past 30 days (see Figure 16).
  • In the same timeframe, 10 percent of high school students in Fairfax County reported that they had used an electronic vaping product within the past 30 days.
  • By contrast, only 2 percent of Fairfax County students and 8 percent of District of Columbia students reported smoking cigarettes in the past 30 days in 2017.
  • From 2010 to 2017, rates of cigarette smoking decreased across all racial and ethnic groups in Fairfax County and the District of Columbia.
    • In Fairfax County, the highest rates of smoking were reported for Hispanic students, at 4 percent; the lowest were for Asian students, at 1 percent.

Neuroscience research has found that significant brain development is ongoing in adolescence and young adulthood, raising concerns about marijuana use by youth. Evidence indicates that marijuana use may impair cognitive functioning, as well as emotional self-regulation, contributing to risky behaviors.59

  • In Fairfax County, 10 percent of high schoolers reported recent marijuana use in 2017.
  • In the same year in the District of Columbia, 33 percent of high school students reported recent marijuana use.

Maintaining regular physical activity is important to maintaining a healthy weight, preventing chronic health conditions, and promoting other positive health outcomes.

  • The two jurisdictions reporting these data experienced a slight decline in the percentage of high school students who were physically active for at least 60 minutes per day on at least five days in the past week.
    • From 2010 to 2017, the percentage of high school students in Fairfax County who reported engaging in at least 60 minutes of physical activity per day on at least five days in the past week decreased from 43 to 40 percent.
    • In the District of Columbia, the percentage of students who reported engaging in at least 60 minutes of physical activity per day on at least five days during the past week decreased from 28 in 2011 to 26 percent in 2017.

Participation in out-of-school-time activities and community service or volunteer projects is high across the region.

Many of today’s young people recognize the value of engaging in activities that strengthen their social, emotional, and physical skills, and that contribute to their communities. Fairly consistently across the region, about eight in 10 youth participate in one or more out-of-school activities, and nearly two thirds are involved regularly in community service. 60

Out-of-school-time (OST) programming can be offered before school, after school, and during the summer for school-age children and teens. Such programs provide important opportunities for young people to learn and play in a safe and supervised environment. Well-designed and managed OST programs can also promote important health benefits and social and personal skills,61 and can even improve academic achievement.62, 63

  • In 2017, 83 percent of children ages 6 to 17 in the Greater Washington area participated in one or more organized activities out of school, a slight decline from 85 percent in 2007 (see Table 3).
  • Small decreases (of 1 percentage point) in OST participation were found in Prince George’s County and Prince William County.
  • Small increases (of 1 percentage point) in OST participation were found in Arlington County and in Alexandria.
  • Larger decreases from 2007 to 2017 were found in OST participation the following jurisdictions:
    • District of Columbia (81 to 77 percent)
    • Fairfax County (84 to 79 percent)
    • Loudoun County (92 to 85 percent)
    • Montgomery County (87 to 82 percent)

Table 3. Children ages 6-17 who participated in one or more organized activities outside of school in the past year, 2007 and 2017

Youth who participate in voluntary service are more likely to develop leadership skills, effective decision making skills, and a sense of belonging and purpose.64, 65 All school districts in the region require a community service component as a graduation requirement.66, 67, 68

  • From 2007 to 2017, community service participation among 12- to 17-year-olds in the Greater Washington area increased by 20 percentage points, from 41 to 61 percent (see Figure 17).
  • The highest rates of service by adolescents were reported in Montgomery and Prince George’s counties, at 62.1 percent in both localities.
  • The lowest rate of service reported was in Falls Church, at 60.2 percent.


Figure 17. Percentage of children ages 12-17 involved in community service a few times per month or more, 2007 and 2017

Source: Child Trends’ synthetic estimates based on data from 2007/2017 National Survey of Children’s Health, and the 2007/2017 American Community Survey 1-Year Estimates, *Except Falls Church 2017 calculations from 2013-2017 ACS 5-Year Estimates.

Data collection challenges

The Greater Washington region is a unique geographic area—an aggregation of counties and cities that are linked economically and culturally, yet governed independently.

