PROVIDENCE – Kids don’t vote. They don’t make campaign donations. They don’t make decisions about what lawn signs to put up. But, in this 2014 election year, the well-being of children in Rhode Island may yet still emerge as an important wedge issue.

The release of national statistics by the Annie E. Casey Foundation on July 22 measuring the state-by-state rankings in 2012 for economic well-being, education, health, and family and community placed Rhode Island smack dab in the middle – at 26th – but last among the six New England states.

Nationally, Massachusetts ranked No. 1, Vermont ranked No. 2, New Hampshire ranked No. 4, Connecticut ranked No. 7, and Maine ranked No. 14.

In recent years, R.I. House Finance Committee members have often claimed that Rhode Island’s benefits are more generous than neighboring states as justification for cutting those benefits, such as RIte Care eligibility.

But the fact-based evidence in the latest national analysis demonstrates that Rhode Island consistently lags behind its New England neighbors in protecting the health, education and economic well-being of children and families.

Rhode Island’s worst scores were in family and community, at No. 32, and in economic well-being, No. 26.

Rhode Island’s best scores were in health, at No. 15, and in education, No. 25.

A growing racial and ethnic divide
The national rankings reinforced the findings of the 2014 Rhode Island Kids Count Factbook, released in April, using more recent data from 2013.

“Racial and ethnic disparities in education are evident before children enter kindergarten and persist throughout high school and college,” the report said, which documented the widening gap in economic well-being, and health, safety and economic outcomes for minority children in Rhode Island.



That gap is magnified by the fact that Rhode Island has the fifth lowest birth rate in the nation: between 2002 and 2012, Rhode Island’s child population decreased by 12 percent, from 247,822 to 216,962.

Another key data point: in four years, in 2018, minority children will become the majority children in Rhode Island, reflecting the changing demographics and the rise of our culturally diverse community, according to Elizabeth Burke Bryant, executive director of Rhode Island Kids Count.

That change puts more urgency to the significant racial and ethnic disparities detailed in the recent local Factbook. In 2013, the numbers for children living in poverty in Rhode Island were an eye-opener – 20 percent, or one out of five overall. But broken down, it’s 14 percent for White, 40 percent for Hispanic, 39 percent for Black, 22 percent for Asian, and 54 percent for Native American.

From performance in fourth-grade reading and mathematics proficiency in education to the likelihood to be hospitalized for asthma in health, the outcomes, according to Bryant, “emphasize that Rhode Island cannot advance as a state if we have achievement gaps – disparities in terms of racial and ethnic groups.”

That message has yet to find a safe and secure home in the current political campaigns for Governor or for Mayor of Providence.

Drilling deeper
The persistent economic malaise in Rhode Island following what’s become known as the Great Recession of 2008, with the continuing high rate of unemployment, appears to have created a widening chasm in Rhode Island between the haves and the have-nots, according to the national data.

Drilling deeper, the national rankings, using 2012 data, showed that for economic well-being, Rhode Island had 19 percent, some 42,000 children, living in poverty – unchanged from 2005. [As reported above, the most recent 2013 data has the poverty figure growing to 20 percent.]

Some 33 percent, 72,000 children, had parents who lacked secure unemployment, a rate that had worsened since 2008, when the measurement was 30 percent.

The data analysis showed that 40 percent of children in Rhode Island, some 87,000 children, were living in households with a high housing cost burden – but that actually was an improvement from 2005, when the measurement was 42 percent.

The number of teens not in school and working as 6 percent, some 4,000 teens, a slight improvement from 2008, when the measurement was 7 percent.

“The fact that more Rhode Island children are living in families without a full-time employed parent shows that the negative economic impacts of the recession continue to be felt among Rhode Island families,” said Bryant, in a statement that accompanied the release of the national data. “Rhode Island must work toward ensuring that parents have strong job skills for stable, good-paying jobs, while at the same time increasing access to high-quality education for all children so they will have the education and skills to compete when they are adults.”

Eyes on the prize
The snapshot of data analysis and graphic mapping shows where Rhode Island stood in 2012, but it does not reveal the current pressure points that exist in 2014 looking ahead to 2015.

ConvergenceRI talked with Bryant to get her perspective on the future – and map out the challenges ahead facing Rhode Island’s children.

ConvergenceRI: Although Rhode Island’s best rankings were in health, particularly for the number of children with health insurance because of changes to the state’s RIte Care program, with parents having to register again, could those numbers fall?
BRYANT: Children and families having health insurance is very important, from both a health and a cost benefit. With children insured, regular preventable problems don’t escalate to more expensive conditions.

While we understand the need [to certify families and children] for renewal in the RIte Care program, we don’t want to go backward, with people falling through the cracks because they may be confused by moving from one data system to a whole new system. We’ve partnered with the Economic Progress Institute and other community groups to provide outreach and assistance to families, to get the word out.

RIte Care is a real success story; it’s a well-run, efficient, high quality program. We’ve come a long way in prioritizing children’s health insurance coverage. We don’t want to come back next year to find a sudden downturn in the number of children insured. No one wants that.

