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Report finds children’s health conditions remain unequal

COVID threatens to reverse years of progress on key indicators of children’s health and well-being. But with schools closed to in-person learning and testing for much of 2020, data remains missing on key indicators of children’s well-being, including obesity, physical fitness, kindergarten readiness, and 3rd grade academic achievement. Thus, researchers don’t yet have a full picture of just how bad the last two years have been for our kids.

Those are a few key takeaways from the 27th Annual Report on the Conditions of Children in Orange County, which was published this fall by the Orange County Children’s Partnership, a consortium of County organizations and nonprofits charged with ensuring children’s health and welfare.

The numbers we do have indicate that the COVID-19 pandemic, which the report describes as “the most profound disruption to daily life in generations,” will have a long-term impact on children. That’s particularly true for children of color in Orange County who are more likely to have suffered from COVID than their white peers: 80% of children in OC who have contracted COVID have been minorities, with Hispanic children bearing the brunt of the pain with over 50% of OC’s total pediatric COVID cases.

Chart courtesy of the the 27th Annual Report on the Conditions of Children in Orange County.

Health disparities like we are seeing with COVID are no surprise. The data aggregated in the charts and tables of this 27th annual report lay bare several categories in which Black and Hispanic children get inferior care. They are, for instance, significantly less likely to be insured, and also less likely to receive prenatal care. The charts also make visible the results of this neglect: lower birth weight and higher infant mortality rates, just to name a few. In other categories, including safety and education, these inequities also stubbornly remain, and in some cases, have worsened in the last decade.

For 2021, the report suggests that the pandemic’s biggest impact on children of whatever color is not COVID itself. Currently, only about 6 in 100,000 of school-age children in Orange County have COVID on any given day. Instead, COVID impacts kids through the fallout of COVID-related shutdowns in the economy and education, both of which impact, among other things, children’s mental health.

The report presents troubling results from a survey conducted by the Orange County Health Care Agency (HCA) Behavioral Health Services, Mental Health Services Act Office in the Fall 2020. Of parents surveyed, 51% reported their kids were experiencing “significant issues related to anxiety and depression.” In the same survey, families reported difficulties in accessing care from therapists, pediatricians, and psychiatrists, with 11% reporting delays in getting appointments and 12% dissatisfied with care being provided online rather than face-to-face.

The report boasts “an all-in response” by County agencies to the COVID crisis, including measures taken to support children’s mental health. Just before the pandemic began, for instance, the report states that “The Orange County Department of Education (OCDE), in partnership with HCA and local school districts, created a Countywide network of seven new regional mental health coordinators to work closely with school districts to increase access to local mental health services.” To combat children’s mental health issues, Adverse Childhood Experiences (ACE) Aware funds have also been awarded to local hospitals and nonprofits to help them identify kids’ needs and support families in developing a resilient response to today’s challenges. Moreover, in conjunction with the Board of Supervisors, the Partnership sponsored community mental health town halls, which were held online.

However, it seems unlikely that such responses will reach the full range of Orange County residents, many of whom aren’t aware of the events, and some of whom lack internet access. (Internet access is another issue that County schools, at least, attempted to address, as is evident with the 500 mobile hot spots that Fullerton Joint Union purchased and distributed early in the pandemic.)

When it comes to food insecurity, another problem that worsened for County children in the pandemic, the report details how State agencies have stepped in to ease the burden. Awards for CalFresh, a State program funding meals for impoverished families, remain much higher than they were before the pandemic, with about 11,000 applications having been received in each of the last two years as compared with about 8,500 before the pandemic, and with 232,000 families receiving benefits, an increase over the 215,000 who had received such benefits in 2019-20. Average household benefits in the program have also risen, and families have been staying on benefits longer, another indicator that working-class families have yet to recover from the pandemic.

Though the 200-plus-page report leads with a discussion of COVID, the bulk of the report is devoted to pre-pandemic data, and here the news is often brighter. Before COVID, several key indicators were on the rise, as explained in the report’s executive summary: “Good Health trends revealed a continued decline in uninsured children and teen birth rates . . . Pre-pandemic data for Educational Achievement revealed fewer students dropping out of high school, and more likely to be college-ready. Within Safe Homes and Communities, the number of juvenile arrests, sustained petitions, and gang-related prosecutions continue to decline year-over-year.” The decrease in teen birth rates over the last decade is particularly striking, with births today at about 1/3 of what they were in 2010, at dropping from 22.7 to 7.5 out of 1000.

However, included along with these findings are more worrisome trends, such as an 88% increase in children’s hospitalization for behavioral health issues including mental illness and substance abuse. Also concerning are a slight increase in child poverty, a substantial rise in housing insecurity, and continued high rates of depression and suicide among Gay and Lesbian teens.

By next year, the Orange County Children’s Partnership will have a firmer grasp on COVID’s impacts, and on the resources dedicated to meeting kids’ needs.

Chart courtesy of the the 27th Annual Report on the Conditions of Children in Orange County.