A baby is sitting in his mom's lap. There are more uninsured children in North Carolina compared to two years ago.
Photo courtesy Kris Gabbard, flickr creative commons


Children in North Carolina make improvements in health and education, but continue to face significant financial barriers to well-being.

By Minali Nigam

North Carolina’s Generation Z kids and teens are making healthier choices and more of them are graduating from school, but they lack economic opportunities and financial stability, as their families struggle to recover from the 2007-2009 economic recession.

These findings come from the annual Annie E. Casey Foundation KIDS COUNT Data Book, a publication showing a state-by-state comparison on child well-being. This year’s report, released Tuesday, measured trends from 2008 and 2014, covering Gen Z kids born after 1995.

North Carolina ranks 34th in the nation overall in child well-being, one spot up from last year. However, the state is still in the bottom half across all four metrics, which include family and community, health, education, and economic well-being.

Laila Bell, NC Child’s director of research and data, said kids today are dealing with tougher economic challenges than their parents or grandparents did: More of them live in poverty, their parents’ jobs are less secure, and about a third of kids live in families who are paying too much for their housing.

Courtesy of Annie E. Casey Foundation, KIDS COUNT

“What’s really remarkable is our kids are doing everything we’re asking them to do, in terms of healthier behaviors, in terms of working to improve their education,” Bell said.

“And yet they are struggling against some pretty significant odds and challenges in terms of living in really difficult economic circumstances that can limit their future potential.”

Push for Policy

Despite declines in community and economic well-being, North Carolina’s young people have made some progress.

One significant gain in education, according to Bell, was that more children in the state graduated from high school on time. In 2007-2008, 27 percent of high school students didn’t graduate on time. Five years later, the number dropped to 20 percent.

Improvements in health were even more apparent. With investments in teen-pregnancy prevention and educational programs in place, teen-pregnancy rates plummeted from 47 births per 1,000 girls to 26 births per 1,000 girls during the course of six years.

Alcohol and drug-abuse rates also fell by 2 percentage points.

The rate of children without health insurance dropped in half, from 10 percent in 2008 to 5 percent in 2014, a change that Bell attributes to funding by Medicaid and NC Health Choice, the state child health insurance program.

“When we couple the good behaviors and proactive behaviors of kids and families with smart public policies that support those behaviors, we see tremendous improvements and outcomes for kids,” she said.

Even with these wins, North Carolina remains in the bottom half of the nation, ranking 33rd for overall child health.

Figure 2 State-by-State Comparison of Health: 2016, Courtesy of Annie E. Casey Foundation, KIDS COUNT
State-by-State Comparison of Health: 2016, Courtesy of Annie E. Casey Foundation, KIDS COUNT

“Knowing that there’s a direct correlation between poverty and social determinants of health, it’s not surprising at all to find that’s the situation,” said Karen McLeod, head of Benchmarks, a North Carolina child and family advocacy organization.

Depressed, economically challenged areas, McLeod said, have poor health outcomes that can often be prevented. When factors like malnutrition, lack of safety, and poor education aren’t addressed early on, she said, they can result in long-term health problems that eat up public funding.

“Our system is set up to not look at a major focus of intervention unless there’s a problem that’s presenting,” she said. “Then we pour a whole lot of money on it.”

“We need to be pushing available funds upstream and addressing social determinants of health.”

A Community Matter

Child well-being can’t be looked at in isolation, according to both women.

“Kids live in families, with parents. Those families live in communities and all of those different areas around really need to be functioning well,” Bell said.

“We have to keep up our end of the bargain by making sure families and communities have the resources they need to enable their kids to thrive.”

The ratio of North Carolina children living in areas of high poverty, grew to 14 percent from 2010 to 2014, an increase of 5 percentage points over the previous four-year period.

Why has this problem become so pervasive for Generation Z?

“A lot of the jobs that were in the country are shipped out overseas,” McLeod said.

“So in our rural areas, you had factories that were making furniture; you had factories that were making clothing. Their parents and their grandparents worked in these factories and they actually made a decent living… When they started shipping out, we started to see a shift in those rural counties.”

Education, health, and poverty are all linked, according to McLeod. With more education, she said, children can work in higher tech industries to boost their community’s economy and transition to better health outcomes.

Part of that transition also means looking at public policy at a systematic level, Bell said, with funds needed to support parents, secure homes, and create safe communities.

“You can’t treat any child as if they are in a microcosm of just themselves,” said McLeod.

“They are completely dependent on a family. And if that family is highly dysfunctional, to expect [children] to function well in a highly dysfunctional family, well, is kind of ridiculous.”

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