Child Health Matters - Voices for Illinois Children

ILLINOIS KIDS COUNT 2014

Child Health Matters VOICES for Illinois Children

Voices for Illinois Children

Illinois Kids Count

Voices for Illinois Children works as a catalyst for change to improve the lives of children of all ages throughout our state.

Illinois Kids Count is a project of Voices for Illinois Children and is part of the KIDS COUNT ® network of projects supported by the Annie E. Casey Foundation to track the status of America’s children on a state-by-state basis. Through Illinois Kids Count reports, media events, statewide and local symposia, legislator forums, and other activities, Voices for Illinois Children assesses the challenges facing children and families and seeks to guide policy trends and goals on behalf of children.

We are committed to the well-being of every child. All children, regardless of circumstances, are vital to the preservation of a vigorous democracy. We believe children do well when they grow up in strong, supportive families, and that families do well in supportive communities. We believe in focusing on preventing problems by employing comprehensive, well-researched strategies to improve children’s education and health care and to strengthen their families’ economic security and the social services on which they depend. For over 25 years, we have helped parents, community leaders, and policymakers understand and respond to the issues facing children and families. Together, we have affected the well-being of an entire generation of Illinois children through achievements in early childhood education and care, K–12 education, health care, children’s mental health, child welfare, family economic security, and afterschool and youth development. Voices raises awareness of the needs facing children and families, builds strong partnerships focused on solutions, convenes stakeholders to explore data, generates public support and political will for needed improvements, and works to ensure implementation of strong policies and programs. OUR MISSION Voices for Illinois Children

champions the full development of every child in Illinois to assure the future well-being of everyone in the state. We work with families, communities, and policymakers to help children grow up healthy, nurtured, safe, and well-educated.

The Illinois Kids Count report uses the best available data to measure the educational, social and emotional, economic, and physical wellbeing of children. By providing policymakers and the broader public with benchmarks of child well-being, Illinois Kids Count enriches local and state discussions of ways to build and secure better futures for all children. Illinois Kids Count monitors child outcomes and contributes to public accountability for those outcomes, resulting in a model for data-driven advocacy for children, their families, and their communities. Illinois Kids Count 2014 can be viewed, downloaded, or ordered online at www.voices4kids.org. KIDS COUNT® is a registered trademark of the Annie E. Casey Foundation.

ILLINOIS KIDS COUNT 2014

Child Health Matters VOICES for Illinois Children

Voice for Illinois Children Board of Directors, 2013 SUSAN J. IRION Chair

BETTY HUTCHISON, PH.D.

Chicago

Chicago

BONNIE WHEELER Vice Chair

TRACY T. JOHNSON

Carterville

Rockford

LAURA AUWERDA

MIRIAM KELM

Chicago

Highland Park

NANCY K. BELLIS

CHRISTA MARKGRAFF

Chicago

McHenry

LINDA COLEMAN-CLEVELAND

JOHN P. MILLER

Frankfort

Westmont

ELIZABETH COULSON

JOHN E. RHINE

Glenview

Mt. Carmel

KIMBERLY FEENEY

ALEXANDER RORKE

Orland Park

Evanston

SAMUEL S. FLINT, PH.D.

MARK ROSENBERG, M.D., M.A.

Buffalo Grove

Deerfield

LUKE GRIFFIN

SUZANNE SWISHER

Hinsdale

Rock Island

RAY HANCOCK, PH.D.

BETH J. TRUETT

Marion

Oak Park

Illinois Kids Count Team YASMINE BAHARLOO

ELIZABETH KENEFICK

Project Assistant

Project Intern

LISA CHRISTENSEN GEE

ANNE KLASSMAN

Policy Analyst, Fiscal Policy Center

Project Manager

LARRY JOSEPH

JOAN VITALE

Director, Fiscal Policy Center

Director of Special Initiatives

5 FOREWORD Better Health for All Illinois Kids GAYLORD GIESEKE President, Voices for Illinois Children

SOCIAL & EMOTIONAL WELL-BEING 38 HIGHLIGHTS 39 Negative experiences 40 Family mental health

8 OVERVIEW ACCESS TO CARE 10 HIGHLIGHTS 11 Health insurance

41 Addressing Parental Stress in Vulnerable Families CARMEN VALDEZ University of Wisconsin-Madison SANDRA MAGAÑA University of Illinois at Chicago

12 What the ACA Means for Children KAY SAVING Illinois Chaper, American Academy of Pediatrics SCOTT ALLEN Illinois Chapter, American Academy of Pediatrics

ORAL HEALTH 42 HIGHLIGHTS 43 Oral health status 44 Dental care

13 Health insurance, medical assistance 14 Primary and preventative care

45 Creating a Dental Home SHEILA HALL Infant Welfare Society of Chicago

15 EPSDT: How Medicaid Helps Children Get Access to Care JOHN BOUMAN Sargent Shriver National Center on Poverty Law

SPECIAL HEALTH CARE NEEDS 46 HIGHLIGHTS 47 Chronic conditions, asthma, school absence

EARLY CHILDHOOD 16 HIGHLIGHTS 17 Maternal and child health 18 Infant health 20 Women, Infants, and Children Program 21 Early childhood health services 23 Childhood Lead Poisoning—An Evolving Challenge DEANNA DURICA Cook County Department of Public Health ANITA WEINBERG Illinois Lead Safe Housing Task Force FAMILY ENVIRONMENT 24 HIGHLIGHTS 25 Child poverty 27 Give Them Your Voice DAVE MCCLURE Illinois Collaboration on Youth 28 29 30 31

Child abuse and neglect Children in substitute care Home visiting, teen mothers Household health

48 Behind the Burden of Asthma STACY IGNOFFO Chicago Asthma Consortium 49 Effects on children and families PERSONAL & COMMUNITY SAFETY 50 HIGHLIGHTS 51 Communities and schools 52 Keeping Our Kids Safe Through Education,

Community Collaboration ARTHUR CULVER East St. Louis School District 189 53 Crimes against children 54 Teen mortality 55 APPENDIX: COUNTY DATA 56 Percentage of Children without Health Insurance,

50 Largest Counties 57 Enrollment of Children in Medical Assistance Programs,

50 Largest Counties 58 Infant Mortality Rates per 1,000 Live Births,

HEALTHY LIVING 32 HIGHLIGHTS 33 Child nutrition 34 YMCAs Support Healthier Communities Through Partnerships MEG COOCH Illinois State Alliance of YMCAs 35 Physical activity 36 Teen behavior

50 Largest Counties 59 Child Poverty, 50 Largest Counties 60 Substantiated Cases of Child Abuse and Neglect, 61 62 63 64

50 Largest Counties Rates of Child Abuse and Neglect, 50 Largest Counties Children in Substitute Care, 50 Largest Counties Teen Births as Percentage of All Births, 50 Largest Counties Reported Crimes Against Children, 50 Largest Counties

KIDS COUNT DATA CENTER 37 The Importance and Effectiveness of Prevention KAREL HOMRIG Prevention First SARA HOWE Illinois Alcohol & Drug Dependence Association

Foreword

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BETTER HEALTH FOR ALL ILLINOIS KIDS Healthy child development is fundamentally important not only for individual children and their families, but also for the broader community and society as a whole. At the state level, we collectively benefit from our efforts to help all Illinois children achieve their optimal health. The converse is also true—we stand to lose from our failure to do so.

GAYLORD GIESEKE President, Voices for Illinois Children

So how are we doing? Illinois Kids Count 2014 documents some positive trends for children’s health in our state—fewer children without health insurance, declining infant mortality rates, fewer young children with lead poisoning, and fewer teen deaths from accidents, homicide, or suicide. However, the data also show disturbing disparities related to household income level, race and ethnicity, special health care needs, and other factors. Because health is impacted by so many factors—individual, family, and community—reducing these disparities will require a broad set of policy strategies. We hope this report will spark conversations among communities, service providers, advocates, and policymakers on what we’re doing now that works and what more each of us can do. We share some of our thoughts below to get the conversation started. We look forward to hearing your ideas and working with you to help create the policy strategies necessary to support the healthy development of all Illinois children.

developmental services. A federal court order, issued in 2005, obligates Illinois to comply with EPSDT requirements for ensuring access to needed services. The state has improved access to primary care services by raising payment rates and improving care coordination, although there are still problems with access to certain kinds of specialty care.1 The Affordable Care Act (ACA) will reduce disparities in access to private health insurance for both children and their families. For children with special health care needs, as well as for many parents, an important provision of the ACA is the prohibition against denying or limiting insurance coverage solely on the basis of pre-existing health conditions. Another provision requires that all new private health plans offer coverage for mental health and substance abuse services and that these services be covered on the same level as medical services. The ACA also extends Medicaid coverage for former foster children until they reach age 26, regardless of their income.

Access to Care

Child health is multidimensional, and children need to be supported in their physical, cognitive, and social-emotional development. Given disparities in healthy development based on special health care needs, it is essential that these needs are identified early and that these children receive well-coordinated care. The Early Intervention program provides a broad array of services for families with children under age 3 who have been diagnosed with disabilities or developmental delays or who are at risk of delays.

Over the past several decades, Illinois has made significant progress reducing disparities in children’s health insurance coverage through Medicaid, the Children’s Health Insurance Program (CHIP), and All Kids. A distinctive feature of Medicaid coverage for children is the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program. Under federal law, states must offer a comprehensive set of benefits, including medical, dental, vision, and hearing services, as well as mental health and

Healthy Child Development

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FOREWORD

1 John Bouman, “EPSDT: How

Medicaid Helps Children Get Access to Care” (in this report). 2 Shadi Houshyar, “Addressing

the Health Care Needs of Children in the Child Welfare System” (First Focus, October 2011); Kamala D. Allen and Taylor Hendricks, “Medicaid and Children in Foster Care” (Center for Health Care Strategies, March 2013). 3 Douglas Almond et al.,

“Inside the War on Poverty: The Impact of Food Stamps on Birth Outcomes,” Review of Economics and Statistics, May 2011; Hillary W. Hoynes et al., “Long Run Impacts of Childhood Access to the Safety Net” (Goldman School of Public Policy, University of California at Berkeley, March 2013). 4 See Emilie Stoltzfus and

Karen E. Lynch, “Home Visitation for Families with Young Children” (Congres sional Research Service, October 23, 2009). 5 Allison Freidman-Krauss

and W. Steven Barnett, “Early Childhood Education: Pathways to Better Health” (National Institute for Early Education Research, April 2013); Joseph A. Durlak and Roger P. Weissberg, “Afterschool Programs that Follow Evidence-Based Practices to Promote Social and Emotional Development Are Effective” (Expanded Learning and Afterschool Project, 2013); “School-Based Health Centers” (National Conference of State Legislatures, October 2011).

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Illinois has been a leader in recognizing the importance of mental health for children’s overall health and well-being. In 2005, the Children’s Mental Health Partnership released a strategic plan for building a comprehensive, coordinated system of services to promote the healthy social and emotional development of children. The state has taken steps to reach more children at younger ages and earlier stages of need, reduce fragmentation of services, and enhance interagency collaboration. However, progress has been impeded by funding cuts and communities’ capacities to serve children in need, and there is still a long way to go. Children who have experienced abuse or neglect often have an exceptionally wide range of special health care needs. Nearly all children in foster care or adoptive families are eligible for Medicaid and should have access to comprehensive EPSDT services. But this uniquely vulnerable population often faces gaps in coverage, unmet needs, and barriers to appropriate services. We need to develop more systematic and effective approaches to meeting the health care needs of children in the child welfare system.2

Communities The disparate physical, social, and economic conditions of communities have an impact on child development. Children who live in poorer communities are at greater risk of exposure to violence and environmental contaminants and are more likely to suffer from preventable health problems. Investing in community-based services should be part of the strategy for promoting better health outcomes for children. Early childhood education programs can have a wide range of positive effects on physical health, as well as on cognitive and social-emotional development. Afterschool initiatives help keep youth safe and encourage healthy choices to help youth avoid drug use, crime, and other risky behaviors. The ACA has provided new federal funding for school-based health centers, which can help reduce health disparities and improve health outcomes for underserved children and youth.5

Moving Forward

Illinois Kids Count 2014 makes it very clear that we need to do more to address disparities in Families children’s health. There are certain policy steps Family conditions—including parental health, we know we must take and others that have yet economic resources, and family stability—are to be defined. We can reduce disparities in access major factors in child development. We cannot to care by maintaining funding for Medicaid hope to reduce disparities in child health outcomes and related programs and by ensuring successful without strengthening families’ capacities to support implementation of the ACA in Illinois. We healthy development. can foster the healthy development of children Living in poverty can have a wide range of negative by supporting families and improving mental effects on children’s health. The federal Supplemental health services. We can strengthen communities’ Nutrition Assistance Program (SNAP)—formerly capacities to support healthy development by the Food Stamp program—plays an essential role in expanding quality early learning, school health mitigating the stresses of economic hardship. Morecenters, and afterschool programs. over, research has shown that access to Food Stamps We recognize that many of our efforts to by pregnant women contributes to improved birth reduce disparities in children’s health depend on outcomes and that access to the program in early child- the state’s fiscal health. In the aftermath of the hood leads to better health outcomes in adulthood.3 Great Recession, many of the programs mentioned Another important type of family support is here have been subject to repeated budget cuts. home visiting, which provides intensive services and At the end of 2014, Illinois is projected to lose supports for “at-risk” families with young children massive amounts of revenue due to the rollback of or those expecting children. Research has shown that current income tax rates, which could lead to more home visiting programs can contribute to improved devastating cuts. Given this immediate challenge, maternal and child health, prevention of child injuVoices for Illinois Children will also be working ries, and enhanced social-emotional development.4 this year to maintain the stable and sustainable Illinois has been expanding and strengthening its revenue necessary to protect and promote the evidence-based home visiting initiatives with new healthy development of Illinois’s youngest and federal resources through the Maternal, Infant, most vulnerable residents. We hope you’ll join and Early Childhood Home Visiting Program. It is us in these important efforts, and look forward imperative that Congress reauthorize this program to collaborating with you on all of the important before its expiration at the end of September 2014. work that lies ahead.

voices4kids.org

Overview

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HEALTH MATTERS Child health matters for numerous reasons—its impact on quality of life, its effects on school readiness and social development, and its long-term influence on outcomes in adulthood. Children’s physical, emotional, and social well-being can be affected by a wide range of factors, including health insurance coverage, access to services, quality of care, family circumstances, community resources, and the broader social and physical environment.

