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New NC Child Health Report Card: Some Grades Better, Some Lag Badly

North Carolina’s latest child health report card tracking 40 areas of child health, shows progress in some areas while others lag badly. The report card is issued annually by the North Carolina Institute of Medicine (NCIOM) and NC Child, and reports on such health concerns and risk factors as asthma, teen births, infant mortality, and child deaths from a variety of causes. (Click here to download the Report Card.)

Improvement has come in hospitalization rates for asthma, (receiving a grade of “A”), and insurance coverage, teen births, immunization rates, and dental health, which got grades of “B.” Badly lagging areas getting a “D” include school health, weight and physical activity, tobacco use, and mental health, alcohol and substance abuse. Birth outcomes, including the state infant death rate, which has not improved since 2010, received a “C.”

Report authors highlighted the need to improve the health of parents as an important strategy for addressing some of the most difficult health problems facing children. Currently, 17.4 percent of all parents statewide (324,000) lack health insurance, which is a major impediment for continued progress in children’s health.

“It’s a simple concept—you can’t separate the future of children from the realities of the families they grow up with,” said Dr. Adam Zolotor, president and chief executive officer of the NCIOM. “Healthy children come from healthy families.”

Infant mortality

In the case of infant mortality, getting mothers regular health care before they ever become pregnant is critical. According to Michelle Hughes, executive director of NC Child, the most economical way to do that is for state leaders to create a North Carolina plan to cover people who are in the “insurance coverage gap”—they earn too much money to receive Medicaid, but earn too little to receive subsidized insurance coverage under the Affordable Care Act. These people typically work in industries such as construction, retail and hospitality, where wages won’t cover insurance and employers don’t provide it.

“North Carolina’s infant mortality rate has stopped improving after declining for most of the past 20 years, and in the last five years it has worsened for Hispanic and American Indian families,” said Hughes. “Those families are the most likely racial and ethnic groups to be uninsured in North Carolina. North Carolina could use federal funding right now to make sure parents and future parents get the care they need to promote healthy births.”

Child health insurance

The uninsurance rate for children reached an all-time low of 5.2 percent in 2014, but the high rate of uninsured parents restricted additional gains. 119,000 children remain uninsured statewide. Two-thirds of uninsured children are eligible for either Medicaid or NC Health Choice, but not enrolled.

“North Carolina has the opportunity to use federal funding to insure half a million adults,” said Hughes. “In states that have closed the coverage gap for adults, we’ve seen corresponding improvements in the health insurance rate for children.”

Having health insurance allows children and their parents to receive preventive care like check-ups, immunizations, and dental cleanings, which can prevent chronic diseases and have a long-term impact on not only their health, but also their education and economic status.  

The Report Card also found that one in 10 babies are born to mothers who smoke, a health risk that often predates pregnancy. Children of parents who smoke have worse birth outcomes, get sick more often, and are more likely to smoke themselves. Parents’ eating behaviors and levels of physical activity also significantly impact those of their children.

“Parental influences on child health begin before conception and continue throughout their lifetime,” said Zolotor. “While North Carolina has made gains in many areas of child health, more attention needs to be given to the significant impact that improving the health of parents would have on children’s health.”

Click here to download the 2016 Report Card.

About the Report Card

For 20 years, the North Carolina Child Health Report Card has monitored the health and safety of children and youth in our state. The report compiles more than 40 indicators of child health and safety into one easy-to-read document that helps policymakers, health professionals, the media, and concerned citizens track children’s health outcomes, identify emerging trends, and plan future investments. The report card presents data for the most current year available, usually 2014, and a comparison year, or benchmark, usually 2010.

About the North Carolina Institute of Medicine

The North Carolina Institute of Medicine (NCIOM) is an independent, quasi-state agency that was chartered by the North Carolina General Assembly in 1983 to provide balanced, nonpartisan information on issues of relevance to the health of North Carolina’s population. The NCIOM convenes task forces of knowledgeable and interested individuals to study complex health issues facing the state in order to develop workable solutions to address these issues to improve health, health care access, and quality of health care in North Carolina. Visit http://www.nciom.org for more information and the full report of the Task Force on Essentials for Childhood.

About NC Child

NC Child advances public policies that improve the lives of North Carolina’s children. We work statewide to ensure that all children are healthy, safe, well-educated, and economically secure by engaging communities, and informing and influencing decision-makers. Visit http://www.ncchild.org for more information.