2018 Child Health Report Card Highlights Impact of Poverty on Child Health

News | February 21, 2018



Whitney Tucker

Research Director, NC Child

803-629-3503 (cell)

Adam Zolotor, MD

DrPH, President and CEO, NCIOM

919-815-4302 (cell)


Media Release

RALEIGH (February 21, 2018) —North Carolina’s latest child health report card gives the state an ‘F’ in “Housing and Economic Security” due to the high percentage of children living in low-income homes and neighborhoods. Children from families that are not financially secure fare worse in almost every indicator of health, including birth outcomes, access to care, health-risk behaviors, and mortality. According to the report card, only 81.5 percent of children in low-income homes are in “excellent” or “very good” health, compared to 96.9 percent of children living in non-low-income homes.


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.


As with other health indicators, troubling racial and ethnic disparities exist in children’s economic security data. In 2015, African American children (67 percent) and Hispanic and Latinx children (75 percent) were more than twice as likely to live in poor or low-income homes than White children (33 percent).


“Children’s health is largely determined by factors outside of the doctor’s office; rather, it’s determined by the environments in which children grow, play, and learn,” said Adam Zolotor, M.D., president and CEO of NCIOM. “That’s why addressing family financial security is a critical health intervention, and why we must focus on ensuring all children, regardless of race or ethnicity, have the opportunity to grow up in thriving families and communities.”


The report card highlights a number of ways in which family income intersects with other child health indicators. Children in low-income homes, for instance, have higher rates of childhood asthma and are more likely to be exposed to environmental triggers such as pollution and allergens, including cockroaches and mold.


“While the economic challenges facing North Carolina families are entrenched and challenging, evidence-based public policy interventions offer a way forward,” said Michelle Hughes, executive director of NC Child. “Implementing refundable tax credits for working families, promoting affordable child care, and expanding access to health insurance are all proven strategies for ensuring family financial health.”


Despite continued struggles in the area of economic security, the Report Card shows progress in children’s health insurance rates (Grade=A), breastfeeding rates (Grade=B), vaccination rates (Grade=B), and teen births (Grade=B).


Children’s and Parental Health Insurance at a Crossroads


Health insurance coverage is necessary for accessing consistent preventive care and needed sick care for children and parents. The good news is that 96 percent of children in North Carolina now have health insurance coverage, a record high for the state and above the national average. Additionally, the percentage of parents with health insurance has increased to 85 percent from 80 percent.


Health insurance coverage rates are at a crossroads--pending public policy decisions at the state and federal levels have the potential to amplify or inhibit these gains. Specifically, North Carolina lawmakers are considering a proposal to expand health coverage to all adults under 133 percent of the Federal Poverty Line, which would have a positive impact on coverage rates.


At the same time, Congress has repealed the individual mandate provision of the Affordable Care Act (ACA), which will likely reduce coverage rates. Additionally, Congress continues to entertain proposals to repeal other key provisions of the ACA and to block grant Medicaid, both of which would likely have a negative impact on children’s and adults’ access to health insurance.


Summary of Grades


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

  • A–Insurance Coverage
  • B–Environmental Health, Family Involvement, Health Services Utilization & Immunization, Postpartum Health & Breastfeeding, Teen Births
  • C–Education, Oral Health, Preconception & Maternal Health & Support
  • D–Birth Outcomes, Child Abuse and Neglect, Children in Out-of-Home Care, 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 2016, and a comparison year, or benchmark, usually 2012. Full report can be found here: https://nciom.org/2018-north-carolina-child-health-report-card/


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 https://nciom.org 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 http://www.ncchild.org for more information.