Ky. has improved on several measures of children’s health, but some counties continue to lag far behind and get worse

Terry Brooks (Kentucky Youth Advocates photo)
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By Melissa Patrick
Kentucky Health News

Almost one in four Kentuckians are children. How goes their health?

Most have health insurance, fewer teenagers are getting pregnant, and fewer babies are being born at a low birth weight — but those situations vary widely by county, according to the annual Kentucky Kids Count County Data Book.

The report, released Nov. 19 by Kentucky Youth Advocates and the Kentucky State Data Center at the University of Louisville, is part of the 29th annual release of Kids Count, a nationwide initiative of the Annie E. Casey Foundation to track the status of children in the United States.

The Data Book provides information on the overall well-being of children in each county, through 17 measures in four areas: economic security, education, community strengths, and health and family.

Map from Kids Count County Data Book; click on it for a larger version.

One great health concern in Kentucky is the 18.7 percent of women who smoke during pregnancy. Nationally, the rate is 6.9%, according to the United Health Foundation.

Kentucky’s rate has stayed about the same for the past few years, the good news is that it has lower that the 20.7% recorded five years ago.

But in some places, the problem is getting worse; 29 counties saw higher rates of pregnant women smoking during pregnancy in 2018. The number of counties where 30% or more pregnant women smoked rose from 22 to 24. In Lee and Owsley counties, more than 40% of pregnant women smoked.

“Smoking during pregnancy remains a serious health problem in Kentucky for both mothers and their babies,” Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky, said in a news release about the report. “It’s an incredibly difficult addiction to break, and it increases health risks for babies both before and after they’re born, even raising the risk of sudden infant death syndrome.”

The foundation’s agenda for the upcoming legislative session includes more money for smoking prevention and cessation.  “Expanding quit-smoking programs, and increasing education campaigns, are essential to reducing smoking during pregnancy,” said Chandler.

Smoking during pregnancy also increases the risk of preterm birth, which the March of Dimes says is the leading cause of infant death, low-birthweight babies, and birth defects of the mouth and lip, says the federal Centers for Disease Control and Prevention.

In 2015-17, 8.8% of Kentucky babies were born with a low birth weight, defined as less than 5.5 pounds. That was down slightly from 9% in 2010-12. But again, those rates varied across the state, with 45 counties showing an increase, and 19 counties with rates higher than 10.3%. Lyon County had the lowest rate, 5.1% and Union County had the highest, 12.9%.

The state’s teen pregnancy rate also continues to drop. It declined to 29.7 teen births per 1,000 females aged 15-19 in 2015-17. That was 31% less than the 42.9 per 1,000 recorded five years ago. That said, it’s still about 58% higher than the national rate of 18.8 teen births per 1,000.

And like so many measures in the report, the differences between counties is great, ranging from a low of 8.5 teen births per 1,000 in Oldham County to a high of 73.6 in Elliott County.

Compared to 2010-12, nine counties had higher teen pregnancy rates: Breathitt (57.5 teen births per 1,000 females 15-19 in 2015-17), Edmonson (36.5), Elliott (73.6), Green (34.6), Greenup (39.2), Jackson (57.7), Lee (48.7), Monroe (36.3) and Nicholas (47.8), which saw the greatest increase, 8.2 per 1,000, over 2010-12.

Other key findings about Kentucky’s children in the report include:

  • 96% of Kentucky’s children have health insurance, and all 120 counties showed improvements.
  • Nearly one in four Kentucky children live in poverty, defined in 2017 as an annual household income of $24,858 or less for a family of four. That rate improved to 22.1% in 2017 from 26.5% in 2012. The poverty rate decreased in 107 of the 120 counties.
  • One in eight, or 12%, of Kentucky’s children live in deep poverty, defined in 2017 as $12,429 or less for a family of four. This rate hasn’t changed since 2008-12. Of the 106 counties that were ranked for this measure, 20 had rates between 21% and 31%.
  • Fewer Kentucky children suffer from food insecurity, down to 18% in 2017 from 22% in 2013. This rate improved in 113 counties, though 17 had rates between 24.8% and 31.5%, mostly in Eastern Kentucky.
  • 115 of the state’s 172 school districts saw an increase in the rate of students graduating from high school on time. However, that rate declined in 49 districts. About 91% of Kentucky’s students graduate on time.
This year’s report also took a deep dive into four additional areas, including child-care supports, teen suicide, the connection between schools and health, and racial disparities in the child-welfare system.
It also goes into detail about the 2020 census and why it is critical that every child get counted. KYA Executive Director Terry Brooks pointed out at a Nov. 19 news conference in Louisville that Kentucky gets billions of dollars based on the census count.

“If you are interested in school funding for low-income kids and special-needs kids, it’s based on the census. If you are interested in childcare supports and food and nutritional support programs, it’s based on the census,” he said. “The list goes on and on. So in a state where we argue about where to get more revenue, one of the most clear and unifying ways to get more revenue is to make sure that every kid is counted.”

The report says that more than 12,000 Kentucky children under age 5 were not counted in the 2010 census, costing the state more than $12 million per year for just five large programs for which data is available.

Brooks stressed the importance of using the report to drive policy changes to benefit Kentucky’s children. “Data has to demand action,” he said. “We know that what gets measured gets attention and what gets attention gets changed. That’s the whole premise of Kids Count.”

The 2019 Kentucky County Data Book was made possible with support from the Casey Foundation and other sponsors, including  Passport Health PlanKosair CharitiesAvesisCorona Spanish MediaDelta Dental, and Mountain Comprehensive Care.

The Kids Count Data Center provides easy access to county and school district data for about 100 indicators and allows the user to rank states, counties and school districts; to create customized profiles of the data ; to generate customized maps; and to embed maps and graphs in websites or blogs. Click here to see your county’s profile.