FIFTY STATE CHART BOOK: DIMENSIONS OF DIVERSITY AND … · Angelica Cardenas-Chaisson, Charles...

FIFTY STATE CHART BOOK: DIMENSIONS OF DIVERSITY

AND THE YOUNG CHILD POPULATION

Child and Family Policy Center BUILD Initiative

Angelica Cardenas-Chaisson, Charles Bruner, and Mary Nelle Trefz

February 2014

50 State Chart Book

Table of Content List of Initial 16 Indicators-------------------------------------------------------------------------------- X

1. Racial And Ethnic Population of Children in the United States------------------------- X

2. Young Child Poverty Levels by Race and Ethnicity--------------------------------------- X

3. Maternal Education Attainment for Women Age 16 and Over with Children 0-5---------------------------------------------------------------------------------------

X

4. Low Birthweight by Race and Ethnicity----------------------------------------------------- X

5. Infant Mortality Levels Broken Down By Race/Ethnicity------------------------------- X

6. Late or No Prenatal Care by Race and Ethnicity------------------------------------------ X

7. Health Insurance Levels by Race and Ethnicity-------------------------------------------- X

8. Access to a Medical Home by Race/Ethnicity and Income----------------------------- X

9. Immunizations Rates for Children 19-35 Months------------------------------------------ X

10. Percent of Children Having Well-Child Visits------------------------------------------------ X

11. Children 10 Months to 5 Years Screened for Developmental, Behavioral, and Social Delays----------------------------------------------------------------------------------------

X

12. Percent in Part C by Race/Ethnicity ---------------------------------------------------------- X

13. Children Under 6 Years Exposure to Risk Factors------------------------------------------ X

14. Mothers’ Mental Health by Race/Ethnicity and Income--------------------------------- X

15. Neighborhood Safety by Age and Race/Ethnicity------------------------------------------ X

16. NAEP 4th Grade Reading Proficiency Scores------------------------------------------------- X

Additional Indicators-------------------------------------------------------------------------------------- X

From the time of their birth, young children are growing, learning, developing, and exploring

the world. Their vision of themselves and the world is being shaped both in how they respond

to others and how others respond to them. Their gender, their appearance, their language, and

their family’s background, culture, and socio-economic status all play into how they perceive

themselves and others perceive them.

Information is collected at various points in time, and at various places about young children,

their families, and environments, but there is no single place where all such information has

been assembled. These sources vary in the degree to which they provide information that can

be broken out by race, ethnicity, language, culture, and family socio-economic status. Often it

takes going to different locations to gather information to try to create a holistic picture of the

status of young children, their families, and communities in which they live.

Even though there is not a universal opportunity to collect information on children during this

birth-to-five time period, there is a universal need for this information. It is critically important

to understand the status of young children during these early developmental years – overall

and by different subgroups of children (race/ethnicity, language, income level, etc.). In order to

develop early childhood systems that ensure all children start school healthy and prepared for

success, it is critical to access and draw upon the best available information about children’s

current health, safety, security, and development during the earliest and most formative years

Unfortunately, there are many gaps in information policymakers, practitioners, researchers,

and the public would like to have about young children. These gaps have historically existed

when dealing with underserved and underrepresented groups such as communities of color,

immigrants, and people who do not speak English. Fortunately, however, there are a variety of

data sources, nationally and at the state level which, collectively, can provide states

information that helps identify differences in young children, their families and communities,

their access to and use of services, and their development.

The Child and Family Policy Center (CFPC), as a part of the BUILD Initiative, has been compiling

this critical information for various states and national leaders. CFPC and BUILD are energized

by the work that states using this information are doing to take on issues of health equity and

young children, in particular, and move towards action. This has motivated us to develop a Fifty

State Chart Book that includes different data and indicators available to states on young

children which can, as much as possible, be broken down by race, language, culture, income,

and/or parental educational status.

Below are three charts showing national data on the young child population in comparison with

other age groups in society. The charts show why developing equitable early childhood systems

FIFTY STATE CHART BOOK:

DIMENSIONS OF DIVERSITY AND THE YOUNG CHILD POPULATION

are so important to diverse children and to society. Each of these charts also can be

constructed for any state through the use of public use microsystem (PUMS) data available

through the American Community Survey.

WHY IS IT IMPORTANT – YOUNG CHILDREN LEADING THE WAY

Over the last two decades, the United States has become much more diverse, but this has

varied substantially by age group. The young child (0-5 years old) population is much more

diverse than all other age groups. The proportion of white, non-Hispanic young children (0-5

years old) has decreased from approximately 66% in 1990 to approximately 50% today. The

proportion of white, non-Hispanic seniors (65 years and older) was much higher (approximately

90%) in 1990 and still remains high today (approximately 80%). Today, the young child

(National data, this table can be constructed for any state.)

population is over twice as diverse as the elderly population. Changes in the working age

population fall between these two extremes, but, currently, nearly two-thirds of individuals

aged 18-64 are white, non-Hispanic.

While this rapid growth in diversity among the young child population differs in size and racial

and ethnic composition across the United States, all states now have a young child population

that is significantly more diverse than the senior population and the current workforce. This

change creates both challenges and opportunities for society – and requires commensurate

public responses. Clearly, developing an early childhood system where all children no matter

their gender, race, ethnicity, or economic background get off to a good start, and live up to

their full potential is both an issue of justice and economics. This requires that we ensure

equity of opportunity and close gaps in outcomes by race/ethnicity, and language; so that our

country can benefit from all its human capital, and provide a healthier future for all.

POVERTY AND YOUNG CHILDREN

Children and young children in particular, are the age group in society most likely to live in poor

and low-income households. Some of this is a reflection of younger families that are starting

out and are generally at the beginning of their earning lives and careers. For example, families

with young children often face challenges of being in the workforce full-time and ensuring that

their children are supervised and nurtured at all times. A large share, however, is due to

historical inequities in public policies that deny equitable access to resources and opportunities

to all its citizens. On international comparisons, the United States ranks at the bottom among

advanced, industrial countries on measures of child poverty – and most of this difference is the

result of the absence of government transfer payments which support families with young

children.

Share of population in poverty by age, 1959-2012 (Source: U.S. Census Bureau, Poverty Status of People, by Age, Race, and Hispanic Origin: 1959 to 2012, Table 3)

Note: Poverty breakouts by age were available on with the decennial census until 1966. There is not specific

information by age in 1964, at the official start of the War on Poverty. The 1960 census (drawing upon 1959

income and poverty levels) shows the rates before the start of the War on Poverty; the 1966 figures are the closest

available to the actual start of the War on Poverty

The differences between young child poverty and senior poverty in the United States are very

pronounced, with young children almost three times as likely as seniors to live in households

under the poverty level. In the 1960’s, prior to the “War on Poverty,” seniors were the age

27.3%

17.6% 18.3% 20.6%

16.2%

21.8%

17.0%

10.5% 10.1% 10.7% 9.6%

13.7%

35.2%

28.5%

15.7%

12.2% 9.9%

9.1%

0%

5%

10%

15%

20%

25%

30%

35%

40%

1959 1966 1980 1990 2000 2012

0-17

18-64

65+

group in American society most likely to be poor, but public policies related to social security,

Medicare, and other transfer payments have lifted most seniors above the poverty level.

Generally, the public is not aware of these profound differences. In fact, public opinion polls

show that many people still believe seniors are the age group most likely to be poor as they do

children.

While many families living in poverty or at low income levels (e.g. below 200 percent of

poverty) provide their children with strong nurturing and learning environments and ensure

that their basic needs are met, the simple fact is that poverty remains a risk factor and is often

indicative of other forms of deprivation or marginalization which jeopardize healthy family

development. At the same age that individuals are growing most rapidly and are most

dependent upon protection and support from others, their families are most likely to be in

need of outside support to meet their needs.

POVERTY AND YOUNG CHILD DIVERSITY

Source: United States Census Bureau, 2009-2011 Public Use Microdata Sample

The first two charts show the importance of developing early childhood systems with the

diversity of the young child population in mind, and developing such systems with the

recognition of the need to address issues related to poverty and low-income – but they do not

connect the two. This is in part due to an old misinformed political and policy debate “Is it race

or is it income?”

The reality is that race and poverty in our country are muddled (multicollinearity) and it is

difficult to statistically separate their interrelated effects. For example, in housing policy where

historical economic disadvantages created by institutionalized racism and discrimination such

as the Homestead Act of 1862 (which gave 160 acres of free land to every white settler), and

the National Housing Act, 1934 (“redlined” certain neighborhoods, predominantly black,

Hispanic, Asian, and Jewish) have led to a lack of wealth, resources and opportunities for

diverse ethnic and racial populations. For many, these structural issues have created a lack of

opportunities which has led to intergenerational poverty that disproportionally impacts families

of color compared to white families.

While one-third of white, non-Hispanic young children in the United States live in low-income

families, two-thirds of Hispanic and African American children live in low-income families.

Meanwhile, while one-third of white, non-Hispanic children live in families with incomes over

400 percent of the poverty level ($90,000 in annual income for a family of four), only one in

nine Hispanic and African American children live in households with incomes over 400 percent

of the poverty level. While 400 percent of the poverty level is not a definition of being wealthy,

by any means, it is a level where families can make substantial investments in their children’s

well-being and development without sacrificing other essential family needs. That said, even if

race and poverty were not correlated, practitioners would still have a professional and ethical

need to ensure culturally and linguistically responsive services.

THE FIFTY STATE CHART BOOK

The Fifty State Chart Book presents charts and data on selected indicators available for all

states on the racial, ethnic, and socio-economic composition of the young child population. This

increasingly diverse and high poverty population faces health, education, and economic

disparities that have a long-lasting impact on their health and development. The initial 16

indicators were chosen because they are currently available and help to paint a picture of

where states and the nation today are in responding to the diverse child population to achieve

health equity for young children. For each indicator, we include a definition of the indicator

and the impact it has on a child’s development, and futures success in school and life. The

information and resources are pulled from diverse sources, national-level and state-level

information that will help states to identify health disparities and inequities for young children,

with particular attention, whenever possible, to racial and socioeconomic breakdowns.

The Fifty State Chart Book also contains a list of 38 additional indicators, with their sources,

states can dig deeper into the indicator and/or expand their search for additional information.

For some indicators there may be limitations on the data available. It may not always be

possible to break down all the data into all the different important subgroups. For some local

data, states my want to look into their state agencies, such as the department of public health,

or department of education to find out what type of data they collect and how the data is

broken down.

Please note, whenever possible federal poverty levels were included to highlight poverty’s role

in disparities for families and their children. Attached are the 2014 US Federal Poverty Level

guidelines for the Nation, Alaska, and Hawaii. The Federal Poverty Level is determined on a

yearly basis. http://aspe.hhs.gov/POVERTY/14poverty.cfm

2014 POVERTY GUIDELINES FOR THE 48 CONTIGUOUS STATES

AND THE DISTRICT OF COLUMBIA

Persons in family/household Poverty guideline

1 $11,670

2 15,730

3 19,790

4 23,850

5 27,910

6 31,970

7 36,030

8 40,090

For families/households with more than 8 persons, add $4,060 for each additional person.

2014 POVERTY GUIDELINES FOR ALASKA


1 $14,580

2 19,660

3 24,740

http://aspe.hhs.gov/POVERTY/14poverty.cfm

2014 POVERTY GUIDELINES FOR ALASKA


4 29,820

5 34,900

6 39,980

7 45,060

8 50,140


2014 POVERTY GUIDELINES FOR HAWAII



1 $13,420

2 18,090

3 22,760

4 27,430

5 32,100

6 36,770

7 41,440

8 46,110


As states work through the data, there are three important questions that should be asked:

1. How well are racial/ethnic and low-income populations doing in comparison to the

population as a whole within our state?

2. How does our state, including our racial/ethnic and low-income populations, compare

to other states?

3. How are the programs/policies in ours state which serve young children doing in

reaching our diverse population and what can we do to ensure they are?

List of the 16 Initial Indicators

1. Racial And Ethnic Population of Children in the United States

2. Young Child Poverty Levels by Race and Ethnicity

3. Maternal Education Attainment for Women Age 16 and Over with Children 0-5

4. Low Birthweight by Race and Ethnicity

5. Infant Mortality Levels Broken Down By Race/Ethnicity

6. Late or No Prenatal Care by Race and Ethnicity

7. Health Insurance Levels by Race and Ethnicity

8. Access to a Medical Home by Race/Ethnicity and Income

9. Immunizations Rates for Children 19-35 Months

10. Percent of Children Having Well-Child Visits

11. Children 10 Months to 5 Years Screened for Developmental, Behavioral, and Social

Delays

12. Percent in Part C by Race/Ethnicity

13. Children Under 6 Years Exposure to Risk Factors

14. Mothers’ Mental Health by Race/Ethnicity and Income

15. Neighborhood Safety by Age and Race/Ethnicity

16. 2013 NAEP 4th Grade Reading Scores: Free and Reduced Meal (FRM) Eligibility

1. Racial and Ethnic Population of Children in the United States

The United States is a country comprised of various racial and ethnic groups that make up

diverse communities. Although race is not a biological concept in the United States, historical,

social, and structural discrimination has disadvantaged some groups (i.e. African-American,

Latinos/Hispanic, Native American) while giving advantage to other groups, such as White

Caucasians. This structure has created institutionalized systems that negatively impact families

of color in gaining access to public and private resources.

What Can the Data Tell Us: U.S. Census data on child trends helps project potential needs for

education, child care, health care, and other services for all children. Being able to view data

through a racial/ethnic equity lens in combination with other indicators such as poverty,

medical coverage, access to a medical home and immunization rates can highlight inequity in

practices, resources, and policies. National, state and local policy makers and advocates can

use the data to be intentional in guiding and creating resources and policies that are culturally

relevant and can better support specific populations. Current US Census data highlights the

increase of children 0-5 of color compared to white children. Hispanic/Latino children are

leading this population growth, comprising one-quarter of all young children 0-5 years old.

Combined, children of color make up about half of the total population of children 18 and

under. The country’s growing diversity has broad implications – including development of

school systems and workforce opportunities that accommodate individuals of all racial and

ethnic backgrounds.

Children under 18 years in households

All Children

White Non- Hispanic

Hispanic or Latino origin

Black or African American

American Indian and Alaska Native

Asian Native Hawaiian and Other Pacific Islander

Under 6 years

6 to 11 years

12 to 17 years

73,461,927 52.6% 23.9% 14.2% 1.0% 4.5% 0.2% 32.8% 33.4% 33.8%

Source: US Census American Community Survey 2012

*Any state can get similar data on the race/ethnicity of children under 18 from the 2012 American Community Survey through the US Census

United States Population

2012

Under 5 years 5 yrs. – 17 yrs.

18 yrs. – 64 yrs.

65 yrs and Over

Total

White Non-Hispanic 9,967,942 50.06%

28,793,213 53.52%

124,314,846 63.08%

34,167,422 79.20%

197,243,423 62.83%

White Hispanics 3,305,502 16.60%

8,103,216 15.06%

21,008,883 10.66%

2,331,353 5.40%

34,748,954 11.07%

African-American 2,829,618 14.21%

7,710,536 14.33%

25,361,139 12.87%

3,721,845 8.63%

39,623,138 12.62%

American Indian/Alaskan Native

190,031 0.95%

532,382 0.99%

1,629,326 0.83%

211,766 0.49%

2,563,505 0.82%

Asian 889,274 2,430,121 10,635,960 1,600,175 15,555,530

4.47% 4.52% 5.40% 3.71% 4.96%

Hawaiian Pacific/Islander 44,153 0.22%

108,523 0.20%

357,300 0.18%

33,222 0.08%

543,198 0.17%

Some Other Race 1,302,316 6.54%

3,279,943 6.10%

9,344,744 4.74%

635,675 1.47%

14,562,678 4.64%

Two or More Races 1,381,490 6.94%

2,842,150 5.28%

4,410,955 2.24%

439,019 1.02%

9,073,614 2.89%

Total of Non White/Non-Hispanic

9,942,384 49.94%

25,006,871 46.48%

72,748,307 36.92%

8,973,055 20.80%

116,670,617 37.17%

Total Population 19,910,326 53,800,084 197,063,153 43,140,477 313,914,040

Hispanics 5,135,206 25.79%

12,438,819 23.12%

32,251,724 16.37%

3,135,268 7.27%

52,961,071 16.87%

Source: United States Census Bureau, 2012 American Community Survey

*This data can also be collected from the US Census on a state level; it requires calculating each race/ethnicity and age separately.

The US Census also collects state level population data, and tables like the above can be constructed for any state. The table below gives state-by-state information on the overall race/ethnic population breakdown of the state as a whole. In all states, the proportion of children of color exceeds the proportion in the population as a whole. There are a growing number of states where non-White racial/ethnic groups make up almost half of the population of the state – and the majority of the child and young child populations. In California and Texas (and the District of Columbia), there is no “majority” population. Hispanic/Latinos are almost the largest ethnic population in California and Texas.