ConvergenceRI: Two new reports have indicated that there is a strong undertow as a result of the epidemic of addiction and accidental deaths from overdoses in Rhode Island – an increase in the number of newborns with addiction, and the increased number of children being removed from homes because of abuse. Will these trends emerge in next year’s data?
BRYANT: The impact of a lingering recession, with parents lacking secure employment, tend to increase the incidences of child abuse and neglect, the research says.

The fact that we’ve had a lingering recession here, in 2012, 33 percent of parents lacked secure employment, is a factor.

In child safety, we track the numbers of children being removed from homes. That number is starting to go back up after a plateau.

We know what works: intervention at the first sign of difficulty, with community-based and home-based services. Child safety is at the core of everything we need to pay attention to. With early intervention of prevention services at the community-based level, at the home-based level, you can keep the children safe and keep the numbers being removed from home down.

We’re watching the drug issues carefully. We don’t have enough data to answer your questions. It’s a very complex issue, and a cause for concern, with all the ramifications it has for children and families.

ConvergenceRI: The recent spree of shootings and gun violence in Providence makes me wonder if there is any studies correlation between the high incidences of levels of lead in the blood and those who have been involved in the violence. Do you know of any such studies?
BRYANT: Let me first talk about the some of the findings of the national rankings. We know that access to high-quality education is the road out of poverty for children, and for parents being able to access higher quality careers through training.

It’s a short-term and long-term challenge. The question is: what do children need to be safe and healthy? What is needed to increase our expectations of what children can achieve in life. How can we prepare them for jobs in the new economy?

The ability to read at the [appropriate] grade level at the end of third grade is predictive of the high school graduation rate and a lot more.

Education is so closely tied to the current and future economic circumstances. We need to be focusing first on ways to make sure our children are safe and healthy and developing well. In a very short time, they will be the next head of households; we need to prepare them for a very different economy, with good jobs, to make sure that they and their families are not living in poverty.

I believe that there is a study out of Brown University that tracks lead-exposed children as they get older.

ConvergenceRI: Do we need to do a better job of mapping the data points in regard to children, education, health care innovation and community public health initiatives? Is the data still too much in silos?
BRYANT: Data mapping and data stories add a much more visual element to this work. There were a lot of previous data silos, and now, we can break down the silos to show what is really happening to children and families in Rhode Island. We are really on the cusp of being able to do that in Rhode Island.

We can make the data more graphically engaging to really tell the story, to share what the data is tell us. The more data you get your hands on, the more you know; it’s a continuous journey. The more data points we can report, the greater our ability to show causation.

Food for thought
In the state’s application for the federal State Innovation Model grant program, which seeks to spur the redesign of the health care delivery system in Rhode Island, public health, community health and population health is a major focus, shifting away from the actuarial design from the previous State Health Innovation Plan, or SHIP.

Given that new emphasis, it would not be surprising to see the work being done under the mantle of Centers for Health, Equity & Wellness, or CHEW, by the R.I. Department of Health, emerging as a key component of that work.

To date, that work has been happening mostly under the radar screen of news coverage and mapping initiatives of the Providence Plan and CommerceRI. Bryant said that she was not familiar with the program.

The CHEW program had distributed $100,000 grants to eight community-based organizations serving low-income neighborhoods in Providence, Pawtucket and Central Falls.

It has two overarching goals: on a local level, to create, sustain and recognize communities that promote health and wellness through prevention, according to Ana Novais, who directs the CHEW program at the R.I. Department of Health.

It does this by implementing evidence-based programs that address chronic disease and its risk factors and maternal and child health priorities.

Novais said that the CHEW program was part of a larger effort by her agency to support community-based organizations to implement evidence-based programs such as home visiting, parent support, women’s cancer screening services, family planning services, teen pregnancy prevention programs, and asthma prevention programs.

The CHEW investments include:
• $100,000 to the City of Providence to increase access to healthy foods by establishing the Lots of Hope, turning unused city property into urban farms.
• $100,000 to the Olneyville Housing Corporation to help transform land and property to affordable, quality housing, to construct and maintain parks and other open spaces for recreation, and to encourage walking, biking, and use of RIPTA.
• $100,000 to the West Elmwood Housing Development Corp. for Sankofa, a neighborhood marketplace to reduce diet related health disparities and improve eating behaviors of West End residents.
• $100,000 to Clinica Esperanza/Hope Clinic to implement a self-management chronic disease education program at the community level tied to a clinical setting.
• $100,000 to Family Service of RI to replicate the Harlem Children’s Zone’s Asthma Initiative in neighborhoods in lower South Providence.
• $100,000 to The Providence Center to provide families in Providence, Pawtucket, and Central Falls with The Incredible Years parenting groups.

In most of the economic policy discussions and debates by candidates, these kind of small-scale, community-based, evidence-based neighborhood interventions often get left out of the conversation and coverage by news media.

Can you imagine a walking tour of the urban gardens, the Sankofa market, and the Clinica Esperanza as a selling point for economic development in Rhode Island – instead of the Superman building?