Illinois Kids Count 2014 examines the health of the state’s children, with particular focus on group disparities related to family income, race and ethnicity, geography, and special health care needs. Reducing health disparities is imperative for improving the lives of children and their families and for building a better future for the state as a whole.

Reducing Disparities in Health Insurance Coverage Over the past several decades, the expansion of public programs has greatly reduced disparities in health care coverage for children in both Illinois and the nation as a whole.1 As a result of federal legislation enacted in 1989 and 1990, Medicaid eligibility was mandated for children under age 6 with family incomes under 133 percent of poverty level and gradually extended to older children with family incomes up to 100 percent of poverty level. This incremental expansion was completed in 2002. Under the Affordable Care Act of 2010, the effective income eligibility limit for all children is now 138 percent of poverty level.2 The Children’s Health Insurance Program (CHIP), established by Congress in 1997, gave states new options for covering low-income

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children. CHIP in Illinois was instituted under the rubric of “KidCare.” In 2006, Illinois implemented the “All Kids” program, offering coverage for uninsured children who were not eligible for either Medicaid or CHIP. The state’s outreach efforts and streamlined application procedures for KidCare and All Kids also facilitated enrollment of eligible children in Medicaid. For five consecutive years from 2009 to 2013, Illinois received federal performance bonuses for successful enrollment and retention of eligible children in Medicaid and CHIP. About 1.7 million children are currently enrolled in the state’s medical assistance programs. As a result of coverage through Medicaid and related programs, Illinois has one of the lowest uninsured rates for children in the nation. Despite the decline in employersponsored coverage during the recession, the proportion of Illinois children without health insurance declined from 6 percent in 2008 to 3 percent in 2012. Over the same period of time, the uninsured rate for non-elderly adults increased from 17 percent to 19 percent. As the data in this report show, Illinois has also significantly narrowed racial-ethnic disparities in children’s health insurance coverage.

OVERVIEW

Beyond Health Insurance: Economic and Racial-Ethnic Disparities Expanding access to health insurance for children is a major policy achievement, but reducing child health disparities must also address issues of access to services, quality of care, and health outcomes, as well as the social and economic factors that underlie health disparities. In particular, the pervasive effects of poverty on child health have been documented by an extensive body of research. Children in poverty have higher incidence of low-birthweight, chronic medical conditions such as asthma, socialemotional problems, inadequate nutrition, and exposure to violence.3 In 2012, close to 625,000 Illinois children lived below poverty level. The low-income child population (below 200% of poverty level) totaled about 1.26 million. Data in this report show wide health-related disparities between Illinois children in low-income families and those in families with higher incomes. Disparities for children in poverty are even greater, but data limitations preclude presentation of state-level findings. A large body of research has found substantial racial-ethnic disparities in access to services and quality of care, even when controlling for health insurance coverage and household income. Such disparities are related to cultural barriers, language differences, discrimination, and community environments, as well as the institutional arrangements of health care systems.4 Data in Illinois Kids Count 2014 show racial-ethnic disparities among children across numerous indicators, including birth outcomes, preventive health care, oral health, personal safety, and overall health status of both children and their parents.

Disparities Related to Special Health Care Needs An estimated 15 percent of Illinois children have special health care needs. This report documents just a few of the many challenges for these children and their families. According to a survey of parents, about 40 percent of Illinois children with special health care needs do not have adequate health insurance. Less than half of youth with special health care needs receive services necessary to make appropriate transitions to adult health care, work, and independence. And children with special health care needs are

much more likely than other children to have frequent school absences. Children in substitute care, as well as other children who have experienced abuse or neglect, have significant and complex health care needs. (Substitute care includes foster care, home-ofrelative care, and institutions and group homes.) Medical, dental, and behavioral health conditions are exceptionally prevalent among children entering foster care.5 Child abuse and neglect are associated with various risk factors, and the relationship between poverty and maltreatment is complex. Some studies indicate significant underreporting of child abuse and neglect in families with higher incomes. At the same time, research does show that family economic stress is associated with higher rates of child abuse. Poverty is more strongly associated with child neglect than with other types of maltreatment.6 Since FY 2006, substantiated cases of child abuse and neglect have increased by 10 percent in Cook County, 33 percent in the collar counties (DuPage, Kane, Lake, McHenry, and Will), and 7 percent in the rest of the state. The collar counties have also been experiencing rapid growth in their child poverty populations. Outside the Chicago metropolitan area, several larger urbanized counties—Macon, Peoria, Vermilion, and Winnebago—have high rates of abuse and neglect as well as high child poverty rates.

Organization of the Report The child health indicators in this report are organized into eight sections: Access to Care, Early Childhood, Family Environment, Healthy Living, Social and Emotional Well-Being, Oral Health, Special Health Care Needs, and Personal and Community Safety. The various sections also include summaries of key findings, as well as guest essays to complement the data exhibits. The indicators presented in the report are not meant to be exhaustive. For many indicators related to child health, state-level data are not readily available, especially in the areas of mental health, oral health, and special health care needs. Unless otherwise noted, all data are measures for Illinois children. The statewide data are supplemented by an appendix with county-level data on access to health care, child poverty, child abuse and neglect, children in substitute care, teen births, and infant mortality.

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1 Lawrence B. Joseph, “The

Quiet Revolution: Medicaid and CHIP Coverage of Low-Income Children in Illinois” (Chapin Hall Center for Children at the University of Chicago, November 2004). 2 In 2012, the federal poverty

threshold was about $23,300 for a family of four with two children and $18,500 for a family of three with two children. 3 See, e.g., Janet Currie, “Pol-

icy Interventions to Address Child Health Disparities: Moving Beyond Health Insurance,” Pediatrics, November 2009; Janet Currie and Wanchuan Lin, “Chipping Away at Health: More on the Relationship between Income and Child Health,” Health Affairs, March 2007. 4 For a comprehensive review

of the research, see National Research Council, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care (National Academies Press, 2003). 5 “Children in Foster Care Are

Children with Special Health Care Needs” (Catalyst Center: Improving Financing of Care for Children and Youth with Special Health Care Needs, November 2011); Kamala D. Allen and Taylor Hendricks, “Medicaid and Children in Foster Care” (Center for Health Care Strategies, March 2013). 6 Matthew W. Stagner and Jiffy

Lansing, “Progress toward a Prevention Perspective,” The Future of Children, Fall 2009; Anne Petersen et al., eds., New Directions in Child Abuse and Neglect Research (National Academies Press, 2013), chapter 3.


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Access to Care HIGHLIGHTS In 2012, only 3.4% of Illinois children lacked health insurance, compared with 5.6% in 2008. Illinois has one of the lowest uninsured rates of any state. Illinois has significantly narrowed racialethnic disparities in health insurance coverage for children. Between 2009 and 2012, uninsured rates dropped from 7% to 4% for Latinos and from 6% to 4% for both African-Americans and Asians. Over the same period of time, uninsured rates for white children remained at about 3%. Between 2005 and 2012, enrollment of children in medical assistance programs increased by 31% in Cook County, 122% in the collar counties, and 42% in the rest of the state.

Children Without Health Insurance, 2012

A survey of parents found that 85% of Latino children had at least one preventive medical visit in the past 12 months, compared with about 90% for both white and African-American children. In 2011, 83% of infants and toddlers in the Illinois Medicaid program received at least one initial or periodic screen, up from 78% in 2008.

12%

Illinois has significantly reduced racialethnic disparities in health insurance coverage for children.

5

3% White

U.S.

7%

6%

%

4%

4%

4%

Black

Latino

Asian

SOURCE U.S. Census Bureau, American Community Survey.

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According to a survey of parents in Illinois, 73% of white children receive comprehensive, coordinated care that meets the criteria for a medical home, compared with 45% of African-American children and 27% of Latino children.

Illinois

ACCESS TO CARE

Children without Health Insurance Coverage Percent

Illinois

U.S.

12 9.9

10

8.6

8.0

8

7.5

7.1

5.6

6

4.5

4.5

3.7

4

Illinois ranks fifth among the 50 states in health insurance coverage for children. Only Massachusetts, Vermont, Connecticut, and Hawaii have lower uninsured rates. [American Community Survey, 2010–2012]

3.4

2 0

2008

2009

2010

2011

2012


Children without Health Insurance by Race-Ethnicity Percent

2009 Illinois

2010 U.S.

Illinois

2011 U.S.

Illinois

2012 U.S.

Illinois

U.S.

White 3.0 5.8 3.3 5.6 2.8 5.4

2.6

5.2

Black

6.1 7.9 5.6 7.1 4.6 6.4

4.4

6.1

Latino

7.0 15.7 6.3 14.1 4.8 12.8

4.2 12.1

Asian

6.1 8.3 5.9 7.8 5.0 7.7

4.3

7.2

All children

4.5 8.6 4.5 8.0 3.7 7.5

3.4

7.1


Children without Health Insurance by Income Level, 2012 Percent

Illinois

U.S.

12 10.0

10 8

6.8

6 4.6 3.5

4

2.4 2 0

1.2

Below 200% FPL

200–399% FPL

400% FPL or higher FPL federal poverty level


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ACCESS TO CARE

WHAT THE ACA MEANS FOR CHILDREN Pediatricians have long championed three fundamental priorities for health care reform, and they are as simple as ABC: Access to health care services, age-appropriate Benefits in a medical home, and health care Coverage for all children. The Patient Protection and Affordable Care Act (ACA) addresses these goals and more. Although the journey to full implementation is long and not without obstacles, Illinois children are on a path to better care and outcomes thanks to the ACA.

KAY L. SAVING, MD, FAAP President, Illinois Chapter, American Academy of Pediatrics; Medical Director, Children’s Hospital of Illinois

SCOTT ALLEN Executive Director, Illinois Chapter, American Academy of Pediatrics

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As early as 2010, ACA benefits fundamentally changed health insurance for children. The law guaranteed coverage for children with pre-existing conditions, eliminated lifetime coverage limits, prevented insurers from dropping coverage when a child gets sick, and ensured young adults could stay on their parents’ plans until they turn 26. What does this mean for children? Our goal of identifying children with delays and disabilities early—which is critical to accessing services and improving outcomes—will no longer put families in impossible situations with their coverage and finances. The ACA guarantees that essential preventive care services are provided with no cost-sharing for families with new health insurance plans. The law also incorporates recommendations from the “Bright Futures Guidelines for Health Supervision,” which are the American Academy of Pediatrics’ own standards, and what every primary care pediatrician strives for when caring for patients and families. What does this mean for children? Preventive care is being supported and prioritized, and families will get the screenings, anticipatory guidance, and other services needed to keep their children healthy. The ACA also includes a provision that raises Medicaid payment rates significantly from 2013–2015. Children are the majority of Medicaid recipients, and pediatricians are the largest group of Medicaid primary care providers. Despite talk about investing in children, state-determined

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payment rates for Medicaid programs have averaged 30% below payment rates for federal Medicare programs serving adults. In 2013, the federal government began funding this two-year increase in Medicaid payment rates for certain primary care and immunization services, raising them to near Medicare levels. What does this mean for children? Because low payment creates barriers for pediatricians to accept Medicaid patients, this temporary parity will help increase access to services for families on Medicaid and All Kids. We hope it will be continued. Finally, 2013 marked the rollout of the Health Insurance Marketplaces, along with the expansion of Medicaid in Illinois to include low-income adults who previously did not qualify. What does this mean for children? Expanding public health insurance coverage to parents leads to increases in Medicaid participation among children. More importantly, as gatekeepers of their children’s health, parents’ choices are conditioned by their own resources, health behaviors, and knowledge. Healthier parents raise healthier children. Like our patients, the ACA is still young, and supporting its development is critical. Changes being made in Illinois and across the country could increase coverage for both children and their families, eliminate barriers to quality health care, increase access to preventive services, and give pediatricians tools and support to do the best for their patients. What does this mean for children? Everything.

ACCESS TO CARE

Health Insurance Coverage by Age Group and Type of Coverage, 2012 Percent

Under age 18

Ages 18–64

Age 65 or over

Private insurance

59.5 70.5 66.1

Public insurance

40.6 13.2 95.8 3.3 18.8 1.2

Uninsured

NOTE Individuals may be covered by more than one type of insurance. SOURCE U.S. Census Bureau, American Community Survey.

Private insurance includes health plans provided through an employer or union and plans purchased by an individual directly from an insurance company. Public insurance includes Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and veterans’ health care.

Enrollment in Medical Assistance Programs Children in 1,000s 1,800 1,600 1,364

1,400 1,200 1,000 800

864

938

940

1,015

1,083

1,158

1,455

1,553

1,697 1,630 1,679

1,215

782

770

800

1997

1998

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

600 400 200

0

2011

2012

June of each year

In FY 2012, children’s enrollment in medical assistance programs included 83% in Medicaid, 13% in the Children’s Health Insurance Program (CHIP), and 4% in All Kids expansion. [Estimates from Fiscal Policy Center at Voices for Illinois Children]

SOURCE Illinois Department of Healthcare and Family Services.