Overall Race/Ethnic Population

White Non-Hispanic

Hispanic or Latino


Asian American Indian and Alaska Native

Native Hawaiian and Other Pacific Islander

United States 62.8% 16.9% 12.6% 5.0% 0.8% 0.2%

Alabama 66.6% 3.8% 26.5% 1.2% 0.5% 0.0%

Alaska 63.0% 6.0% 3.6% 5.9% 14.0% 1.1%

Arizona 56.9% 30.2% 4.4% 2.9% 4.4% 0.2%

Arkansas 73.9% 6.7% 15.7% 1.3% 0.6% 0.2%

California 39.2% 38.2% 6.0% 13.5% 0.8% 0.4%

Colorado 69.4% 21.0% 4.2% 2.8% 0.9% 0.1%

Connecticut 70.0% 14.2% 10.2% 4.1% 0.3% 0.1%

Delaware 64.3% 8.6% 21.5% 3.3% 0.3% 0.0%

District of Columbia

35.3% 9.9% 49.5% 3.5% 0.4% 0.0%

Florida 56.8% 23.2% 16.1% 2.5% 0.3% 0.1%

Georgia 55.0% 9.1% 30.9% 3.4% 0.2% 0.0%

Hawaii 22.8% 9.5% 1.8% 38.2% 0.2% 10.4%

Idaho 83.4% 11.6% 0.5% 1.3% 1.3% 0.1%

Illinois 62.9% 16.3% 14.4% 4.8% 0.2% 0.0%

Indiana 80.9% 6.3% 9.2% 1.6% 0.2% 0.0%

Iowa 88.0% 5.2% 3.0% 1.8% 0.3% 0.1%

Kansas 77.4% 10.9% 5.8% 2.5% 0.9% 0.1%

Kentucky 85.8% 3.1% 7.9% 1.3% 0.2% 0.0%

Louisiana 59.7% 4.5% 32.2% 1.6% 0.6% 0.0%

Maine 94.1% 1.4% 1.0% 1.1% 0.6% 0.0%

Maryland 53.8% 8.7% 29.2% 5.8% 0.3% 0.0%

Massachusetts 75.3% 10.1% 7.1% 5.7% 0.2% 0.0%

Michigan 76.1% 4.6% 14.0% 2.5% 0.6% 0.0%

Minnesota 82.3% 4.9% 5.3% 4.2% 1.0% 0.0%

Mississippi 57.5% 2.7% 37.6% 0.8% 0.4% 0.0%

Missouri 80.5% 3.7% 11.5% 1.7% 0.5% 0.1%

Montana 87.2% 3.1% 0.4% 0.6% 6.5% 0.1%

Nebraska 81.3% 9.6% 4.6% 2.0% 0.9% 0.1%

Nevada 52.7% 27.3% 8.3% 7.5% 1.1% 0.7%

New Hampshire 91.8% 3.0% 1.3% 2.3% 0.2% 0.0%

New Jersey 57.9% 18.5% 13.6% 8.7% 0.2% 0.0%

New Mexico 39.7% 47.0% 2.1% 1.3% 9.2% 0.1%

New York 57.4% 18.2% 15.6% 7.7% 0.4% 0.0%

North Carolina 64.5% 8.7% 21.6% 2.3% 1.2% 0.1%

North Dakota 88.1% 2.4% 1.5% 1.0% 5.3% 0.2%

Ohio 80.6% 3.2% 12.2% 1.7% 0.2% 0.0%

Oklahoma 67.8% 9.3% 7.2% 1.8% 7.3% 0.1%

Overall Race/Ethnic Population

White Non-Hispanic

Hispanic or Latino


Asian American Indian and Alaska Native

Native Hawaiian and Other Pacific Islander

Oregon 77.6% 12.2% 1.8% 3.8% 1.2% 0.4%

Pennsylvania 78.6% 6.1% 11.0% 2.9% 0.2% 0.1%

Rhode Island 75.4% 13.2% 6.5% 3.2% 0.5% 0.0%

South Carolina 63.9% 5.3% 27.7% 1.3% 0.3% 0.0%

South Dakota 83.8% 3.0% 1.6% 1.1% 8.8% 0.1%

Tennessee 75.0% 4.8% 16.9% 1.5% 0.3% 0.0%

Texas 44.3% 38.2% 11.9% 4.0% 0.5% 0.1%

Utah 79.8% 13.3% 1.1% 2.2% 1.1% 0.9%

Vermont 94.0% 1.6% 1.0% 1.3% 0.3% 0.0%

Virginia 63.9% 8.4% 19.3% 5.7% 0.3% 0.1%

Washington 71.4% 11.7% 3.6% 7.4% 1.4% 0.6%

West Virginia 92.8% 1.3% 3.3% 0.7% 0.1% 0.0%

Wisconsin 82.8% 6.2% 6.3% 2.4% 0.9% 0.0%

Wyoming 84.6% 9.4% 1.0% 1.0% 2.1% 0.0% Source: 2012 American Community Survey 1-Year Estimates

2. Young Child Poverty Levels by Race and Ethnicity

Childhood poverty can have a powerful influence on a child’s well being. Young children living

in poverty are much more likely to experience multiple adverse childhood experiences such as

stress and deprivation and exposure to violence that severely affects all aspects of a child’s

social emotional, physical, cognitive, and language development – making it difficult for

children to be ready for school and life. Their parents are much more likely to struggle to

provide the basic resources needed to predictably address their needs for stability and support.

These effects are detrimental and have lasting impacts into adulthood. Alternatively, while

young children living in families with much more affluence still can experience early childhood

adversity and its impacts, they also have resources available to address those and to make

other investments in their youngest children. In general, families with incomes at or below 200

percent of poverty ($45,000 for a family of four) struggle to make ends meet, while those with

incomes above 400 percent of poverty ($90,000) have substantial opportunities to provide

extra developmental opportunities for their children.

What Can the Data Tell Us: There are very substantial differences in child poverty levels by the

child’s race in the United States. As the national data below show, young child poverty rates

among African American and Hispanic children are more than double that for White, non-

Hispanic children, and, on the other side of the spectrum, White non-Hispanic children are

three times as likely to be in affluent families than African American or Hispanic children.

Looking at poverty-level data in conjunction with race and ethnicity is important in providing a

clear picture of which racial and ethnic groups are most being affected by poverty and income

and where resources and supports need to be directed to create as equal and opportunity as

possible for all children to be healthy and prepared for success by the time they enter

kindergarten.

United States Poverty 2009-2011

Age 0-5

Total

White Non-

Hispanic African

American Asian Hispanic

Less Than 100% Poverty

5,808,069 2,051,599 1,710,487 171,175 2,112,802

% 24.4% 15.6% 41.8% 11.2% 35.1%

100-199% Poverty 5,509,865 2,558,225 1,046,195 250,830 1,858,684

% 23.1% 19.4% 25.6% 16.4% 30.9%

United States Poverty 2009-2011

Age 0-5

Total

White Non-

Hispanic African

American Asian Hispanic

200-299% Poverty 3,938,471 2,375,075 566,904 226,073 918,712

% 16.5% 18.0% 13.9% 14.8% 15.3%

300-399% Poverty 2,825,961 1,932,644 317,632 206,579 474,634

% 11.9% 14.7% 7.8% 13.5% 7.9%

400+% Poverty 5,740,097 4,245,972 448,938 677,425 647,732

% 24.1% 32.3% 11.0% 44.2% 10.8%

Source: United States Census Bureau, 2009-2011 Public Use Microdata Sample* *A breakdown of poverty levels of young children by race and ethnicity requires use of the PUMS (public use microdata system) data from the US

Census. National data are provided here from the most recent years of PUMS data, and these data can be developed for any state, but this

requires separate calculations for each state.

Other organizations provide some of this data on a state-by-state basis, particularly around the

percentage of children who are in poverty or are low-income. Often, the child poverty data from

such organizations and their sites offers fifty state comparisons as well as already conducting the

PUMS calculation, although they are not always the most up-to-date available census data.

The National Council of la Raza Latino Kids Data Explorer is one excellent source for much of this

information, one where any state can find child poverty data as well as other child and family

indicators broken up by state, race/ethnicity, and income.

% of Children Below 100% of Poverty by Race/Ethnicity and State (2008-2010), Age: 0-8

% of Children Below 200% of Poverty by Race/Ethnicity and State

(2008-2010), Age: 0-8

Location All Races/ Ethnicities

Latino/ Hispanic Black White Other

All Races/ Ethnicities


United States 22.12 32.53 40.3 13.42 17.76 44.88 63.96 66.2 31.88 37.64

Alabama 27.64 38.35 48.67 15.69 28.41 50.7 70.96 72.81 37.22 49.27

Alaska 15.47 11.52 4.17 11.43 22.97 36.14 30.95 28.67 28.24 49.08

Arizona 24.88 35.35 34.16 12.17 26.3 51.71 68.87 57.39 32.41 51.91

Arkansas 29.4 41.8 51.55 20.62 29.53 57.14 76.69 79.35 47.04 57

California 21.31 29.11 33.88 9.87 10.82 45.3 61.2 57.78 22.99 26.47

Colorado 18.38 33.52 32.57 9.61 14.02 39.62 65.7 60.33 24.71 32.39

Connecticut 14.03 30.76 30.76 5.35 11.92 28.84 57.02 57.09 14.14 25.82

Delaware 19.39 32.47 31.53 10.91 14.39 41.16 65.67 57.82 27.41 35.84



(2008-2010), Age: 0-8





District of Columbia 28.65 19.57 42.82 1.08 4.1 47.57 53.28 65.34 2.65 12.94

Florida 23.58 27.79 40.3 14.22 16.94 48.6 57.86 69.62 34.28 40.46

Georgia 24.91 40.94 36.96 12.89 15.02 49.38 73.58 64.68 32.92 36.91

Hawaii 13.44 23.88 15.93 10.64 11.48 32.35 46.37 31.51 24.68 30.63

Idaho 19.97 33.93 26.34 16.43 22.63 53 74.53 62.16 48.22 47.71

Illinois 20.65 27.28 44.65 11.02 16.19 41.54 60.88 68.42 25.77 31.76

Indiana 23.49 39.62 47.26 17.05 27.94 47.77 72.4 73.86 39.57 53.54

Iowa 18.44 33.42 51.66 14.18 26.05 39.68 67.88 78.17 33.4 49.08

Kansas 19.45 35.27 39.63 12.8 23.48 45.07 69.8 72.33 34.89 52.74

Kentucky 27.83 41.8 52.03 23.92 31.12 52.05 70.07 75.4 47.79 57.67

Louisiana 28.77 30.43 48.6 14.26 25.55 51.32 52.28 75.09 33.72 50.29

Maine 19.99 33.12 53 18.39 25.4 45.43 71.13 92.36 43.38 46.35

Maryland 13.22 16.89 21.88 6.72 11.4 30.5 48.22 43.53 17.76 26.14

Massachusetts 14.25 38.37 26.26 7.21 13.18 29.58 64.5 53.37 18.46 29.16

Michigan 24.38 39.16 48.71 16.53 27.45 46.4 67.77 73.37 37.58 46.08

Minnesota 15.16 30.47 46.96 8.54 22.85 34.43 64.98 72.09 24.42 47.24

Mississippi 33.82 35.36 52.74 17.53 30.05 58.43 69.05 79.21 39.72 55.45

Missouri 23.11 35.72 43.16 18.17 24.29 46.9 64.83 71.41 40.88 45.6

Montana 23.51 38.55 14.04 20.06 36.96 46.43 52.77 54.39 42.97 62.58

Nebraska 18.4 31.54 58.67 12.35 16.74 40.88 69.01 79.66 31.44 41.62

Nevada 20.51 30.35 31.6 10.24 12.86 45.28 62.93 61.23 27.24 33.05

New Hampshire 10.76 19.29 26 9.89 12.38 26.39 44.48 46.47 24.78 29.45

New Jersey 14.42 25.31 28.03 7.28 8.55 30.08 52.1 52.11 16.83 19.33

New Mexico 29.9 34.88 42.62 14.87 34.9 56.2 63.16 61.79 38.16 58.92

New York 21.57 32.55 33.05 13.62 19.22 41.35 60.3 56.11 28.28 41.25

North Carolina 25.27 41.05 41.8 14.01 24.72 49.73 77.48 70.01 33.72 47.83

North Dakota 17.63 20.75 78.88 12.93 34.62 39.3 57.27 95.46 32.55 64.97

Ohio 24.53 39.86 51.64 17.86 26.37 46.3 64.23 76.51 38.87 47.51

Oklahoma 26.97 40.52 47.12 19.27 29.63 54.37 74.56 74.87 44.32 58.12

Oregon 21.85 36.8 44.07 16.73 17.85 46.93 71.49 62.68 38.94 41.44

Pennsylvania 19.59 36.32 40.44 12.86 24.73 40.07 65.01 67.56 31.33 41.67



(2008-2010), Age: 0-8





Rhode Island 18.1 35.32 39.09 10.05 17.77 39.47 71.01 68.69 25.58 40.27

South Carolina 27.9 43.73 46.02 15.1 25.58 52.01 74.33 74.02 36.02 48.5

South Dakota 22.69 37.36 22.02 14.33 52.84 46.09 77.48 77.65 35.63 77.04

Tennessee 26.2 43.09 45.79 18.38 25.76 51.24 77.15 72.59 41.63 52.04

Texas 26.58 36.66 35.95 10.6 13.05 52.17 68.43 61.77 27.71 33.63

Utah 13.32 26.96 27.22 9.85 15.96 39.75 64.4 54.54 33.7 43.4

Vermont 17.11 22.1 38.29 16.46 21.11 35.44 30.19 75.17 35.03 36.88

Virginia 16.41 21.39 33.39 10.22 11.14 34.39 48.12 57.13 25.02 25.4

Washington 18.36 35.23 39.09 12.3 14.32 39.98 65.22 66.52 31.15 34.18

West Virginia 26.89 25.04 49 25.93 30.64 50.15 56.28 70.88 48.98 54.95

Wisconsin 18.99 33.78 49.51 12.37 24.34 40.89 65.41 76.23 31.24 54.23

Wyoming 14.83 22 64.17 12.63 18.97 38.75 57.05 72.58 34.09 49.08 Source: The National Council of la Raza Latino Kids Data Explorer (http://www.nclr.org/index.php/latinokidsdata)

http://www.nclr.org/index.php/latinokidsdata

3. Maternal Education Attainment for Women Age 16 and Over with

Children Ages 0-5

A mother’s educational level plays a key role in her child’s success in school and future achievement. National research has consistently shown a strong relationship between maternal education level and her child’s well-being, including, healthy social emotional development, and academic performance. Studies also show that when a mother increases her educational level, it has a positive effect on her children. Higher maternal education level brings higher earnings for the family and increases overall family well-being. Less educated mothers are more likely to struggle with meeting their family’s basic needs, leading to less resources and increases in family stress.

What Can the Data Tell Us: Reviewing the U.S. Census data on the percentage of women who

are graduating with a high school diploma and those who have higher levels of education helps

in understanding how young children and their families are doing. National data shows 13.7%

of mothers with young children have less than a high school diploma and 22.3% have only a

high school diploma. Combined, 36% of all mothers with young children have a high school

diploma or less. This means that young children in these households are more likely to have

additional barriers that negatively impact their healthy development. Understanding the data

helps to identify opportunities to target resources that support mothers with young children to

pursue higher education.

Breakdowns of educational levels for women age 16 and over with children 0-5 requires use of

the *PUMS (public use microdata system) data from the US Census. National data are provided

here from the most recent years of PUMS data, and these data can be developed for any state,

but this requires separate calculations for each state.

United States Educational Attainment Women Age 16 and Over With Children

Ages 0-5 2009-2011

Number Percentage

Less Than High School Diploma 2,115,366 13.7%

High School Diploma 3,459,303 22.3%

Some College 5,081,310 32.8%

Bachelor's Degree 3,121,556 20.1%

Master's Degree 1,295,874 8.4%

Professional/Doctorate Degree 422,133 2.7%

Total 15,495,542 Source: United States Census Bureau, 2009-2011 Public Use Microdata Sample

(*PUMS)

Through the US Census states can also find general information on school attainment broken

down by ethnicity. While the data is not broken down by mothers with children 0-5 years old, it

does give a general overview on how racial/ethnic populations are doing in terms their

educational attainment. The data shows that when it comes to college or higher education,

African/American and Hispanics are significantly less likely to have degrees. Therefore, they are

more likely to have fewer resources, less access to resources, and additional stressors that come

with having less income.

Source: Table 3. Detailed Years of School Completed by People 25 Years and Over by Sex, Age Groups, Race and Hispanic Origin: 2012

(Numbers in thousands. Civilian non-institutionalized population /1.)

Detailed Years of School

All Races Non-Hispanic

White African/American Asian Hispanic

(of any race)

# % # % # % # % # %

Total 204,579 100 139,001 100 23,899 100 10,851 100 28,445 100

Elementary or High school, no diploma 25,276 12.4 10,450 7.5 3,594 15.0 1,204 11.1 9,956 35.0

Elementary or High school, GED 96,277 47.1 66,184 47.6 12,983 54.3 3,352 30.9 12,425 43.7

Associate's degree, vocational/academic 19,736 9.6 14,436 10.4 2,244 9.4 759 7.0 1,931 6.8

Bachelors degree only/Some Graduate 40,561 19.8 30,552 22.0 3,278 13.7 3,407 31.4 2,935 10.3

Master's degree programs 16,549 8.0 12,538 9.0 1,358 5.7 1,492 13.8 903 3.2

Professional degree/Doctorate Degree 6,271 3.1 4,841 3.5 441 1.9 638 5.9 295 1.0 Notes: /1 Excluding members of the Armed Forces living in barracks. Source: U.S. Census Bureau, Current Population Survey, 2012 Annual Social and Economic Supplement

State-by-state detailed data on educational attainment can also obtain from the US Census.

Local data is more useful for states to better understand which racial/ethnic population is more

likely to have better income and access to the resources.

4. Low Birthweight by Race and Ethnicity

Low birthweight refers to infants who weigh less than 2500 grams at birth. Infants born at low

birth weight are at higher risk for physical and developmental delays that effect their healthy

development and their school readiness. Low birthweight can be indicative of a larger public

health problem that may include long-term maternal malnutrition, ill health, and poor prenatal

care.

