By Tami Silverman, President & CEO, Indiana Youth Institute 

It’s basketball season in Indiana. The Pacers are playing their hearts out, March Madness is around the corner, and high school hoops are heating up. Basketball, like so many sports and activities, offers a way for young people to connect, compete, and have fun. Coaches also often play a defining role in youth growth and development. Basketball and MENTOR champion Bill Russell said it well when he once described our collective responsibility toward kids: “There is no such thing as other people’s children.” 

It is also KIDS COUNT Data Book season. As in previous years, in this 25th Anniversary Edition of the KIDS COUNT Data Book, the Indiana Youth Institute provides objective, reliable information on the status of Indiana’s children and youth. Looking at the whole child, and our whole state, we examine indicators in the categories of family and community, economic well-being, education, and health. 

A child’s development is critically impacted by their home life, yet many kids face harmful family and community challenges. The data shows one out of every 11 Hoosier children (9.2%) have lived with someone who had a problem with alcohol or drugs, slightly higher than the national average of 8.5%. In 2017, parental drug and/or alcohol abuse was the primary cause behind the majority of Indiana Department of Child Services cases in which children were removed from their homes, and this rate continued to rise over previous years. The rate of child abuse and neglect again increased in our state, placing Indiana as having the third highest child maltreatment rate in the country. On a positive note, our understanding of Adverse Childhood Experiences (ACEs) continues to grow, equipping youth-serving professionals with additional tools to help all children.  

Children who experience poverty, especially during early life or for extended periods of time, are at risk for adverse health and developmental outcomes. Our data shows that economically, the basic needs of most Indiana children are being met, and the number of children living in poverty has decreased over prior years. Housing costs in Indiana are relatively low, placing us 10th nationally. At the same time, there are significant racial and geographic differences in the share of Hoosier families with children living in poverty.  

High-quality early childhood education, math and reading proficiency, and school engagement contribute to college and career readiness. Expansion of high-quality early childhood education remains a state priority, yet the number of Hoosier three-and four-year-olds are enrolled in pre-K fell slightly, and Indiana lags when compared to the national average of enrollees. Meanwhile, on average, Indiana 4th and 8th grade students scored better in math and reading than their peers nationally.  

Postsecondary success improves individual outcomes, builds stronger communities, and strengthens the economy. Our data shows the commitment made by schools, community agencies, and the state to make college and career planning a priority has contributed to a slight increase in the number of Hoosier 12th graders (80.7%) planning to pursue education after high school, whether through a college/university, community college, apprenticeship program, or career-technical college. Our data also indicates students and families are making plans and preparations for college and career earlier than in previous years.  

Childhood physical and mental health affects other critical aspects of a child’s life, including school attendance and performance, and can have lasting effects on a child’s future health and well-being. Our data unfortunately confirms Indiana children and youth face a variety of health challenges, with too many kids dealing with substance abuse, lack of health care, inadequate insurance, and/or poor health habits.  

Infant mortality remains a critical concern. Indiana infants are more likely to die in their first year than those in 42 other states, and black infants are more than twice as likely to die before their first birthday than white infants. Children with health insurance tend to be healthier than their uninsured peers. Indiana ranks 40th nationally in covering kids, with 93.7% of Indiana youth having some type of health insurance (the national rate is 95.0%). 

Tragically Hoosier youth are more likely to consider suicide and engage in suicidal behavior than those in other states. Indiana ranks 2nd out of 34 states in the percentage of students who made a suicide plan and ranks 3rd out of 36 states in the percentage of students who seriously considered attempting suicide. Nicotine use among Indiana students also remains concerning, and this year we saw an increase in the average percentage use of electronic vapor products in all middle and high school grades.  

To improve the well-being of our children and youth, we must first understand their current reality. All of Indiana’s 1,573,409 children deserve a safe, productive, healthy environment where they can learn, grow, and thrive. IYI’s 2019 KIDS COUNT Data Book is a starting point for community conversations and activation. Let’s all act to improve the well-being of our children.   

 

 

teenager vaping

Indiana’s children face many significant health issues, with our opioid crisis and an alarming increase in nicotine use being two of the most urgent. Our state needs all its children to be healthy and have the opportunity to become the strong workforce and leaders of tomorrow.

