Children’s Health in California

The California Department of Public Health’s mission is to protect and support the health of all Californians, especially children and young families. The Maternal, Child and Adolescent Health (MCAH) Division takes a life course approach to public health, promoting healthy lifestyles and environments for infants, children, youth and their families. Healthy choices and health promoting activities lead to healthier and more productive communities.

This data brief serves as an overarching summary of the current state of health among California children ages 1–10 years, based on data available as of 2024. This is an introductory brief. Future data briefs will explore in more detail various components of children’s health, such as mental health, special health care needs, access to care and living environments.

By understanding who the children of California are, the circumstances in which they are living, and the challenges and opportunities presented to them, we can be better prepared to support them and their families and propel them towards healthy, fulfilling futures.

California Children by the Numbers

(Source: Department of Finance, DOF, Projections 2024 unless otherwise stated.1)

California Children by Race/Ethnicity

• Hispanic: 50% in 2016 and 48% in 2026
• White: 29% in 2016 and 26% in 2026
• Asian: 11% in 2016 and 13% in 2026
• Black: 5% in 2016 and 5% in 2026
• Multiracial: 5% in 2016 and 7% in 2026
• American Indian/Alaska Native: 0% in 2016 and 0% in 2026
• Pacific Islander: 0% in 2016 and 0% in 2026

Children With Special Health Care Needs

Children with Special Health Care Needs (CSHCN) are defined by the Health Resources and Services Administration, Maternal and Child Health Bureau as children who have or are at increased risk for having chronic physical, developmental, behavioral or emotional conditions. They have conditions such as asthma, sickle cell disease, epilepsy, anxiety, autism or learning disorders. They may need more specialized health and educational services to thrive.2)

Health Status 

A healthy child is on track for positive development and well-being. Optimizing a child’s health leads to benefits in education, lifelong health status, and social productivity. It also enhances family and community life during childhood as well as adulthood. 4, 5

Child’s Health Status*

(Source: NSCH, 20226)

* Fair or poor percentage for White children is very small (0.1); color bar is not visible.

• Ages 1-10 1.5% fair or poor, 7.6% good, 91% excellent or very good
• White 0.1% fair or poor, 5% good, 94.8% excellent or very good
• Asian 2% fair or poor, 8.1% good, 89.9% excellent or very good
• Hispanic 1.6% fair or poor, 9.1% good, 89.3% excellent or very good
• Black 6.3% fair or poor, 9.6% good, 84.1% excellent or very good

Black children in California are less likely to be in very good or excellent health compared to children of all other races/ethnicities6, reflecting the impact of structural racism on Black children’s health and development.7, 8

Child Mortality

Mortality rates are important indicators of health among children aged 1-10. Thanks to medical advances and preventive public health measures such as vaccination campaigns and hygiene practices, deaths among children are relatively rare in California and in the US.9 The death rate is highest in the 1–5-year old age group.10

Child Mortality 

(Source: California Comprehensive Death Master File, CCDMF, 202210)

• 1-5 years: 15.5 in 2018, 15 in 2019, 14.9 in 2020, 14.3 in 2021, 17.1 in 2022
• 1-10 years: 11.9 in 2018, 11.6 in 2019, 11.4 in 2020, 11.5 in 2021, 12.6 in 2022
• 6-10 years: 8.3 in 2018, 8.5 in 2019, 8.1 in 2020, 9 in 2021, 8.5 in 2022

Child mortality rates have been mostly stable since 2018, though there was close to a 20% rise in 1–5-year-olds’ mortality in 2022.10  

Child Mortality by Race/Ethnicity, 1–10 Years Old

(Source: CCDMF, 202210)

Black children’s mortality rates are roughly twice those of children of all other races/ethnicities in all age groups.10 The spike in the Black children’s mortality rate in 2020 coincided with the onset of the COVID pandemic.