What Can the Data Tell Us: Data from the Center for Disease Control National Vital Statistics

highlights the association between race/ethnicity and low birthweight. This is mirrored both at

the national and state level. This is especially true for Black non-Hispanics, in some states

doubling the percentage of low birthweight infants compared to the White non-Hispanic

population. Understanding which populations have a disproportionate number of low

birthweight infants helps health advocates target policies and programs designed for these

populations. While not all low birthweights are preventable, Healthy People 2020 set a goal of

achieving a rate of 5.0% and reducing existing disparities by race and ethnicity at least in half.

Low Birthweight Births National and State Data

2012

Non-Hispanic

Area All races1 White2 Black2 Hispanic3

United States 8% 7% 13.2% 7.0

Alabama 10.0 7.9 15.0 6.3

Alaska 5.7 4.8 11.4 5.5

Arizona 6.9 6.5 12.0 6.8

Arkansas 8.7 7.4 13.9 7.1

California 6.7 5.8 11.7 6.1

Colorado 8.8 8.2 13.5 8.7

Connecticut 7.9 6.5 12.2 8.8

Delaware 8.3 7.1 11.7 6.6

District of Columbia 9.6 6.3 12.0 8.3

Florida 8.6 7.2 12.8 7.3

Georgia 9.3 7.2 13.3 6.4

Hawaii 8.1 5.8 9.0 8.7

Idaho 6.4 6.3 * 6.9

Illinois 8.1 6.9 13.4 7.0

Indiana 7.9 7.3 12.5 6.6

Iowa 6.7 6.4 11.0 5.7

Kansas 7.1 6.5 12.9 6.9

Kentucky 8.7 8.2 13.8 6.8

Low Birthweight Births National and State Data

2012

Non-Hispanics

All Races White3 Black3 Hispanics3

Louisiana 10.8 8.1 15.1 7.6

Maine 6.6 6.5 9.3 12.0

Maryland 8.8 6.8 12.5 7.0

Massachusetts 7.6 6.9 10.2 8.4

Michigan 8.4 7.0 13.9 7.3

Minnesota 6.6 6.0 10.2 6.3

Mississippi 11.6 8.3 16.2 6.6

Missouri 7.7 6.8 13.2 6.5

Montana 7.4 7.1 * 9.2

Nebraska 6.7 6.2 12.6 6.4

Nevada 8.0 7.1 13.3 6.8

New Hampshire 7.3 7.2 10.0 8.1

New Jersey 8.2 7.2 12.3 7.1

New Mexico 8.8 8.3 14.7 8.9

New York 7.9 6.6 12.2 7.6

North Carolina 8.8 7.4 13.5 6.7

North Dakota 6.2 6.0 9.3 5.3

Ohio 8.6 7.4 13.8 7.5

Oklahoma 8.0 7.5 13.8 6.5

Oregon 6.1 6.0 9.3 5.7

Pennsylvania 8.1 7.0 12.8 8.4

Rhode Island 8.0 7.4 11.8 8.2

South Carolina 9.6 7.4 14.4 6.0

South Dakota 6.2 5.6 9.8 8.0

Tennessee 9.2 8.1 14.0 6.3

Texas 8.3 7.4 13.7 7.5

Utah 6.8 6.6 10.4 7.3

Vermont 6.2 6.1 * *

Virginia 8.1 6.7 13.0 6.3

Washington 6.1 5.6 9.4 6.3

West Virginia 9.2 9.1 13.1 *

Wisconsin 7.1 6.5 12.7 6.6

Wyoming 8.5 8.6 * 7.6 * Figure does not meet standards of reliability or precision; based on fewer than 20 births in the numerator. - Quantity zero. --- Data not available. 1 Includes races other than white and black and origin not stated. 3 Includes all persons of Hispanic origin of any race. 4 Excludes data for the territories. 2 Race and Hispanic origin are reported separately on birth certificates. Persons of Hispanic origin may be of any race. Race categories are consistent with the 1977 Office of Management and Budget standards. Forty-one states and the District of Columbia reported multiple-race data for 2012 that were bridged to single-race categories for comparability with other states; see "Technical Notes." Source: 2012 Final Report Internet Tablets, National Vital Statistics Reports

5. Infant Mortality Levels Broken Down by Race/Ethnicity

Infant mortality is defined as the death of an infant during the first year of life, usually expressed per 1000 live births. Some of the leading causes of infant mortality in the United States are congenital malformations, deformities and chromosomal abnormalities, disorders related to short gestation and low birth weight, and sudden infant death syndrome (Source: Births: Final Data for 2011, tables 1, 18) .

What Can the Data Tell Us: In addition to being a clear child outcome, data on infant mortality

rate is used as a proxy for population health. The national and state data below is broken down

by race/ethnicity. Using infant mortality data helps to assess how healthy a specific

ethnic/racial group is, it also helps to focus resources and implement programs that are tailored

to the specific needs of a population. At the national level, the data highlights how Black non-

Hispanics infants are twice as likely to die within the first year as White non-Hispanics or

Hispanics infants. In some states the likelihood that a Black non-Hispanic child will die within

the first year more than triples. There is a great need for intentional focus and resources to

reduce infant mortality rates for the Black non-Hispanic population.

Infant mortality Rates By Race and Ethnicity Infant mortality rates by race and Hispanic origin of mother: 2008-2010 linked files.

(Per 1,000 live births)

Total Non-Hispanic White

Non-Hispanic Black

American Indian or Alaska Native

Asian or Pacific Islander

Hispanic

Ratio of rate, non-Hispanic black and non-Hispanic white

United States 6.39 5.34 12.19 8.39 4.39 5.38 2.28

Alabama 8.83 6.98 13.08 * * 7.38 1.87

Alaska 5.49 3.50 * 9.24 * * *

Arizona 6.11 5.41 13.48 7.98 7.34 5.59 2.49

Arkansas 7.40 6.52 11.47 * * 5.62 1.76

California 4.93 4.13 9.77 6.85 4.05 4.82 2.37

Colorado 6.12 5.26 12.71 * 5.70 6.65 2.42

Connecticut 5.60 4.00 11.76 * 4.78 6.67 2.94

Delaware 7.94 5.90 14.49 * * 5.09 2.46


9.72 4.32 13.87 * * 5.03 3.21

Florida 6.90 5.45 12.20 * 5.13 5.04 2.24

Georgia 7.24 5.44 11.09 * 2.90 5.08 2.04

Hawaii 5.93 4.22 * * 6.45 6.12 *

Idaho 5.34 4.96 * * * 6.80 *

Illinois 6.99 5.45 13.59 * 5.45 5.92 2.49

Indiana 7.42 6.50 14.09 * 6.09 6.80 2.17

Iowa 5.06 4.65 12.12 * * 6.34 2.61

Infant mortality Rates By Race and Ethnicity Infant mortality rates by race and Hispanic origin of mother: 2008-2010 linked files.

(Per 1,000 live births

http://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_01.pdf#table01

Total Non-

Hispanic White

Non-Hispanic

Black

American Indian or

Alaska Native

Asian or Pacific

Islander Hispanic

Ratio of rate, non-Hispanic

black and non-Hispanic white

Kansas 6.89 6.34 13.06 * 5.72 6.50 2.06

Kentucky 6.86 6.66 10.49 * * 4.74 1.58

Louisiana 8.48 6.55 11.92 * 7.00 3.26 1.82

Maine 5.52 5.54 * * * * *

Maryland 7.35 4.56 12.71 * 4.01 4.91 2.79

Massachusetts 4.84 3.78 9.24 * 4.19 6.75 2.44

Michigan 7.38 5.68 14.28 12.33 4.46 6.41 2.51

Minnesota 5.03 4.31 9.64 8.60 4.83 5.05 2.24

Mississippi 9.89 7.18 13.37 * * 5.99 1.86

Missouri 6.94 5.97 12.81 * 3.97 5.47 2.15

Montana 6.45 6.07 * 8.84 * * *

Nebraska 5.37 4.61 13.46 * * 5.48 2.92

Nevada 5.56 5.27 9.98 * 4.37 5.02 1.89

New Hampshire

4.24 4.18 * * * * *

New Jersey 5.18 3.58 12.16 * 3.12 4.76 3.40

New Mexico 5.49 5.50 * 4.95 * 5.29 *

New York 5.32 4.01 10.56 * 3.44 5.03 2.63

North Carolina 7.76 5.68 13.89 13.67 4.87 5.80 2.45

North Dakota 6.32 4.91 * 16.58 * * *

Ohio 7.71 6.33 14.52 * 4.49 6.72 2.29

Oklahoma 7.53 6.93 12.50 9.26 * 5.89 1.80

Oregon 4.99 4.78 9.46 7.73 5.35 4.61 1.98

Pennsylvania 7.24 5.53 12.59 * 4.83 8.55 2.28

Rhode Island 6.29 5.11 12.54 * * 5.03 2.45

South Carolina 7.47 5.58 11.50 * * 5.39 2.06

South Dakota 7.38 5.93 * 13.58 * * *

Tennessee 8.01 6.41 14.09 * 4.98 6.52 2.20

Texas 6.10 5.50 10.89 7.51 4.16 5.54 1.98

Utah 4.94 4.64 * * 7.73 5.21 *

Vermont 4.99 4.97 * * * * *

Virginia 6.95 5.31 12.66 * 4.15 6.01 2.38

Washington 4.96 4.66 6.97 8.79 3.78 5.38 1.50

West Virginia 7.60 7.61 9.63 * * * 1.27

Wisconsin 6.26 5.26 13.90 8.02 6.44 5.61 2.64

Wyoming 6.61 5.94 * * * 8.38 * * Figure does not meet standards of reliability or precision; based on fewer than 20 deaths in the numerator. NOTES: Race and Hispanic origin are reported separately on birth certificates. Race categories are consistent with the 1977 Office of Management and Budget standards. Persons of Hispanic origin may be of any race. In this table Hispanic women are classified only by place of origin; non-Hispanic women are classified by race. Thirty-eighth states and DC reported multiple-race data on the birth certificate for 2010 and 33 for 2009. The multiple-race data for these states were bridged to the single-race categories of the 1977 standards for comparability with other states. Source: http://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_08.pdf

6. Late or No Prenatal Care by Race and Ethnicity

Prenatal care is health care a woman receives when she is pregnant. Prenatal care is important

for healthy mothers and healthy infants. Getting early and regular prenatal care increases the

chances of a healthy pregnancy and a healthy birth. When a health care provider sees a woman

regularly during her pregnancy the provider can identify health problems early on. Early

treatment can cure many problems and prevent others. Health care providers will also talk to

pregnant women about things they can do to give their unborn babies a healthy start to life. A

child’s healthy development begins in the womb. An infant who is born healthy has a better

chance to grow up healthy.

What Can the Data Tell Us: Late or no prenatal care broken down by race/ethnicity reveals

specific populations that are less likely to have access to adequate prenatal care. The chart

below demonstrates that non-Hispanic white women have a higher likelihood of receiving

prenatal care compared to all other ethnic populations. This disparity is larger among Black

non-Hispanic woman and American Indian/Alaskan Native woman. Late or no prenatal care

puts women of color at a higher risk for complications during pregnancy and delivery, and for

their infant to have medical issues at birth.

Source: Child Trends Bank http://www.childtrends.org/?indicators=late-or-no-prenatal-care

http://www.childtrends.org/?indicators=late-or-no-prenatal-care

States can find state data from other organizations, such as the National Council of La Raza,

shown here. This data is from 2009 and represents 21 states. State’s public health department

may be an excellent resource to find more up to date data.

Percent of Births to Mothers with Late or No Prenatal Care (21 Reporting States)Year: 2009, Age: 0-2

Location Total

% Latino

% Black

% White

%

United States 6.55 8.78 10.63 4.5

Alabama N/A N/A N/A N/A

Alaska N/A N/A N/A N/A

Arizona N/A N/A N/A N/A

Arkansas N/A N/A N/A N/A

California 3.45 4.11 5.08 2.38

Colorado 7.05 10.13 12.79 4.86

Connecticut N/A N/A N/A N/A

Delaware 8.51 16.54 8.83 6.16

District of Columbia N/A N/A N/A N/A

Florida 6.31 6.78 9.18 4.7

Georgia 7.37 14.35 9.41 3.7

Hawaii N/A N/A N/A N/A

Idaho 5.34 8.85 9.49 4.4

Illinois N/A N/A N/A N/A

Indiana 6.61 11 12.06 5.18

Iowa 3.99 7.77 10.1 3.2

Kansas 4.87 9.4 9.41 3.33

Kentucky 5.98 10.47 8.77 5.37

Louisiana N/A N/A N/A N/A

Maine N/A N/A N/A N/A

Maryland N/A N/A N/A N/A

Massachusetts N/A N/A N/A N/A

Michigan 4.5 6.33 7.81 3.46

Minnesota N/A N/A N/A N/A

Mississippi N/A N/A N/A N/A

Missouri N/A N/A N/A N/A

Montana 5.38 8.05 9.09 3.87

Nebraska 4.4 7.85 8.68 3.18

Nevada N/A N/A N/A N/A

New Hampshire 3.34 6.08 10.31 3.07

New Jersey N/A N/A N/A N/A

New Mexico 9.08 9.55 13.26 5.7

Percent of Births to Mothers with Late or No Prenatal Care (21 Reporting States)Year: 2009, Age: 0-2

Location Total

% Latino

% Black

% White

%

New York 5.44 6.86 10.26 3.09

North Carolina N/A N/A N/A N/A

North Dakota 5.81 8.42 7.1 3.98

Ohio 6.44 12.21 12.14 4.95

Oklahoma N/A N/A N/A N/A

Oregon 4.81 6.28 6.61 4.11

Pennsylvania 6.88 9.97 13.38 5.02

Rhode Island N/A N/A N/A N/A

South Carolina 7.12 16.54 8.5 4.67

South Dakota 6.8 10.15 10.29 4.93

Tennessee 7.84 19.05 13.25 4.73

Texas 12.27 14.66 16.42 7.77

Utah 4.99 8.84 17.97 3.75

Vermont 2.87 3.26 6.67 2.74

Virginia N/A N/A N/A N/A

Washington 6.8 9.09 10.44 5.62

West Virginia N/A N/A N/A N/A

Wisconsin N/A N/A N/A N/A

Wyoming 5.88 10.39 11.54 4.85 Source: The National Council of la Raza Latino Kids Data Explorer (http://www.nclr.org/index.php/latinokidsdata)

http://www.nclr.org/index.php/latinokidsdata

7. Health Insurance Levels by Race and Ethnicity

Health insurance is needed to ensure that individuals can receive health services regardless of

their needs for and cost of that care. Individuals and families receive health insurance coverage

through their employer, through state and/or local health insurance programs, or through

purchasing private health insurance. The Affordable Care Act requires individuals to secure

some form of health insurance coverage and creates additional options for that coverage

through Health Exchanges.

In addition to providing insurance to cover catastrophic and high cost health services, health

insurance coverage helps people access to timely medical care and preventive services and

improves their lives and health. Individuals with health insurance are more likely to go to

preventive health care appointments. Families which have health insurance for young children

are more likely to take their child to well-child visits, which are critical for preventing illness and

identifying and responding to potential developmental issues in young children. Families who

lack health insurance are often deterred by the cost of health care and may only seek medical

treatment when a major medical issue arises. Preventive well-child visits are critical in

supporting young children to better developmental and health trajectories.

Over the last twenty years, the federal government has expanded options for states to provide

health coverage for children – both through the Medicaid program and through the Child

Health Insurance Program (CHIP). Through Medicaid and CHIP, most states now cover children

up to at least 200 percent of poverty, and many cover children well above that amount. A few

states cover undocumented children under their Medicaid and CHIP programs, although they

must use state funding to do so. States are required by federal law to cover children who are

legal residents after five years of being in the country, but are given the option to cover all legal

resident children, and many do so.

There are different sources of information available for health insurance coverage by age,

which produce somewhat different estimates of overall child health coverage. The American

Community Survey provides data that generally can be broken out for the 0-17 population and

is available on an annual basis. The National Survey of Child Health provides further

breakdowns by child age (0-5, 6-11, 12-17) but is available only every four years. Select

information from both is provided here.

What Can the Data Tell Us: Examining national and state data on health insurance coverage

and access to care by race/ethnicity is critical to understanding disparities in health outcomes

for specific groups. Health insurance coverage varies significantly from state to state as well as

by race, ethnicity, and socioeconomic status. Children under 5 years who are American Indian

or Alaska Native are three times more likely not to have health insurance than the national

average and children of Hispanic descent are much more likely to be uninsured than White or

African American children. Differences across the states, particularly in relation to poverty

levels, are generally reflective of state policies regarding the eligibility for Medicaid and CHIP

coverage.

Health Insurance Coverage* Children Age 0-5

United States 2012

Children Age 0-5 Uninsured Percentage

Total 24,090,718 1,362,884 5.7%

White, Non-Hispanic 12,072,282 568,631 4.7%

African American 3,436,346 161,460 4.7%

American Indian and Alaska Native 232,511 34,821 15.0%

Asian 1,079,708 49,257 4.6%

Hispanic 6,199,166 503,199 8.1% Source: United States Census Bureau, 2012 American Community Survey One-Year Estimates

* National data on health coverage for young children by race and ethnicity are provided here from the 2012 Census American Community Survey, this data can be developed for any state; but the standard errors of estimate may be substantial for some ethnic populations.

The National Survey on Children’s Health (NSCH) provides some of this data on a state-by-state

basis. The data from NSCH shows health insurance coverage broken down for each state by

income, race/ethnicity, and by children under 5 years. Pulling these data pieces together from

NHSC gives a good picture of the state’s uninsured children population. Often, the health

insurance coverage data from such organizations are more users friendly, but they may not be

using the most up-to-date available census data.

