Abstract
The outcome of flourishing and its predictors have not been well documented among US children, especially those who face adversity. Using data for 2016 and 2017 from the National Survey of Children's Health, we determined the prevalence and predictors of flourishing among US children ages 6-17. A three-item index included indicators of flourishing: children's interest and curiosity in learning new things, persistence in completing tasks, and capacity to regulate emotions. The national prevalence of flourishing was 40.3percent (29.9-45.0percent across states). At each level of adverse childhood experiences, household income, and special health care needs, the prevalence of flourishing increased in a graded fashion with increasing levels of family resilience and connection. Across the sectors of health care, education, and human services, evidence-based programs and policies to increase family resilience and connection could increase flourishing in US children, even as society addresses remediable causes of childhood adversity.
Highlights
The outcome of flourishing and its predictors have not been well documented among US children, especially those who face adversity
Validity Of The Child Flourishing Index We found a significant graded relationship between greater flourishing as shown on the child flourishing index (CFI) score and the prevalence of school engagement
40 percent of school-age children in the US meet criteria for flourishing, as operationalized by an index derived from three items designed to assess flourishing in the National Survey of Children’s Health
Summary
▸ CHILD FLOURISHING INDEX CONSTRUCT VALIDITY: Multivariable logistic regression models were used to assess the construct validity of the CFI These models used school engagement as the outcome (dependent) variable, the CFI items or scores as the predictor variables, and ACEs, special health care needs status, and sociodemographic variables as covariates. ▸ ASSOCIATIONS BETWEEN INDEXES ACROSS CHILD ADVERSITY CATEGORIES: Chi-square tests were used to assess the significance of differences in the prevalence of child flourishing across levels of exposure to ACEs (0, 1, 2 or 3, and 4 or more), household income (four levels, expressed as a percentage of the federal poverty level), special health care needs status (“more complex needs,” “less complex needs,” and “no special health care needs”), and other sociodemographic characteristics. The strength of the association between FRCI scores and the prevalence of flourishing was separately evaluated for subgroups of children who faced different levels of adversity as measured by ACEs, household income, and the presence of special health care needs
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