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Poverty, Hunger, Loss of Health Coverage are Growing Threats for Children in Watauga County

New county data cards present crucial benchmarks on child health and well-being in all 100 counties

Fallout from the COVID-19 pandemic means that many more families are struggling with basic needs. Today, NC Child releases its annual County Data Cards, highlighting key indicators of child well-being that elected officials should track, and respond to, in their communities. In Watauga County, 42% of children lived in families struggling with poverty before the pandemic struck.

Download the County Data Cards at: https://www.ncchild.org/datacards

“Before the pandemic struck, nearly half of children in North Carolina lived in a family that was struggling with poverty,” said Michelle Hughes, executive director of NC Child. “Widespread job losses have meant that many more families are now sliding into dangerous territory. That’s concerning because of the cascade of other traumatic events for kids that can come along with poverty, from losing your home to a parent struggling with depression.”

“Our leaders are taking important steps to buffer against these impacts, but much more needs to be done to provide strong community supports,” said Whitney Tucker, Acting Policy Director at NC Child and lead author of the County Data Cards. “We can prevent long-term harm for kids by keeping our attention focused on programs that are proven to insulate families against the harmful effects of poverty.”


One of the most immediate threats to children’s health and well-being is hunger. Many families are now relying on the thousands of feeding sites set up by schools and local food banks across the state. Even before the pandemic hit, 1 in 5 children in North Carolina lived in families that struggled to put nutritious food on the table. The hungriest counties are located in eastern North

Carolina. In Tyrell, Scotland, Washington, and Robeson counties, nearly 30% of children were in families considered “food insecure” before COVID-19 hit. Federal and state officials must ensure that programs like SNAP, WIC, and school nutrition programs have adequate resources to meet the sharp increase in need. Even before the pandemic hit, 20% of children in Watauga County lived in families that struggled to put nutritious food on the table.

Health Coverage

In the last few weeks, hundreds of thousands of North Carolina families have lost the health insurance they previously received through their jobs.

“North Carolina is one of only 14 states that has not taken federal funds to expand its Medicaid program to get health coverage to people with low incomes,” said Ciara Zachary, Health Program Director at NC Child. “That means there are fewer options for people to get coverage in our state than in states like Virginia and Kentucky that have expanded Medicaid. That’s a problem for kids, because when parents aren’t covered, their children are less likely to be covered as well.”

The rate of children with no health insurance is at 5% statewide, or 130,000 children with no health coverage. Children’s health coverage is critically important, because children need regular preventive care throughout childhood. Well-child visits and immunizations have dropped significantly since the COVID-19 pandemic began – meaning that many children are not getting the vaccinations and developmental screenings they need to stay on track and grow up healthy. This can have painful and expensive consequences later.

Infant Mortality

The infant mortality rate in Watauga County in 2018 was 11 deaths for every 1,000 live births, compared with 6.8 deaths for every 1,000 live births in the state. While this new statewide low is an important milestone, mortality rates remain much higher among Black families and those with lower incomes. As high numbers of adults lose their employer-provided health insurance in North Carolina, it will be critical to ensure that women of child-bearing age continue to get the care they need to ensure healthy pregnancies.

The infant mortality rate was more than double the statewide average in eight North Carolina counties: Pamlico, Hertford, Perquimans, Washington, Greene, Montgomery, Chowan, and Caswell. As high numbers of adults lose their employer-provided health insurance in North Carolina, it will be critical to ensure that women of child-bearing age continue to get the care they need to ensure healthy pregnancies.

NC Child anticipates that parents’ decreasing access to health care could impact critical children’s health indicators in future years, including babies born prematurely and at low birth weight, and infant mortality. These outcomes are strongly influenced by the health of mothers – before, during, and after their pregnancies.

Early Childhood Education

One key indicator included in the County Data Cards is whether children are reading on grade level when they reach the third grade – a huge predictor of future school success and lifetime earnings. High quality early childhood programs are proven to bolster children’s success in school.

In Watauga County, 67% of third-grade students scored proficient in reading in the 2018-19 school year, compared to 57% statewide. Third grade reading scores will be an important indicator to watch in future years. Many families already struggle to find high-quality, affordable care for their young children. COVID-19 has reduced families’ access to early education across the state. This could impact both children’s school performance in the future, as well as their parents’ ability to keep their jobs right now.

Data points for state and local officials to track

The data benchmarks presented in the new County Data Cards indicate how North Carolina’s children were faring before COVID-19 struck. Officials should use these data points as a baseline and watch for changes as North Carolina moves from emergency response into long-term recovery.

For complete data notes, sources, and graphics, visit: https://www.ncchild.org/datacards

NC Child is a 501(c)(3) non-profit organization whose mission is to build a strong North Carolina by advancing public policies to ensure all children – regardless of race, ethnicity, or place of birth – have the opportunity to thrive.