Uninsured Children by Race 0-17 years old Poverty level of Uninsured Children 0-17

Region Hispanic %

White, non-

Hispanic %

Black, non-

Hispanic %

Other, non-

Hispanic %

0 - 99% FPL %

100 - 199% FPL

%

200 - 399% FPL %

400% FPL or higher

%

Children 0- 5

years %

United States 9.7 3.9 4.9 4.5 8.2 9.2 4.3 1.7 4.6

Alabama 10.4 2.4 5.1 4.8 5.4 6.4 2.5 2 1.8

Alaska 7.5 5.2 60.2 6.1 8 7.3 5.6 2.2 5.4

http://childhealthdata.org/survey/results?q=2196&r=2&g=456



Region Hispanic %

White, non-

Hispanic %

Black, non-

Hispanic %

Other, non-

Hispanic %

0 - 99% FPL %

100 - 199% FPL

%

200 - 399% FPL %

400% FPL or higher

%

Children 0- 5

years %

Arizona 15 9 9.8 9.6 15.8 19.8 7.4 3.3 8.1

Arkansas 5.9 4.1 5.4 5.8 4.1 7 4.9 1.5 4.2

California 8 4.1 7.1 2.1 9.6 10.5 5.1 2.1 8.4

Colorado 13.3 4.7 1.7 7.6 10.2 14.7 6.8 1.9 5.1

Connecticut 5.5 1.8 2.9 2.7 5.1 4.3 3.8 0.5 1.7

Delaware 9.5 2.7 1.9 6 7.6 5.3 3.5 0.5 2.1


3 0.1 1.5 0.1 1.7 0.1 2.8 0.6 1.7

Florida 12.7 7.4 10.5 8.6 17.1 12.9 4.7 3.1 7.6

Georgia 12.9 5.7 6.3 4.4 6 15 4.7 3.1 4.8

Hawaii 2 1.4 0 0.9 2.5 2.1 0.4 0.4 0.7

Idaho 9.7 5.1 0 3.4 6.5 7.8 5.7 2.2 3.8

Illinois 0.5 1.7 2.8 2.2 0.5 3.2 2 0.8 0.8

Indiana 11.8 4.8 2.8 5.8 8.8 9.8 3.1 0.6 5.5

Iowa 13.9 1.7 0.5 1.5 4.2 5.9 1.7 0.4 1.5

Kansas 13.4 2.8 4.8 6 12.4 7.1 2.1 1 4.1

Kentucky 13.1 3.4 2.4 9.3 5.2 8.6 2.4 0.6 2.2

Louisiana 6.8 1.4 2.7 0.8 2 1.6 3 1.5 2

Maine 3.5 4 0 2.2 1.4 4.9 5.5 1.9 2.7

Maryland 7.6 2 6.2 2.6 6.6 9.2 5.3 1.5 3.8

Massachusetts

0.8 0.6 0.6 4.1 2.7 1.4 1 0.4 1.8

Michigan 0.6 2.9 2.5 3.4 4 4.3 2 0.8 3.1

Minnesota 16.3 2.9 1.4 9.6 7.4 10 4.2 0.5 4

























Mississippi 19.8 8.5 4.1 7.5 9.3 10.3 4.5 2.4 7.1


Region Hispanic %

White, non-

Hispanic %

Black, non-

Hispanic %

Other, non-

Hispanic %

0 - 99% FPL %

100 - 199% FPL

%

200 - 399% FPL %

400% FPL or higher

%

Children 0- 5

years %

Missouri 9.2 3.9 4.9 3.8 3.3 9.9 3.1 1.1 2.5

Montana 5.3 8.1 0 11.9 8.2 14.3 6.6 3.7 7.4

Nebraska 14.5 3.1 4.3 2.2 10 8.4 3.2 1.4 4.4

Nevada 21.7 7.2 7.7 7.1 26.7 15 8.6 2.5 8.8

New Hampshire

2.7 3.2 0 2.3 9.7 7 3.2 0.3 1.9

New Jersey 7.8 1.4 3.1 4.3 7.6 6.1 4.1 0.7 2.4

New Mexico 8.6 2.6 3.3 5.9 10.2 10.2 3 0.9 3.9

New York 4 1.7 2.7 6.6 3.3 6 2.7 0.8 1.8

North Carolina

14.6 3.5 5.7 12.1 9.7 7.4 5.3 2.1 3.8

North Dakota 9.6 5 0 11.7 9.9 10.6 5.4 3.5 5.1

Ohio 8.5 3.2 1.9 2.3 3.7 5.6 3.4 0.4 3.3

Oklahoma 17.5 5 5.1 6.7 11.1 6.4 7.7 3.3 5.6

Oregon 9 3 3.4 3.4 6.3 8.7 2.6 0.5 4.7

Pennsylvania 8.4 3.6 4.3 5 7.7 3.1 4.4 2.1 2

Rhode Island 5.9 2.9 3.6 5.6 3.1 7.5 4.1 1.7 2.2

South Carolina

15.4 7.3 4 2.8 5.8 10.2 6.3 2.5 6.1

South Dakota 6.4 2.7 6.5 4.5 2.8 6.7 2.9 0.4 2

Tennessee 16 4.5 3.5 8.1 7.5 8.7 3.6 1.1 4.6

Texas 12.1 7.4 6.5 2.4 12.2 15.5 6.9 3.1 5.9

Utah 21.5 6 2.4 8.3 20.7 9.9 6.6 2.1 6.3

Vermont 3.2 1.4 6.7 0 0.2 3.5 1.7 0.2 1.7


























Virginia 15.1 3.3 5.3 4.2 6.8 12.4 3.8 2.3 5.8

Washington 6.2 3.3 4 1 4.4 2.5 6.2 1.5 3.1


Region Hispanic %

White, non-

Hispanic %

Black, non-

Hispanic %

Other, non-

Hispanic %

0 - 99% FPL %

100 - 199% FPL

%

200 - 399% FPL %

400% FPL or higher

%

Children 0- 5

years %

West Virginia 0 4.2 0 8.4 4.4 6.3 5.1 0.4 4.7

Wisconsin 4.3 1.4 0.6 1.3 3.1 3.6 0.5 0.5 1.7

Wyoming 12 4.9 0 4.4 6.4 8.5 6 2.8 5.3

Source: National Survey of Children's Health. NSCH 2011/12. Data query from the Child and Adolescent Health Measurement Initiative, Data Resource Center for Child and Adolescent Health website. Retrieved [12/01/13] from www.childhealthdata.org.






8. Access to a Medical Home by Race/Ethnicity and Income

A medical home is a team based health care delivery model led by a physician, physician assistant or nurse practitioner that provides comprehensive and continuous medical care to patients with the goal of obtaining maximized health outcomes. Young children that receive coordinated, ongoing, comprehensive care within a medical home involve the child's family, providing anticipatory guidance (advice) to the parents on child development issues and working to ensure that all of the medical and non-medical needs of the child are met. Sometimes, the term “family-centered medical home” is used to describe such care. Establishing a medical home is important in accessing and using appropriate health care services in the context of an overall treatment plan, particularly for persons with chronic health conditions requiring multiple services. It also is important for children and young children in particular, in tracking healthy development and providing preventive and developmental services, as well as medical care. According to a report from the University of Iowa, September 2013, titled Medical Homes for Children in Iowa, having a medical home is associated with increased parent satisfaction, decreased emergency room use, lower rates of hospitalization, and more preventive care.

What Can the Data Tell Us: The National Survey of Children's Health data shown here illustrates

how both at the national and state level the number of children who do not have a usual source

of care (medical home) varies substantially across racial and ethnic groups as well as

socioeconomic status. Hispanic children are almost twice as likely as their White non-Hispanic

counterparts not to have a coordinated medical home. Both nationally and at the state level,

children living below the poverty level are significantly more likely not to have a coordinated

medical home than children 400% of Federal Poverty Level, but there is a very large variation

across states in the proportion of children not having a medical home. Understanding data on

a specific race/ethnic group’s level of access to medical homes helps to target resources, and

programs that are relevant to groups that do not have equitable access to ongoing

comprehensive care within a medical home, while examining overall rates helps to identify

general needs to promote comprehensive, family-centered medical homes for children.

Child reported as Not having coordinated, ongoing comprehensive care within a medical home

By Race/Ethnicity Children 0-17 years old

5 and Under

Poverty Level Children 0-17

Region Hispanic White, non-

Hispanic %

Black, non-

Hispanic %

Other, non-

Hispanic %

0-5 yrs. Old %

0 - 99% FPL

100 - 199% FPL

200 - 399% FPL

400% FPL or higher

Nationally 62.8 34.3 55.3 49.5 41.8 63.3 52 39.7 32.3

Alabama 62.1 36.9 57.3 48.2 39.5 61.5 54.9 36.7 28.3


By Race/Ethnicity

Children 0-17 years old 5 and Under

Poverty Level Children 0-17


Hispanic %

Black, non-

Hispanic %

Other, non-

Hispanic %

0-5 yrs. Old %

0 - 99% FPL

100 - 199% FPL

200 - 399% FPL

400% FPL or higher

Alaska 52.9 40.8 60.2 55.8 38.7 61 54.2 42.4 39.2

Arizona 62.3 40.5 69.3 59.7 49.7 71.8 61.2 40.4 40

Arkansas 68.4 34.1 69 43.4 36.4 56.8 52.2 37.4 28.6

California 65.9 36.1 49.4 53.5 51.4 75.5 62.7 53.3 36.8

Colorado 56.6 37.8 55.9 44.3 40 62.4 57.2 37 34.3

Connecticut 67.1 29.6 55.2 44.2 41.7 65.7 50.7 42.9 29.8

Delaware 57.6 32.7 54.6 52.3 39.8 54.9 51.3 43.4 34.4


58.8 28.4 56 39.6 44.3 62 62.9 45.6 32.5

Florida 58.1 36.8 67.6 47.1 46.2 68.6 55.8 39 34.7

Georgia 72.9 35.9 53.8 51.7 43.7 61.2 52.6 45.4 33.4

Hawaii 51 31.5 39.8 42.8 35.5 60.5 47.1 37.9 31

Idaho 54.3 40.4 30 44.1 41 55.8 46.1 37.1 34.5

Illinois 72.9 27.1 54.7 53.4 40.7 71.6 51.6 35.7 28.5

Indiana 64.7 37.4 55.1 41.2 39.6 58.3 49.7 37.6 26.1

Iowa 51.9 29.1 48.2 46.9 31.4 44.8 41.1 29.7 23.3

Kansas 64.6 32.7 57 42.1 38.1 57.4 48.8 32.7 30.8

Kentucky 53.6 41.5 52.9 49.4 41.7 52.1 52.6 37.8 30.8

Louisiana 39.1 34.4 56.2 46.6 41.2 58.8 46.8 38.1 30.6

Maine 28.9 36 69.5 38.9 32.8 45.8 47.5 29.7 29.3

Maryland 60 29.6 52.9 48.3 38.4 62.1 54.1 45.1 31.6

Massachusetts 64.3 31.1 40.4 34.7 36.2 58.9 45.1 32 31

Michigan 60.9 32 66.3 50.4 36.5 61.7 45.8 35.7 25.2

Minnesota 70.5 31.7 64.9 47.4 35.8 66.7 45.6 35.2 27.6

Mississippi 84.5 39.2 57.6 66.6 45.6 67.6 50.5 42.2 31

Missouri 58 31.4 56.8 38.4 33.8 48.4 45.5 33.7 25.6

Montana 59.8 38.1 26.8 57.1 37.2 56.7 46.4 35.8 35.5

Nebraska 57.9 31.9 49 58.6 38.7 60.8 45.2 34.8 26.7

Nevada 68.4 38.6 51.8 64 47.5 77.9 59.5 47.7 36.2

New Hampshire 54.5 30.3 61.2 57.5 29 59.9 44.9 25.3 28.9

http://www.childhealthdata.org/survey/results?q=2507&r=2&g=456































New Jersey 64.4 34.1 56.5 55.6 45.1 59.2 55.4 45.7 40.3


By Race/Ethnicity

Children 0-17 years old 5 and

Under Poverty Level Children 0-17


Hispanic %

Black, non-

Hispanic %

Other, non-

Hispanic %

0-5 yrs. Old %

0 - 99% FPL

100 - 199% FPL

200 - 399% FPL

400% FPL or higher

New Mexico 55 38.4 60.3 60.6 45.3 67.7 51.7 46.3 34.2

New York 61.2 36.5 47.9 58 44.5 65.1 55.5 40.4 34.1

North Carolina 64.3 31.8 59.7 46.7 38.6 62.1 49.4 33 34.4

North Dakota 49.2 34.3 56.5 49.3 38.9 55.7 44.9 35.6 29

Ohio 55.8 39 54.7 51.5 39.9 54.3 50.2 38.9 30.3

Oklahoma 57.1 39.7 51.3 41.1 39.7 52.7 51.7 39.6 30.1

Oregon 61.7 35.8 46.8 46.2 35.1 55.1 49.5 38.1 29.4

Pennsylvania 64.3 34.5 56.2 46.1 37.5 63.9 46 34.1 30.7

Rhode Island 61 29.8 62.6 47.5 37.2 60.3 45.9 37.8 26

South Carolina 67.6 34.3 57.6 45.9 41.5 56.8 50.9 40.9 31

South Dakota 48.8 31.9 86.1 60.3 33.4 53.8 47.5 34.5 25.9

Tennessee 62 33.4 53.9 38.6 34.5 55.3 43.9 32.6 26.6

Texas 59.9 31.6 44.4 51 44.9 66.5 53.8 40.6 32.4

Utah 57 29.5 39.5 48.4 27.9 63 38.5 29 25.3

Vermont 28.5 30.6 33.7 37.4 25.3 37.3 41.8 30.1 24.8

Virginia 73.8 32 56.1 44.9 41.1 50.6 55.7 42.3 35.4

Washington 55.4 35.3 57 40.7 34.4 54.6 41.9 41.6 33.2

West Virginia 46.7 37.4 51.6 46.9 33.3 50.8 40.5 37.2 25.8

Wisconsin 49.4 29 48.6 39.9 29 55 35.1 29.5 23.9

Wyoming 57 35.8 90.2 57.6 32.8 52 47.1 38.4 32.4

Source: National Survey of Children's Health. NSCH 2011/12. Data query from the Child and Adolescent Health Measurement Initiative, Data Resource Center for Child and Adolescent Health website. Retrieved [10/14/13] from www.childhealthdata.org.






















9. Immunizations Rates for Children 19-35 Months

Immunizing young children protects them from devastating and life threatening diseases such

as polio, measles, diphtheria, pertussis (whooping cough), rubella (German measles), mumps,

tetanus, Haemophilus influenzae type b (Hib), and smallpox. Protecting children from these

(and other) preventable diseases helps supports children’s physical health—a key component

to a child’s healthy development and school readiness. In addition, immunization rates often

are a good marker for receiving other forms of primary and preventive health services.

What Can the Data Tell Us: The Centers for Disease Control and Prevention, National

Immunization Survey for 2012 shows national data on immunization broken down by poverty

level and race/ethnicity. At the national level about 30% of children ages 19-35 months are not

fully immunized. Children living in poverty are less likely to be fully immunized compared

children at or above poverty. Viewing data by race/ethnicity and poverty level makes it easier

to identify groups at risk of vaccine-preventable diseases and create and evaluate the

effectiveness of programs designed to increase coverage.

Estimated Vaccination Coverage Among Children 19-35 Months of Age By Poverty Level^ and Race/Ethnicity^^ US, National Immunization Survey Q1/2012-Q4/2012†

4:3:1:3*:3:1:4†

Total

White only, non-

Hispanic

Black only, non-

Hispanic Hispanic

American Indian or

Alaska Native only, non-Hispanic

Asian only, non-

Hispanic

Native Hawaiian or other Pacific

Islander only, non-Hispanic

Multiple Race, non-

Hispanic

US National 68.4 69.3 64.8 67.8 NA 71.6 NA 71.5

At or Above Poverty 71.6 72.1 68.5 68.3 NA 77.2 NA 76.7

Below Poverty 63.4 58.2 62.7 68.1 NA NA NA NA

Unknown Poverty 67.1 73.9 NA NA NA NA NA NA * Estimate=NA (Not Available) if the unweighted sample size for the denominator was <30 or (CI half width)/Estimate > 0.588 or (CI half width) >10. Estimates presented as point estimate (%) ± 95% Confidence Interval. ^ Poverty status was based on 2011 U.S. Census poverty thresholds (available at http://www.census.gov/hhes/www/poverty/data/threshld) ^^ Self-reported by respondent. Children of Hispanic ethnicity may be of any race. † Children in the Q1/2012-Q4/2012 National Immunization Survey were born from January 2009 through May 2011. † 4:3:1 plus full series Hib vaccine, 3 or more doses of HepB, 1 or more doses of varicella vaccine, and 4 or more doses of PCV. Source: http://www.cdc.gov/vaccines/stats-surv/nis/data/tables_2012.htm#overall

Below is national and state level data for 2012 from the Center for Disease Control, National Center for Health Statistics. Overall state data gives a good overview on immunization rates for total populations. Unfortunately, state data broken down by race and ethnicity for all states is not available. States can contact their state level public health department to find out what type of immunization data they obtain and how it is broken down. Local information broken down by race/ethnicity and income is more useful to see disparities.