Flourishing

Flourishing means that a child is growing and thriving physically, mentally, and emotionally as appropriate for one’s age.11

 

78.3%  of children aged 1–5 are flourishing in California

63.9% of children aged 6–10 are flourishing in California 

(Source: NSCH, 20226)

Healthy Weight

A healthy weight is important for a child’s overall health and leads to a healthier adulthood. Healthy weight is dependent on many different factors, including genetics, metabolism, environment, and more. Proper nutrition and healthy physical activity are key factors in promoting health weight.12

Parent Very Concerned About Child’s Weight Being Too High

(Source: NSCH, 20226) 

• Ages 1-5: 2.3%
• Ages 6-10: 7.2%
• Hispanic: 6.7%
• Asian: 4%
• White: 3%
• Black: 0.8%

When surveyed about the overweight status of one’s child, the vast majority of parent did not express concern. A greater percentage of parents of children aged 6 to 10 report being very concerned compared to parents of children aged 1 to 5. More parents of Hispanic children report being very concerned compared to parents of children of other races/ethnicities.6

Dental Health

Children’s health and quality of life are evident on the condition of their teeth. Tooth decay, also known as dental caries, is the prevalent chronic disease among children.13 Poor dental health can negatively impact a child’s psychosocial well-being as well as school performance.14

Condition of Child’s Teeth

(Source: NSCH, 20226)

• Ages 1-5: 4.2% fair or poor 11.3% good 84.5% excellent or very good
• Ages 6-10: 8.6% fair or poor 23.1% good 68.3% excellent or very good
• White: 3.9% fair or poor 13.2% good 82.9% excellent or very good
• Hispanic: 7.9% fair or poor 18.8% good 73.2% excellent or very good
• Black: 0% fair or poor 27.2% good 72.8% excellent or very good
• Asian: 8.7% fair or poor 19.6% good 71.7% excellent or very good

Approximately three quarters of children in California have teeth in excellent or very good condition. Children aged 1–5 are more likely to have teeth in excellent or very good condition than are children aged 6-10. White children are more likely to have teeth in excellent or very good condition than are Hispanic, Black and Asian children.6

Immunizations

Vaccination greatly reduces children’s risks of contracting certain infectious diseases. In countries where vaccination is not widespread, infectious diseases, collectively, are the main cause of death for children aged 5 years and younger.15 In the U.S. and in California, children’s deaths due to infectious diseases were greatly reduced with the introduction of vaccination programs.9

Kindergartners’ Vaccines - California

(Source: CDPH Immunization Branch, Kindergartner Immunization Assessment, School Years 2020–21 & 2021–2216)

Vaccination rates among kindergartners dropped between School Year (SY) 2015–2016 and SY 2021–2022. Chickenpox (Varicella) dropped the most, from 98.5% (2016–17) to 96% (2021–22).16 High immunization rates among children are essential to protect people of all ages from infectious diseases, especially those who are too young or unable to be vaccinated for other reasons.17

Family Income

Family income is a major predictor of children’s growth, development, and overall health18, determining access to resources such as food, shelter, education and health care. 

Children Living in Poverty 

(Source: IPUMS. IPUMS center for Data Integrations, 202119)

• Ages 1–10, 16.9%
  
• American Indian and Alaska Native, 30.7%
  
• Black, 24.6%
  
• Hispanic, 22.0%
  
• White, 9.6%
  
• Asian/Pacific Islander, 9.5%
  

Children aged 1 to 10 living in poverty are defined as children living in families with incomes at or below the federal poverty thresholds established by the U.S. Census Bureau.20 In California, White and Asian/Pacific Islander (API) groups have the lowest percentage of children living in poverty, with a 0.1 percentage point difference between the two. American Indian/ Alaska Native (AIAN) children are over three times more likely to live in poverty while Black and Hispanic children are over two times more likely to do so, when compared to White and API children.