Enrollment in Medical Assistance Programs by Region Children in 1,000s

Cook County

900 800 700

716.0 637.3

752.8

400

367.5

393.8

300 200

Rest of state

835.0

788.5

815.9

831.7

480.2

502.6

515.9

521.6

284.6

312.0

331.7

340.7

2009

2010

2011

2012

648.9

600 500

Collar counties

153.2

171.9

2005

2006

428.3

219.5

453.1

249.3

100 0

2007

2008

June of each year NOTE Collar counties are DuPage, Kane, Lake, McHenry, and Will. SOURCE Illinois Department of Healthcare and Family Services.

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ACCESS TO CARE

Children Receiving Care within a Medical Home, 2011–2012

Preventive Medical Care Visits in Past 12 Months, 2011–2012

Percent

Percent

All children

None

89 11

All children

56

Race-Ethnicity Children are considered to have a medical home if they have a personal doctor or nurse, have a usual source for care, receive family-centered and culturally sensitive care, obtain needed referrals for specialty care, and receive effective care coordination across multiple providers and services. [Data Resource Center for Child & Adolescent Health]

One or more

Race-Ethnicity

White

73

Black

45

Latino

27

Income Level

White

90 10

Black

91 9

Latino

85 15

Income Level

Below 200% FPL

39

200–399% FPL

64

400% FPL or higher

72

Below 200% FPL

85 15

200–399% FPL

92 8

400% FPL or higher

92 8

FPL federal poverty level


NOTE Children ages 0–17.


SOURCE National Survey of Children’s Health (survey of parents).


Participation in Medicaid Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Percent

The child health component of Medicaid is known as the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program. Federal law requires that Medicaid cover a very comprehensive set of benefits and services for children, including medical, dental, vision, and hearing services, as well as mental health and developmental services.


2009

2010

2011

Illinois

Under age 3

78 81 84 83

Ages 3–5

64 68 70 69

Ages 6–9

60 69 75 76

Ages 10–14

62 77 81 80

Ages 15–18

60 68 73 71

U.S.

Under age 3

78

Ages 3–5

66 68 70 67

Ages 6–9

69 67 64 63

Ages 10–14

53 54 54 54

Ages 15–18

45 45 44 45

78

NOTE Percentage of eligible children receiving at least one initial or periodic screen for each fiscal year. SOURCE Centers for Medicare and Medicaid Services.

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2008

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85

81

ACCESS TO CARE

EPSDT: HOW MEDICAID HELPS CHILDREN GET ACCESS TO CARE Illinois gets billions of federal dollars for health care under Medicaid in return for following federal program standards. Medicaid has a special rule to ensure children’s access to all kinds of care. It is called the Early and Periodic Screening, Diagnostic, and Treatment requirement—EPSDT. To implement the well-child part of this requirement (early and periodic screening and diagnostic services— EPSD), the program embraces the prescriptions of the American Academy of Pediatrics for specified numbers of well-child visits, immunizations, and diagnostic screenings in each year of a child’s life. If a medical issue is diagnosed in these visits or otherwise arises (like falling out of a tree or getting an infection), then coverage of all necessary treatment (the “T” in EPSDT) is required.

JOHN BOUMAN President, Sargent Shriver National Center on Poverty Law

After years of complaints from families about lack of access to care for their children, lawyers representing the children filed a lawsuit on their behalf to enforce the Medicaid EPSDT requirement. After long delays, the children won their case, Memisovski v. Maram, in 2004. Making a decision to try to fix the problem rather than keep fighting, the state agreed to a settlement, known as a consent order, in 2005. Under the Memisovski order, the state committed to comply with the EPSDT requirement and to take certain specific steps. To increase participation by doctors and dentists, the state increased rates for well-child visits and basic dentistry significantly and assigned priority to those bills for payment. In addition, children’s health services, pediatric rates of pay, and the priority in the payment cycle were spared from erosion during the recession and from Medicaid program cuts enacted in 2012. The state cited the Memisovski court order as a reason for this outcome. The state also agreed in the court order to create a new primary care case management system to help incentivize doctors to provide the full array of well-child and primary care services. It paid a monthly care management fee for every child and

an annual bonus for each patient that received the full set of recommended EPSDT services. This system was built out statewide and named Illinois Health Connect. It is still in effect. In some parts of the state, it will be replaced by other forms of care coordination in the coming year, but these arrangements must still comply with EPSDT and the court order. Children continue to experience difficulty accessing certain kinds of specialty care, especially behavioral and non-routine dental care. The court order requires the state to comply with EPSDT by providing access to all needed care. The state’s new care coordination arrangements offer an opportunity to improve access to specialty care. While there are always problem areas, in general the Quinn Administration has a very cooperative record on EPSDT and children’s access to care. The measures have been taken as a matter of policy choices and not just compliance with the court order. Many of the policies providing care to children exceed the strict letter of the court order’s requirements, and there is a clear intent to address problem areas with specialty care in the care coordination process.

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Early Childhood HIGHLIGHTS Prenatal care in the first trimester of pregnancy is less prevalent among African-American women, Latino women, younger women, and women with lower levels of educational attainment.

Infant Mortality Rate per 1,000 births Infant mortality rates in Illinois have been steadily declining over the past several decades.

Illinois

U.S.

10.7

9.2

1990

2010

Illinois

U.S.

6.8

6.2

SOURCE National Center for Health Statistics.

16

Participation in the state’s Family Case Management Program for low-income expectant mothers has declined by 27% since FY 2007. Although the prevalence of low-birthweight babies among African-American mothers is substantially higher than among white or Latino mothers, the prevalence has declined since 2005. Infant mortality rates are substantially higher among African-American children compared to other children, but have been steadily declining over several decades. In 2012, 70% of Illinois women in the WIC program were breastfeeding when discharged from the hospital, but only 18% were still breastfeeding six months later. The prevalence of elevated lead levels among Illinois children under age 6 has steadily declined over the past decade. However, current measures of lead poisoning may understate the harmful effects of exposure to lead on children’s healthy development.

EARLY CHILDHOOD

Pregnant Women Receiving Prenatal Care in First Trimester, 2008–2009 Percent Total

Age

81.8

Education

High school

89.8

Race

72.6

25–34

87.5

35+

87.8

Ethnicity

White

Latino

84.4

Black

73.6

Non-Latino

67.7

84.7

NOTE Two-year averages. SOURCES Illinois Department of Public Health, Pregnancy Risk Assessment Monitoring System (PRAMS).

Family Case Management Program Enrollment 1,000s 350 300 250

267 224

230

277

281

283

286

292

291

277

263

234

243

229

212

200 150 100 50 0

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013*

Fiscal years *Projected enrollment. NOTE Numbers of pregnant women and infants enrolled.

The Family Case Management (FCM) program provides comprehensive service coordination to assure healthy pregnancies and promote children’s healthy development. FCM assessments and care plans address a wide range of needs, including health care, mental health, nutrition, education, child care, and transportation.

SOURCE Illinois Office of the Comptroller, Public Accountability Reports; based on data from Illinois Department of Human Services.

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17

EARLY CHILDHOOD

Preterm Births by Race-Ethnicity, 2011 Percent 18

17.0

16 14 12.1

12

12.0 10.8

10 8 6 4 2 0

Total

White

Black

Latino

NOTE An infant born prior to 37 weeks of pregnancy is preterm. SOURCES National Center for Health Statistics.

Low-Birthweight Babies by Race-Ethnicity of Mother Percent

White

Black

Latino

18 16

15.1

14.6

14.3

14

13.8

13.8

13.6

13.5

12 10 7.3

8

6.7

7.4

7.2

7.3

6.8

7.3

6.6

7.2

6.9

7.0

6.8

7.1

6.7

6 4 2 0

2005

2006

2007

NOTE Low-birthweight is less than 5.5 pounds or 2,500 grams. SOURCE National Center for Health Statistics.

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voices4kids.org

2008

2009

2010

2011

EARLY CHILDHOOD

Infant Mortality Rate per 1,000 births

Illinois

U.S.

14 12

10.7

10

9.4

9.2

8.5

7.6

8

7.4

6.9

6.9

6.8

6.2

6

Between 1990 and 2010, infant mortality rates declined by 36% in Illinois and 33% nationwide. However, infant mortality remains much more prevalent for the AfricanAmerican population.

4 2 0

1990

1995

2000

2005

2010

SOURCE National Center for Health Statistics.

Infant Mortality by Race-Ethnicity, 2010 Rate per 1,000 births

Illinois

U.S.

13.6

14

11.6

12 10 8 6

6.2

5.5

5.1

4.9

4.6 3.6

4 2 0

White

Black

Latino

Asian

SOURCE Annie E. Casey Foundation, KIDS COUNT Data Center; based on data from National Center for Health Statistics.

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19

EARLY CHILDHOOD

Persons Served in WIC Program, FY 2012 1,000s 105.0

Pregnant women

49.7

Post-partum breastfeeding women Infants

167.6

Children

198.3

Total

520.6

SOURCE Illinois Department of Human Services.

Breastfeeding by WIC Participants at Hospital Discharge Percent 71

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) seeks to reduce the incidence of infant mortality, premature births, and low birth-weight; to promote breastfeeding; and to aid in the growth and development of children. The federally funded program serves low-income pregnant, breastfeeding, and postpartum women, as well as infants and children up to age five who have nutritional risk factors.

69.7 68.6

69

67 65.7

66.0

65.1

65

64.4

63

61

2007

2008

2009

2010

2011

2012

NOTE Proportion of women who participated in WIC program during pregnancy and began to breastfeed right after giving birth. SOURCE Illinois Department of Human Services.

Breastfeeding of WIC Infants at Six Months, FY 2013

Number

WIC infants at 6 months old

81,770 100.0

Ever breastfed

56,344 68.9

Still breastfed at 6 months SOURCE Illinois Department of Human Services.

20


Percent

voices4kids.org

14,908 18.2

EARLY CHILDHOOD

Early Intervention Program Number of children served (1,000s) 20

16.6

15

17.0

17.9

18.8

19.0

19.2

18.7

19.6

15.4

11.1

10

11.5

5

0

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

Fiscal years

The Early Intervention program provides a broad array of services and supports for families with children under age 3 who have diagnosed disabilities or developmental delays, as well as those who are at risk for developmental delays.

SOURCE Illinois Department of Human Services.

At High or Moderate Risk for Developmental, Behavioral, or Social Delays, 2011–2012 Percent All children

32 Income Level

Race-Ethnicity White

Below 200% FPL

26

Black

39

200–399% FPL

Latino

41

400% FPL or higher

40 28 23 FPL federal poverty level

NOTE Children ages 4 months–5 years. SOURCE National Survey of Children’s Health (survey of parents).

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EARLY CHILDHOOD

Lead Poisoning Rates, Children Under Age 6 Percent 10

Illinois

U.S.

9.4

8

7.3 6.3

6 4.9 4

3.6

4.0

3.0 3.0

2

0

2.3 2.6 2.0

2000

2001

2002

2003

1.8

2004

1.6

2005

1.8

1.7

1.2

1.0

0.8

2006

2007

2008

1.3

1.1

1.1

0.6 2009

0.6 2010

0.6 2011

NOTE Percentage of children screened with elevated lead levels of 10 micrograms per deciliter or above. SOURCE Illinois Department of Public Health.

Children Tested for Lead Poisoning Children in 1,000s 350 300

278 244

250

263

268

273

2002

2003

2004

275

278

2005

2006

297

305

297

300

291

2007

2008

2009

2010

2011

200 150 100 50 0

2000

2001

SOURCE Illinois Department of Public Health.

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EARLY CHILDHOOD

CHILDHOOD LEAD POISONING—AN EVOLVING CHALLENGE Data illustrating the declining numbers of lead poisoned young children in Illinois—and nationwide—is evidence of a public health success story. In the decades since the removal of lead from household paint and gasoline, fewer children meet the definition of lead poisoning. This should be celebrated as significant progress toward eliminating lead poisoning in our children.

DEANNA DURICA Director, Lead Poisoning Prevention/Healthy Homes Unit, Cook County Department of Public Health

ANITA WEINBERG Chair, Illinois Lead Safe Housing Task Force; Director, ChildLaw Policy Institute, Loyola University Chicago School of Law

But lead poisoning is a complex issue. And as with most complex issues, these numbers tell just part of the story. A growing body of research indicates that the way lead poisoning is currently defined and monitored under-represents the numbers of children whose neurological, cognitive, and physical development are compromised by exposure to lead. In 2012, the Center for Disease Control and Prevention’s Advisory Committee on Childhood Lead Poisoning Prevention recommended interventions at low levels of lead exposure, as research shows that even very low levels of lead are linked to hyperactivity, reductions in IQ, and behavioral problems. A recent study of almost 50,000 children in the Chicago Public Schools found low-level exposure reduces standardized test performance, and increases risk of school failure. The study controlled for factors associated with school performance, including poverty, birthweight, maternal education, and race-ethnicity. Studies in other parts of the country have found similar results. The Advisory Committee recommended beginning intervention at 5 ug/dL (micrograms per deciliter); Illinois lags behind at 10 ug/dL. In 2010 alone, over 3,300 Illinois children were identified as lead-poisoned based on this definition. An additional 18,000 children, however, met the CDC’s reference level. So, while the numbers are decreasing, every year we still identify thousands of new Illinois children whose long-term health and development are compromised by lead exposure. And there are

tens of thousands more children who are not tested, and therefore not counted, even while the lead in their systems makes it difficult for them to learn, interact with their peers, or pay attention. Once lead poisoning occurs, the damage to a child’s developing brain is done and the focus must shift to addressing problems caused by the poisoning and to avoiding further accumulation of lead in the child’s body. Lead can irreversibly affect the child’s ability to think, learn, and behave. And yet, the CDC describes lead poisoning as an entirely preventable disease. As we learn more about environmental toxins, it becomes clear that other household and neighborhood pollutants also contribute to poor health and developmental outcomes in our children, especially children living in poverty. As we continue to work toward the elimination of lead poisoning, advocates are also working to raise awareness and address other indoor environmental toxins that impact children’s futures, including mold, radon, carbon monoxide, and pesticides. In the 1950’s, when the polio epidemic was at its height, a vaccination campaign essentially wiped out the disease. Fewer than 60,000 new cases of polio instigated this grand scale response. Nationwide, the estimates of children with elevated blood lead levels range from 450,000 to 750,000. If we are to write a true success story regarding lead poisoning, we must ensure that we are not leaving thousands of children behind.