Estimated Vaccination Coverage* Among Children 19-35 Months of Age by Race/Ethnicity‡ and by State and Local Area -- US, National Immunization Survey, Q1/2012-Q4/2012§

4:3:1:3*:3:1:4†

Non-Hispanic

Total %

White %

Black %

American Indian or

Alaska Native %

Asian %


Islander %

Hispanic %

US National 68.4 69.3 64.8 NA 71.6 NA 67.8

Alabama 71.3 68.5 NA NA NA NA NA

Alaska 59.5 61.3 NA NA NA NA NA

Arizona 67.5 NA NA NA NA NA NA

Arkansas 66.4 65.5 NA NA NA NA NA

California 66.8 NA NA NA NA NA NA

Colorado 71.7 NA NA NA NA NA NA

Connecticut 77.1 76.5 NA NA NA NA NA

Delaware 72.6 70.9 NA NA NA NA NA

Dist. of Columbia 73.4 80.0 NA NA NA NA NA

Florida 68.6 78.4 NA NA NA NA NA

Georgia 74.7 NA NA NA NA NA NA

Hawaii 80.2 NA NA NA 87.2 NA NA

Idaho 63.0 61.3 NA NA NA NA NA

Illinois 68.5 76.7 NA NA NA NA 64.1

Indiana 61.4 62.5 NA NA NA NA NA

Iowa 74.8 77.5 NA NA NA NA NA

Kansas 65.0 63.4 NA NA NA NA NA

Kentucky 68.2 69.8 NA NA NA NA NA

Louisiana 68.5 65.0 NA NA NA NA NA

Maine 72.6 71.9 NA NA NA NA NA

Maryland 67.1 78.2 NA NA NA NA NA

Massachusetts 73.5 74.9 NA NA NA NA NA

Michigan 70.5 71.4 NA NA NA NA NA

Minnesota 66.2 69.9 NA NA NA NA NA

Mississippi 77.5 NA 83.4 NA NA NA NA

Missouri 63.9 67.5 NA NA NA NA NA

Montana 66.5 68.4 NA NA NA NA NA

Nebraska 72.6 77.7 NA NA NA NA NA

Estimated Vaccination Coverage* Among Children 19-35 Months of Age by Race/Ethnicity‡ and by State and Local Area -- US, National Immunization Survey, Q1/2012-Q4/2012§

4:3:1:3*:3:1:4†

Non-Hispanics

Total

% White

% Black

%

American Indian or

Alaska Native %

Asian %


Islander %

Hispanic %

Nevada 65.3 62.4 NA NA NA NA NA

New Hampshire 80.1 80.5 NA NA NA NA NA

New Jersey 71.5 71.3 NA NA NA NA NA

New Mexico 71.6 NA NA NA NA NA 68.8

New York 63.7 64.3 NA NA NA NA 57.7

North Carolina 75.4 76.8 NA NA NA NA NA

North Dakota 72.2 77.2 NA NA NA NA NA

Ohio 66.8 69.8 NA NA NA NA NA

Oklahoma 61.0 NA NA NA NA NA NA

Oregon 66.7 66.0 NA NA NA NA NA

Pennsylvania 68.3 64.4 NA NA NA NA NA

Rhode Island 72.5 76.3 NA NA NA NA NA

South Carolina 71.8 80.7 NA NA NA NA NA

South Dakota 63.6 70.4 NA NA NA NA NA

Tennessee 73.1 74.2 NA NA NA NA NA

Texas 64.8 66.6 NA NA NA NA 65.2

Utah 73.0 70.1 NA NA NA NA NA

Vermont 63.2 65.5 NA NA NA NA NA

Virginia 69.8 73.4 NA NA NA NA NA

Washington 65.2 63.1 NA NA NA NA NA

West Virginia 60.8 60.5 NA NA NA NA NA

Wisconsin 75.2 76.9 NA NA NA NA NA

Wyoming 67.2 64.9 NA NA NA NA NA

* Estimate=NA (Not Available) if the unweighted sample size for the denominator was <30 or (CI half width)/Estimate > 0.588 or (CI half width) >10. Estimates presented as point estimate (%) ± 95% Confidence Interval. † 4 or more doses of DTaP, 3 or more doses of poliovirus vaccine, 1 or more doses of any MMR, full series of Hib (≥3 or ≥4 doses of Haemophilus influenzae type b vaccine depending on product type received--includes primary series plus the booster dose), 3 or more doses of HepB, 1 or more doses of varicella vaccine, and 4 or more doses of PCV. ‡ Self-reported by respondent. Children of Hispanic ethnicity may be of any race. § Children in the Q1/2012-Q4/2012 National Immunization Survey were born from January 2009 through May 2011. Source: http://www.cdc.gov/vaccines/stats-surv/nis/data/tables_2012.htm#overall

10. Percentage of Children Having Well-Child Visits

While it is common to speak about health maintenance among the adult population, children –

and young children in particular – grow rapidly and set a health trajectory that affects future

growth and development. Early identification and response to conditions that can affect that

development is key to healthy development and the reason for regular well-child check-ups.

Bright Futures, a comprehensive document regarding the components of well-child visits, also

contains a periodicity chart for well-child visits, with at least annual visits during the first five

years of life. During a well-child visit, the child health practitioner a doctor or other health care

screens for possible developmental issues and concerns as well as various physical ones. This is

the time when parents can ask any questions regarding the child’s growth, physical and

emotional development, behavior and or other concerns they may have. Well-child visits are

important in early detection of and response to the child’s own health needs and to providing

parents with information (anticipatory guidance) that supports them in providing a healthy

environment and response to their child’s needs.

What Can the Data Tell Us: In most states and nationally, disparities among families of color

and low-income families’ ability to access preventive care, including well-child visit, for their

children are troubling. The following data from the National Survey on Children’s Health shows

that, in some states, the percentage of children of color who do not have preventive care is

twice that for white children. For most states and nationally children living below the poverty

level are twice as likely not to have seen a doctor, nurse, or other health care provider for

preventive medical care in the last 12 months in comparison to children living at 400% or more

of the Poverty level. The percentages of children not having a physical examination or well-

child check-up are higher for the 0-17 population than the 0-5 population because annual

examinations are not necessarily expected for older children. The 0-17 data is shown for

comparative purposes by race/ethnicity and poverty level. It is important for states to put in

place resources and policies that help families of color and families living in poverty to have

better access to preventive care, including well-child visits for children birth to 5 years.

Percentage of children who have Not seen a doctor, nurse, or other health care provider for preventive medical care such as, a physical exam or well-child checkup in the past 12 months or

since birth

Age Race/Ethnicity 0-17 Yrs Old

Federal Poverty Level 0-17 Years Old

Location

0-5 yrs old Hispanic

%

White Non-Hispanic %

Black Non-Hispanic %

Other Non-Hispanic % 0-99%

100-199%

200-399%

400% FPL of higher

National 10.3 19.3 13.6 15.8 15.3 21.5 19 14.1 9.7

Alabama 10.6 23.8 14.7 18.3 14 24.1 14.9 13.8 12.8

Alaska 13.8 22 21.2 11.8 25.2 32.9 24.8 18.8 17.9

Arizona 11.5 21.1 18 10.1 15.4 25.1 19.3 15.5 13.5

Arkansas 12.4 18.9 18.8 23.4 25.7 21.3 22.9 18.6 20.9

California 13 19.8 20 11.7 16.9 32 17.5 17.5 12.4

Colorado 9.1 18.7 11.9 1.8 27.5 17.1 24.6 12.7 10.1

Connecticut 8.7 13.3 7.6 12.5 9.8 15 13.3 8.7 7.1

Delaware 8.8 21.2 8.4 10.9 10.2 19.3 13.4 8 9.1


9.8 12.5 2 11.2 4.4 19.9 6.8 6.3 4.9

Florida 13.1 19.8 15.4 18.9 15.3 22.3 21 15.3 10.7

Georgia 11.8 25.5 14.8 21.4 15.6 28 23.2 14.9 9.4

Hawaii 8.9 16.1 12.5 7.3 16.5 24 17.8 13.5 9.8

Idaho 13.5 23.9 27.2 7.4 29.9 22.1 28.8 28.5 27.2

Illinois 6.5 14.8 9.6 9.4 11.6 15 14.9 8.2 7.6

Indiana 11 21.1 14.5 13.3 20 24.1 16.6 11.6 11.4

Iowa 8.9 28.1 14.1 6.9 20 21 19.6 15.5 8.1

Kansas 8.2 16.5 13.9 13.2 22.6 19.4 20.3 14.8 7.5

Kentucky 5.6 18.7 12.8 10.8 15.7 12.6 16.5 14.3 8.7

Louisiana 14.9 23.9 20.1 19.3 23.4 20 22.1 22.4 16.2

Maine 9.3 13.9 12.5 0.5 13.3 16.2 17.2 10.8 6.5

Maryland 9.3 10.4 10.1 14 11.1 11.6 24 12.1 7.6

Massachusetts 9.4 14.6 5.5 17.3 11.8 14.8 14.9 8.2 4.8

Michigan 8.2 14.8 13 17 13.4 15.6 16.5 13.8 9.4

Minnesota 10.8 23.1 22.3 16.1 20.1 24.9 24 24.6 15.6

Mississippi 14.9 28.7 22 22.6 26.9 26.9 26.2 18.4 16.9



























Percentage of children who have Not seen a doctor, nurse, or other health care provider for preventive medical care such as a physical exam or well-child checkup in the past 12 months or

since birth

Age Race/Ethnicity

0-17 Yrs Old Federal Poverty Level

0-17 Years Old

Location

0-5 yrs old

Hispanic %




100-199%

200-399%

400% FPL of higher

Missouri 11.5 11.6 14.8 18.4 19.6 20.1 22.9 12.6 9.3

Montana 13.3 29.5 23.8 20.4 17.6 18.4 28.2 22.6 20.1

Nebraska 10.5 22.5 14.4 15.3 18.6 20.4 19.1 16.7 11.6

Nevada 13.1 29.7 22.4 22.2 24.6 29.9 32.8 19.6 19.1

New Hampshire

5.3 15.9 7.7 29.2 14.9 17.8 12.2 6.1 7.4

New Jersey 11.6 12 5.4 13.7 9.7 17.7 13.4 9.9 3.4

New Mexico 15 20.6 18.8 22.6 20.9 23 22.2 17.4 15

New York 7.7 14.5 5.4 8.8 5.4 14.6 8.5 6.9 4.2

North Carolina 11.6 20.7 14.7 16.8 23.8 21.5 21.4 14.6 11.2

North Dakota 15 30.8 20.3 37.5 20.7 24.5 26.2 21.4 16.4

Ohio 6.1 23.8 10.6 15.3 14.2 16.6 17.1 10.8 5.9

Oklahoma 10.5 25.2 18.6 26.5 14.9 24.3 19.8 19.4 14.3

Oregon 12.6 31.8 16.3 23.5 22.7 24.8 25.4 20 13.5

Pennsylvania 7.8 17.1 8.5 10 8.5 16.9 8.4 7.2 7.8

Rhode Island 7.8 14.8 7.2 15.3 7.9 19 15.8 6.2 4.2

South Carolina 12.3 21.4 17.1 20.2 18.8 19.6 20.1 17.1 18.3

South Dakota 14.7 20.9 26.3 31.1 28.2 29.1 28.6 27.6 21.5

Tennessee 10.8 20.6 10.7 17.7 13.7 17.7 13.6 10.8 10.5

Texas 9.9 19.4 14.7 12.4 12.8 19.9 23.5 14.3 8.9

Utah 12.3 30.5 21.2 7 32.9 32.3 26.4 21.2 19.2

Vermont 4.8 6.5 9.5 0 6 7.6 12.7 8.4 7.7

Virginia 6.3 15.2 10.5 19 12.5 20.5 21.1 12.5 7.5
























Washington 7.6 22.6 15.2 13.8 14.3 18.8 23.9 18.2 10.7

Percentage of children who have Not seen a doctor, nurse, or other health care provider for preventive medical care such as a physical exam or well-child checkup in the past 12 months or

since birth

Age Race/Ethnicity

0-17 Yrs Old Federal Poverty Level

0-17 Years Old

Location

0-5 yrs old

Hispanic %




100-199%

200-399%

400% FPL of higher

West Virginia 8.5 11.7 11.5 10.7 6.4 12.2 14.8 9.8 9.2

Wisconsin 6.6 16 14.4 16.5 8.8 18 14.8 14.8 11.4

Wyoming 13.1 18.3 19.7 11.1 19 20.3 22.4 19 16.5 Source: National Survey of Children's Health. NSCH 2011/12. Data query from the Child and Adolescent Health Measurement Initiative, Data

Resource Center for Child and Adolescent Health website. Retrieved [11/15/2013] from www.childhealthdata.org.





11. Children 10 Months to 5 Years Screened for Developmental, Behavioral, and

Social Delays

Child screening is important for early detection of developmental and social-emotional issues.

In general, the earlier that a child with developmental and/or social emotional delays is

provided services the better the outcome. Children’s preventive well-child visits almost always

focus on the physical health of the child. While this is important, it is only part of a child’s

overall health. Screening also should include developmental, behavioral and social delays. In

addition, screening for environmental risk factors, such as; poverty, parental depression, and

domestic violence, can identify environmental factors which have a compounding effect on the

child’s overall development. For most young children, especially children under three years,

the health provider is the only professional in contact with the family. Therefore, this often is

the only opportunity for a young child to have a comprehensive developmental screening that

includes screening for environmental risk factors.

What Can the Data Tell Us: The data from the National Survey on Children’s Health shows that

most medical practitioners are not conducting developmental screenings as a routine part of

seeing young children for their regular well-child visits. Unlike most of the indicators provided,

there is little difference across racial and income groups. In part, this may be because Medicaid

does emphasize the importance of screening through its Early, Periodic, Screening, Diagnosis,

and Treatment (EPSDT) provisions. Still, less than one-third of all parents report their child

received a developmental screen during their young child’s health visit. Working to support

practitioners to include developmental screening as part of their preventative well-child visits

routine is imperative in identifying and responding to young children and their families who

may need additional support and resources.

Percentage of children who during the past 12 months was NOT screened for being at risk for developmental, behavioral and social delays using a parent-reported

standardized screening tool during a health care visit age 10mo.-5yrs

Region Hispanic

%

White, non-

Hispanic %

Black, non-

Hispanic %

Other, non-

Hispanic %

0-99% FPL

100-199% FPL

200-399% FPL

400+% FPL

National 67.6 70.1 68.3 68.8 68.2 68.7 70.3 69.5

Alabama

79.8 77 75.7 45.1 72.9 78.3 79.9 68.1

Alaska

49.8 69.4 56.5 67.8 79 66.9 65.5 56



Arizona

86.4 70.1 96.3 70.5 83 72.3 78.9 76.2

Percentage of children who during the past 12 months was NOT screened for being at

risk for developmental, behavioral and social delays using a parent-reported standardized screening tool during a health care visit age 10mo.-5yrs

Region Hispanic

%

White, non-

Hispanic %

Black, non-

Hispanic %

Other, non-

Hispanic %

0-99% FPL

100-199% FPL

200-399% FPL

400+% FPL

Arkansas

68.8 76.6 71.3 68.7 66.9 84 77.1 66.5

California

67.6 72.5 89.6 77.8 69.7 77.2 71.4 69.6

Colorado

53.9 53.5 13.9 57.4 62 60.6 43.6 50.7

Connecticut

78 71.4 65.9 82.7 70.6 76.5 74.2 72.9

Delaware

61.8 69.8 72.2 71.3 79.5 69.5 60.3 68.9


81 81.3 76.3 84.5 79.8 79.3 65.8 82.9

Florida

80.3 74.8 72.6 68.6 72.5 89.6 67.2 77

Georgia

65.9 63.9 54.6 42.5 65.4 50.6 61.8 57.8

Hawaii

61.2 56.7 37.9 63.8 54.3 57 66.3 65

Idaho

69.2 77.7 100 54 69.5 71.6 81.6 78.9

Illinois

58.6 68.1 59.7 83.1 56.5 60.6 72 72.4

Indiana

67 78.1 71.7 76.2 78.9 69.3 81.5 75.3

Iowa

51.1 67.5 46.4 71.1 70.2 68.1 65.2 59.5

Kansas

61.8 66.5 55.3 49.9 51.1 67.5 59 72

Kentucky

78.9 73.6 63.5 78.3 62.4 85 77.9 68.9

Louisiana

69.6 70.4 53 46.5 55.6 71.6 58.5 70.6

Maine

74.2 73.9 90.7 63.7 68.1 66.3 76.4 80.3

Maryland

85 64.7 65.7 65.6 83.3 71.3 72.4 57.8

Massachusetts

32.4 51.3 26 45.8 25.6 25.7 51.2 54.1

Michigan

93.4 77.1 62.8 57.2 75.4 74.6 73.9 74.7

Minnesota

56.8 51.9 70.4 60.8 63.2 38.1 62.7 53.6

Mississippi

97.6 84.1 80.5 69 82.2 82 84.1 80.8

Missouri

77.3 73 60.6 72.3 68.8 71.4 72.6 75.6

Montana

56.7 77.1 63.9 86.5 80.5 75.7 77.4 73.5

Nebraska

75 67.3 59.6 49.3 68.8 79 62.2 63.5

Nevada

76.7 79.2 76.5 82.3 71.4 76.8 77.2 89.3





























Percentage of children who during the past 12 months was NOT screened for being at risk for developmental, behavioral and social delays using a parent-reported

standardized screening tool during a health care visit age 10mo.-5yrs

Region Hispanic

%

White, non-

Hispanic %

Black, non-

Hispanic %

Other, non-

Hispanic %

0-99% FPL

100-199% FPL

200-399% FPL

400+% FPL

New Hampshire

68.4 69.1 82 73.7 77.7 74.8 66.4 66.1

New Jersey

76.3 76.2 69.2 74 78.1 72.4 73 76.8

New Mexico

62.3 65.5 51 58.5 60.9 63.3 62 60.9

New York

79.1 79.2 84.8 75.6 78.8 75.5 77.8 81.1

North Carolina

39.8 38.3 48 51.6 44.8 43.8 40.3 38.3

North Dakota

63.6 81.2 100 67.7 77.5 82.2 75.4 83.2

Ohio

53.1 73.9 79.2 65.9 72.3 74.6 70.6 71.3

Oklahoma

66.4 72.3 64.6 68.5 64.6 72 70.5 78

Oregon

65.9 64.3 35.8 79.5 62.7 65.4 68.3 65.9

Pennsylvania

77.2 73.7 63.3 53.2 63.9 52.4 75.3 76.8

Rhode Island

68.8 68.3 76.8 74 58.6 85.2 62.2 70.6

South Carolina

70.4 69.5 72.6 65 70.4 64.3 73.1 72.3

South Dakota

65.1 76.2 78.4 80.5 70.9 81.9 76.5 76.3

Tennessee

50.3 60.5 62.4 70.8 58.4 52.5 66.9 69.8

Texas

60.2 78.3 81.6 76.8 65.8 65.9 75.2 71.1

Utah

78 71.8 100 73.9 72.2 73.5 77.9 64

Vermont

83.7 69.2 100 55.8 69.6 77.4 63.3 64.2

Virginia

74.8 71.6 68.1 65 70.5 68.1 75.2 69.1

Washington

69.2 70.7 92.8 65.7 71.3 73.2 65.8 71.3

West Virginia

51 60.6 57.1 79.6 58.4 57.2 67.8 64.9

Wisconsin

63.6 68.7 84.2 49.4 68.2 74.6 68.1 50.5

Wyoming

72.7 70.8 100 69.3 62.3 68.5 77.9 69.3 Source: National Survey of Children's Health. NSCH 2011/12. Data query from the Child and Adolescent Health Measurement Initiative, Data Resource Center for Child and Adolescent Health website. Retrieved [10/30/2013] from www.childhealthdata.org.
