Food Security

Proper nutrition is essential to a child’s healthy growth and development and is highly dependent on family income and place of residence. Food deserts, or areas without easy access to healthy foods, are more likely to be located in areas with higher numbers of families experiencing poverty.21

Could Always Afford Enough to Eat

(Source: NSCH, 20226)

• Ages 1–10, 95%
  
• Asian, 99.4%
  
• White, 97.8%
  
• Black, 93.9%
  
• Hispanic, 93.0%
  
• Multi-racial, 92.9%
  

Hispanic, Black and Multiracial children in California are at a higher risk of food insecurity compared to White and Asian children.6

Summary

Most children in California are in good or excellent health, have good dental health, are up to date on their recommended immunizations and are flourishing. Overall child mortality rates have been stable over the last few years. There are important disparities by age group and race/ethnicity. Most notably, mortality is higher among 1–5-year-olds, and Black and Hispanic children experience poor health status, poverty, and mortality disproportionately, compared to their peers of other races/ethnicities. Additionally, American Indian/Alaskan Native children have a three-fold higher risk of living in poverty than do White children in California. California’s children’s health can be improved through evidence-based public health efforts targeting these disparities.

References

1. State of California Department of Finance. Population Projections. State of California Department of Finance; 2024.
2. Health Resources & Services Administration, Maternal & Child Health Bureau. Children and Youth with Special Health Care Needs: National Survey of Children’s Health Data Brief; June 2022
3. National Survey of Children’s Health; 2016–2021.
4. Case A, Lubotsky D, Paxson C. Economic Status and Health in Childhood: The Origins of the Gradient. The American Economic Review. 2002;92(5):1308–1334. doi:10.1257/000282802762024520.
5. Case A, Fertig A, Paxson C. The lasting impact of childhood health and circumstance. Journal of Health Economics. 2005;24(2):365-389. doi:10. 1016/j.jhealeco.2004.09.008
6. National Survey of Children’s Health; 2022.
7. American Medical Association. What is Structural Racism? American Medical Association; 2021.
8. Children’s Partnership. A Child is a Child: A Snapshot of Children’s Health in California. Children’s Partnership; 2024.
9. Cunningham RM, Walton MA, Carter PM. The Major Causes of Death in Children and Adolescents in the United States. The New England Journal of Medicine. 2018;379(25):2468–2475. doi:10.1056/NEJMsr1804754.
10. California Comprehensive Death Master File. Death Profiles. California Comprehensive Death Master File; 2022.
11. California Department of Public Health. California State of Public Health Report. Office of Policy and Planning; 2024.
12. Hagan JF, Shaw JS, Duncan PM. Bright Futures Guidelines for Health Supervision of Infants, Children and Adolescents:Promoting Healthy Weight. 4th ed. American Academy of Pediatrics; 2017.
13. Burgette JM, Divaris K, Fontana M. Reducing Inequities in Early Childhood Dental Caries in Primary Health Care Settings. JAMA Health Forum. 2021;2(12):e214115. doi:10.1001/jamahealthforum.2021.4115.
14. Guarnizo-Herreño CC, Wehby GL. Children’s dental health, school performance, and psychosocial well-being. The Journal of pediatrics. 2012;161(6):1153-9. doi:10.1016/j.jpeds.2012.05.025
15. United Nations International Children’s Emergency Fund. Vaccinating Every Child. United Nations Children’s Fund.
    
16. Immunization Branch. Kindergarten Immunization Assessment, 2020–2021 and 2021–2022. California Department of Public Health.
17. Mallory ML, Lindesmith LC, Baric RS. Vaccination-induced herd immunity: Successes and challenges. Journal of Allergy and Clinical Immunology. 2018;142(1):64–66. doi:10.1016/j.jaci.2018.05.007.
18. Hill HD. Family Income Level, Variability, and Trend as Predictors of Child Achievement and Behavior, Demography.
19. Integrated Public Use Microdata Series (IPUMS). Children in Poverty. IPUMS Center for Data Integration; 2021.
20. US Census Bureau. How the Census Bureau Measures Poverty. Apr, 2025. URL: https://www.census.gov/topics/income-poverty/poverty/guidance/poverty-measures.html
21. Dutko P, Ploeg SV, Farrigan T. Characteristics and Influential Factors of Food Deserts. Department of Agriculture, Economic Research Service; 2012.
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
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