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Childhood vaccinations show startling decline

For immediate release: February 20, 2019

Whitney Tucker, Research Director, NC Child, 919-726-6540
Adam Zolotor, MD, DrPH, President and CEO, NCIOM, 919-815-4302

Link to download the full report & print-ready infographics.

RALEIGH—North Carolina’s latest child health report card gives the state high marks for children’s health coverage, but also points out some troubling trends. The rate of youth suicide in the state has nearly doubled over the previous decade. Suicide is now the second leading cause of death among youth ages 10-17 in North Carolina.

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 and well-being in four areas: Healthy Births, Access to Care, Secure 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.

“Suicide is a multi-factorial problem, complicated by the lack of appropriate mental health services available to many children in our state,” said Adam Zolotor, M.D., president and CEO of NCIOM. “The solutions run the gamut, from improving the availability of health services in school settings, to reducing children’s access to lethal means of self-harm.”

The report highlights the racial disparities plaguing many children’s health indicators. For example, African-American high school students in 2017 were twice as likely as white students to have attempted suicide in the past year – and were much less likely to receive treatment for depression.

“The reality is that many kids have to cope with tremendous stressors and don’t have the supports they need to navigate them,” said Michelle Hughes, executive director of NC Child. “Dealing with things like discrimination because of their race or sexual identity, or experiencing abuse and neglect, all contribute to a child’s likelihood of attempting suicide. These are all things that we can address with better public policy choices. We don’t have to accept this as a given.”

Troubling Decrease in Childhood Vaccinations

Another troubling trend in the 2019 Child Health Report Card is decreasing vaccination rates. NC received a grade of “B” due to its relatively high rate of vaccinations compared to other states. However, just three-quarters of children have had the appropriate vaccinations by age three in North Carolina – a drop of more than 11% since 2014. Whatever the cause of this dangerous trend, the results can be painful and even deadly for children.

Childhood diseases such as measles are completely preventable, but have re-emerged as troubling public health challenges due to the drop in childhood vaccinations. The US Centers for Disease Control declared measles to have been eliminated in the US in 2000. But in 2019 a measles outbreak across the United States has led to hundreds of new cases, especially in the western states where vaccination rates are even lower. On a positive note, the Child Health Report Card shows a growing number of teens being vaccinated for HPV – a step that can prevent women from contracting deadly cervical cancers later in life.

Summary of Grades

Despite continued struggles in the area of child poverty, the Report Card shows progress in breastfeeding, asthma, oral health, and teen births.

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

  • A–Insurance Coverage
  • B–Environmental Health; Health Services Utilization & Immunization; Breastfeeding; Teen Births
  • C–Education; Oral Health; Preconception and Maternal Health & Support;
  • D–Birth Outcomes; Child Abuse and Neglect; Healthy Eating and Active Living; Mental Health; Tobacco, Alcohol, and Substance Use; School Health
  • F–Housing and 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 2017, and a comparison year, or benchmark, usually 2013.


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 for more information.

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 for more information.

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