12. Participation in Part C By Race/Ethnicity

Identifying early any disabilities a child, especially a young child has is vital for their healthy

development. The earlier that a child receives services, the better the outcome is for the child. Part C of

the Individual Disability Education Act (IDEA) is a federal grant program that supports states in providing

comprehensive early intervention services for infants and toddlers, up to age 3 with disabilities. States

that participate agree to make the program available to any child that is eligible. Different states have

different policies and eligibility criteria for Part C early intervention services for 0-2 under the IDEA.

Some states supplement federal funding with state funding, while others do not. Some do extensive

outreach.

What Can the Data Tell Us: Overall participation rates in Part C vary from 1.6 percent of the

population in several states (Alabama, Georgia, Oklahoma, and Tennessee) to 6.7 percent of the

population (Massachusetts). The average rate of participation is 2.8 percent across the United States.

The rate of service receipt is somewhat higher for White, non-Hispanic young children (3.0 percent) than

for either American non-Hispanic children (2.8 percent) or Hispanic children (2.6 percent), although

relative participation rates by race and ethnicity also vary substantially by state. For instance, the four

states with the lowest participation rates all serve a smaller percentage of children of color than White,

non-Hispanic children; while the state serving the largest percent serves a greater percentage of

children of color. Outreach to traditionally underserved populations may be needed to ensure they are

identified and participate in such early intervention services.

Children Receiving Intervention Services Under IDEA, Part C Age 0-2

State Total Receiving

Services % White

Non-Hispanic Receiving

Services %

Alabama 182,171 2,991 1.6% 102,769 1,699 1.7%

Alaska 32,731 797 2.4% 16,660 366 2.2%

Arizona 270,519 4,850 1.8% 106,198 2,717 2.6%

Arkansas 117,194 3,140 2.7% 73,000 1,673 2.3%

California 1,507,814 32,575 2.2% 380,512 8,779 2.3%

Colorado 203,659 5,806 2.9% 112,464 3,320 3.0%

Connecticut 117,688 4,431 3.8% 64,033 2,414 3.8%

Delaware 33,154 925 2.8% 16,192 412 2.5%

District of Columbia 20,551 467 2.3% 5,201 56 1.1%

Florida 637,815 11,955 1.9% 273,368 4,486 1.6%

Georgia 406,969 6,640 1.6% 178,794 3,033 1.7%

Hawaii 53,219 1,863 3.5% 8,183 293 3.6%

Idaho 72,475 1,717 2.4% 54,340 1,380 2.5%

Illinois 495,710 18,576 3.7% 248,866 9,725 3.9%

Indiana 257,202 8,976 3.5% 180,840 6,687 3.7%

Iowa 119,932 3,605 3.0% 94,271 2,731 2.9%

Kansas 123,099 4,141 3.4% 79,908 2,875 3.6%

Kentucky 168,074 4,592 2.7% 130,615 3,626 2.8%

Louisiana 188,193 5,106 2.7% 94,803 2,626 2.8%

Maine 40,596 982 2.4% 35,595 937 2.6%

Maryland 217,560 7,380 3.4% 92,025 3,480 3.8%

Massachusetts 217,691 14,519 6.7% 134,771 8,574 6.4%

Michigan 350,984 10,285 2.9% 229,099 7,084 3.1%

Minnesota 211,087 5,077 2.4% 145,652 3,704 2.5%

Mississippi 125,257 2,122 1.7% 59,605 1,052 1.8%

Missouri 231,982 5,024 2.2% 167,334 3,659 2.2%

Montana 37,122 728 2.0% 28,911 544 1.9%

Nebraska 79,031 1,496 1.9% 54,481 1,131 2.1%

Nevada 111,905 2,544 2.3% 42,169 1,112 2.6%

New Hampshire 40,474 1,775 4.4% 34,223 1,593 4.7%

New Jersey 319,713 10,570 3.3% 147,984 5,500 3.7%

New Mexico 86,492 4,705 5.4% 21,464 1,053 4.9%

New York 693,268 28,645 4.1% 335,804 16,228 4.8%

North Carolina 376,163 10,163 2.7% 193,877 5,044 2.6%

North Dakota 26,985 922 3.4% 21,310 745 3.5%

Ohio 425,980 14,103 3.3% 301,710 10,036 3.3%

Oklahoma 157,953 2,564 1.6% 83,415 1,871 2.2%

Oregon 141,405 2,990 2.1% 89,378 2,042 2.3%

Pennsylvania 432,581 19,036 4.4% 291,814 12,903 4.4%

Rhode Island 33,788 1,928 5.7% 19,698 1,066 5.4%

South Carolina 180,307 4,405 2.4% 93,626 2,307 2.5%

South Dakota 35,671 1,091 3.1% 25,846 729 2.8%

Tennessee 242,477 4,000 1.6% 155,248 2,659 1.7%

Texas 1,151,310 23,613 2.1% 362,004 7,942 2.2%

Utah 159,028 3,392 2.1% 118,704 2,475 2.1%

Vermont 18,676 785 4.2% 16,809 717 4.3%

Virginia 303,439 8,384 2.8% 162,482 4,863 3.0%

Washington 264,022 5,567 2.1% 149,577 3,113 2.1%

West Virginia 61,983 2,499 4.0% 54,874 2,304 4.2%

Wisconsin 212,019 6,011 2.8% 146,984 4,009 2.7%

Wyoming 24,034 1,178 4.9% 18,544 932 5.0%

United States 12,019,152 331,636 2.8% 6,056,034 180,306 3.0%

Continuation….

Children Receiving Intervention Services Under IDEA, Part C

Age 0-2

State

African American,

Non-Hispanic

Receiving Services % Hispanic

Receiving Services %

Alabama 54,572 932 1.7% 15,366 245 1.6%

Alaska 915 24 2.6% 2,877 36 1.3%

Arizona 10,657 101 0.9% 122,079 1,682 1.4%

Arkansas 21,945 1,166 5.3% 14,726 231 1.6%

California 77,414 1,888 2.4% 806,803 18,158 2.3%

Colorado 8,205 247 3.0% 67,313 1,826 2.7%

Connecticut 13,018 496 3.8% 28,055 1,272 4.5%

Delaware 8,161 215 2.6% 5,340 135 2.5%

District of Columbia 11,033 300 2.7% 2,821 95 3.4%

Florida 132,657 2,825 2.1% 185,984 3,988 2.1%

Georgia 133,020 2,369 1.8% 63,866 887 1.4%

Hawaii 805 NA NA 9,160 153 1.7%

Idaho 491 15 3.1% 13,664 243 1.8%

Illinois 76,815 2,769 3.6% 126,350 5,303 4.2%

Indiana 28,512 889 3.1% 30,098 980 3.3%

Iowa 5,174 185 3.6% 12,428 409 3.3%

Kansas 8,020 291 3.6% 23,791 729 3.1%

Kentucky 15,515 425 2.7% 11,109 271 2.4%

Louisiana 70,304 2,091 3.0% 12,299 194 1.6%

Maine 1,160 10 0.9% 1,196 13 1.1%

Maryland 68,675 2,252 3.3% 30,471 956 3.1%

Massachusetts 16,369 1,433 8.8% 38,061 3,419 9.0%

Michigan 58,792 1,951 3.3% 31,343 739 2.4%

Minnesota 17,815 466 2.6% 19,988 399 2.0%

Mississippi 54,409 960 1.8% 6,073 55 0.9%

Missouri 31,571 818 2.6% 16,117 195 1.2%

Montana 171 NA NA 2,079 24 1.2%

Nebraska 4,550 71 1.6% 13,773 209 1.5%

Nevada 8,808 196 2.2% 46,357 927 2.0%

New Hampshire 651 NA NA 2,488 68 2.7%

New Jersey 43,931 1,136 2.6% 83,267 2,942 3.5%

New Mexico 1,286 86 6.7% 51,586 3,019 5.9%

New York 104,849 3,849 3.7% 171,767 6,609 3.8%

North Carolina 85,194 2,781 3.3% 64,054 1,816 2.8%

North Dakota 587 17 2.9% 1,211 21 1.7%

Ohio 64,545 2,503 3.9% 26,576 814 3.1%

Oklahoma 12,342 216 1.8% 26,747 133 0.5%

Oregon 3,017 85 2.8% 33,015 679 2.1%

Pennsylvania 57,656 2,697 4.7% 47,902 2,236 4.7%

Rhode Island 2,328 105 4.5% 8,095 634 7.8%

South Carolina 57,210 1,492 2.6% 18,232 442 2.4%

South Dakota 747 32 4.3% 1,966 59 3.0%

Tennessee 48,225 821 1.7% 23,864 325 1.4%

Texas 128,367 2,301 1.8% 585,766 12,549 2.1%

Utah 1,717 38 2.2% 27,702 665 2.4%

Vermont 299 12 4.0% 461 9 2.0%

Virginia 60,963 1,707 2.8% 41,126 883 2.1%

Washington 10,291 203 2.0% 57,775 1,441 2.5%

West Virginia 2,180 97 4.4% 1,500 27 1.8%

Wisconsin 19,236 655 3.4% 26,559 927 3.5%

Wyoming 193 19 9.8% 3,600 153 4.3%

United States 1,645,367 46,237 2.8% 3,064,846 80,224 2.6%

Source: United States Census Bureau, 2010 Census and Early Childhood Technical Assistance Center Data Tables

13. Children Under 6 Years Exposure to Risk Factors

Risk factors such as low parental education, unemployment, adolescent parenting, and

residential mobility can negatively affect a young child’s development. These effects are more

severe when they are combined with poverty. When poor families have such risk factors, they

are less able to get resources to mitigate the effects on their family’s physical and mental

health, including their child’s development. These experiences are often referred to as adverse

childhood experiences and can shape a child’s overall development – not just cognitive and

emotional, but long term physical health as well. A growing body of evidence now links early

childhood adversity in childhood to increased risk of a range of adult health problems, including

diabetes, hypertension, stroke, obesity, and some forms of cancer. The National Center for

Children in Poverty states that children with three or more risks factors and living in poverty are

exceptionally vulnerable. These risk factors increase the likelihood that young children will

experience high levels of stress. Frequent stress on a child, without adequate support and

protection from the adults in their life, results in what the Center for the Developing Child

refers to as “toxic stress” and its long lasting developmental effects on the child.

What Can the Data Tell Us: Data from the National Center for Children in Poverty (NCCP) shows the percentage of children nationally and by state experiencing poverty and specific risk factors, such as: households without English speakers, large family, low parental education, residential mobility, single parent, teen mother and nonemployed parent(s). These risk factors were chosen because they are known to increase the chance of poor health, school, and developmental outcomes for young children

Nationally, only four in ten (39%) of young children live in families with no risk factors, and one in five live in families with three or more risk factors. Understanding children and family poverty levels in combination with risk factors families with young children experience; helps to guide policies that can improve outcomes for vulnerable children.

Children Under 6 Years Risk Factors

Location No Risk 1-2 Risk 3+ Risk

National 39% 41% 20%

Alabama 37% 40% 23%

Alaska 35% 50% 14%

Arizona 30% 47% 22%

Arkansas 35% 44% 21%

California 35% 44% 21%

Colorado 43% 42% 15%


Location No Risk 1-2 Risk 3+Risk

Connecticut 51% 36% 13%

Delaware 39% 45% 16%

District of Colombia 33% 42% 25%

Florida 36% 43% 21%

Georgia 37% 42% 21%

Hawaii 42% 47% 11%

Idaho 40% 47% 13%

Illinois 43% 39% 18%

Indiana 40% 41% 20%

Iowa 47% 39% 14%

Kansas 41% 42% 17%

Kentucky 38% 39% 22%

Louisiana 35% 41% 24%

Maine 46% 42% 12%

Maryland 44% 43% 13%

Massachusetts 51% 35% 14%

Michigan 41% 40% 20%

Minnesota 51% 36% 13%

Mississippi 32% 42% 26%

Missouri 40% 40% 19%

Montana 43% 42% 15%

Nebraska 44% 42% 14%

Nevada 31% 48% 22%

New Hampshire 60% 30% 10%

New Jersey 49% 38% 14%

New Mexico 30% 47% 23%

New York 42% 41% 18%

North Carolina 40% 40% 21%

North Dakota 52% 41% 8%

Ohio 41% 38% 21%

Oklahoma 36% 45% 19%

Oregon 40% 41% 19%

Pennsylvania 45% 38% 17%

Rhode Island 42% 39% 19%

South Carolina 37% 41% 22%

South Dakota 46% 41% 13%

Tennessee 39% 41% 21%


Location No Risk 1-2 Risk 3+Risk

Texas 34% 43% 23%

Utah 43% 48% 9%

Vermont 49% 39% 12%

Virginia 46% 41% 13%

Washington 43% 41% 16%

West Virginia 44% 38% 19%

Wisconsin 46% 38% 16%

Wyoming 43% 44% 13% National data were calculated from the 2011 American Community Survey, representing information from 2011. State data were calculated from the 2009-2011 American Community Survey, representing information from the years 2009 to 2011. SOURCE: National Center for Children in Poverty 2012

14. Mothers’ Mental Health by Race/Ethnicity and Income

A mother’s mental and emotional health plays a key role in her child’s development. A child’s

healthy development is dependent on having a close nurturing relationship with the child’s

primary caretaker. When a mother is suffering from depression, anxiety, or another mental

health concern, she is much less able to respond adequately to her child’s needs. This lack of

response interferes with the bonding that is critical for healthy social emotional development

of her child. Social and emotional health is critical to all other parts of a child’s development.

Without a strong social emotional foundation other developmental domains suffer.

What Can the Data Tell Us: Data from the National Survey on Children’s Health indicates that

poverty is an important indicator of a mother’s reported mental health. Mothers who are

below the federal poverty level are seven times more likely to have their mental state rated as

fair or poor than mothers at or above 400 percent of the poverty level. Women of color are

significantly more likely to suffer from mental health issues than White, non-Hispanic women –

which research shows can be the result of discrimination and the stress such discrimination

produces. The national data showing disparities in income and race/ethnicity mirrors data

found in most states. Data on a mother’s mental health helps advocates be more intentional in

implementing programs, such as maternal mental health screening, designed to reach women

living in poverty as well as women of color and respond to their needs.