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Voices for Illinois Children 23

Family Environment HIGHLIGHTS In 2012, 21% of Illinois children lived below poverty, compared with less than 17% in 2007. In 2011, poverty rates in Illinois were 44% for AfricanAmerican children and 28% for Latino children, compared with 11% for both white and Asian children.

Substantiated Cases of Child Abuse and Neglect

Between 2006 and 2011, the child poverty population increased by 2% in Chicago, 26% in suburban Cook County, 68% in the collar counties, and 18% in the rest of the state.

Since 2001, there have been significant changes in the geographic distribution of child abuse and neglect cases in Illinois.

2001

2013 Collar Counties

Collar Counties % 5

Among the 50 largest counties, the highest child poverty rates in 2011 were in Vermilion, Jackson, Knox, Macon, Winnebago, St. Clair, Peoria, and Marion (see appendix).

% 12

68 %

35 %

Cook County

Cook County

In FY 2013, substantiated cases of child abuse and neglect were 14% higher than in FY 2006. Since FY 2006, the number of substantiated cases has increased by 10% in Cook County, 32% in the collar counties, and 7% in the rest of the state. Among the 50 largest counties, the highest rates of child abuse and neglect over the past five years were in Jefferson, Vermilion, Logan, Winnebago, Macon, Marion, and Franklin (see appendix).

% 27

% 53

Rest of State Rest of State

SOURCE Illinois Department of Children and Family Services.

24

Illinois has been receiving new federal funding (about $35 million over five years) through the Maternal, Infant, and Early Childhood Home Visiting Program. The state is using the new resources to expand and strengthen evidence-based home visiting initiatives in six targeted communities around the state. A survey of Illinois parents showed that 74% of white children had mothers whose overall health was excellent or very good, compared with 59% of African-American children, and 47% of Latino children. There was a similar pattern among fathers.

FAMILY ENVIRONMENT

Child Poverty Rates Percent

Illinois

25 21.6 20 16.2

16.3

15 14.6

14.6

16.7 15.3

17.6 15.6

17.8 16.7

18.5 16.5

20.0 18.3 17.1

18.0

18.2

16.6

17.0

18.9

22.5 21.6

19.4

U.S.

22.6 20.7

10

5

0

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

In 2012, the federal poverty threshold for families comprised of two parents and two children was $23,283. For a single parent with two children, the poverty threshold was $18,498.

SOURCES U.S. Census Bureau, Small Area Income and Poverty Estimates, 1995–2005; American Community Survey, 2006–2011.

Children in Low-Income Families, 2012

Children in 1,000s

Percent of all children

Below 200% FPL

1,262 42

Below 150% FPL

958 32

Below 100% FPL

624 21

Below 50% FPL

266 9 FPL federal poverty level

“Low-income” generally means household income below 200% of the federal poverty level. The lowincome child population in Illinois is about twice the size of the child poverty population.


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FAMILY ENVIRONMENT

Child Poverty Rates by Age and Race-Ethnicity, 2010–2012 Percent

Total

White

Black

Latino

Asian

All ages 20.6

10.8 43.6 28.0 11.2

Under age 6 23.2

12.7 49.7 30.1 10.6

Ages 6–11 20.7

10.8 43.4 28.9 10.6

Ages 12–17 18.1

9.2 38.9 24.7 12.5

NOTE Three-year pooled data. SOURCE U.S. Census Bureau, American Community Survey.

Child Poverty by Region

Number in poverty (1,000s)

Percent change

2006

2011

2006–2011

Chicago 206.7

210.7

Suburban Cook County 78.3

98.3

Collar counties 64.5

108.4

Rest of state 179.6

211.7

18

Statewide 529.0

629.1

19

2 26 68

NOTE Three-year pooled data for 2005–2007 and 2010–2012. Collar counties are DuPage, Kane, Lake, McHenry, and Will. SOURCE U.S. Census Bureau, American Community Survey.

Child Poverty Rates by Region Percent

2006

40

2011

34.6

35

31.0

30 25 20

17.9

16.4

15

20.6 16.7

13.0

12.1

10

21.0

7.6

5 0

Chicago

Suburban Cook County

Collar counties

Rest of state

Statewide

NOTE Three-year pooled data for 2005–2007 and 2010–2012. Collar counties are DuPage, Kane, Lake, McHenry, and Will. SOURCE U.S. Census Bureau, American Community Survey.

26


voices4kids.org

FAMILY ENVIRONMENT

GIVE THEM YOUR VOICE For thirty-two years as the director of a child welfare agency, one aspect of my job was to read accounts of abuse to children at the hands of trusted adults. Unlike the children represented here as numbers—broken down by county, categorized, divided by age, and compared to previous years—I knew them by their names. I saw their faces. From the unusual incident reports I put my signature on, I knew their parents and their abuser.

DAVE MCCLURE Member, Board of Directors, Illinois Collaboration on Youth

I knew the extent of their injuries and the date, time, and location the trauma took place. Sometimes I read medical reports that detailed injuries to their bodies in clinical terms. And because I worked most of my years in a small organization, I saw the subjects of my reports. Some walked by my door. My office was across the hall from the treatment director, a therapist who supervised our clinical team and also carried a caseload. At times I would ask her, after a child left her office, “Is that the little girl? The one I just read about?” And most often she would nod yes. The parents of the abused, often those responsible for the abuse, would sit in the lobby waiting for a meeting or a counseling session. I would say hello to them, and they would speak back to me. Regular people, indistinguishable from you and me, their lives changed forever. Now that I am out of that job and in retirement, I have joined the ranks of those for whom child abuse is abstract—a problem experienced by someone else. I understand better our collective reluctance to confront it. In the eighties, when the lid came off the taboo that we now know as sexual abuse, I

would speak publicly of new programs being offered at our agency to serve the growing number of young people and adults disclosing sexual abuse. I would explain the new knowledge we were gaining about the dynamics of familial sexual abuse, and as I did, people in the crowd would bow their heads or look away. It horrified them. Sexual abuse was somehow over the line of what they could handle. I understand. Is it a relief to no longer read and absorb in detail the absolute cruelty that children endure from those they love? Yes it is. But sadly, I know it continues. Only occasionally do I feel as if I turned my back on those kids. I am helped by knowing the character and devotion of those who continue to care for abused kids day after day. We cannot, we should not, accept the level of abuse these numbers represent. The plight of children and families who survive abuse is rarely portrayed in the media. If you are reading this, I ask you to carry their story to those close to you—to your extended family, to your community. We must do more, and to accomplish that we must lend these children our voice.

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27

FAMILY ENVIRONMENT

Substantiated Cases of Child Abuse and Neglect Children in 1,000s 30

25.9

25.0

25.3

25.4

25.4

24.5

2001

2002

2003

2004

2005

2006

Fiscal years

25

26.2

27.8

27.5

26.9

26.9

26.5

27.9

2008

2009

2010

2011

2012

2013

20 15 10 5

Cases of substantiated abuse and neglect remain as high in 2013 as they were during the onset of the Great Recession in 2008.

0

2007

NOTE Data reflect unduplicated count. SOURCE Illinois Department of Children and Family Services.

Substantiated Cases of Child Abuse and Neglect by Race-Ethnicity Children in 1,000s

White

16

14.4

Black

Latino

15.2

15.1

15.2

14.6

14.7

13.3

13.9

14.0

13.4

9.2

9.0

8.7

8.6

8.3

8.8

9.1

8.9

8.4

8.1

8.5

2.5

2.5

2.0

2.1

2.0

2.0

2.2

2.3

2.1

1.9

1.9

2.1

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

Fiscal years

14 12 10

12.4

12.3

9.8

8 6 4 2 0


Substantiated Cases of Child Abuse and Neglect by Region Children in 1,000s 16

13.8

14

Cook County

13.1

13.4

8.8

8.6

14.8

15.2

15.3

7.8

14.5

14.7

7.6

7.4

7.2

7.3

13.8

Collar Counties

15.1

14.6

7.4

7.3

7.0

5.0

4.9

4.6

2008

2009

2010

Rest of State

14.1

14.8

12 9.2

10 8 6

3.1

3.3

3.5

3.4

3.5

3.8

4.3

2001

2002

2003

2004

2005

2006

2007

Fiscal years

4

7.9

7.9

4.5

4.7

5.0

2011

2012

2013

2 0

NOTE Collar counties are DuPage, Kane, Lake, McHenry, and Will. SOURCE Illinois Department of Children and Family Services.

28


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FAMILY ENVIRONMENT

Children in Substitute Care Children in 1,000s 30

27.0 23.4

25

20.5

20

18.8

17.9

17.1

15.9

16.0

15.8

15.4

15.4

15.1

14.9

2005

2006

2007

2008

2009

2010

2011

2012

2013

15 10 5 0

2001

June of each year

2002

2003

2004


Children in Substitute Care by Race-Ethnicity White

12,000

10,295

9,325

10,000

9,239

8,790

Black

Latino

8,298

8,052

8,000 6,000

5,274

5,156

5,414

5,710

5,965

6,179

976

948

930

897

876

854

2006

2007

2008

2009

2010

2011

4,000 2,000

0

June of each year

SOURCE Children and Family Research Center at University of Illinois at Urbana-Champaign; based on data from Illinois Department of

Children and Family Services.

Children in Substitute Care by Region Children in 1,000s 20

Cook County

Rest of State

17.2 14.6

15

12.2

10.5

10 6.7

6.3

1.4

2001

June of each year

5 0

Collar Counties

9.5

8.2

7.1

7.0

7.4

7.7

7.9

7.7

7.9

5.2

6.4

6.6

6.6

6.8

6.3

1.0

1.1

1.2

1.2

1.3

1.3

5.8 1.3

5.7 1.3

5.3 1.8

1.9

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

6.2

1.2

6.0 1.1

2002

2003

NOTE Collar counties are DuPage, Kane, Lake, McHenry, and Will.

In 2013, Cook County accounted for 35% of substitute care cases in Illinois, down from 68% in 2001.


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FAMILY ENVIRONMENT

Illinois Department of Human Services, Funding for Home Visiting Programs $ millions

MIECHV (federal)

Parents Too Soon (GRF & non-GRF)

Healthy Families Illinois (GRF)

35

14.0

30 8.5 25 11.3 20

2.8

10.6

0.2 10.5

10.3

9.6

9.7

2011

10.7

10.7

9.6

10.0

10.0

2012

2013

2014

15

Healthy Families Illinois and Parents Too Soon are home visiting programs that offer a broad range of preventive services and supports for at-risk families with young children or those expecting children. These programs are designed to promote positive parenting, enhance child health and development, and prevent child abuse and neglect.

11.1

10

5

0

2009

2010

Fiscal years

GRF General Revenue Fund MIECHV Maternal, Infant, and Early Childhood Home Visiting

NOTE Data reflect actual expenditures for Healthy Families Illinois and Parents Too Soon in FY09–FY12 and for MIECHV in FY11–FY13.

Appropriation in FY14 for Parents Too Soon includes $1.3 million that was shifted from the Department of Human Services to the Department of Public Health. SOURCES Illinois Office of the Comptroller; Governor’s Office of Management and Budget; Illinois Department of Human Services.

Births to Teen Mothers, Ages 15–19 Percent of all births 14 12

12.1

11.8

11.2

10.7

10

10.1

9.5

9.7

9.5

9.8

10.0

9.8

9.5

9.0

8

8.1

6 4 2 0

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

SOURCE Annie E. Casey Foundation, KIDS COUNT Data Center; based on data from National Center on Health Statistics.

30


voices4kids.org

2011

FAMILY ENVIRONMENT

Health Status of Children and Parents, 2011–2012 Excellent or very good Percent Children’s overall health Total

Mother’s physical health

84

Father’s physical health

65

69


93

Black

74

80

Latino

77

59

67

63

47

54

47

54

Income Level 72

Below 200% FPL

91

200–399% FPL 400% FPL or higher

75

95

75

79

79 FPL federal poverty level

NOTE Children ages 0–17. Race-ethnicity refers to the child.

The physical and emotional health of parents can affect their ability to care for their children, as well as the health and well-being of the family as a whole. [The Health and Well-Being of Children: A Portrait of States and the Nation 2007 (U.S. Department of Health and Human Services, 2009)]


Children Living in a Household with a Smoker, 2011–2012 Percent All children

24

Race-Ethnicity

Income Level

White

25

Black Latino

32 15

Below 200% FPL

31

200–399% FPL 400% FPL or higher


NOTE Children ages 0–17. SOURCE National Survey of Children’s Health (survey of parents).

voices4kids.org


31

Healthy Living HIGHLIGHTS Despite improvement in recent years, Illinois lags behind most other states in participation of low-income children in the National School Breakfast Program.

Forty percent of high school students in Chicago report not attending physical education classes in an average school week, compared with 17% statewide.

Nearly half of Illinois children in low-income families are overweight or obese, compared with one-fourth of children in families with higher incomes.

About 30% of Illinois high school students report watching three or more hours of TV on an average school day. Similarly, about 30% report three or more hours of playing video/computer games or using computers for something other than schoolwork.

Low-income children are less likely than other children to engage in vigorous physical activity.

A survey of Illinois high school students found that 38% had consumed alcohol in the past 30 days, and 26% reported riding with a driver who had been drinking alcohol.

