The North Carolina Child Health Report Card is issued annually by the North Carolina Institute of Medicine (NCIOM) and NC Child. The report compiles the leading indicators of child health and safety to help policymakers, health professionals, the media, and concerned citizens track child health, identify emerging trends, and plan future investments. This year's report tracks key indicators of child health in four areas: Healthy Births, Access to Care, Safe Homes and Neighborhoods, and Health Risk Factors. The report provides data on health concerns and risk factors such as asthma, teen births, infant mortality, poverty, and child deaths. It also shows that children's chances of having fundamental building blocks of good health often differ dramatically by race and ethnicity. This report card presents data for the most current year available, usually 2015, and a comparison year, usually 2011.
Access to care
North Carolina's latest child health report card gives the state an ‘A’ in children's health insurance for achieving a record high coverage rate of 96%. The uninsured rate for children has declined by half since 2009, the 14th largest drop in the rate of uninsured children nationally. This progress is largely attributable to the three pillars of children's health coverage that support and supplement the private market-the Affordable Care Act (ACA), Medicaid, and NC Health Choice (the state Children's Health Insurance Program in North Carolina). As such, the future of children's health insurance coverage is closely tied to proposed changes to these policies and programs in Congress. Which could eliminate or reverse coverage gains.
Despite overall progress, some children encounter health insurance barriers: 1 in 18 low-income children is uninsured. Hispanic or Latinx kids are nearly three times more likely to be uninsured than their non-Hispanic White peers.
While the Report Card shows progress in children's health insurance and other key health indicators, including teen births, vaccination rates, and breastfeeding, the grades reveal many areas of profound concern where the state has made little or no progress.
Healthy Births
North Carolina received a ‘D’ for birth outcomes, a grade determined largely by the state's record on infant mortality and because of the large and persistent racial and ethnic disparities. Infant mortality rates were lowest among Hispanic infants (5.4 per 1.000 live births) and highest among African American infants (12.5 per 1.000 live births). Just over two-thirds of women received the early prenatal care that promotes healthy pregnancies and deliveries (67.896) in 2015, down from 71.2% in 2011. Early prenatal care is essential for identifying the mental health and the physical health challenges that pose a risk to a healthy pregnancy, such as smoking, mental illness, and risk of premature delivery.
Safe Homes and Neighborhoods and Health Risk Factors
North carolina received its only ‘F’ in economic security for failing to address the serious public health epidemic and its deep racial and ethnic inequities. Evidence shows income has a profound effect on health outcomes. The greater children's household income, the lower their likelihood of disease and premature death. The report card documents a series of troubling indicators in the area of economic well-being:
More than half of all North Carolina children under age 5 (52.6%) live in poor or near-poor homes. Children in low-income homes face greater risk of poor health outcomes, lower educational attainment, and reduced economic opportunity.
One in three children (32%) live in homes with a high housing cost burden, defined as more than 30% of monthly income spent on housing expenses. Higher housing costs can cause families to spend less on health care and increase rates of food insecurity.
One in seven children live in high poverty neighborhoods (14%), up 56% since 2006-2010. African American, American Indian, and Latinx children are more likely to live in concentrated poverty than their non-Hispanic White peers. Children who live in high poverty neighborhoods are more likely to suffer poor physical and mental health outcomes and to be exposed to violence and crime.
The full 2017 Child Health Report Card, including background information, citations, and complete data tables, is available on the North Carolina Institute of Medicine website: www.nciom.org/publications/?2017-child-health-report-card
- ©2017 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.
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