Child Health Survey Information Status of Mother's Mental and Emotional Health as Fair/Poor

Locataion

Hispanic

%

White,

non-

Hispanic

%

Black,

non-

Hispanic

%

Other,

non-

Hispanic

%

0-

99%

FPL

100-

199%

FPL

200-

399%

FPL

400+%

FPL

National 10 5.7 11.4 8.4 15.5 9.8 4.9 2.8

Alabama 14.4 5.7 12.6 6.7 16.2 8 4.8 3.4

Alaska 8.2 5.8 5.9 10 14.8 9.9 3.5 3.8

Arizona 10.3 5.4 13.1 15.6 14.8 12.9 4.4 2.6

Arkansas 9.8 6.7 15.4 7.4 18.2 9 2.4 4.5

California 12.4 4.3 4.2 4.9 15.8 10.6 7.4 2.5






Child Health Survey Information

Status of Mother's Mental and Emotional Health as Fair/Poor

Location

Hispanic

%

White,

non-

Hispanic

%

Black,

non-

Hispanic

%

Other,

non-

Hispanic

%

0-

99%

FPL

100-

199%

FPL

200-

399%

FPL

400+%

FPL

Colorado 6.7 3.4 18.7 3.1 7.6 11 3.2 2.3

Connecticut 7.6 4.1 12 4.9 8.3 12.4 5.9 2.9

Delaware 12.1 6.3 12.4 8.6 18.4 11.3 6.8 3.6

District of

Columbia 8 2.5 12.4 4.6 16.4 12.8 5.9 3.1

Florida 5.6 5.8 8.6 10.1 9.2 9.2 4.9 3.2

Georgia 10.4 7.8 9.1 9 14.8 11.4 4.3 4.1

Hawaii 9.5 5.3 6.8 5.4 7.1 10.3 4.3 3.2

Idaho 6.5 4.3 26.3 10.4 10.7 4.2 3.8 1.9

Illinois 10 4.3 14.9 7.2 17.6 7.6 4.1 3.5

Indiana 23.3 5.9 6.5 16.7 17.2 8.3 5.1 5.4

Iowa 14.6 5.3 2.6 4.4 7.7 11.6 4.1 2.9

Kansas 8 5.2 6.4 11.5 12.3 5.5 6 2.8

Kentucky 13.6 9 12 8.4 20.9 8.5 3.6 3.3

Louisiana 16.4 6.6 8.5 10.4 14.6 10.5 3.8 3.5

Maine 15.4 6.6 0 13.1 13.1 10.4 5.2 2.2

Maryland 10.3 2.9 10 12.9 18.8 7.5 6.1 4.4

Massachusetts 6.7 3.4 11.1 8.6 9.6 11.5 3.1 2.8

Michigan 7.3 4.9 17.4 7.6 15 8.7 5.1 1.3

Minnesota 10.8 5.2 20.3 7.5 16.5 11.2 4.5 3.5

Mississippi 19.9 8.4 9.2 14.4 16.6 9.4 4.5 2.7

Missouri 11.6 5.4 10.9 6.8 16.9 8.9 2.3 1.5

Montana 12.2 7.1 21.6 11.4 16.4 8.4 6 2.7

Nebraska 7 5.1 12.3 6.6 7.6 10.6 3.5 4

Nevada 7.1 5.8 13.8 8.8 11.6 9.3 5.8 2.5

New Hampshire 8.1 5.6 28.8 6.8 25 10.5 3.2 1.9

New Jersey 10.2 5.6 9.8 7.4 13.4 10.8 7.3 4

New Mexico 9.9 4.7 0.9 9 12.4 9.1 6.4 2.5





























Child Health Survey Information

Status of Mother's Mental and Emotional Health as Fair/Poor

Location

Hispanic

%

White,

non-

Hispanic

%

Black,

non-

Hispanic

%

Other,

non-

Hispanic

%

0-

99%

FPL

100-

199%

FPL

200-

399%

FPL

400+%

FPL

New York 11.1 5.7 11 9.9 15.5 13.1 4.8 2.8

North Carolina 11.8 6.7 6.5 15.3 16.8 8.6 3.7 3.8

North Dakota 33 6.3 0 4.4 14.7 10.6 4.3 4.2

Ohio 9.6 7.2 20.5 7.1 23.7 8.6 3.8 2.7

Oklahoma 14.4 5.3 10.5 6.4 14.2 9.2 3.9 3

Oregon 10.1 5.3 5.8 10.5 17.3 7.7 3.1 1.8

Pennsylvania 22.4 7.5 24.9 10.5 23.7 18.1 8.1 1.9

Rhode Island 14.4 5.1 10.5 3.9 16.1 8.9 5.4 2.8

South Carolina 10.4 5.4 13.7 9.9 11.2 14.9 5 2

South Dakota 10.6 3.9 7.1 7.3 11 5.8 2.6 3.6

Tennessee 11.2 9.3 15.1 9.4 20.2 13.5 5.4 3.9

Texas 6.5 4.6 10.9 9.2 13.5 7.7 3.3 1.5

Utah 12.7 3.9 0 14.8 16.3 4.7 5 2.3

Vermont 22.6 5.8 0 10.8 21.6 10 3.5 2.2

Virginia 8.9 5.1 5.8 7.9 19.7 6.7 4.3 1.6

Washington 12 5.3 10.8 8.4 13.7 10.6 3.7 5

West Virginia 8.8 10.9 13.2 6.9 20.8 10.2 7.9 3.3

Wisconsin 3 5.9 21.9 9.3 18.1 7.3 5.7 2.1

Wyoming 9.4 5.5 0 10.5 10.7 10.8 5.4 1.3

Source: Source: National Survey of Children's Health. NSCH 2011/12. Data query from the Child and

Adolescent Health Measurement Initiative, Data Resource Center for Child and Adolescent Health

website. Retrieved [10/30/2013] from www.childhealthdata.org.




















15. Neighborhood Safety by Age and Race/Ethnicity

The neighborhood in which a child grows up has important implications for the child’s health,

growth, and development. Economic and social features of neighborhoods—like the perceived

safety of a neighborhood—have been linked with mortality, general health status, birth

outcomes, chronic conditions, health behaviors, mental health, injuries, violence, and other

important health indicators.1 For example, a child that is raised in an unsafe neighborhood may

not feel safe exercising or participating in physical activities. As a result, the child can be at

higher risk for developing obesity and obesity-related conditions like diabetes. The ongoing

stress of living in an unsafe neighborhood can also exert a toll on the mental health and well-

being of children and their families.

What Can the Data Tell Us: Data on the relative safety of children’s neighborhoods indicates

significant racial, ethnic, and economic disparities. The parents of white, non-Hispanic children

are least likely to report that their children do not live in safe neighborhoods. Parents of Black

and Hispanic children are nearly four times more likely than parents of White, non-Hispanic

children to report that their children live in unsafe neighborhoods. Household income and

neighborhood safety are also related. As household income increases, the probability of

parents reporting living in unsafe neighborhoods decreases. Families with household incomes

below 100 percent of the federal poverty level are over 5 times more likely to report living in

unsafe neighborhoods as families with household incomes over 400 percent of the poverty

level. Improving the safety of neighborhoods through economic development, community

investment, and public safety programs can significantly impact the health, growth, and

development of children. The data below identifies disparities in neighborhood safety across

several subgroups and can be used to identify at-risk populations for targeted interventions,

resource allocation, and policy development. Many of the responses required involve

community-level actions (e.g. population health strategies) which go beyond services and

supports to individual families.

1 Where We Live Matters for Our Health: Neighborhoods and Health

https://folio.iupui.edu/bitstream/handle/10244/638/commissionneighborhood102008.pdf

https://folio.iupui.edu/bitstream/handle/10244/638/commissionneighborhood102008.pdf

Children Whose Parents Report They Do Not Live in a Safe Neighborhoods

Region 0-5

years %

6-11 years

%

12-17 years

%

Hispanic %

White, non-

Hispanic %

Black, non-Hispanic %

Other, non-

Hispanic %

0-99% FPL

100-199% FPL

200-399% FPL

400+% FPL

National 14.2 14.3 11.9 22.8 6.8 23 13.1 25.7 16.5 9.7 4.9

Alabama

10.9 13.2 10.6 30 6.6 15.6 16.3 23.1 11.9 7.3 2.3

Alaska

10.3 8 9 11.2 5.7 26 13 20.8 9.7 5.3 3.9

Arizona

16 20.3 15.5 22.7 8 21.1 27.2 32.5 19.9 7.7 6

Arkansas

13.7 10.3 12.2 15.4 6.1 31.5 7 23.8 11.7 7.8 2.3

California

15.8 19.3 19.8 25.4 8.3 16.5 14.3 29.8 27 15.9 5.8

Colorado

8 7.5 9.6 17.1 2.6 28.1 9 22 14.7 3.8 1.1

Connecticut

14.6 10.7 9.9 23.1 4.5 25.4 14.7 31.1 19.2 9.6 3.6

Delaware

12.8 14.4 10.8 19.9 6.9 20.1 14.1 22.3 23.2 8.2 5.5


21.5 27.9 34.2 30.2 4.6 35.1 14.3 35.7 43.7 24.2 11.3

Florida

16.7 14.1 12.8 19.6 10.2 19.6 5.2 24.4 14 11.3 7.4

Georgia

14 14.4 9.2 23.8 6.3 16.8 13.3 22.6 14.7 7.7 4.7

Hawaii

11.5 15.1 12.5 16.1 6.6 6.9 14.4 22.6 15.5 11.7 5.2

Idaho

6.5 4 5.4 10.1 4 17.7 8.2 12.1 5.1 2.4 3

Illinois

16.5 16.1 12.4 27.1 7 24.5 9.6 32.6 18.5 10.3 4.7

Indiana

12.7 13 8.8 26.1 8.7 19.4 7.7 27.4 14.1 5.7 1.9

Iowa

5.9 7.6 4.4 23 3.6 9.9 7.7 12.5 9.3 3.1 2.5

Kansas

9.6 10.3 7.4 18.8 6.3 7.7 12.9 19.1 12.3 5.8 3

Kentucky

11.4 10.5 9.2 17.6 8.4 22.6 12.2 18.6 12.4 7 1.8

Louisiana

13.3 16.8 14.3 16.4 8.3 22.2 15.4 22.1 18.7 9.7 7.6

Maine

9.5 6.3 5.8 21.8 6.4 21 7.7 9.5 10.9 5.9 3

Maryland

11.7 11 11.2 21.9 6.1 15.2 10.7 20.8 19.1 10.7 6

Massachusetts

12.3 16 9.8 24.5 7.2 35.6 13.4 29.7 18.6 12.3 5.2

Michigan

12.8 13.6 13 26.1 6.5 35.2 14.4 30 12.9 8.2 3.5


























Minnesota

10.5 6 3.9 13.2 3.9 21 12.8 20.1 10.9 3.9 1.5

Mississippi

11.5 9.6 15.5 16.9 8.2 17.5 4.7 21.4 13.3 4.4 3.7

Missouri

9.8 9.1 9.1 19.3 5.7 22.5 13.9 20.3 10 5.3 4.1

Children Whose Parents Report They Do Not Live in a Safe Neighborhoods

Montana

8.5 10.4 6.2 8.5 7 13.7 14.6 20.5 9.9 4 2.4

Nebraska

10.7 7.3 8.2 24.3 4 29.9 7.6 22.5 9.9 6.2 2.8

Nevada

19.3 12.7 19.3 21.1 9.2 17.5 26 23.3 21.6 14.1 9.2

New Hampshire

9.5 5 4.6 14.1 5.1 17.4 13.7 21.4 8.8 4.8 2.3

New Jersey

18.3 14.4 9.9 24.1 4.4 30 14.9 30.3 26.9 11.4 4.8

New Mexico

17.9 18.7 11.7 16.8 7.8 28.7 25.1 24.1 14.7 16.2 5.1

New York

23.7 22.3 14.8 29.4 8.7 46.3 16.7 41.7 19.8 15.2 9.7

North Carolina

10.4 15.3 5.8 19.2 4.5 20.3 9.2 18.3 12.7 8.2 2.6

North Dakota

5.7 7.3 4.8 10.2 5.9 21.1 4.2 12.5 6.4 4.9 4.4

Ohio

11.7 13.7 10 26.5 7.4 29.5 11.9 24.8 15.7 6.1 2.6

Oklahoma

12.1 10.6 12 21.6 8.6 16 10.6 20.8 13.9 7.2 4.4

Oregon

12.5 10.9 9.7 19.7 6.9 15.6 15 20.2 14.6 6.9 3.8

Pennsylvania

14.7 13.1 10.3 40.3 6 28.7 12.9 29.5 15.5 8.3 4.1

Rhode Island

17.2 16.4 12.4 34.3 7.5 24.4 17.3 37.6 19 11.1 3.5

South Carolina

14.1 13.5 12.2 22.6 7.6 20.5 14.7 22.2 18 8 2.2

South Dakota

7.5 7.1 5 15.4 4.3 4.1 14.6 16.3 10.5 3.4 1.9

Tennessee

14.7 12.5 9.1 19.5 8.6 21.4 7.1 22.4 13.1 5.9 6.1

Texas

15.5 16.8 12.7 19.4 7.7 19.2 13.2 21.8 17 14.5 6.3

Utah

6.4 4.1 6.3 17.7 2.9 2.4 3.7 15.9 6.2 3 1.8

Vermont

7.1 6.3 4.5 0.8 5.8 22 6.5 17.3 10.1 4.1 0.7

Virginia

10.2 8.6 8.4 18.3 5.4 12.3 11.8 16 11.9 10.8 3.9

Washington

13.1 12.1 7.9 23.4 6.2 14.9 13.4 27.6 9.6 9 4.5

West Virginia

9.7 9.3 6.3 19.2 7.7 18.6 11.5 12.9 10.4 6.3 4.3

Wisconsin

14.7 9.2 7.9 14.3 6.3 39.5 10.5 29.4 13.2 5.2 2.7

Wyoming

5.2 9.1 3 11.5 4.4 0 10.1 11.4 5 5.8 4.1 Source: National Survey of Children's Health. NSCH 2011/12. Data query from the Child and Adolescent Health Measurement Initiative, Data Resource Center for Child and Adolescent Health website. Retrieved [11/15/2013] from www.childhealthdata.org.





































16. NAEP 4th Grade Reading Proficiency Scores

Reading proficiency by the end of 3rd grade, as measured by National Assessment of

Educational Progress (NAEP) scores at the beginning of 4th grade, can be a turning point in a

child’s educational career. Prior to the completion of 3rd grade, most students are learning to

read. After the completion of 3rd grade, students are reading to learn—using their reading skills

to gain information, solve problems and think critically. Fourth grade reading scores serve as a

crucial marker in children’s educational development. Reading proficiency also is a lagging

indicator of “what children know and can do at the time of kindergarten entry (school

readiness). Currently, there is no comparative information across states (and often across

subpopulations) to compare children’s development at kindergarten, although select national

research shows there are profound differences in children’s school readiness by class, income,

and ethnicity. While schools should be responsible for narrowing such gaps, the research also

shows that third grade reading proficiency is strongly correlated with measures of school

readiness at the time of kindergarten entry.

What Can the Data Tell Us: Reading proficiency varies by race and ethnicity as well as by

income. National averages from 2013 reveal that white, non-Hispanic fourth graders scored

approximately 25 points higher on fourth grade reading assessments than their African-

American and Hispanic peers. A similarly large disparity exists between students who are

eligible for free or reduced meals (FRM) and students who are not eligible for free or reduced

meals. Nationally, students who are eligible for FRM scored 29 points lower than students who

were not eligible for FRM. Identifying and addressing disparities in reading proficiency is

important because low-achievement in reading has significant long-term consequences in

terms of individual earning potential, global competitiveness and general productivity. Often,

state “rankings” on fourth grade reading proficiency vary dramatically when examined not in

terms of overall scores but by different subgroups. States with relatively small low-income

children or small non-white populations may appear relatively high on overall proficiency

rankings, but look much worse when examined by different subpopulations.

2013 NAEP 4th Grade Reading Scores: Race and Ethnicity

Jurisdiction

All students

2013 Scale Score

White 2013 Scale Score

Black 2013 Scale Score

Hispanic 2013 Scale Score

White - Black

difference 2013 Scale Score

White - Hispanic


Hispanic -

Black difference

2013 Scale Score

National 221 231 205 207 26 24 1

Alabama 219 227 202 206 25 22 3

Alaska 209 228 203 213 25 14 10

Arizona 213 228 206 202 23 26 -3

Arkansas 219 226 200 211 25 15 11

California 213 232 202 201 30 31 -1

Colorado 227 237 203 210 34 27 7

Connecticut 230 238 208 209 31 29 2

Delaware 226 235 213 216 22 19 3

D.C. 206 259 197 208 62 51 11

Florida 227 236 212 225 24 11 12

Georgia 222 233 209 213 24 20 4

Hawaii 215 231 223 211 8 21 -12

Idaho 219 224 ? 198 ? 26 ?

Illinois 219 231 199 204 32 27 6

Indiana 225 229 207 215 22 14 8

Iowa 224 227 200 210 28 17 10

Kansas 223 230 200 208 30 22 8

Kentucky 224 227 204 220 23 7 16

Louisiana 210 223 198 212 26 11 14

Maine 225 226 192 ? 34 ? ?

Maryland 232 244 214 224 31 20 10

Massachusetts 232 241 209 208 31 32 -1

Michigan 217 224 196 209 28 15 13

Minnesota 227 233 208 207 25 25 -1

Mississippi 209 222 197 206 26 16 10

Missouri 222 228 200 219 28 9 19

Montana 223 228 ? 214 ? 14 ?

Nebraska 223 229 202 207 27 22 5

Nevada 214 226 201 202 26 24 1

New Hampshire

232 233 215 209 18 25 -6

2013 NAEP 4th Grade Reading Scores: Race and Ethnicity

Jurisdiction

All students

2013 Scale Score

White 2013 Scale Score

Black 2013 Scale Score

Hispanic 2013 Scale Score

White - Black


White - Hispanic


Hispanic -

Black difference

2013 Scale Score

New Jersey 229 238 211 212 26 26 0

New Mexico 206 225 210 201 15 24 -10

New York 224 233 211 210 22 23 -1

North Carolina 222 232 210 210 23 22 0

North Dakota 224 227 211 217 17 10 7

Ohio 224 231 195 214 36 17 18

Oklahoma 217 223 201 204 23 19 4

Oregon 219 225 200 199 25 26 -1

Pennsylvania 226 233 208 208 25 24 1

Rhode Island 223 233 205 201 28 32 -4

South Carolina 214 224 197 211 27 13 14

South Dakota 218 225 202 207 23 18 5

Tennessee 220 227 201 203 26 24 2

Texas 217 233 209 206 24 27 -3

Utah 223 229 ? 196 ? 33 ?

Vermont 228 229 ? ? ? ? ?

Virginia 229 236 211 211 25 25 0

Washington 225 232 211 205 20 26 -6

West Virginia 215 215 203 ? 12 ? ?

