Sustain the gains for N.C. children, News and Observer (11.11.2010)
Each year the N.C. Institute of Medicine and Action for Children North Carolina publish a Child Health Report Card. By presenting trend data on important indicators of child health and well-being, the document provides an opportunity for legislators, policymakers, service providers and the public to reflect on how our children and youth are faring.
From a review of the data in the just-published 2010 Report Card, it is evident - and most heartening - that the health and safety of our youngest residents continues to improve.
Infant and child death rates are at the lowest levels ever recorded in our state; the teen pregnancy rate continues to decline; North Carolina is among the national leaders in immunization rates and in providing early intervention services to infants and toddlers with special needs; and though the rates are still too high, teens' usage of tobacco, alcohol and illicit substances declined.
It is also evident that families are in stress, with 20 percent of our children in poverty and more than 11 percent still without health insurance. Approximately 25 percent are obese, which does not bode well for their health now and as adults.
There are several things that are not evident in the Report Card, but bringing them to light can help us get a more complete picture of the implications of the data.
First, the significant progress made over the years is not happenstance. It is the result of sustained public investments made by the General Assembly, the hard work and perseverance of public and private providers in implementing evidence-based services, and the attentiveness of parents and families. "Sustained" is the key here. Outcomes do not change overnight. They can be attained and maintained only when support is adequate and continuous.
Second, while there should be delight in the progress that has been achieved, it is instructive to note that on several indices of the overall well-being of children, North Carolina ranks somewhere around 37th among the states. This indicates not only that we have a long way to go on behalf of children, but also that there is no way that North Carolina can "Race to the Top" in education when our children are relatively unhealthy and unsafe.
Third, the outcomes in the Report Card reflect a period before the full onset of the recession. With the loss in revenues, both in 2009 and earlier this year the Perdue administration and the General Assembly were forced to cut programs and services, many of which affect children and families. For example, several services intended to reduce infant mortality were eliminated or compromised, and enrollment in the state's health insurance program for children in low-income working families has been severely restricted.
This means we should expect that the outcomes in next year's Report Card (and the year after that) will reflect the loss of some of the gains that have been made in child health and safety. With losses already expected, it is all the more critical that children's services be protected in the next budget cycle.
That protection needs to come from a champion. The decision-making processes in the General Assembly are too diffuse to expect a clear vision of healthy and safe children to emerge from that body. The role of champion thus falls to the governor, who has the opportunity to set the tone and the vision in the creation of her budget proposal for the next biennium.
Balancing needs with resources is the major challenge our leaders face, and the revenue outlook means that difficult choices will have to be made. In hoping for that balance, we note that in a recent report on "business-friendliness" North Carolina ranks third. Yet, as noted above, the state ranks 37th in what could be called "child-friendliness."
These laudable goals need not be competing. But surely, our children deserve better than 37th.