Children Who Are Overweight or Obese, 2011–2012 Children who are overweight or obese have higher risk of having both physical and mental health problems.

46

%

Low-income children

26

%

All other children

NOTE Children ages 10–17 with weight in 85th percentile and above based on Body Mass Index (BMI). SOURCE National Survey of Children’s Health (survey of parents).

32

HEALTHY LIVING

Student Participation in National School Lunch and Breakfast Programs Children in 1,000s

School Lunch Program

School Breakfast Program

1,000

800 695

705

695

714

737

770

768

293

302

2009–10

2010–11

790

600

400 197

200

0

2004–05

224

232

239

252

2005–06

2006–07

2007–08

2008–09

350

2011–12

School years NOTE Income eligibility limit for both programs is 185% of federal poverty level.

In 2008–09, school breakfast participation in Illinois was 34% of school lunch participation—the lowest rate among the 50 states and D.C. By 2011–12, the state’s school breakfast participation rate had risen to 44%, and its rank improved to 36th.

SOURCE Food Research and Action Center, “School Breakfast Scorecard” (various years).

Children Who Are Overweight or Obese, 2011–2012 Percent All children

34

Below 200% FPL

Gender Female Male

Income Level

28 39

46

200–399% FPL

26

400% FPL or higher


NOTE Children, ages 10–17, with weight in 85th percentile and above based on Body Mass Index (BMI). SOURCE National Survey of Children’s Health (survey of parents).

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HEALTHY LIVING

YMCAs SUPPORT HEALTHIER COMMUNITIES THROUGH PARTNERSHIPS YMCAs historically have addressed childhood obesity through promoting nutrition and physical activity in their programming. However, since 2006, Illinois Ys have reached beyond their walls to build collaborations to address systemic obesity and other healthy living issues. Eighteen YMCAs across Illinois, along with hundreds of local and state partners, are actively engaged in Healthier Communities Initiatives (HCI) to transform policies and the physical environment with a goal of long-term sustainable, healthy communities.

MEG COOCH Executive Director, Illinois State Alliance of YMCAs

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Ys are using a model that gathers community leaders and diverse organizations from multi-sectors to define a common vision and specific strategies for healthier communities. Local partnerships vary in structure, depending on communities’ priorities and needs. However, all are working to strengthen communities towards a healthier future. For example, Decatur Family YMCA and its local partners recently joined forces with Grow Decatur, which is focused on business development. This new partnership will ensure that health and wellness priorities are included in economic growth efforts. HCI in the Quad Cities, supported by the Two Rivers YMCA, is promoting physical activity through implementation of the Safe Routes to Schools program and the creation of city-based bikeways and alternative transportation plans. This grassroots work has led to a regional approach to funding healthy food systems, plans for all schools to have enhanced wellness policies, and on-going support for worksite wellness across the region. St. Clair HCI in southwest Illinois has held five annual Health Policy Summits, convening 160 health leaders, policymakers, and school professionals around a common agenda. The St. Clair HCI has transformed an initial investment of $2,000 into an alliance that has provided more than $1.5 million in funding and resources to

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nearly 80 schools, communities, neighborhoods, and organizations throughout the county. Wild About Wellness, the Oak Park HCI, is working with schools to capture data including students’ BMI (Body Mass Index) and the amount of fresh foods purchased by schools to create a report card that tracks progress towards its goals. The Indian Boundary YMCA is also tracking BMI metrics through FORWARD, a DuPage County initiative. At the state level, the Illinois State Alliance of YMCAs—the association of the 47 corporate Ys serving more than 200 communities—is working with members and stakeholders to create healthier community policies, systems, and environments. The Alliance was a part of the Governor’s Enhance P.E. Task Force, supporting recommendations for greater physical activity in schools. In addition, the Alliance has advocated for improved nutritional standards in schools and child care settings. Illinois HCIs are a part of a national network of more than 224 community efforts that have made more than 35,970 changes in healthy living, environmental, and systems policies impacting up to 65 million lives. As HCIs gain more experience in building collaborations, they are identifying additional opportunities to foster healthy and sustainable futures in communities across the state and beyond.

HEALTHY LIVING

Engaged in Physical Activity Four or More Days During Past Week, 2011–2012 Percent 64

All children

Income Level

Gender

52

Below 200% FPL 62

Female

67

Male

70

200–399% FPL

74

400% FPL or higher

FPL federal poverty level NOTE Children ages 6–17. Includes exercising, playing a sport, or participating in other vigorous physical activity for at least 20 minutes. SOURCE National Survey of Children’s Health (survey of parents).

High School Students Not Attending Physical Education Classes, 2011 Percent

Illinois

Chicago

50

40

40

40

38

30

20

18

17

A substantial body of research shows that physical activity and fitness are not only important for children’s health and wellbeing, but also contribute to improved academic achievement. [“Illinois Enhance Physical Education Task Force: Recommendations and Report” (Illinois State Board of Education, August 2013)]

17

10

0

Total

Male

Female

NOTE In an average week when in school. SOURCE Centers for Disease Control and Prevention, High School Youth Risk Behavior Survey.

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35

HEALTHY LIVING

High School Students and Screen Time on an Average School Day, 2011 Percent

Illinois

50

41

40 30

31

29

42

41

33

29

28

Chicago

36

34

25

31

20 10 0

Total

Male

Female

Total

Watched television 3 or more hours

Male

Female

Played video or computer games or used computers 3 or more hours

NOTE Computer use not for school work. SOURCE Centers for Disease Control and Prevention, High School Youth Risk Behavior Survey.

High School Students and Risky Activities in Past 30 Days, 2011 Percent

Total

Male

Drank alcohol About 18% of high school students in Illinois have smoked cigarettes in the past month, compared with 38% of young adults (ages 18–25). [Youth Risk Behavior Survey and National Survey on Drug Use and Health]

38

Rode with a driver who had been drinking alcohol Smoked cigarettes Used marijuana

Female

37

26

39

24

18

19

23

28 16

28

19

SOURCE Centers for Disease Control and Prevention, High School Youth Risk Behavior Survey.

High School Students and Sexual Activity, 2011 Percent

Total

Male

Female

All Students Had sexual intercourse in past 3 months

33

30

35

Those Who Had Sexual Intercourse Did not use a condom during last sexual intercourse Did not use any method to prevent pregnancy during last sexual intercourse

39

14

30

12


36


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17

HEALTHY LIVING

THE IMPORTANCE AND EFFECTIVENESS OF PREVENTION Addiction is a developmental disease that usually begins in adolescence. However, according to the National Institute on Drug Abuse (NIDA), these same developmental years might also present opportunities for resiliency and for receptivity to intervention that can alter the course of addiction. An understanding of the young brain can therefore aid in the development of prevention strategies.

KAREL HOMRIG Executive Director, Prevention First

SARA HOWE Chief Executive Officer, Illinois Alcohol & Drug Dependence Association (IADDA)

We already know many of the risk factors that lead to drug abuse and addiction—mental illness, physical or sexual abuse, aggressive behavior, academic problems, poor social skills, and poor parent-child relations. This knowledge, combined with a better understanding of the motivational processes at work in the young brain, can be applied to prevent drug abuse from starting or to intervene early to stop it when warning signs emerge. While parents play a primary role in supporting teens, support can’t end there. Prevention is collaborative, and effective prevention requires the support of a community. Relationships throughout the community must be developed and nurtured so teenagers find support in their day-to-day school and community activities. Effective prevention strategies also require addressing the accessibility and acceptability of drugs in communities. In general, when alcohol and other drugs are easily accessible, young people will tend to use them more. In addition, if community, school, and family norms convey the message that drug and/or alcohol use is a rite of passage for teens, or that use is actually acceptable, the likelihood of teens using drugs will increase. Given the recent legalization of medical marijuana in Illinois, along with the handful of other states (plus the District of Columbia) that now have laws legalizing marijuana in some form, data from the 2012 Illinois Youth Survey (IYS) should probably not shock anyone. According to the IYS, favorable attitudes among youth about marijuana

are increasing. Alarmingly, the proportion of 8th, 10th, and 12th graders that believe they would be seen as “cool” if they used marijuana has increased significantly since 2010. Prevention strategies save taxpayer dollars. Each year, drug abuse and addiction cost taxpayers nearly $534 billion in preventable health care, law enforcement, crime, and other costs. However, each dollar invested in prevention achieves a savings of up to $7 in areas such as substance abuse treatment and criminal justice system costs, not to mention their wider impact on the trajectory of young lives and their families. Unfortunately, state funding for addiction prevention has been reduced by 88% in the past six years. Currently, only $1 million in state funding is dedicated to addiction prevention services. Accordingly, we have seen significant reductions in the number and type of prevention programs/ services available to communities. Arguably, the diminished presence of substance abuse prevention in Illinois cannot compete with the pro-social norms and increased access and availability that lead to increases drug use among youth. Decreased funding, legalization, and perceptions of a lax attitude toward marijuana are just some of the obstacles faced by prevention professionals. However, professionals in the drug prevention field stand firmly by the fact that the developing mind is resilient and that communities, schools, and families can continue to work together toward helping adolescents make healthy, safe decisions.

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Social & Emotional Well-Being HIGHLIGHTS A survey of Illinois high school students found that 35% of girls and 21% of boys felt sad or hopeless almost every day for two or more weeks in a row so that they stopped doing some usual activities. A high school survey found that 18% of girls and 11% of boys had seriously considered attempting suicide in the past 12 months. One in five Illinois high school students reported being bullied on school property in the past 12 months. Electronic bullying was reported by 22% of female high school students and 11% of male students.

Among children with emotional, developmental, or behavioral problems, only 55% received treatment or counseling over the past 12 months, according to a survey of parents. The frequency of stress from parenting is much greater among low-income families than among other families. Similarly, parental stress is much more frequent in mother-only households than in twoparent households. A survey of Illinois parents found that 80% of white children had mothers whose mental health was excellent or very good, compared with 72% of African-American children, and 57% of Latino children. There was a similar pattern among fathers.

Mental Health Status of Mother, 2011–2012 Both the physical and emotional health of parents can affect the healthy development of children.

6 out of10

low-income children had mothers with excellent or very good mental health

children at higher income levels had mothers with excellent or very good mental health


38

8 out of10

SOCIAL & EMOTIONAL WELL-BEING

Two or More Adverse Family Experiences, 2011–2012 Percent All children

19

Race-Ethnicity

Income Level

White

Below 200% FPL

17

Black

200–399% FPL

31

Latino

25 19

400% FPL or higher

15


NOTE Children ages 0–17. Adverse family experiences are a modified version of the risk factors in the Adverse Childhood

Experiences (ACE) Study.

Adverse family experiences include: socioeconomic hardship, divorce/separation of parent, death of parent, parent served time in jail, witness to domestic violence, victim of neighborhood violence, lived with someone who was mentally ill or suicidal, lived with someone with alcohol/ drug problem, and discrimination based on race/ethnicity. [National Survey of Children’s Health]


Bullying Experienced by High School Students in Past 12 Months, 2011 Percent

Illinois

25 20

19

20

18 13

15

Chicago

22 13

12

16

15

12

11

10

8

5 0

Total

Male

Female

Bullied on school property

Total

Male

Female

Electronically bullied

Bullying at school has been increasing nationwide since 2001. Bullying can lead to negative outcomes including increased loneliness and unhappiness, greater difficulty making friends, more health problems, and increased anxiety and depression. [Child Trends DataBank]


High School Students with Depressive or Suicidal Feelings in Past 12 Months, 2011 Percent

Felt sad or hopeless

Total

28

Seriously considered attempting suicide Attempted suicide

14

8

11

6

Gender Male

21

Female

35

18

9


26

14

6

Black

25

14

11

16

11

Latino

34

NOTE Depressive feelings mean feeling sad or hopeless almost every day for two or more weeks in a row so that they stopped

doing some usual activities. SOURCE Centers for Disease Control and Prevention, High School Youth Risk Behavior Survey.

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39


Children Who Needed and Received Services from a Mental Health Professional, 2011–2012 Percent

Yes

No

Children with any kind of emotional, developmental, or behavioral problems for which they need treatment or counseling

10

90

55

45

Received any treatment or counseling from a mental health professional during past 12 months NOTE Children ages 2–17. SOURCE National Survey of Children’s Health (survey of parents).

Mental Health Status of Parents, 2011–2012

Frequency of Stress from Parenting, 2011–2012

Excellent or very good

Percent Seldom feels stress

Percent All children

Mother’s mental health

73

Father’s mental health

76

Race-Ethnicity 80

White Black Latino Parental stress related to economic hardship and other factors can have a range of harmful effects on child development. [Carly Tubbs and Lawrence Aber, “Cascading Effects of Parental Stress,” The American Prospect, May 31, 2013]

72

81 77

57

66

60

65

200–399% FPL

81

400% FPL or higher

82

88 12


93 7

Black

77 23

Latino

85 15

Income Level

Income Level Below 200% FPL

All children

Usually or always feels stress


NOTE Children ages 0–17. Race-ethnicity refers to the child. SOURCE National Survey of Children’s Health (survey of parents).

Below 200% FPL

82 18

200–399% FPL

92 8

400% FPL or higher

93 7

Household Type Two-parent household

91 9

Mother-only household


NOTE Children ages 0–17. Race-ethnicity refers to the child. SOURCE National Survey of Children’s Health (survey of parents).

40


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ADDRESSING PARENTAL STRESS IN VULNERABLE FAMILIES Parental stress can have far-reaching consequences for children. When parents are chronically stressed, as is the case with those suffering from depression, their children are at risk for emotional, behavioral, and academic difficulties. Children may internalize these challenges and experience depression, anxiety, and other emotional problems; or they may externalize these challenges and act out through problem behaviors. They may be unable to focus and concentrate on their studies at school and other responsibilities.