Wisconsin 221 228 193 201 36 27 8

Wyoming 226 229 ? 215 ? 14 ?` ? = Reporting standards not met. NOTE: Black includes African American, Hispanic includes Latino, and Pacific Islander includes Native Hawaiian. Race categories exclude Hispanic origin. Prior to 2011, students in the "two or more races" category were categorized as "unclassified." National public is included for reference only and is not included in sorting the jurisdictions. Score differences are calculated based on differences between unrounded average scale scores. SOURCE: National Center for Education Statistics (NCES) Institute of Education Sciences (IES) National Assessment of Educational Progress (NAEP) http://nces.ed.gov/nationsreportcard/naepdata/report.aspx

http://nces.ed.gov/nationsreportcard/naepdata/report.aspx

2013 NAEP 4th Grade Reading Scores: Free and Reduced Meal (FRM) Eligibility

Jurisdiction

All students 2013

Scale Score

FRM Eligible 2013

Scale Score

Not FRM eligible

2013 Scale Score

Eligible - Not eligible Difference 2013

Scale Score

National 221 207 236 -29

Alabama 219 207 236 -29

Alaska 209 193 226 -33

Arizona 213 201 228 -28

Arkansas 219 209 233 -24

California 213 200 232 -32

Colorado 227 210 239 -29

Connecticut 230 210 242 -32

Delaware 226 215 238 -23

D.C. 206 195 245 -50

Florida 227 218 242 -24

Georgia 222 211 239 -28

Hawaii 215 201 229 -28

Idaho 219 208 230 -22

Illinois 219 202 235 -33

Indiana 225 215 237 -22

Iowa 224 208 234 -26

Kansas 223 210 238 -29

Kentucky 224 213 237 -23

Louisiana 210 203 230 -27

Maine 225 214 234 -20

Maryland 232 216 242 -27

Massachusetts 232 213 245 -31

Michigan 217 206 231 -25

Minnesota 227 209 237 -28

Mississippi 209 201 231 -30

Missouri 222 211 236 -25

Montana 223 212 233 -21

Nebraska 223 209 234 -25

Nevada 214 203 230 -27

New Hampshire

232 216 238 -22

2013 NAEP 4th Grade Reading Scores: Free and Reduced Meal (FRM) Eligibility

Jurisdiction

All students 2013

Scale Score

FRM Eligible 2013

Scale Score

Not FRM eligible

2013 Scale Score

Eligible - Not eligible Difference 2013

Scale Score

New Jersey 229 212 241 -29

New Mexico 206 199 226 -27

New York 224 211 238 -26

North Carolina 222 211 237 -26

North Dakota 224 213 230 -17

Ohio 224 208 237 -29

Oklahoma 217 208 230 -22

Oregon 219 207 236 -29

Pennsylvania 226 211 239 -27

Rhode Island 223 206 239 -32

South Carolina 214 202 232 -29

South Dakota 218 203 229 -26

Tennessee 220 205 237 -32

Texas 217 206 234 -28

Utah 223 209 232 -22

Vermont 228 213 239 -26

Virginia 229 209 239 -30

Washington 225 209 238 -28

West Virginia 215 211 225 -14

Wisconsin 221 205 233 -28

Wyoming 226 215 233 -18 ? = Reporting standards not met. NOTE: Black includes African American, Hispanic includes Latino, and Pacific Islander includes Native Hawaiian. Race categories exclude Hispanic origin. Prior to 2011, students in the "two or more races" category were categorized as "unclassified." National public is included for reference only and is not included in sorting the jurisdictions. Score differences are calculated based on differences between unrounded average scale scores. SOURCE: U.S. Department of Education, Institute of Education Sciences, National Center for Education Statistics, National Assessment of Educational Progress (NAEP), 2011 Reading Assessment. http://nces.ed.gov/nationsreportcard/naepdata/report.aspx

http://nces.ed.gov/nationsreportcard/naepdata/report.aspx

50 State Chart Book Additional Indicators

CHILD HEALTH INDICATORS

SOURCE

1. Elevated blood-lead levels Center for Disease Control and Prevention/National Center for Environmental Health

Overall national and state data: http://www.cdc.gov/nceh/lead/data/StateConfirmedByYear1997-2011.htm

National data broken down by race/ethnicity: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6213a3.htm?s_cid=mm6213a3_e

2. Diagnoses of HIV infection 15-19 year-olds

Centers for Disease Control and Prevention.

National data broken down by age and

race/ethnicity

HIV Surveillance Report, 2011; vol. 23 (2008 – 2011)

http://www.cdc.gov/hiv/pdf/statistics_2011_HIV_S

urveillance_Report_vol_23.pdf#Page=17

3. Overweight or obese (10-17) (+ obesity/overweight 0-5 national)

National Survey of Children's Health (NSCH)

National and state data broken down by race/ethnicity, age, and poverty level http://www.childhealthdata.org/browse/survey?s=2

4. Overweight or obese obesity/overweight children

Center for Disease and Prevention

National and state data on low-income children (0-4 years) http://www.cdc.gov/obesity/downloads/pednssfactsheet.pdf

National data with information on race, and overall state data - Progress on Obesity http://www.cdc.gov/VitalSigns/ChildhoodObesity/

Robert Wood Johnson Foundation,

State data broken down by age and state ranking F as in Fat: How Obesity Threatens American’s Future http://www.rwjf.org/content/dam/farm/reports/reports/2013/rwjf407528

5. Adult Overweight and Obesity Rates

Henry J. Kaiser Family Foundation

National and state data broken down race/ethnicity http://kff.org/other/state-indicator/adult-overweightobesity-rate-by-re/

http://www.cdc.gov/nceh/lead/data/StateConfirmedByYear1997-2011.htm

http://www.cdc.gov/nceh/lead/data/StateConfirmedByYear1997-2011.htm

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6213a3.htm?s_cid=mm6213a3_e

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6213a3.htm?s_cid=mm6213a3_e

http://www.cdc.gov/hiv/pdf/statistics_2011_HIV_Surveillance_Report_vol_23.pdf#Page=17

http://www.cdc.gov/hiv/pdf/statistics_2011_HIV_Surveillance_Report_vol_23.pdf#Page=17

http://www.childhealthdata.org/browse/survey?s=2

http://www.childhealthdata.org/browse/survey?s=2

http://www.cdc.gov/obesity/downloads/pednssfactsheet.pdf

http://www.cdc.gov/obesity/downloads/pednssfactsheet.pdf

http://www.cdc.gov/VitalSigns/ChildhoodObesity/

http://www.rwjf.org/content/dam/farm/reports/reports/2013/rwjf407528

http://www.rwjf.org/content/dam/farm/reports/reports/2013/rwjf407528

FAMILY AND COMMUNITY INDICATORS

SOURCDE

6. Parents stressed about parenting


2011-2012 National and state data broken down by race/ethnicity, age, and poverty level www.childhealthdata.org

7. Children in Single-Parent Families

Child Trends Databank

National data broken down by race/ethnicity http://www.childtrendsdatabank.org/?q=node/234

8. Teen birth rate per 1,000 Center for Disease Control and Prevention/National Vital Statistics Report

2011-2012 Overall national and state data http://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_09.pdf

2007 – 2011 national and state data broken down my race and ethnicity http://www.cdc.gov/nchs/data/databriefs/db123_table.pdf

9. 20-24 year old males in state federal prisons/1000

US Department of Justice

National data broken down by age and race/ethnicity Bureau of Justice Statistics. Prisoners in 2011. http://bjs.gov/content/pub/pdf/p11.pdf

10. Percent of children living in high poverty neighborhoods

Annie E. Casey Foundation

National data broken down by race A Kids Count Special Report reviewed all census tracts in the United States in both 2000 and 2010 http://www.aecf.org/~/media/Pubs/Initiatives/KIDS%20COUNT/D/DataSnapshotonHighPovertyCommunities/KIDSCOUNTDataSnapshot_HighPovertyCommunities.pdf

11. During the past week, family members read stories to children ages 0-5 year old every day



12. First time births by mother’s age and race/ethnicity

Center for Disease Control and Prevention/National Center for Health Statistics

2012 national data broken down by race/ethnicity http://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_09.pdf

13. Young children (0-5) Foster care placement (Ratio on likeliness that black child will be in FC versus white child) Foster care

Children’s Bureau

2012 national and state data broken down by race/ethnicity, and age http://cwoutcomes.acf.hhs.gov/data/overview

http://www.childhealthdata.org/

http://www.childtrendsdatabank.org/?q=node/234

http://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_09.pdf


http://www.cdc.gov/nchs/data/databriefs/db123_table.pdf

http://www.cdc.gov/nchs/data/databriefs/db123_table.pdf

http://bjs.gov/content/pub/pdf/p11.pdf

http://www.aecf.org/~/media/Pubs/Initiatives/KIDS%20COUNT/D/DataSnapshotonHighPovertyCommunities/KIDSCOUNTDataSnapshot_HighPovertyCommunities.pdf







http://cwoutcomes.acf.hhs.gov/data/overview

placements/1000

14. Parental concerns about Child’s Physical, Behavioral, or Social Development



15. Food insecure households United States Department of Agriculture

National data broken down by race/ethnicity and income, overall state data Federal Interagency Forum on Child and Family Statistics. America’s Children: Key National Indicators of Well-Being, 2013. Washington, DC: US Government Printing Office. http://www.ers.usda.gov/publications/err-economic-research-report/err155.aspx#.UkWtCxCWngw

16. Number of households receiving the Earned Income Tax Credit (EITC) and Child Tax Credit (CTC)

Center on Budget and Policy Priorities

Overall national and state data Earned Income Tax Credit Promotes Work, Encourages Children’s Success at School, Research Finds: For Children, Research Indicates that Work, Income, and Health Benefits Extend Into Adulthood http://www.cbpp.org/cms/?fa=view&id=3793

17. Estimates of children lifted out of poverty as a result of Earned Income Tax Credit (EITC) and Child Tax Credit (CTC)

Center on Budget and Policy Priorities

Overall national and state data Earned Income Tax Credit Promotes Work, Encourages Children’s Success at School, Research Finds: For Children, Research Indicates that Work, Income, and Health Benefits Extend Into Adulthood http://www.cbpp.org/cms/?fa=view&id=3793

EDUCATION INDICATORS SOURCE

18. 25-34 year olds with associate degrees

US Department of Education

National and state data broken down by race/ethnicity http://dashboard.ed.gov/statecomparison.aspx?i=o&id=0&wt=40

19. NAEP 4th grade math scores

National Center for Education Statistics (NCES) Institute of Education Sciences (IES) National Assessment of Educational Progress (NAEP)

National and state data broken down by race/ethnicity http://nces.ed.gov/nationsreportcard/tdw/database/data_tool.asp

20. 16-19 year olds not in school or working

Annie E. Casey Foundation- Kids Count

National and state data broken down by race/ethnicity http://datacenter.kidscount.org/data/tables/5065-


http://www.ers.usda.gov/publications/err-economic-research-report/err155.aspx#.UkWtCxCWngw



http://www.cbpp.org/cms/?fa=view&id=3793

http://www.cbpp.org/cms/?fa=view&id=3793

http://dashboard.ed.gov/statecomparison.aspx?i=o&id=0&wt=40

http://dashboard.ed.gov/statecomparison.aspx?i=o&id=0&wt=40

http://nces.ed.gov/nationsreportcard/tdw/database/data_tool.asp

http://nces.ed.gov/nationsreportcard/tdw/database/data_tool.asp

http://datacenter.kidscount.org/data/tables/5065-teens-ages-16-to-19-not-attending-school-and-not-working-by-race#detailed/2/10-19,2,20-29,3,30-39,4,40-49,5,50-52,6-9/false/868,867,133,38,35/10,11,9,12,1,185,13/11489,11488

teens-ages-16-to-19-not-attending-school-and-not-working-by-race#detailed/2/10-19,2,20-29,3,30-39,4,40-49,5,50-52,6-9/false/868,867,133,38,35/10,11,9,12,1,185,13/11489,11488

21. Adults without high school diploma/equivalent

Centers for Disease Control and Prevention

National data broken down by race/ethnicity Health disparities and inequalities report—United States, 2011. MMWR 2011;60(Suppl):14. http://www.cdc.gov/mmwr/pdf/other/su6001.pdf

ACCESS AND HEALTH CARE UTILIZATION

SOURCES

22. Children who do not have usual source of care


National and state data broken down by race/ethnicity, age, and poverty level www.childhealthdata.org

23. 3-5 year olds untreated dental caries

Center for Disease Control and Prevention

National data by race/ethnicity Oral Health Disparities as Determined by Selected Healthy People 2020 Oral Health Objectives for the United States 2009-2010 http://www.cdc.gov/nchs/data/databriefs/db104.pdf

24. Children (5-11) with untreated dental caries

ChildStats.gov Forum on Child and Family Statistics

National data by poverty level America’s Children: Key National Indicators of Well-Being, 2013. http://www.childstats.gov/pdf/ac2013/ac_13.pdf

National data by race/ethnicity and poverty level (1988-2010) http://www.childstats.gov/americaschildren/tables/hc4c.asp

25. Number of children 3-5 years served under IDEA, Part B

TAD: Historical State-Level IDEA Data Files

National and state data by age and ethnicity http://tadnet.public.tadnet.org/pages/712

26. Part C Participation, 2005-2011 monthly rates

TAD: Historical State-Level IDEA Data Files

National and state data by age and ethnicity http://tadnet.public.tadnet.org/pages/712

27. Medicaid/EPSDT enrollment of all 0-2, 3-5,6-9, and 15-18 year olds (416/ACS)

Medicaid.gov: Keeping American Healthy

National and state data http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Benefits/Early-and-Periodic-Screening-Diagnostic-and-Treatment.html

28. 0-2, 3-5,6-9, and 15-18 year olds Average number of EPSDT visits annually

Medicaid.gov: Keeping American Healthy

National and state data http://www.medicaid.gov/Medicaid-CHIP-Program-






http://www.cdc.gov/mmwr/pdf/other/su6001.pdf


http://www.cdc.gov/nchs/data/databriefs/db104.pdf

http://www.cdc.gov/nchs/data/databriefs/db104.pdf

http://www.childstats.gov/pdf/ac2013/ac_13.pdf

http://www.childstats.gov/americaschildren/tables/hc4c.asp

http://www.childstats.gov/americaschildren/tables/hc4c.asp

http://tadnet.public.tadnet.org/pages/712

http://tadnet.public.tadnet.org/pages/712

http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Benefits/Early-and-Periodic-Screening-Diagnostic-and-Treatment.html




(Note: Average needs to be calculated from the data provided)

Information/By-Topics/Benefits/Early-and-Periodic-Screening-Diagnostic-and-Treatment.html

29. Asthma hospital admissions (2-17 year olds)/100,000

Agency for Healthcare Research and Quality. 2006

National Health Care Disparities Report. Appendix D. Data

Tables.

National data by age, income, race/ethnicity and

overall state data (Management of Asthma, table

2_9_3_3)

http://www.ahrq.gov/research/findings/nhqrdr/nh

qrdr12/index.html

PUBLIC PROGRAM PARTICIPATION

SOURCE

30. Public home visiting, Early Head Start, family support programs

BUILD Initiative and Child and Family Policy Center

Overall national data Early Learning Left Out (February 2013) http://www.buildinitiative.org/Portals/0/Uploads/Documents/Early%20Learning%20Left%20Out.pdf

31. Head Start and Early Head Start participation

Head Start/Early Head Start Participation: National Head Start Association

National and state data broken down by federal funding amount and number of participants. http://eclkc.ohs.acf.hhs.gov/hslc/mr/factsheets/2012-hs-program-factsheet.html

CLASP: Policy Solutions that Work for Low-Income People

National and state data broken down by race/ethnicity http://www.clasp.org/data

32. Overall public preschool participation rates

The National Institute for Early Education Research (NIEER)

Overall national state and national data for 3 and 4 year olds. The State of Preschool 2012 http://nieer.org/sites/nieer/files/yearbook2012.pdf

33. WIC participation rates Women Infant and Children (WIC), U.S. Department of Agriculture, Food and Nutrition Service

National and state data broken down by race/ethnicity and age WIC Participation: U.S. Department of Agriculture, Food and Nutrition Service, Office of Analysis, Nutrition, and Education – available online: http://www.fns.usda.gov/sites/default/files/WICPC2012.pdf

34. TANF child participation Temporary Assistance to Needy Families (TANF)



http://www.ahrq.gov/research/findings/nhqrdr/nhqrdr12/index.html

http://www.ahrq.gov/research/findings/nhqrdr/nhqrdr12/index.html

http://www.buildinitiative.org/Portals/0/Uploads/Documents/Early%20Learning%20Left%20Out.pdf


http://eclkc.ohs.acf.hhs.gov/hslc/mr/factsheets/2012-hs-program-factsheet.html

http://eclkc.ohs.acf.hhs.gov/hslc/mr/factsheets/2012-hs-program-factsheet.html

http://www.clasp.org/data

http://nieer.org/sites/nieer/files/yearbook2012.pdf

http://www.fns.usda.gov/sites/default/files/WICPC2012.pdf

http://www.fns.usda.gov/sites/default/files/WICPC2012.pdf

rates Overall national and state data The Temporary Assistance for Needy Families (TANF) Block Grant: Responses to Frequently Asked Questions http://www.fas.org/sgp/crs/misc/RL32760.pdf

35. Child care subsidy monthly participation levels/rates by age

The Center for Law and Social Policy (CLASP)

National and state data by age and race/ethnicity http://www.clasp.org/data

PUBLIC FINANCE IN EDUCATION

SOURCE

36. Public finance pre-school for 3 yrs olds


Overall national data Early Learning Left Out (February 2013) http://www.buildinitiative.org/Portals/0/Uploads/Documents/Early%20Learning%20Left%20Out.pdf

37. Public finance preschool for 4 yrs olds


Overall national data BUILD Initiative and the Child and Family Policy Center (February 2013) http://www.buildinitiative.org/Portals/0/Uploads/Documents/Early%20Learning%20Left%20Out.pdf

38. Investment in education and development by child age

Build Initiative and Child and Family Policy Center

National and state data by age. Early Learning Left Out (February 2013) http://www.buildinitiative.org/Portals/0/Uploads/Documents/Early%20Learning%20Left%20Out.pdf

http://www.fas.org/sgp/crs/misc/RL32760.pdf

http://www.clasp.org/data







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