The North Carolina Child Health Report Card, issued 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 such health concerns and risk factors as asthma, teen births, infant mortality, poverty, and child deaths.
Family financial security is one of the most impactful determinants of children's health, and children who live in poverty, particularly during early childhood, are at risk of poor health outcomes throughout their lives. Children from low-income families fare worse in almost every indicator of health, including birth outcomes, access to care, health-risk behaviors, and mortality. These children are also often exposed to high levels of toxic stress, which can have a negative impact on brain development and can contribute to behavioral, social, emotional, and health problems later in life. Children living in financially secure families are more likely to achieve educational success and grow to be healthy, self-sufficient adults.
Unfortunately, not all of North Carolina's kids have the benefits that come from living in financially secure families. Almost half of North Carolina's children live in poor or low-income households (defined as income less than 200% of the federal poverty level), and one-third live in households that spend more than 30% of income on housing. In addition, 14% of children live in high-poverty neighborhoods; these children are more likely to be exposed to neighborhood violence and crime.
There are many opportunities for North Carolina stakeholders to work to reduce poverty, address the structural barriers that serve to keep families poor, and ensure that all of our state's families are financially secure. Stakeholders can enhance financial security for families through programs and policies that promote job creation, improve education, and examine the impact of tax and wage policies. Together we can identify evidence-based solutions to improve the financial security of North Carolina's families and improve opportunities and health outcomes for our state's children.
Healthy Births
Preconception & Maternal Health ° Birth Outcomes Postpartum Health & Breastfeeding ° Teen Births
North Carolina receives a D in birth outcomes: North Carolina ranks 42nd in the country for infant mortality, and there are persistent racial disparities in rates of preterm births and low birth weight. While 83.1% of women of childbearing age have health insurance coverage, nearly one-third still do not receive the early prenatal care that promotes healthy pregnancies and can help prevent babies born with health complications. Successful policies have contributed to a 31% decrease in births to teen girls since 2012. However, significant racial disparities persist: African American teens are nearly twice as likely and American Indian and Hispanic/Latinx teens almost three times as likely as their white peers to give birth.
Access to Care
Insurance Coverage ° Oral Health ° School Health Health Services Utilizations & Immunization
North Carolina receives its only A in the area of health insurance coverage. Children with health insurance are better able to access preventive health care services that can reduce unmet health needs The expansion of enrollment processes, greater outreach, and increased coverage for parents have contributed to near total (96%) health insurance coverage for children in North Carolina. In addition, more parents in North Carolina have insurance. This can lead to greater economic security, as adults without insurance are more likely to have difficulty paying for basic items such as food, rent, or utility bills.
Secure Homes
Family Involvement ° Housing & Economic Security ° Environmental Health ° Child Abuse & Neglect ° Children in Out-of-Home Care
Providing children with safe, stable, and nurturing relationships and environments can protect against the impact of adverse childhood experiences (including abuse, neglect, or poverty), improve health, and increase household financial security. North Carolina receives a B in Family Involvement, with 72% of families reporting that they eat together four or more times each week and more than 40% of families reporting that they read to their young children every day.
Health Risk Factors
Education ° Healthy Eating and Active Living ° Tobacco, Alcohol, & Substance Use ° Mental Health
In North Carolina, only 57.8% of third grade students are reading at grade level. However, the 4-year graduation rate continues to increase, contributing to a strong foundation for improved financial security and better health outcomes for our state. North Carolina receives a D in mental health, as rates of depression have continued to rise among adolescents, and nearly one in 10 North Carolina high school students attempted suicide in 2015. The state also receives a D in Healthy Eating and Active Living: fewer than one in 4 children in North Carolina are physically active for at least an hour a day, and 30.9% of children aged 10-17 are overweight or obese.
Footnotes
For the full Child Health Report Card visit: www.nciom.org or www.ncchild.org
- ©2018 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.