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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We all benefit when the next generation is healthy, safe, well-educated and economically secure. Indiana can be a wonderful place to be a child, but when we look at overall child well-being, it ranks as the 28th state in the nation. A deeper look at the data shows the disproportionate challenges and barriers to success faced by some children.

The Indiana Youth Institute (IYI) recently published the 24th annual KIDS COUNT Data Book, part of a national effort to measure childhood well-being at the local, state and national levels using data in areas including health, education, economics, safety and family.

The 2018 Indiana KIDS COUNT Data Book shows improvements over last year in children’s health insurance coverage and teen pregnancy rates. Meanwhile, significant challenges remain in the areas of economics, safety and education. Furthermore, substantial inequities appear in most indicators when the data is disaggregated by race, place and income.

In his 2018 State of the State address, Gov. 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 rightly labeled our current infant mortality rate as “unacceptable.” Indiana is ranked 41st nationally, with our babies being 24 percent more likely to die before their first birthday than infants nationally.

Indiana’s black infants are twice as likely as white babies to die before their first birthday, with this disparity widening over the prior year. Tony Mason, CEO of the Indianapolis Urban League, says “There are many socio-economic and health factors that put black infants at a higher risk of infant mortality than white infants. On a state level we need to address the issues of food access and quality care.” Jeni O’Malley, director of public affairs for the Indiana Department of Health, highlights numerous programs aimed at infant health, including the new Liv pregnancy mobile app launched in November.

Child maltreatment is also rising with increasing substantiated cases of abuse and neglect, hotline reports and placements in foster care. Over the past five years, Indiana has seen a 58 percent increase in the number of children in foster care with 58 percent due to parent drug and/or alcohol abuse.

Leaders in government, education and community services all stress the importance of collective efforts, purposeful and consistent partnerships, to increase educational outcomes for all kids. Superintendent of Public Instruction Jennifer McCormick says “Math and reading growth and proficiency impact student success, which is why we have placed an important focus on these subjects in Indiana. Compared to our sister states, we have made great strides.” Yet students of color and those with low incomes and other risk factors, such as homelessness, have lower educational proficiency rates. As Gov. Holcomb states, “We need to move those kids who are at the back of the line—the most disadvantaged among us—to the front of the line,” beginning with increasing access to quality pre-K programs.

Clearly, the conditions necessary for children to thrive are complex. Children growing up in poverty are significantly more likely to experience stress and deprivation that hinders development and school readiness, health and other outcomes. Indiana’s child poverty rates decreased, with 19.5 percent of Hoosier children living in poverty as of 2016, down from 20.9 percent in 2015.

Jennifer Walthall, secretary of Indiana’s Family and Social Services Administration, says her agency believes a two-generation approach provides the best solutions for reducing child poverty because it” addresses the needs of both children and adults in their lives together.” Mason points to providing youth with access to quality education and employment skills as key to breaking the cycle of poverty. Access to such multi-faceted interventions is vital for children of color, as black Hoosier children are three times more likely to live in poverty than their white peers (42.2 percent vs. 13.9 percent).

To ensure all Hoosier children have the opportunity to reach their full potential and become productive and responsible adults, we must understand and work together to improve the conditions that support their success. Our goal with the 2018 KIDS COUNT Data Book is to spark conversations and action throughout the state. Whether working in a region, county, city, school district or neighborhood, the data can help further such efforts.

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(Tami Silverman is the president and CEO of the Indiana Youth Institute. She may be reached at iyi@iyi.org or on Twitter at @Tami_IYI)

ADDITIONAL RESOURCES:

The news offers daily reminders of the complex challenges our communities, state and country face in the opioid crisis. Governor Eric Holcomb made attacking the drug epidemic a pillar of his inaugural policy agenda. Indiana University has announced its Grand Challenge to respond to the addictions crisis, committing $50 million to finding solutions. Indiana’s social service, emergency service, criminal justice, health care, and public health providers are working to respond to the relentless array of ongoing, interconnected needs arising from the crisis. Collaborations among local, state and federal agencies are developing new cross-cutting partnerships and interventions. At the Indiana Youth Institute, we are concentrating on identifying and addressing the short- and long-term consequences of the opioid crisis on Hoosier children.

For the past three years the number of children in Indiana’s foster care system has increased steadily. Experts, including Mary Beth Bonaventura, director of the Indiana Department of Child services, agree these increases are directly linked to the opioid problem.

“We have more children in care than we’ve ever had in history, nationwide and in Indiana, Bonventura said. “With all cases counted, (we have) close to 29,000 kids in care in some way shape or form.”

In 2016, 52 percent of children DCS removed from a home were removed due to parental substance abuse. When substance abuse is included as a secondary cause, that rate rises to nearly 80 percent.

Who cares for the kids caught in this crisis? In Whitley County, 2 percent of children live with foster parents, and 6.2 percent of children live with their grandparents. Bonaventura states in Indiana nearly 51 percent of all DCS foster care placements are with relatives. A September 2017 Pew Charitable Trusts study shows parents of adult children who either struggle with substance use disorder, or have died from an overdose, are raising an increasing number of their grandchildren.

Child placements with relatives, also called kinship care, can be a formal placement from the state or an informal arrangement between the parents and the relative caregivers. In fact, the Pew research estimates that for every foster child formally placed with a relative as a primary caregiver, there are 20 more in informal kinship arrangements. Tina Cloer, president and CEO of Children’s Bureau, Inc., says “I get calls all the time from people all over the city and state who have now inherited their nieces and nephews, their grandchildren, their friends’ kids, because they’re struggling with addiction.”

