North Carolina Child Health Report Card 2021

doi:10.18043/ncm.82.2.145

The North Carolina Child Health Report Card, issued bi-annually by the North Carolina Institute of Medicine (NCIOM) and NC Child, tracks key indicators of child health and well-being in four areas: Healthy Births, Access to Care, Secure Homes and Neighborhoods, and Health Risk Factors. The report provides data on drivers of health and risk factors such as asthma, teen births, infant mortality, poverty, and child deaths.

The report also highlights the racial disparities in children’s health. For example, the infant mortality rate for African Americans and American Indians is more than double the infant mortality rate for White infants in North Carolina.

Another troubling trend in the 2021 Child Health Report Card is the increase in electronic vapor product use by high school students In North Carolina. Even though we see encouraging trends in cigarette and alcohol use among North Carolina youth in recent years, the increasing popularity of electronic vapor products is very concerning. Approximately 3 in 10 high school students report using these products, a 60.6% increase between 2017 and 2019. Since health behaviors picked up in youth, such as tobacco and alcohol use, can last a lifetime, North Carolina health leaders should consider increased investment in substance use prevention and cessation programs targeting youth to address the rise in use of electronic vapor products and other substances.

Despite continued struggles in child poverty, substance use, and mental health, the Report Card shows progress in asthma, insurance coverage, teen births, and health services utilization and immunization.

SUMMARY OF GRADES

Insurance Coverage
Environmental Health; Health Services Utilizations and Immunization; and Teen Births
Oral Health; Breastfeeding; Preconception and Maternal Health and Support; and Education
Child Abuse or Neglect; School Health; and Healthy Eating & Active Living
Housing and Economic Security; Birth Outcomes; Tobacco, Alcohol, and Substance Use; Mental Health

For the full 2021 Child Health Report Card and downloadable data sources, please visit www.nciom.org or www.ncchild.org.

Special Issue: The Impact of the COVID-19 Pandemic on NC Families

The COVID-19 pandemic has touched the lives of all North Carolina famlies. As many families try to find their footing, the pandemic is putting a harsh spotlight on the deeply embedded barriers that create massive racial and economic inequities in health and well-being. Children are quite resilient by nature. But when parents lose jobs or income, as so many have recently, it can cause a cascade of other traumatic events for children.

Losing a home, skipping meals, or having a parent struggling with depression can result in serious long-term consequences for kids. Before COVID-19, nearly half of children in North Carolina lived in a family that was struggling with poverty. Now, many more families are having a hard time meeting their children’s basic needs. COVID-19 is also changing the way children receive education across the state. While most schools have turned to full-time or part-time distance learning (67.3%), access to the internet and computers remains a challenge for many families, particularly for low-income households and rural communities.

The U.S. Census Bureau’s weekly Household Pulse Survey is capturing the social and economic impact of the pandemic on families across the country in real time. Approximately 1 in 4 families with children struggle to pay rent, while a fifth of homeowners with children are behind on mortgage payments. Fifteen percent of households with children report not having enough to eat over the past week. More than half of parents are struggling with anxiety and depression symptoms and have not received mental health care.

THE DATA PROVIDES A STARTING POINT FOR A PATH TO RECOVERY IN NORTH CAROLINA. Stakeholders can do much to support families during the pandemic, including:

Strengthening health coverage as a crucial part of North Carolina’s public health response to COVID-19. Expanding access to affordable health coverage - for adults and children alike - is important to children’s physical, mental, and emotional health. When parents are insured, they are better able to stay healthy and care for their children. Likewise, their children are more likely to have health insurance and to use it. Hundreds of thousands of North Carolina caregivers have lost the health coverage they previously received through their employers. Without health insurance, it can be nearly impossible for parents and caregivers to get health care when they need it.

Removing barriers to health and health care for North Carolina’s most vulnerable families. We can ensure that thousands of families get the high-quality care they need, because we understand the barriers. Some of the biggest are not having a car to get to health appointments, a shortage of local health care providers, unaffordable services, and a shortage of providers who understand their patients’ language and/or culture.

Preventing long-term harm to kids by investing in the programs that are proven to insulate families against the harmful effects of poverty. Programs such as Medicaid, SNAP, WIC, and high-quality early childhood education are proven to boost school success, and help keep kids healthy throughout their lives.

Expanding access to broadband internet. State legislators have an opportunity to get broadband internet to the 200,000 homes with students in North Carolina that still have no internet access at home. Currently, these families don’t have the wi-fi access they need for their kids to attend class, and can’t access telehealth services or apply for jobs or needed benefits like Medicaid or SNAP.

State legislators and health officials are justly prioritizing COVID-19 recovery efforts this year. The pandemic has had a hugely disproportionate impact on communities of color, so solutions must address the long-standing structural racism that leads to disparities in health outcomes for children and their families. Prioritizing an equitable recovery will get us closer to the goal that all children and families can thrive.