CARMEN VALDEZ Associate Professor, Department of Counseling Psychology, University of Wisconsin–Madison

SANDRA MAGAÑA Professor, Department of Disability and Human Development, University of Illinois at Chicago

Parental stress can affect children directly in the form of negative parent-child interactions. However, parental stress often affects children indirectly through the parent’s inability to spend time with his or her child, monitor child activities, or help with homework. There are many contributing factors to parental stress, including household finances, marital strife, and having a child with a chronic disability. Some households, such as those that are low-income, from ethnic or racial minority backgrounds, or headed by a single parent, face additional levels of stress. These additional stress factors can include housing instability, discrimination, unstable and unsafe neighborhoods, food insufficiency, and unemployment. Immigrant parents face additional challenges such as language barriers, limited knowledge about how to help their children succeed in a new environment, isolation, and cultural differences. In order to deal with stress, families may need additional support from their extended families, communities, and social service agencies. Not all parents who face high levels of stress develop depression. However, research shows that women are more likely to become depressed, and Latina women have been found to have exceptionally high rates of depression. While there are traditional treatments for individuals with

depression, it is important to develop family oriented programs that are culturally sensitive. Keeping Families Strong, a program that was initially developed and studied in Maryland, served low-income white and African-American families. We culturally adapted the program for Latina mothers and their families in Wisconsin, calling it Fortalezas Familiares (FF). The FF program is delivered in a multifamily group format consisting of three to six families. Each of twelve weekly meetings begins with a culturally appropriate meal shared by the parents and their children. These family meals are designed to build trust and promote social support. After the meal, the families divide into two groups, one of parents and the other of youth between the ages of 9 and 18. Children under 9 years old are provided with child care. A unique aspect of the FF program is that each family member who is involved receives and discusses information about understanding depression, building positive communication, and how to support each other, all in the context of integrating two cultures. The results of FF so far have been promising. Mothers reported improved emotional well-being, family support, and family functioning. Children also reported positive changes. We hope to bring Fortalezas Familiares to Illinois to expand the research on this important program.

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41

Oral Health HIGHLIGHTS According to a survey of Illinois parents, 83% of white children, 66% of AfricanAmerican children, and 54% of Latino children had teeth that were in excellent or very good condition. Among low-income children, 58% were described as having excellent or very good teeth, compared with more than 80% for children at higher income levels. One-fifth of both African-American children and Latino children have one or more oral health problems, compared with about oneeighth of white children.

One or More Oral Health Problems in Past 12 Months, 2011–2012 There are significant oral health disparities related to both race-ethnicity and family income.

% 12

of White children

One-fifth of low-income children have one or more oral health problems, compared with about one-eighth of children at higher income levels. A survey of parents found that 16% of white children, 16% of Latino children, and 28% of African-American children did not have any preventive dental care visits in the past 12 months. Among low-income children, 26% received no preventive dental care in the past 12 months, compared with only 14% of other children. In FY 2011, 53% of Illinois children in Medicaid received dental services, compared with 46% in the U.S. as a whole. In FY 2003, the figures were 30% in Illinois and 34% nationwide.

21%

of Black children


42

% 20

of Latino children

ORAL HEALTH

Condition of Teeth, 2011–2012 Percent

Excellent or very good

Good

All children

73

Fair or poor

20

8


83

Black

12

66

Latino

4 24

54

10

32

14


58

200–399% FPL

29 82 86

400% FPL or higher

13

14

5

12



Children’s dental problems can have negative effects on school attendance and academic achievement, as well as on overall physical health and social-emotional well-being. [“Falling Short: Most States Lag on Dental Sealants” (Pew Center on the States, January 2013)]


One or More Oral Health Problems in Past 12 Months, 2011–2012 Percent All children

15



12

20

Black

21

200–399% FPL

12

Latino

20

400% FPL or higher



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ORAL HEALTH

One or More Preventive Dental Care Visits in Past 12 Months, 2011–2012 Percent All children

81

Race-Ethnicity

Income Level 84

White 72

Black

83

Latino

74

Below 200% FPL 200–399% FPL

86

400% FPL or higher



Children in Medicaid Receiving Dental Services Percent

Illinois

U.S.

60 53.2

51.2

50

46.5

40 28.2

30

30.8 30.3

33.6 32.8 34.8

35.7 36.1

39.1

36.3

40.1

42.4 38.1

40.2

43.8

44.8

45.8

20 10 0

2002

2003

2004

2005

Federal fiscal years

NOTE Children ages 1–18. SOURCE Centers for Medicare and Medicaid Services.

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2006

2007

2008

2009

2010

2011

ORAL HEALTH

CREATING A DENTAL HOME There’s no doubt that oral health is related to the overall well-being and health of the child. As a pediatric dentist at a community health center serving low-income women, children, and families, my big emphasis is to have a “dental home.” It is a key component of oral health and it’s the best way for me to provide the highest quality of care. At a dental home, issues are caught early. There is consistency in treatment planning and in overall care, whether it’s dealing with emergencies, creating opportunities for education, or stressing the importance of preventive care. In Illinois, the concept of a “dental home” became prevalent among pediatric dentists about six years ago. The American Association of Pediatric Dentists defines a dental home as having these characteristics: ongoing relationship between the dentist and the patient ■■

DR. SHEILA HALL Vice President of Dental Services, Infant Welfare Society of Chicago (IWS)

■■

inclusive of all aspects of oral health

delivered in a comprehensive, continuously accessible, coordinated, and family-centered way ■■

establishment of a dental home beginning no later than 12 months of age ■■

■■

referrals to dental specialists when appropriate

As a dental home, the Infant Welfare Society of Chicago provides specialized treatment plans for children to avoid over- and under-treatment. Under-treating patients causes greater problems later, while over-treating is more expensive and more invasive. Specialized planning helps us avoid wasting time and resources.

Within a dental home, patient education and outreach are critical components of serving the needs of our patients. There are principles of oral health and key messages that we want to share with our community, because we are that resource for people. These messages help to get people to the dentist. Once people arrive at their dental home, we can talk to them further about home care, nutrition, and oral health. For example, I talk about loose baby teeth, double teeth, what to do when a child has an injury to the mouth, brushing, nutrition, and a lot of other issues. I also teach about the importance of oral health for caregivers of children. Many people do not know that bacteria passes from mouth to mouth, so the oral health of the caregivers of children is incredibly important. Given the importance of a dental home, our community health center practices comprehensive care by combining dentistry, child development, primary medical care, optometry, and mental health at one, easily accessible central location. It’s important for the well-being of our patient population, who are some of the Chicago area’s neediest women and children, that we can follow up with them and their families to provide ongoing support and education to reduce negative oral health outcomes and health disparities.

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Special Health Care Needs HIGHLIGHTS More than 450,000 Illinois children (about 15% of the state’s child population) have special health care needs.

School Absence Due to Illness or Injury, 2011–2012 Data show the percentage of children who missed 11 or more days of school due to illness or injury. Children with special health care needs

14% Other children

3% NOTE Children ages 6–17. SOURCE National Survey of Children’s Health (survey of parents).

46

Aside from allergies, asthma is the most prevalent chronic condition among children with special health care needs. According to a survey of parents, 23% of AfricanAmerican children, 14% of Latino children, and 11% of white children have or have had asthma. Children with special health care needs are much more likely than other children to have frequent school absences. According to a survey of parents, only 62% of children with special health care needs have adequate private or public health insurance. About 45% of children with special health care needs receive coordinated, ongoing, comprehensive care within a medical home, compared with 58% of other children. More than 20% of children with special health care needs have problems getting specialist care or have other unmet needs for services.

SPECIAL HEALTH CARE NEEDS

Prevalence of Special Health Care Needs, 2009–2010

Children Who Currently Have or Have Had Asthma, 2011–2012

Percent

Percent

All children

14

Gender Male Female

Gender 16 12

Race-Ethnicity

Male

15

Female

13

Race-Ethnicity

White

15

White

Black

16

Black

Latino

14

All children

11 23

Latino

12

Income Level

14

Income Level

Below 200% FPL

15

Below 200% FPL

17

200–399% FPL

14

200–399% FPL

15

400% FPL or higher

14

400% FPL or higher

12





SOURCE National Survey of Children with Special Health Care Needs


Children with special health care needs are defined as “those who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally.” [U.S. Maternal and Child Health Bureau]

(survey of parents).

Most Prevalent Chronic Conditions Among Children with Special Health Care Needs, 2009–2010 Percent Allergies

45

Asthma

31

ADD/ADHD

25

Food allergies

11

Behavioral problems*

10

Depression*

8

Development delay*

16

Migraine headaches

7

Anxiety problems*

14

Autism spectrum disorder*

6


*Ages 2–17.

SOURCE National Survey of Children with Special Health Care Needs (survey of parents).

School Absence Due to Illness or Injury, 2011–2012 Percent

0 days

1–5 days

6–10 days

11 or more days

Children with special health care needs

16 57 13 14

Other children

28 60 8 3


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BEHIND THE BURDEN OF ASTHMA While people from all backgrounds are at risk for asthma, minority children and children with family incomes below the poverty level are disproportionately affected. Disparities exist in asthma prevalence and also in asthma outcomes— hospitalizations, emergency department visits, and deaths. This essay focuses on disparities in African-American children, but it is important to note that striking asthma disparities have been highlighted in Puerto Rican children as well.

STACY IGNOFFO, MSW Executive Director, Chicago Asthma Consortium

48


African American children in the United States are twice as likely to have asthma as Caucasian children. They are also twice as likely to be hospitalized due to asthma, more than twice as likely to visit the emergency department due to asthma, and four times more likely to die from asthma than Caucasian children. This frequent need for emergency care, combined with the daily symptoms of poorly controlled asthma, causes disruptions in daily life. Asthma is one of the leading causes of school absences, affects the ability of children to be physically active, and causes frequent disruptions in sleep. In addition, children with asthma are more likely to be overweight and obese than children without asthma. The reasons for these disparities in asthma prevalence and outcomes are complex and cannot be attributed to one cause alone. They result instead from an interaction of many individual and community-level factors. While genetics plays a role, environment is a main contributor as well. Current research suggests that certain environmental factors might “turn on” asthma in someone with a genetic risk. The environment is not limited to the physical environment—individuals of lower socioeconomic status (SES) are more affected by asthma than those of higher SES. Other lifestyle

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and environmental factors known to cause and exacerbate asthma include cigarette smoking, environmental tobacco smoke, outdoor air pollutants, and other indoor allergens such as cockroaches. Minority and lower SES populations are also more likely to experience psychosocial stress, which is another known risk factor for asthma. Other factors contributing to asthma disparities include a lack of access to quality healthcare and asthma self-management education, fragmented medical care, health beliefs, low literacy, challenges with adherence to asthma treatment, prolonged exposure to indoor and outdoor air pollutants in homes and schools, and substandard housing conditions. Further research is needed to fully understand these disparities, but efforts are underway at the federal, state, and local levels to begin to address asthma disparities. Additional multi-level and multi-disciplinary efforts are needed that include asthma coalitions, schools, day care centers, professional societies, medical providers, insurers, foundations, policymakers, housing providers, and community-based organizations. Given the high prevalence of asthma and the striking disparities that exist, it is critical that we work together to close the disparities gap to improve the health of children throughout Illinois.


Core Outcomes for Children with Special Health Care Needs, 2009–2010 Percent Families are partners in shared decision-making for child’s optimal health

71

Receive coordinated, ongoing, comprehensive care within a medical home

45

Families have adequate private and/or public insurance to pay for the services they need

62

Are screened early and continuously for special health care needs

81

Can easily access community based services

65

Youth, ages 12–17, who receive the services necessary to make appropriate transitions to adult health care, work, and independence

45

NOTE Children ages 0–17. Core outcomes defined by U.S. Maternal and Child Health Bureau.

A successful transition from pediatric to adult systems of care is especially important for youth with special health care needs, who are much less likely than their peers to finish high school, pursue post-secondary education, get jobs, or live independently. [National Survey of Children with Special Health Care Needs]

SOURCE National Survey of Children with Special Health Care Needs (survey of parents).

Access to Services for Children with Special Health Care Needs, 2009–2010 Percent Does not have a usual source of care when sick or relies on emergency room

14

Needed a referral for specialist care or services and had problems getting it

22

With any unmet need for specific health care services or equipment, past 12 months*

22

*Services/equipment needs include: routine preventive care; specialist care; counseling; substance abuse treatment or counseling; home health care; vision care or eyeglasses; hearing aids or hearing care; mobility aids or devices; communication aids or devices; disposable medical supplies; and durable medical equipment. NOTE Children ages 0–17. SOURCE National Survey of Children with Special Health Care Needs (survey of parents).

Impact on Families of Children with Special Health Care Needs, 2009–2010 Percent Families spend 5 or more hours per week providing and/or coordinating child’s health care

20

Child’s health conditions cause financial problems for the family

21

Child’s health conditions cause family members to cut back or stop working

24

NOTE Children ages 0–17. SOURCE National Survey of Children with Special Health Care Needs (survey of parents).

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Personal & Community Safety HIGHLIGHTS One-fourth of low-income parents in Illinois report that their neighborhoods are never or only sometimes safe, compared with less than 10% of parents with higher income levels.

Perceived Safety of Communities, 2011–2012 Data show the percentage of parents who feel that their children are usually or always safe in their communities or neighborhoods.

According to a survey of Illinois parents, 21% of African-American children, 13% of Latino children, and 3% of white children attend schools that are never or only sometimes safe. In 2011, one-fifth of male high school students in Illinois reported carrying a weapon (such as a gun, knife, or club) in the past 30 days.

Low-income families

Other families

A survey of Illinois youth found that one out of eight high school girls reported having been physically forced to have sexual intercourse. Between 2005 and 2011, reported crimes against children in Illinois declined 35%.

