The North Carolina Child Health Report Card, released annually by the North Carolina Institute of Medicine (NCIOM) and NC Child, issued its lastest report today, highlighting troubling disparities for children’s health outcomes across racial and socioeconomic lines.

The report card focuses on four key indicators pertaining to children’s health: healthy births, access to care, secure homes and neighborhoods, and health risk factors. The study’s authors emphasized the state’s low marks on housing and poverty, which reflect the high percentage of kids living in poor homes and neighborhoods. That’s consequential, the report explains, because poverty affects a wide variety of health outcomes for kids. Just eighty-one percent of children living in low-income houses are in “excellent or very good health,” compared to more than ninety-six percent of kids in higher-income households.

Those disparities manifest across racial lines, as well. According to the report, African-American and Latino children are more than twice as likely to live in poor neighborhoods and homes than white children. That can also affect their health. Children living in poor households have higher rates of childhood asthma and are more likely to be exposed to pollution and allergens. African-American and Latino children are also more likely to live in families with a high housing burden, meaning they spent a large percentage of their income on rent. That can give them less money to spend on insurance coverage and healthy food, both of which can help improve children’s health.

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


The study did show gains in other areas, however, including children’s health insurance rates, breastfeeding rates, vaccination rates, and teen births.

The state received an “A” grade for health insurance coverage, with ninety-six percent of children now covered—a record high. The percentage of uninsured children in the state fell more than forty points from 2012 to 2016, and the percentage of parents with insurance has also risen. Still, about 100,000 parents in the state still lack insurance because they fall in the coverage gap, earning too much to qualify for Medicaid but not enough to buy private insurance plans.

Since 2012, teen births have also fallen more than thirty percent, thanks to more family planning services and sexual education programs, the report says. Additionally, more mothers across the state are breastfeeding, and childhood blood lead levels continue to decline.