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For Immediate Release: March 14, 2017

2017 Child Health Report Card Highlights Record-breaking Children’s Health Insurance Coverage

North Carolina receives an ‘F’ for child poverty

RALEIGH—North Carolina’s latest child health report card gives the state an ‘A’ in children’s health insurance for achieving a record high coverage rate of 96 percent. However, the state received its only ‘F’ in child poverty for failing to address this serious public health epidemic and its deep racial and ethnic inequities.

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 in four areas: Healthy Births, Access to Care, Safe 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.

North Carolina has reached an important milestone—the uninsured rate for children has declined by half since 2009, the 14th largest drop in the rate of uninsured children nationally. Ninety-six percent of children in North Carolina have health insurance coverage, a record high for the state and above the national average.

“High-quality health insurance improves access to care and economic security for families, both of which support health and well-being,” said Adam Zolotor, president and CEO of NCIOM. “Children with health insurance are more likely to access preventive care and receive needed services.”

This progress is largely attributable to the three pillars of children’s health coverage that support and supplement the private market—the Affordable Care Act (ACA), Medicaid, and NC Health Choice (the state Children’s Health Insurance Program in North Carolina). As such, the future of children’s health insurance coverage is closely tied to proposed changes to these policies and programs in Congress, which could eliminate or reverse coverage gains.

“It’s important for state legislators, the President, and members of Congress to understand how far we’ve come,” said Michelle Hughes, executive director of NC Child. “Just 20 years ago, one in six of our kids were uninsured. Today, because of strong public health insurance programs and the ACA’s support of the private market, North Carolina is strikingly close to achieving full coverage for our children.”

Despite overall progress, some children encounter health insurance barriers: 1 in 18 low-income children is uninsured. Hispanic or Latinx kids are nearly three times more likely to be uninsured than their non-Hispanic White peers.

While the Report Card shows progress in children’s health insurance and other key health indicators, including teen births, vaccination rates, and breastfeeding, the grades reveal many areas of profound concern where the state has made little or no progress.

Economic Security — Grade: ‘F’

North Carolina received a ‘F’ for economic security. Evidence shows income has a profound effect on health outcomes. The greater children’s household income, the lower their likelihood of disease and premature death. The report card documents a series of troubling indicators in the area of economic well-being:

  • More than half of all North Carolina children under age 5 (52.6 percent) live in poor or near-poor homes. Children in low-income homes face greater risk of poor health outcomes, lower educational attainment, and reduced economic opportunity.
  • One in three children (32 percent) live in homes with a high housing cost burden, defined as more than 30 percent of monthly income spent on housing expenses. Higher housing costs can cause families to spend less on health care and increase rates of food insecurity.
  • One in seven children live in high poverty neighborhoods (14 percent), up 56 percent since 2006-2010. African American, American Indian, and Latinx children are more likely to live in concentrated poverty than their non-Hispanic White peers. Children who live in high poverty neighborhoods are more likely to suffer poor physical and mental health outcomes and to be exposed to violence and crime.

Birth Outcomes — Grade: ‘D’

North Carolina received a ‘D’ for birth outcomes, a grade determined largely by the state’s record on infant mortality and because of the large and persistent disparity between African American and non-Hispanic White infants. Infant mortality rates were lowest among Hispanic infants (5.4 per 1,000 live births) and highest among African American infants (12.5 per 1,000 live births). Just over two-thirds of women receive the early prenatal care that promotes healthy pregnancies and deliveries (67.8%), down from 71.2 percent in 2011. Early prenatal care is essential for identifying mental health and physical health challenges that pose a risk to a healthy pregnancy, such as smoking, mental illness, and risk of premature delivery.

Summary of Grades

Below is a summary of grades in this year’s report:

  • A–Insurance Coverage
  • B–Breastfeeding, Immunization, Postpartum Health, Teen Pregnancy and Family Involvement
  • C–Preconception Health, Maternal Health and Support, Health Services Utilization, Housing and Neighborhood Stability, Child Abuse and Neglect, Education, Environmental Health, Child Fatality, and Oral Health
  • D–Birth Outcomes, Children in Out of Home Care, Healthy Eating and Active Living, Tobacco, Alcohol, and Substance Use, School Health, and Mental Health
  • F–Economic Security

About the Report Card

For over 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 the leading indicators of child health and safety to help policymakers, health professionals, the media, and concerned citizens track child health, identify emerging trends, and plan future investments. The report card presents data for the most current year available, usually 2015, and a comparison year, or benchmark, usually 2011.

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. 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 builds a strong North Carolina by advancing public policies to ensure all children – regardless of race, ethnicity, or place of birth – have the opportunity to achieve their full potential. Visit http://www.ncchild.org for more information.

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