Children are often the unseen victims of the opioid crisis, with kids of all ages both directly and indirectly affected. Family and community opioid abuse often affects younger children, while older youth may combat opioid addiction themselves. Hoosier children whose parents struggle with substance use disorder are more likely to experience abuse or neglect than other children.

Research shows a clear connection between parents’ substance abuse and child maltreatment, and the number of Indiana kids negatively affected by substance use disorder is growing. Parental substance abuse is the primary factor in more than half (52.2%) of Indiana cases where a child was removed from their home. The addictions crisis also has contributed to a crisis in foster care for the state, with the number of children in foster care having risen 50.2 percent from 2012 to 2015.

Although we may not hear as much about Indiana’s alarmingly high rates of tobacco use, the toll it is taking on our kids is no less dire. The use of any type of tobacco product is unsafe for young people. Experts agree that whether a teen smokes or vapes, the nicotine is both addictive and damaging to their developing brains.

Youth are sensitive to nicotine addiction and feel dependence earlier than adults. Each year, over 3,500 Hoosier children under 18 become new daily smokers. Nearly 9 out of 10 smokers start before age 18, and three out of four teen smokers become adult smokers. The brain continues developing until age 25 and adolescent use of products containing nicotine can harm the part of the brain responsible for mood, learning, and impulse control.

Today, the most commonly used tobacco product among teens are e-cigarettes. When adolescents use vaping products, they are both more likely to use cigarettes, and more likely to increase their use of cigarettes and vaping products over time. Teens who would otherwise be deterred from tobacco cigarettes may be attracted to e-cigarettes because of their unique qualities such as flavorings, design, and perceived social acceptance. The top reasons why teens use e-cigarettes are the use of the product by a friend of family member, availability of flavors, and the belief that vaping is less harmful than other forms of tobacco.

Smoking and substance use are just two of the health issues impacting young Hoosiers – overall, we rank 34th in kids health. We can, and must, do better. We will not change these trends without investing in our kids and our communities. Distressingly, we are 49th out of the 50 states in per-capita spending on public health issues like smoking, drug addiction and obesity.

The Indiana Youth Institute is part of a broad coalition of health, business and youth leaders that are coming together around a plan that calls for improving health outcomes by raising the state cigarette tax as part of next year’s biennial budget. A $2 increase in the state cigarette tax—which is currently under $1 and even lower than Kentucky—would significantly lower the appeal of cigarettes to young, price-sensitive people. It also would generate $360 million in the first year alone that could go toward funding opioid treatment and prevention, educating and protecting youth from e-cigarettes and smoking, addressing our state’s infant mortality concerns and strengthening the Healthy Indiana Plan.

Kids and families benefit from these initiatives. We have the potential to move from bottom ten states in public health spending to the top 10. By raising cigarette user fees in next year’s budget, we can make meaningful and transformative investments to improve our kids’ health.

Our kids are our future. They have limitless potential. Let’s ensure they have the good health needed to become Indiana’s next generation of citizens, innovators, and leaders.

(Tami Silverman is the president and CEO of the Indiana Youth Institute)

The homeless enrollment in Indiana public schools has increased by 34.2% since the 2010-11 school year.

Who Is Considered Homeless? Under the McKinney-Vento Act, schools are required to keep track of the number of children whom they know lack a fixed, regular, adequate nighttime residence. Students experiencing housing instability may be living in motels, trailer parks, campgrounds, transitional shelters, or sharing housing with others because of economic hardship.

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For many of us, it is easy to see how our childhood experiences influence our adult choices, behaviors, and preferences. Perhaps you like basketball because all the kids on your street played together after school. Or you learned to cook by helping a beloved grandparent make special family meals. Years spent in a scouting program can create a lasting love of exploration. Examples of positive experiences are endless and unique to each of us.

In the same way, stressful or traumatic childhood events also have lasting impact. The importance of Adverse Childhood Experiences, or “ACEs”, was first discovered 20 years ago as a result of a large-scale research study led by Kaiser Permanente and the Centers for Disease Control and Prevention. The resulting ACEs screening tool established a way to gauge the cumulative effect of different types of childhood abuse, neglect or stressful events.

While adverse childhood experiences are very common, as the number of ACEs experienced by a child increase, so does that child’s risk for chronic disease as an adult. Unfortunately, as documented in the Indiana Youth Institute’s September data brief, Hoosier youth have a higher prevalence than their peers nationally in eight of out nine ACEs as measured by the National Survey of Children’s Health.

