Raleigh News & Observer
by Tom Vitaglione
Healthy children within nurturing families
-- it's a vision all North Carolinians can agree on. Even when not
stated explicitly, this vision is realized when the priority is
reflected in state investments. If children are not a priority in the
state budget, they are not a priority in North Carolina. Though not the
sole determinant of child health and safety, government, with its
authority to make fiscal investments as well as statutory changes, does
indeed set the tone.
The recently published 2009 N.C. Child
Health Report Card provides an opportunity to assess the results of our
investments in child heath. For the last 15 years, Action for Children
N.C. and the N.C. Institute of Medicine have published annual cards to
heighten awareness of children's health and safety. This year, the
Report Card presents the progress made on 14 indicators from 2000 to
2008, which includes the administrations of Governor Easley and the
concurrent sessions of the General Assembly.
The period began and
ended in recessions, with several years of growth in between. The
number of children (ages 0-17) grew each year, to more than 2.2
million. However, approximately 20 percent of them continued to live in
poverty, meaning that more children than ever before were living under
significant financial stress. Under such conditions, a general decline
in children's health and safety would be expected.
Fortunately, this was not the
case. A review of the indicators in the Report Card shows that, though
the picture is not always rosy, the health and safety of our children
generally improved during this period, and analysis makes it clear that
these generally favorable outcomes are not happenstance.
In fact, all of the indicators were addressed by government policy. Here are some highlights of direct action:
Additional appropriations, proposed by the administration and approved
by the General Assembly, have significantly expanded public health
insurance for children, reducing the uninsured rate. They also have
brought the infant mortality rate to historic lows and have expanded
access to dental care for low-income children.
Laws were enacted to enhance children's safety, particularly to prevent
motor vehicle-related injuries, and the overall child fatality rate
fell to the lowest ever recorded in North Carolina.
By maintaining the vision of healthy children in nurturing families,
policymakers also create an environment for state and local agencies,
providers and advocates to come together to improve service delivery,
and in some instances revamp entire service systems. Community Care of
North Carolina has enhanced both access and quality of health care for
children, the Early Intervention System was reorganized to expand
services for young children with special needs and the Multiple
Response System has been implemented statewide to respond more
appropriately to families under stress.
During this same period, initiatives were developed to promote healthy
weight among children, to enhance the initiation and duration of
breastfeeding, to eliminate childhood lead poisoning and to reduce the
use of tobacco among children and youth.
While all of these
efforts are heartening, it is clear that North Carolina has a long way
to go. Data for some of the indicators -- child abuse homicides,
overweight children, the use of tobacco, alcohol and illegal substances
by teens -- reflect continued unacceptable risks to children and youth
and should be cause for grave concern.
The Report Card data now
become a baseline for the new administration of Governor Perdue and
coming legislative sessions. These leaders inherit the progress that
has been made in 2000-2008, but they also face daunting economic
challenges. Maintaining and acting on a vision of healthy children in
nurturing families will be very difficult, but it is critical that they
By Leslie Boyd
The proposed budget released by Gov. Bev Perdue this week avoids
crippling cuts in health and human services, but there are portions
that leave health and social services advocates worrying.
“One of the best pieces is the dollar increase in the
cigarette tax,” said Adam Searing of the N.C. Justice Center, and
project director of the North Carolina Health Access Coalition. “We
talk about all these wellness programs to cut health care costs, and a
lot of them are expensive. This one costs nothing, and it's very
The budget also will allow 8,000 more children to
enroll in the state children's health insurance program. Most will be
children who are eligible but haven't enrolled yet.
More would be
saved under the governor's proposal to rely more on generic drugs when
the state is footing the bill. Perdue does not rule out the possibility
of developing a preferred drug list, or formulary.
“She is taking
aim at the big pharmaceutical companies,” Searing said. “This proposal
is not just about saving money; it's also a tool to limit off-label
The proposed budget would increase funding for
community-based services and short-term psychiatric beds in community
hospitals. So far, the state has contracted for about 150 beds in
communities across the state; 50 more are planned. This would allow the
state to cut 25 short-term psychiatric beds each at Broughton and
Cherry state hospitals.
Overall, Searing said, health care would not be hit too hard.
Child care gets a boost — for now
The governor's budget proposes using federal economic-recovery funds
to increase the number of child care subsidies by 11,000 in the next
two years. The plan also would use federal money to replace state money
in child care subsidies.
Although the money will reduce the
waiting list by 11,000 children, between 20,000 and 40,000 children are
waiting statewide, said Louisa Warren of the N.C. Justice Center.
The problem is there is no state money to continue the funding after 2011.
“You can't rely on a complete economic recovery by then,” Warren said.
Greg Borom of Children First/Communities in Schools of Buncombe County said the proposed cuts are not as bad as he had feared.
SCHIP is great,” Borom said. “But we still have to worry about not
losing ground in other areas where children, youth and families are
Child welfare faces cuts
Outside of SCHIP and child care subsidies, the news isn't as good.
The proposed budget eliminates funding for two inexpensive programs.
Child Welfare Collaborative works with college and graduate students
studying to be child protective workers to give them experience in the
field before they graduate and prepare them for the difficult
situations they will face. The program has been shown to reduce
turnover once people are on the job.
“Turnover is a major problem
in the system,” said Sorien Schmidt, senior vice president of Action
for Children N.C. “Reducing it saves money.”
The other program
proposed to be de-funded is Support Our Students, an after-school study
and mentoring program for 14,000 at-risk students in the state.
show the time most juvenile crime is committed is between 3 and 6
p.m.,” Schmidt said. “This program is during those times.”
Support Our Students also has been shown to increase students' reading scores.
“The cuts, by and large, are thoughtful,” she said. “The reality is we have a huge shortfall and cuts have to be made.”
Our kids are making progress according to the “2009 North Carolina Children’s Index”. But, the index, which comes out every couple of years says racial and geographic disparities continue to hurt our children.
The index says our kids are doing better in health care and childcare subsidies. In fact, three out of four kids in our state have some kind of medical home. Like a primary care physician. That means they are not costing quit so much by making trips to the emergency room.
And another good point, there has been a dramatic decline in tooth decay.
But we also have a lot of work to do in a number of other areas:
Infant mortality increased slightly from 2003 to 8-point 5 per 1-thousand live births in 2007. Infant mortality is closely associated with the health care of mothers.
And almost one of every two children, live in low income households. Most poor kids like either along the coast or in the mountains.
The report shows race does matter. Black and Hispanic children are four times as likely to be in the juvenile justice system as white children. However, many people, both black and white, say this is a problem that parents need to step up and handle.
Nearly one in five children are overweight. And black infants are twice as likely as their white counterparts of being born with low birth weight. The index also says the number of kids who do not have medical care has grown by about 10 percent since 2003.
For more on the study just go to this website: http://www.ncchild.org.