About 39 percent of grandparents caring for grandchildren are older than 60, 21 percent live below the poverty line and 26 percent have a disability. Like all children in care, children in kinship care have been found to lack adequate access to primary care, immunization, vision, hearing and dental care services. Despite these challenges, the American Academy of Pediatrics stresses the benefits of kinship care, including increased stability and well-being, reduced trauma, and an increased likelihood that siblings will stay together.

We can help grandparents and family members caring for these young victims of our state’s addiction crisis. Kinship care is often unexpected and unplanned. Many families are unaware of available help. For instance, grandparents and families who become licensed foster families can access services and financial supports. Organizations such as Grandfamilies.org provide valuable information on applicable laws and resources. Cloer works with many faith-based and community groups that are reaching out to grandparents caring for their grandchildren with basic needs items such as diapers, formula and clothing. As employers, we can offer flexible schedules for those suddenly faced with caring for these children. Schools and youth organizations also need to be sensitive to kinship care arrangements.

Any comprehensive solution to Indiana’s opioid crisis must include the impacted children and family members. Most child welfare experts agree that an increased focus on the impacts on the youngest victims is warranted. While we look for policy and systems change at the state level, at the local level we can immediately step in to help families providing kinship care. Actions taken now can help prevent this crisis from lasting into the next generation.

For more information on the impact of opioids on children, see IYI’s Issue Brief on the opioid epidemic’s impact on Hoosierchildren.

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Tami Silverman is the president and CEO of the Indiana Youth Institute. She may be reached at iyi@iyi.org or on Twitter at @Tami_IYI. IYI’s mission is to promote the healthy development of Indiana children and youth by serving the people, institutions and communities that impact their well-being.
Download data on children in foster families and children living with grandparents.

EVERY HOOSIER ADULT IS A MANDATED REPORTER OF SUSPECTED CHILD ABUSE AND NEGLECT. TO SUBMIT A REPORT, CALL THE STATE’S HOTLINE AT 1-800-800-5556. IT’S OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS A YEAR.

The number of cases of abused and neglected children in Indiana continues to grow, and 2016 marked the fifth straight year of increases. While the statistics are staggering, the individual stories are heart-wrenching. Recent cases include a 9-year-old dying from starvation in Vigo County, a 2-year-old boy beaten to death in Marion County, and a 1-year-old girl sexually abused and killed in Owen County. For every 1,000 children in Indiana, there were 17 cases of child abuse or neglect in 2015. April is National Child Abuse Prevention month and clearly more needs to be done to protect our children.

Every adult in the state of Indiana is a mandatory reporter of suspected child abuse and neglect. But how do you know what actions correspond to the legal definitions of abuse or neglect? The above cases obviously do, yet many cases are not so clear cut.  Furthermore, many children in such situations understandably are too frightened to tell anyone what is happening.

Indiana’s Child Abuse and Neglect Law, Indiana Code 31-34-1, lists definitions for child neglect, physical abuse, psychological maltreatment and sexual abuse. Prevent Child Abuse Indiana’s website, www.pcain.org, offers straightforward lists of both physical and behavioral indicators of each category of maltreatment. Signs of neglect include persistent hunger, developmental lags and consistent fatigue. Unexplained bruises, numerous bruises in various stages of healing, and marks on many surfaces of the body are all potential signs of physical abuse. Sexual abuse indicators include the child having sexual knowledge advanced for their age, preoccupation with their body, and acting out sexual behavior. Although each of these signs may be found separately, they often occur in combination.

The complexity of child abuse cases has increased in recent years, with severe physical abuse often connected to parental drug and alcohol use and mental illness in the home. In 2016, the child advocacy centers in Indiana served more than 10,000 children for the first time through their multi-disciplinary investigative team model. Historically, the majority of cases centered on child sexual abuse. Today, cases often involve parental addictions, children witnessing domestic violence and human trafficking. There also has been an increase in very severe neglect cases.

“We’re talking about the serious neglect cases where kids are locked in a room and forgotten,” said Emily Perry, founder, executive director and child forensic interviewer for child advocacy center Susie’s Place. “Parents aren’t feeding them for days or weeks because (the parents are) strung out on drugs.”

In 2016, 52 percent of children removed from their home by the Indiana Department of Child Services were removed because of parental substance abuse. This is a 65 percent increase from 2013. In 2015, DCS substantiated 2,702 cases of sexual abuse, 2,175 cases of physical abuse and 22,015 cases of neglect statewide.

As all adults are mandatory reporters, it is critical that we be familiar with how to report child abuse. A hotline report must be made if you have a reasonable suspicion that child abuse or neglect has occurred. You do not need to have direct knowledge of abuse or neglect. James Wide, ‎Deputy Director of Communications for DCS says “That’s the main, core message. You don’t have to do a lot of deliberating and thinking about ‘Is this right? Is this wrong? Is that abuse?’ Just call. You just call.” Hopefully, the increasing number of hotline calls are an indication that more Hoosiers are willing to step up and help protect our children.

Horrific stories of child abuse and neglect could easily immobilize us. Yet our children’s safety requires action. As a caring family member, neighbor, teacher, coach or youth worker, you may be in the ideal position to see that something is not right in a child’s life. Call the Indiana Child Abuse and Neglect Hotline at 1-800-800-5556. Locate your nearest Prevention Council (www.pcain.org) or Child Advocacy Center (www.incacs.org) to donate and/or volunteer. April is designated as Child Abuse Prevention Month, but the work of protecting our children is something we must all do 24 hours a day, 365 days a year.

(Tami Silverman is the president and CEO of the Indiana Youth Institute. She may be reached at iyi@iyi.org or on Twitter at @Tami_IYI)