The good news is that the earlier we can identify a child’s ACEs score, the sooner we can connect them to services to prevent, reverse, or heal the effects. Both physicians and educators are building systems to screen and respond to ACEs.

In many cases, positive childhood experiences can mitigate the stressful or traumatic events. All children need adults that support, trust and love them. Caring adults, whether parents, grandparents, teachers, coaches or mentors, are key to helping children build long-term resilience.

Find more information about ACEs from the following resources:
Indiana Youth Institute ACEs Data Brief
Substance Abuse and Mental Health Services Administration
American Academy of Pediatrics

sad boy

The cumulative effect of Adverse Childhood Experiences (ACEs) has a lifelong impact on children. As the number of ACEs increases, there is a greater likelihood of negative wellbeing outcomes such as obesity, depression, and other chronic conditions throughout life.

What are ACEs? Adverse childhood experiences are stressful or traumatic events occurring in childhood and are used to assess the long-term impact of abuse and household dysfunction on later-life health.

  • Nearly half (47.3%) of Hoosier children have experienced one or more ACEs.
  • Indiana has a higher prevalence of children experiencing at least one ACE (47.3%) than half of our neighboring states: Illinois (39.7%), Michigan (46.2%), Ohio (49.5%), and Kentucky (53.1%).
  • Hoosier youth have a higher prevalence than their peers nationally in eight of out nine ACEs as measured by the National Survey of Children’s Health.

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Our kids are going back to school and many of us are thinking about backpacks, school supplies and physicals. With bus schedules, class schedules and afterschool activities, our kids can easily get stressed about the beginning of a new school year. For some children, especially teens, this stress and anxiety exists at a dangerous level.

In Indiana suicide is the 2nd leading cause of death for youth ages 15-24 and the 4th leading cause of death for youth ages 5-14. Experts and teens list several reasons for the increase, including insufficient mental health screening, poor access to mental health services and resistance to seeking care. Suicide ideation and attempt rates are also found to be higher during the school year than in the summer.

Sadly, Hoosier youth are significantly more likely to consider or attempt suicide than their peers nationally, and Indiana faces significant disparities in youth suicide among vulnerable groups.

  • 1 in 5 Indiana high school students seriously considered attempting suicide in the past year. The percentage of students who seriously considered suicide increased from 18.0% in 2005 to 19.8% in 2015.
  • Indiana ranks 2nd out of 34 states in the percentage of students who made a suicide plan and ranks 3rd out of 37 states in the percentage of students who seriously considered attempting suicide.
  • Among our neighboring states, Indiana has the highest percentage of students who seriously considered attempting suicide and the highest percentage of students who made a suicide plan.

For more data on Youth Suicide in Indiana, read IYI’s Data Brief.

Based on these pressing needs, the Indiana General Assembly has passed youth suicide prevention legislation in the past two sessions. Effective June 30, 2018, all teachers and educators for students in grades 5-12 are required to participate in at least two hours of youth suicide awareness and prevention training every three years.

For details about the required training, school responses and effective interventions, go to the Indiana Department of Education’s website.

Child Reaching for Hamburger and Fries

Childhood obesity presents a critical and widespread issue for Indiana children.

One in three Hoosier children ages 10-17 are overweight or obese (33.9%). While childhood obesity presents a concern nationally, this issue is especially relevant in Indiana. Hoosier children are 14.9% more likely to be obese than their peers nationwide. This ranks Indiana as the 9th highest rate of childhood overweight and obesity. In comparison to all neighboring states, Indiana has the highest rate.

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Hoosier youth are significantly more likely to consider or attempt suicide than their peers nationally. Indiana faces significant disparities in youth suicide among vulnerable groups.

Youth Suicide Deaths:

  • In 2016, 57 Hoosier youth ages 19 and younger died by suicide. This represents an increase from 55 deaths in 2015 and 52 deaths in 2014.
  • Suicide is the 2nd leading cause of death for youth ages 15-24 and the 4th leading cause of death for youth ages 5-14.
  • 39% of Indiana’s youth suicide deaths are concentrated in 5 counties: Lake, Marion, Allen, Hendricks, and Porter.
  • 59 of Indiana’s 92 counties had zero youth suicide deaths in 2016.