% 75 Feel safe

% 93 Feel safe

Among the 50 largest counties, the highest rates of reported crimes against children in 2009–2011 were in Sangamon, Vermilion, Peoria, Champaign, Cook, Livingston, and Macon (see appendix). In 2010, accidents, homicides, and suicides accounted for 72% of teen deaths in Illinois, down from 82% in 1994.


50

PERSONAL & COMMUNITY SAFETY

Perceived Safety of Communities and Schools, 2011–2012

Community or Neighborhood (Ages 0–17)

Usually or always safe

Percent

School (Ages 6–17)

Never or sometimes safe

Usually or always safe

Never or sometimes safe

85 15

92 8

White

93 7

97 3

Black

76 24

79 21

Latino

73 27

87 13

Below 200% FPL

75 25

84 16

200–399% FPL

90 10

95 5

400% FPL or higher

95 5

98 2

All children Race-Ethnicity

Income Level


Parents of African-American or Latino children and children from low-income households are much less likely to perceive their schools and communities to be usually or always safe.


High School Students and Sexual Violence, 2011 Percent 15

12

10

8

8

9

Black

Latino

5

5 0

9

Total

Male

Female

White

NOTE Ever physically forced to have sexual intercourse. SOURCE Centers for Disease Control and Prevention, High School Youth Risk Behavior Survey.

High School Students Who Carried a Weapon in Past 30 Days, 2011 Percent

Illinois

25 20 15

17

21

19

13

13

10

12

13

12

White

Black

Latino

6

5 0

Chicago

Total

Male

Female

NOTE Weapons include gun, knife, or club. SOURCE Centers for Disease Control and Prevention, High School Youth Risk Behavior Survey.

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51


KEEPING OUR KIDS SAFE THROUGH EDUCATION, COMMUNITY COLLABORATION In the close-knit community of East St. Louis, our students are bright, inquisitive learners who, like most children, strive for excellence every day. However, unlike most children, our students face challenges that are unimaginable in most communities.

ARTHUR CULVER Superintendent, East St. Louis School District 189

52


Some of those challenges involve situations such as students walking to school through neighborhoods that are unsafe because of busy thoroughfares, loitering, gun violence, or registered sex offenders whose residences are in route to school. We take these matters very seriously, and we are working on several initiatives to ensure the safety of our students in and out of the classroom. In order to provide safe routes to school, we have been talking with the Illinois State Board of Education about changing the definition of hazardous routes so that we can provide bus service to students who need safe transportation to school. In the areas of loitering and truancy, we are partnering with the City of East St. Louis to pass an ordinance that would help keep students off the streets when they should be in school. This is important because truancy hurts students in terms of poor grades, dropping out and earning lower incomes. Truancy also hurts the community in terms of potential crime, nuisance activity, and a decreased talent pool for jobs. We have in place several other initiatives that support student safety. The 21st Century Community Learning Center Program provides academic enrichment opportunities for students after school in subjects such as reading and math. It also offers a variety of services to students and their families, including drug and violence prevention lessons,

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counseling, art, music and recreation classes, technology education, and character education. The Positive Behavior Interventions and Supports Program (PBIS) provides an operational framework for improving academic and behavior outcomes by ensuring access to research-based instructional and behavioral practices and interventions. The goal of PBIS is to create teaching and learning environments that are less reactive and more engaging, address classroom management/disciplinary issues, and improve supports for students who may have emotional, behavioral disorders, or other mental health issues. Incentives are provided to students to reinforce positive behavior outcomes. This year we will implement a school-based HIV/STD Prevention Education Program that will provide sexual health education, sexual health services through our school-based health clinic, and professional development for school nurses, health teachers, and others involved in assuring healthy adolescents. The program will also focus on preventing student pregnancy. Together, we will continue to work as a com munity to make a positive difference in the lives of our students by improving programs already in place that address safety and providing new initiatives that enhance current personal and community safety measures.


Crimes Against Children 1,000s 45 40

37.3

40.1

39.6

38.1

39.4 36.4

35

34.1

32.5 29.7

30

29.7 25.9

25 20 15 10 5 0

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011


Crimes against children in Illinois (as reported to police) declined by 35% between 2004 and 2011. African-American children are much more likely to be victims of crime than white or Latino children. [Illinois State Police]

SOURCE Illinois State Police, “Crime in Illinois” (various years).

Child Victims of Crimes by Age, 2011 Age of victim

Crimes Against Youth, 2011

Ages 5 & under Ages 6–12 Ages 13–16

11.5

26.8

61.7

Number

Percent

Battery/aggravated battery

7,170 39.4

Domestic battery/aggravated domestic battery

2,806 15.4

Theft

1,576 8.7

Assault/aggravated assault

1,518 8.3

Robbery

1,488 8.2

Criminal sexual assault/ aggravated criminal sexual assault

561 3.1

Criminal sexual abuse

520 2.9

All other Total

2,574 14.1 18,213 100.0

NOTE Children ages 13–16. SOURCE Illinois State Police, “Crime in Illinois.”

SOURCE Illinois State Police, “Crime in Illinois.”

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Teen Deaths Accident, homicide, and suicide

Other causes

1,000

800

146 677

600

191

174 155

535

148

517 451

400

428

159

143

399

409

2004

2006

132

133

372

350

2008

2010

200

0

1994

1996

1998

2000

2002

NOTE Children ages 15–19. SOURCE Annie E. Casey Foundation, KIDS COUNT Data Center; based on data from Centers for Disease Control and Prevention.

Leading Causes of Death for Youth, 2010 Percent 27.5

34.0

14.3

164 34.0

Homicide

117 24.2

Suicide

69 14.3

All other

133 27.5

All Deaths

483 100.0

NOTE Children ages 15–19. SOURCE National Center for Health Statistics, National Vital Statistics System.


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Percent

Unintentional injury

24.2

54

Number

Appendix

55

APPENDIX

Percentage of Children without Health Insurance, 50 Largest Counties 2006 2011 Adams Boone Bureau Champaign Christian Clinton Coles Cook DeKalb DuPage Effingham Franklin Fulton Grundy Henry Jackson Jefferson Kane Kankakee Kendall Knox Lake LaSalle Lee Livingston Logan Macon Macoupin Madison Marion McDonough McHenry McLean Monroe Montgomery Morgan Ogle Peoria Randolph Rock Island Saint Clair Sangamon Stephenson Tazewell Vermilion Whiteside Will Williamson Winnebago Woodford Statewide

56

NOTE Children under age 19.

SOURCE U.S. Census Bureau, Small Area Health Insurance Estimates.


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Change 2006–2011

7.6 3.3 –4.3 14.3 4.8 –9.5 11.3 4.5 –6.8 9.5 4.2 –5.3 7.2 3.3 –3.9 10.6 3.2 –7.4 7.9 3.1 –4.8 10.6 4.7 –5.9 11.0 4.1 –6.9 9.2 3.3 –5.9 9.6 3.6 –6.0 8.4 3.4 –5.0 8.5 3.4 –5.1 8.8 3.3 –5.5 9.4 3.3 –6.1 11.3 3.9 –7.4 10.1 3.5 –6.6 11.6 4.5 –7.1 8.5 4.0 –4.5 10.2 3.4 –6.8 8.3 3.1 –5.2 11.8 3.6 –8.2 10.6 3.4 –7.2 8.9 3.4 –5.5 8.2 3.1 –5.1 7.2 3.3 –3.9 7.2 3.0 –4.2 8.8 3.4 –5.4 10.5 3.1 –7.4 6.7 3.4 –3.3 10.9 3.6 –7.3 10.7 3.8 –6.9 7.2 3.1 –4.1 8.9 2.7 –6.2 8.3 3.4 –4.9 6.8 3.0 –3.8 11.1 3.9 –7.2 7.3 3.2 –4.1 7.8 3.0 –4.8 9.5 3.5 –6.0 8.5 3.1 –5.4 8.7 3.2 –5.5 9.3 3.2 –6.1 6.4 2.9 –3.5 7.5 3.5 –4.0 11.9 3.6 –8.3 10.3 3.4 –6.9 10.8 3.0 –7.8 11.1 4.0 –7.1 9.8 3.1 –6.7 10.2 4.0 –6.2

APPENDIX

Enrollment of Children in Medical Assistance Programs, 50 Largest Counties (June of each year) Adams Boone Bureau Champaign Christian Clinton Coles Cook DeKalb DuPage Effingham Franklin Fulton Grundy Henry Jackson Jefferson Kane Kankakee Kendall Knox Lake LaSalle Lee Livingston Logan Macon Macoupin Madison Marion McDonough McHenry McLean Monroe Montgomery Morgan Ogle Peoria Randolph Rock Island Saint Clair Sangamon Stephenson Tazewell Vermilion Whiteside Will Williamson Winnebago Woodford All other counties Statewide

2005

2006

2007

Number of children 2008 2009

2010

2011

2012

Percent change 2005–2012

5,485 5,744 6,273 6,550 6,943 7,209 7,549 7,627 39.1 3,382 3,979 5,010 5,757 6,312 6,685 6,944 5,581 65.0 2,588 2,810 3,170 3,331 3,549 3,804 3,832 3,873 49.7 13,207 13,770 15,297 16,346 17,562 18,910 19,734 19,928 50.9 3,244 3,333 3,653 3,881 4,049 4,200 4,296 4,329 33.4 1,740 1,912 2,167 2,242 2,374 2,564 2,672 2,392 37.5 3,702 3,901 4,196 4,577 5,015 5,226 5,358 5,477 47.9 637,296 648,924 715,961 752,801 788,471 815,865 831,658 834,991 31.0 4,706 5,338 6,573 7,572 8,487 9,287 9,970 10,135 115.4 35,710 40,114 51,640 59,270 67,995 75,317 82,057 85,031 138.1 2,728 2,856 3,147 3,244 3,363 3,597 3,891 4,036 47.9 4,536 4,858 5,237 5,565 5,730 5,942 5,998 6,065 33.7 3,331 3,384 3,560 3,684 3,789 3,977 4,089 4,092 22.8 2,050 1,905 2,289 2,555 2,992 3,336 3,179 3,166 54.4 3,361 3,454 3,913 4,212 4,437 4,868 5,133 5,190 54.4 5,342 5,436 5,963 6,137 6,437 6,648 6,751 7,170 34.2 4,206 4,400 4,894 5,203 5,424 5,837 6,353 6,305 49.9 41,729 46,317 59,340 67,207 76,483 83,206 85,952 88,059 111.0 10,094 10,668 11,904 12,835 13,956 14,536 15,057 15,675 55.3 2,485 3,172 4,434 5,550 6,687 7,972 8,732 9,601 286.4 5,287 5,378 5,818 6,013 6,189 6,321 6,387 6,356 20.2 35,710 40,009 51,340 57,155 63,749 69,081 73,147 74,738 109.3 8,108 9,052 10,425 11,217 12,079 12,959 13,886 14,388 77.5 1,905 1,723 1,735 1,753 1,725 1,856 1,748 1,728 –9.3 2,703 2,886 3,226 3,374 3,600 3,765 3,938 4,058 50.1 2,385 2,483 2,771 2,838 3,046 3,318 3,774 3,928 64.7 11,580 12,036 12,711 13,100 13,612 14,270 14,660 14,650 26.5 3,886 3,983 4,459 4,670 4,965 5,186 5,283 5,242 34.9 20,058 21,403 23,301 24,359 26,108 27,338 27,947 28,668 42.9 4,728 4,945 5,328 5,648 5,935 6,054 6,045 6,850 44.9 2,039 2,110 2,214 2,333 2,450 2,532 2,636 2,706 32.7 9,495 11,429 14,447 16,699 19,946 22,316 24,459 25,715 170.8 9,092 9,637 11,108 12,027 12,681 13,072 13,655 13,833 52.1 623 717 775 850 936 963 877 835 34.0 2,637 2,754 2,964 3,183 3,251 3,372 3,477 3,447 30.7 2,935 3,021 3,218 3,407 3,499 3,673 3,775 3,935 34.1 3,709 4,322 5,207 5,779 6,338 6,806 7,302 7,288 96.5 19,427 20,224 20,925 21,823 23,110 24,006 25,024 25,532 31.4 2,693 2,770 3,039 3,273 3,427 3,634 3,728 3,761 39.7 13,324 13,950 15,471 16,576 17,503 18,496 19,249 20,040 50.4 29,024 29,916 31,920 33,053 34,458 35,449 35,599 35,188 21.2 17,109 17,990 19,401 20,447 21,234 22,016 22,851 22,944 34.1 4,086 4,274 4,744 4,978 5,358 5,605 5,811 6,030 47.6 9,059 9,531 10,444 11,070 12,023 12,711 13,036 13,597 50.1 9,990 10,739 11,762 11,990 12,386 12,642 12,935 13,126 31.4 4,870 5,233 5,656 6,086 6,432 6,808 7,111 7,171 47.2 30,541 34,077 42,725 48,933 56,412 62,065 66,105 67,164 119.9 6,105 6,424 7,244 7,825 8,252 8,449 8,700 8,782 43.8 28,048 30,246 34,334 36,762 39,717 41,861 43,239 45,248 61.3 1,725 1,840 2,056 2,152 2,353 2,349 2,079 1,667 –3.4 64,177 73,337 74,400 77,280 80,426 82,536 81,564 79,981 24.6 1,157,980 1,214,714 1,363,789 1,455,172 1,553,255 1,630,495 1,679,232 1,697,319 46.6

SOURCE Illinois Department of Healthcare and Family Services.

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57

APPENDIX

Infant Mortality Rates per 1,000 Live Births, 50 Largest Counties Adams Boone Bureau Champaign Christian Clinton Coles Cook Chicago Suburbs DeKalb DuPage Effingham Franklin Fulton Grundy Henry Jackson Jefferson Kane Kankakee Kendall Knox Lake LaSalle Lee Livingston Logan Macon Macoupin Madison Marion McDonough McHenry McLean Monroe Montgomery Morgan Ogle Peoria Randolph Rock Island Saint Clair Sangamon Stephenson Tazewell Vermilion Whiteside Will Williamson Winnebago Woodford Statewide

58

NOTE Three-year pooled data.