Comparable data for all jurisdictions, as well as data on a wider range of indicators, would facilitate region-wide planning and action to promote the well-being of all young people in the Greater Washington region.

Regrettably, such robust, region-wide data are lacking for Greater Washington’s children and youth, particularly for nonacademic indicators. For several important topic areas, including infant development, behavioral health, and postsecondary education, we were unable to locate data that met conventional standards for consistency of measurement across jurisdictions, disaggregation by important subgroups, or timely reporting.

An additional challenge is identifying an appropriate context for comparing the region’s data with those of other metro areas. In some cases, we use national data for this purpose, but we hesitate to hold up any other metro region as a likely peer. The cultural and historical characteristics of the Greater Washington region are sufficiently distinctive to raise cautions about making such  comparisons.


Young people will lead our society into the future, regardless of what adults do to either support or hinder them. That future will be brighter if our communities rise to the challenges of nurturing, guiding, equipping, and engaging all young people to succeed.

The Greater Washington region rebounded from the Great Recession and moved into a period of growth and prosperity, but the region’s children have not benefited equally. Research suggests that the recession had more negative and lasting effects on those who have experienced intergenerational poverty and discriminatory policies, the consequences of which reverberate throughout society. Both nationally and in many schools and districts within the Greater Washington area, de facto residential and school segregation, both by income and race, continue to be a reality. As a result, Black, Hispanic, American Indian, and low-income students of all races are more likely to attend lower-resourced and lower-performing schools. Similarly, unequal access to preventative and comprehensive health care contribute to differential outcomes in infant mortality rates.

Much work remains to improve prospects for all of the region’s children and youth. The path to progress will not be short or easy. However, history suggests that progress is possible and that gaps in achievement, income, health, and other areas can be narrowed or eliminated. Leaders across the region may want to examine, for example, how current policies and practices related to housing, transportation, schools, and businesses perpetuate historical inequities. We strongly encourage regional and local leaders to explore ways to ensure that children from all backgrounds—especially low-income students; immigrants; and Black, Hispanic, Asian, and American Indian children—are equally prepared to succeed. To the extent that Greater Washington’s current and future leaders bridge these gaps and broaden participation in a prosperous, inclusive community, they will have proven lessons to share with other metro areas that seek to enhance the quality of life for their own young people.

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  6. Note this is calculated using three-year averages.
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  8. Child Trends DataBank. Family meals. Accessible at
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  15. Weir, K. (2015). Marijuana and the developing brain. Monitor on Psychology,46(10), 48.
  16. Access to quality out-of-school time programs and other enrichment activities is widely dependent on family income (Moore, K.A., Murphey, D., Bandy, T., Cooper, M (March, 2014). Participation in Out-of-School Time Activities and Programs. Child Trends Research Brief, 2014-13. Retrieved from: Families in low-income areas have fewer opportunities and limited access to programs for their communities. Also, low-income families spend significantly less on these opportunities than their high-income counterparts, because of financial limitations. The growing divide in opportunity and access has been documented and has also been called “the activity gap” and is particularly exacerbated in the summer (e.g. McCombs, J., Whitaker, A., & Yoo, P. (2017). The value of out-of-school time programs. RAND Corporation).
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  19. Durlak, J. A., & Weissberg, R. P. (2007). The impact of after-school programs that promote personal and social skills. Chicago, IL: Collaborative for Academic, Social, and Emotional Learning. Moore, K., & Hamilton, K. (2010). How out-of-school time program quality is related to adolescent outcomes. Washington, DC: Child Trends.
  20. Brennan, M. A., Barnett, R. V. (2009). Bridging community and youth development: Exploring theory, research, and application. Community Development, 40, 305-310.
  21. Brennan, M. A., Barnett, R. V., McGrath, B. (2009). The intersection of youth and community development in Ireland and Florida: Building stronger communities through youth civic engagement. Community Development, 40, 331-345.
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  23. Virginia Department of Education. (n.d.). Graduation (Diploma) Seals of Achievement. Retrieved from
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