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As parents, caring adults and community leaders, we must create the conditions for healthy kids to thrive. This means recognizing and addressing the dangers children face when they live in unhealthy environments, reducing health-harming behaviors like smoking and substance use by children and around children, and building communities that make it easier for kids and families to make healthy choices about food and physical activity.

Unfortunately, Indiana comes in 35th for overall children’s health in the U.S. Recognizing this, a new statewide collaboration, the Alliance for a Healthier Indiana, is bringing together business and community leaders to address the health of our citizens. The Indiana Youth Institute is joining this important effort to support building a healthier state from the child up.

Growing up in an environment with trauma and abuse creates lasting negative effects on children’s health, including slowing a child’s social and cognitive growth, raising their likelihood for obesity, tobacco and drug use, and inflicting long term consequences to their health and life opportunities. By understanding the co-occurrence and impact of these Adverse Childhood Experiences (ACEs)*, we are better able to create positive interventions and conditions for change.

If we can reduce child and adult smoking rates, we can have a significant effect on Hoosier health. Indiana ranks 41st in the nation for the percentage of smokers, and an estimated 95 percent of adult smokers start smoking before age 21. More than 4,100 Hoosiers under age 18 become new daily smokers each year. In 2017, nine percent of Indiana high school students smoked cigarettes in the past month, and 14.9 percent of Indiana high school students used electronic vapor products. This is especially concerning, as teens who use e-cigarettes are more likely to subsequently take up cigarette smoking.

Governor Holcomb has challenged Indiana to lower its infant mortality rate, as Hoosier kids infants are 24 percent more likely to die before their first birthday than the national average. Smoking is a significant contributor to problems arising during pregnancy and in the child’s development and health. Almost 1 out of every 7 pregnant women in Indiana smokes during pregnancy, a rate that is 68 percent higher than the national average. Smoking while pregnant is associated with a higher risk of miscarriage, low birthweight, premature birth, some birth defects and Sudden Infant Death Syndrome (SIDS).

Our state’s struggle with opioid use disorder is also taking a tremendous toll on our babies and children. Newborns exposed to opioids in utero have a 60-80 percent likelihood of suffering from Neonatal Abstinence Syndrome, a condition which impacts the child’s long-term growth, behaviors, language abilities, cognitive development, and academic achievement. Last year, Indiana had one of the nation’s greatest percentage increases in the number of children being placed in foster care. The Indiana Department of Child Services reported a sizable increase in the number of substantiated cases of abuse or neglect, with over half of the removals due to parental substance abuse.

Parental overdoses have both an immediate as well as a cumulative impact on children in the home. Children double their likelihood of developing addictive disorders when they come from homes where one or more adults abuse alcohol or drugs. While we do not yet know precisely how many Indiana children are living with adults struggling with opioid use disorder, we do know that these children are suffering and that immediate interventions are needed.

The prevalence of substance use disorder has captured recent headlines, but Indiana’s struggle with obesity is a longstanding problem that we have yet to effectively address. Indiana is the 10th worst state for adult obesity rates, and 1 in 3 Indiana youth ages 10-17 are overweight or obese. According to Julie Burns, CEO of Jump IN for Healthy Kids, in central Indiana the obesity/overweight rate is 25 percent higher than the national average, and three times higher than the goal of 15 percent. Burns stresses the importance of focusing on young children, as habits around food and physical activity are developed by age 5.

Healthy kids grow up with greater chances to be healthy adults, and are more likely to become productive and successful citizens. Far too many Hoosier children face the issues caused by ACEs, smoking, opioid use, obesity and are lost due to infant mortality. We support and applaud the efforts of the Alliance for a Healthier Indiana. Local events to improve Hoosier health are taking place across the state, and we encourage everyone to find a way to contribute by going to www.healthierindiana.org. By collectively dedicating ourselves to these efforts, and by taking a multi-generational approach, we hope to increase the health and success of all Indiana residents.

The well-being of mothers and infants determines the health of the next generation.

In the 2018 State of the State address, Governor Eric Holcomb set the goal for Indiana to become the best state in the Midwest for infant mortality rates by 2024, challenging us to work together to improve conditions for infants. The governor labeled our current infant mortality rate as “unacceptable.” In 2016, 623 Hoosier children died before their first birthday. Indiana ranks 41st nationally for infant mortality, with our babies being 24% more likely to die before their first birthday than infants nationally. Indiana has lagged behind the national average for the past two decades.

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