North Carolina’s parents and caregivers are struggling to afford health care, and the impact is evident in child well-being outcomes across the state, according to the advocacy group NC Child.

While the percentage of NC children with health insurance is hovering near a historic high, the number of parents with health coverage is tracking downward again. That has a huge impact on their children – and not just in health care.

NC Child’s new County Data Cards explore 15 key indicators in every NC county, including educational outcomes, and child abuse and neglect.

Access to quality health care is an important factor to maintaining a child’s physical, mental and emotional health. Research shows that when parents have health insurance, they have healthier babies, they are better able to stay healthy and care for their children, and their kids are more likely to have health coverage and use it.

Uninsured rates are high among those working in construction, retail and food service. These fields rarely offer health insurance to employees. In McDowell County, for instance, 25.8% of residents work in these industries. Without employer-provided health insurance, it can be nearly impossible for people to get health care when they need it.

Right now, according to NC Child, 4,846 people in McDowell County have no health coverage. Parents with two children who earn $12,000 a year earn too much for Medicaid. They cannot get a subsidy to buy private insurance in the marketplace until they earn $25,750.

More than 100,000 parents in North Carolina are without health coverage due to high costs. Thousands more of those without coverage are women of child-bearing age, whose health will affect the well-being of our state’s next generation. Health insurance coverage also has strong anti-poverty effects – reduced out-of-pocket spending, and decreased family medical debt.

The connection between parental health insurance coverage and child well-being plays out in many of the data points:

• Seven infants of every 1,000 born in North Carolina never live to see their first birthdays.

• Only half of new moms in high-poverty counties like Robeson and Edgecombe receive prenatal care during their first trimesters, compared with 85% of mothers in Buncombe and Transylvania counties, where incomes are higher.

• More than 2 out of 3 children in Robeson and Edgecombe counties are in poor or near-poor households, earning below $51,500 for a family of four (that’s 200% of the federal poverty line).

While the overall poverty rate in North Carolina is decreasing, and household income has risen across the state, many parents and caregivers are still unable to afford the high costs of health care. More than one quarter of all North Carolinians work in retail, construction, or food service – industries that rarely offer health insurance to employees. One in five early childhood educators has no health coverage. These low-wage employees, parents and caregivers are critical to North Carolina’s economy. Without employer-sponsored insurance, it can be nearly impossible for working parents to afford health care when they need it. That’s tough on kids as well as parents.

NC Child is advocating for state legislators to take advantage of a powerful tool to cover more low-income families. They can do this by widening eligibility for the federally-funded Medicaid program, or by creating a North Carolina-specific health insurance option. This approach has been extremely successful in dozens of other states, according to the group.

This data snapshot shows how children and families are faring in key areas of well-being.

(From NC Child)

Child population: 12,008

Percent under age six: 30%

Number of live births: 457

Women who received early prenatal care: 80.5% (2017)

Babies born at low birth weight: 11.8% (2017)

Babies born pre-term: 12.5% (2017)

Children living in poor/low-income homes: 58.1% (2017)

Children in households that food insecure: 23.5% (2016)

Median family income: $35,969 (2013-2017)

Children in foster care per 1,000: 21.3 (2017)

Children assessed for abuse/neglect per 1,000: 93.9 (2017)

Third-grade students proficient in reading: 58.1% (2017-2018)

High school students graduating: 85.2% (2018)

Residents with bachelor’s degree or higher: 15.8% (2017)

Children without health insurance: 4.9% (2017)

Infant mortality per 1,000: 6.6 (2017)

Child deaths per 100,000: 59.9 (2017)

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