BACKGROUND: Children raised in a protective home environment (PHE) have better language and social skills, and are at lower risk for chronic diseases such as obesity and asthma. Increasing awareness of the role these factors play in children’s current and future health and promoting the elements of PHEs in communities are important public health goals. The prevalence of a PHE for children aged 0-5 years (younger children) and children aged 6-17 years (older children) was examined by state and race-income subpopulations.
METHODS: Data were obtained from the 2011/2012 National Survey of Children’s Health data files prepared by the Data Resource Center for Children and Adolescents and analyzed using Stata v14.1 to account for the complex survey design. PHE is defined separately for younger children (percentage who have >=4 family meals/week, are read/sung to every day, were ever breastfed, watch <=2 hours of television/day, and experience no household tobacco smoke exposure) and older children (percentage who have >=4 family meals/week, no television in their bedroom and watch <=2 hours of television/day, parents have met all/most of their friends, usually/always do required homework, and experience no household tobacco smoke exposure) to account for differences in the components of a PHE in the 0-5 and 6-17 age groups. National and state prevalence estimates were calculated using the specified survey weights and stratified by race-income subpopulations.
RESULTS: Nationally, an estimated 39.4% of younger children and 21.9% of older children live in a PHE. The prevalence of a PHE for younger children varied from a low of 24.1% in Mississippi to a high of 62.7% in Vermont (ratio 2.6). Among older children PHE prevalence ranged from a low of 10.3% in Mississippi to a high of 38.5% in Utah (ratio 3.7). Stratification by race-income groups revealed a positive relationship between income and the percentage of younger children living in a PHE for all 3 race/ethnicity groups. A similar relationship was present for all 3 race/ethnicity groups in older children, but was substantially weaker for black children.
CONCLUSIONS: We should aim to provide all children with a PHE yet national prevalence estimates for both age groups fall below 40%. The wide geographic variation in the prevalence of PHE provides an opportunity for states to learn from peer states with higher estimates of PHE. The relationship between PHE and race-income supports previous research, however further investigation of this relationship, particularly among older black children, and potential policy implications are warranted.