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1995–1997

1998–2000

2001–2003

2004–2006

2007–2009

5.7 6.3 7.4 7.6 6.4 6.2 8.1 5.2 3.8 5.4 8.2 7.2 3.0 5.8 5.0 7.2 7.4 8.2 9.5 6.1 10.1 8.3 4.2 10.5 6.4 4.1 3.3 7.0 4.7 5.6 8.5 8.3 6.5 7.6 5.8 10.2 9.7 8.3 7.8 7.3 11.4 10.9 9.1 8.3 8.0 8.4 7.9 7.2 7.2 6.4 6.2 5.5 7.8 7.4 7.7 6.1 6.3 6.5 7.1 5.4 3.6 8.5 5.1 7.2 8.1 7.1 8.1 9.2 2.1 8.4 6.4 4.1 6.6 5.9 8.1 13.9 4.8 7.7 7.7 6.0 4.7 9.6 7.3 2.9 3.0 12.2 9.9 8.0 7.3 6.9 7.0 6.5 4.9 2.7 5.9 8.1 6.8 6.1 5.9 5.6 8.6 9.2 9.5 9.2 8.6 6.2 6.5 6.3 6.4 4.4 5.9 5.7 8.2 7.0 7.3 6.1 4.9 4.9 5.8 5.2 7.4 5.4 5.7 8.1 7.5 8.9 7.9 5.5 2.6 5.1 6.4 4.9 9.6 7.8 8.8 6.1 7.7 6.1 4.1 12.7 10.8 8.2 8.6 11.2 10.7 5.0 3.1 7.7 5.9 8.9 7.5 8.2 7.1 7.4 5.7 9.0 6.3 7.2 6.5 3.8 6.9 5.4 8.2 6.9 5.7 4.7 5.7 3.9 4.4 5.2 7.8 6.3 9.2 9.5 5.5 3.3 5.0 2.8 6.3 2.8 6.8 2.9 2.0 10.2 4.1 9.0 9.6 6.4 5.9 2.6 7.4 5.4 6.9 7.1 3.4 8.5 9.5 8.1 10.7 8.7 7.3 11.9 8.8 3.6 7.3 8.4 9.0 6.0 6.4 8.2 10.1 10.0 9.5 8.0 8.1 9.9 7.5 9.1 9.2 9.3 7.6 4.3 6.9 11.8 6.9 6.3 8.7 6.7 7.3 5.6 10.2 9.3 9.4 7.1 8.5 4.7 3.8 5.4 7.5 7.9 6.9 8.0 6.1 5.9 7.2 7.8 8.6 4.9 6.2 9.9 8.1 8.4 8.5 7.5 7.3 7.3 7.8 8.6 6.9 4.9 8.6 8.3 7.4 7.3 6.9

APPENDIX

Child Poverty, 50 Largest Counties

Number of children in poverty 2006 2011 Percent change

Adams Boone Bureau Champaign Christian Clinton Coles

2,452 2,733 11.5 16.1 18.5 2,037 2,908 42.8 14.5 19.2

Cook

DeKalb DuPage Effingham Franklin Fulton Grundy Henry Jackson Jefferson Kane Kankakee Kendall Knox Lake LaSalle Lee Livingston Logan Macon Macoupin Madison Marion McDonough McHenry McLean Monroe Montgomery Morgan Ogle Peoria Randolph Rock Island Saint Clair Sangamon Stephenson Tazewell Vermilion Whiteside Will Williamson Winnebago Woodford Statewide

Poverty rate (percent) 2006 2011

1,080 1,461 35.3 13.7 19.0 6,245 8,916 42.8 16.7 23.4 1,856 1,845 –0.6 23.8 24.4 949 962 1.4 11.9 11.4 1,578 2,521 59.8 17.4 25.6 284,925 308,978 8.4 21.7 25.5 2,280 4,507 97.7 10.4 20.0 13,301 22,111 66.2 5.7 9.9 848 942 11.1 9.8 11.4 2,292 2,178 –5.0 26.5 24.8 1,541 1,227 –20.4 20.5 16.6 630 1,443 129.0 5.6 10.8 2,061 1,900 –7.8 18.7 16.6 2,975 3,311 11.3 30.4 32.4 1,925 1,763 –8.4 22.3 21.1 17,042 27,902 63.7 11.8 19.1 5,004 6,546 30.8 18.4 23.5 1,555 1,808 16.3 6.2 5.1 2,715 3,164 16.5 25.4 30.3 15,834 26,416 66.8 8.1 14.1 4,518 4,692 3.9 17.1 18.8 747 1,158 55.0 9.6 15.7 1,118 1,344 20.2 13.6 16.1 936 1,124 20.1 16.1 19.3 6,729 7,165 6.5 27.1 29.4 1,727 2,196 27.2 16.1 21.3 9,043 12,056 33.3 14.7 20.4 2,208 2,309 4.6 24.2 26.2 1,172 1,103 –5.9 23.8 21.9 5,761 9,041 56.9 6.8 11.1 4,964 4,386 –11.6 13.6 11.7 305 708 132.1 4.2 8.9 1,090 1,069 –1.9 17.3 17.8 1,900 1,306 –31.3 26.7 17.8 896 1,787 99.4 6.8 14.2 8,531 11,623 36.2 19.2 26.7 1,152 1,253 8.8 16.9 20.0 7,384 6,674 –9.6 22.2 20.6 14,836 18,260 23.1 22.1 27.5 8,351 11,084 32.7 18.4 24.3 2,175 2,523 16.0 20.1 24.4 4,223 4,298 1.8 14.5 13.8 6,002 6,594 9.9 31.1 34.0 2,616 2,618 0.1 19.3 19.9 12,606 22,938 82.0 6.8 11.9 2,838 2,698 –4.9 20.5 18.7 15,275 19,390 26.9 20.8 27.5 665 819 23.2 7.4 8.5 529,045 629,052 18.9 16.7 20.6

SOURCE U.S. Census Bureau, American Community Survey, 2005–2007 and 2010–2012 (three-year pooled data).

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APPENDIX

Substantiated Cases of Child Abuse and Neglect, 50 Largest Counties (fiscal years)

1999

Adams Boone Bureau Champaign Christian Clinton Coles Cook DeKalb DuPage Effingham Franklin Fulton Grundy Henry Jackson Jefferson Kane Kankakee Kendall Knox Lake LaSalle Lee Livingston Logan Macon Macoupin Madison Marion McDonough McHenry McLean Monroe Montgomery Morgan Ogle Peoria Randolph Rock Island Saint Clair Sangamon Stephenson Tazewell Vermilion Whiteside Will Williamson Winnebago Woodford All other Statewide

2000

2001

2002

NOTE Data reflect unduplicated counts.


60

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

222 287 217 243 233 280 359 252 292 280 239 316 296 244 240 91 69 77 49 73 80 79 99 109 122 88 94 85 69 110 83 65 87 102 62 74 95 94 114 115 123 91 77 59 98 434 621 603 567 528 608 485 606 577 549 536 531 542 580 553 107 70 99 85 117 167 147 135 79 93 126 100 141 97 143 67 89 68 53 61 78 70 75 60 70 76 69 70 66 43 166 121 152 137 194 199 210 187 155 175 179 212 142 118 204 11,259 10,170 9,185 8,769 8,647 7,610 7,378 7,219 7,332 7,770 7,435 7,344 7,033 7,895 7,938 241 142 172 174 151 153 118 137 131 157 166 161 166 145 177 596 515 410 494 544 498 609 675 633 787 720 713 732 906 984 150 86 90 70 67 103 110 137 122 143 135 110 96 100 101 108 182 121 86 120 179 178 160 147 148 154 167 156 140 168 143 143 131 126 128 119 102 153 120 126 113 105 169 137 139 32 32 61 58 52 39 44 51 58 50 77 79 75 78 93 144 162 114 118 155 142 188 124 150 140 162 214 220 158 180 189 175 192 151 186 173 182 176 195 195 119 160 178 188 216 151 150 181 186 164 158 207 232 220 272 269 286 272 257 363 1,005 1,012 687 709 681 654 620 699 983 1,050 1,110 971 951 982 1,087 365 470 408 361 350 328 298 282 197 221 147 188 170 202 245 68 71 76 63 68 62 54 77 103 106 134 120 146 120 145 268 314 222 193 193 219 219 244 208 187 209 175 159 194 173 1,207 1,049 866 1,177 1,129 1,195 1,239 1,204 1,450 1,567 1,635 1,567 1,357 1,476 1,421 579 451 473 392 428 438 450 448 494 472 455 460 453 389 448 147 161 109 139 94 128 111 100 128 113 160 171 98 73 128 188 249 141 137 142 149 146 122 134 156 170 166 173 140 146 85 110 97 81 91 114 88 89 105 136 144 143 119 139 169 350 290 357 324 280 353 291 403 409 532 516 537 475 531 631 134 134 118 153 190 177 167 134 153 168 147 189 220 208 200 1,036 996 833 931 796 737 675 597 713 698 659 784 598 536 642 242 318 268 200 212 237 278 272 226 219 148 203 183 210 227 130 87 73 70 77 80 63 74 56 77 61 87 90 57 64 603 498 403 327 474 485 506 620 573 652 518 504 573 502 544 668 728 506 413 492 575 568 516 703 601 496 559 484 497 456 25 40 33 28 19 28 44 34 50 54 54 78 34 32 41 106 72 93 85 101 122 96 79 86 103 84 54 96 92 94 106 98 85 137 148 183 149 130 139 146 137 105 132 142 174 164 118 100 107 130 121 135 84 157 114 126 91 99 72 104 912 975 754 633 570 663 659 690 695 703 703 691 706 740 853 93 100 130 90 77 77 122 92 132 121 117 147 98 75 80 687 686 535 538 535 643 602 545 654 613 654 712 570 563 564 1,034 1,064 835 684 647 552 682 548 716 678 612 547 620 535 602 635 753 676 716 586 701 799 691 768 837 908 701 693 727 757 140 154 114 101 113 125 148 172 183 143 163 164 138 126 121 392 419 355 390 414 378 363 443 384 469 505 457 397 368 282 393 356 362 344 319 506 410 298 381 429 471 417 440 409 515 256 262 205 208 215 196 231 250 217 269 269 249 176 178 171 514 706 699 589 628 596 548 584 649 924 910 839 850 866 984 177 239 271 185 257 247 280 280 254 256 245 202 276 212 248 935 1,003 862 843 1,020 1,111 1,170 1,080 1,208 1,434 1,592 1,344 1,323 1,300 1,316 80 67 52 52 63 73 79 58 84 72 78 59 52 55 81 2,321 2,234 2,276 2,292 2,482 2,670 2,720 2,321 2,513 2,435 2,556 2,599 2,655 2,697 2,425 30,228 29,363 26,034 25,160 25,503 25,583 25,571 24,772 26,399 27,947 27,610 27,032 26,054 26,682 27,888


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APPENDIX

Rates of Child Abuse and Neglect, 50 Largest Counties, rate per 1,000 (fiscal years)

1999

Adams Boone Bureau Champaign Christian Clinton Coles Cook DeKalb DuPage Effingham Franklin Fulton Grundy Henry Jackson Jefferson Kane Kankakee Kendall Knox Lake LaSalle Lee Livingston Logan Macon Macoupin Madison Marion McDonough McHenry McLean Monroe Montgomery Morgan Ogle Peoria Randolph Rock Island Saint Clair Sangamon Stephenson Tazewell Vermilion Whiteside Will Williamson Winnebago Woodford Statewide

12.7 16.5 12.5 14.0 13.6 16.4 21.0 14.8 17.1 16.4 14.0 18.5 17.3 14.3 14.1 8.3 6.3 7.0 4.4 6.0 6.5 6.5 8.1 8.9 10.0 7.2 7.7 6.9 5.6 12.8 8.8 6.9 9.2 10.8 7.1 8.5 10.9 10.8 13.1 13.2 14.1 10.5 8.8 6.8 10.4 11.9 17.0 16.5 15.5 12.2 14.1 11.2 14.0 13.4 12.7 12.4 12.3 12.5 13.4 14.6 12.2 8.0 11.3 9.7 13.9 19.9 17.5 16.1 9.4 11.1 15.0 11.9 16.8 11.6 16.4 7.0 9.3 7.1 5.6 7.0 8.9 8.0 8.6 6.8 8.0 8.7 7.9 8.0 7.5 4.7 15.2 11.1 14.0 12.6 16.3 16.8 17.7 15.8 13.1 14.7 15.1 17.9 12.0 9.9 19.1 8.3 7.5 6.8 6.5 6.2 5.4 5.3 5.2 5.2 5.6 5.3 5.3 5.0 5.7 6.2 12.6 7.4 9.0 9.1 6.6 6.7 5.2 6.0 5.7 6.9 7.3 7.0 7.3 6.3 10.6 2.6 2.2 1.8 2.1 2.3 2.1 2.6 2.8 2.7 3.3 3.0 3.0 3.1 3.8 4.8 14.9 8.5 8.9 6.9 6.9 10.7 11.4 14.2 12.6 14.8 14.0 11.4 9.9 10.3 10.6 10.9 18.4 12.2 8.7 13.4 20.0 19.9 17.9 16.4 16.5 17.2 18.6 17.4 15.6 17.3 15.3 15.3 14.1 13.5 15.3 14.2 12.2 18.3 14.3 15.0 13.5 12.5 20.2 16.4 14.9 3.1 3.1 5.9 5.6 5.2 3.9 4.4 5.1 5.8 5.0 7.7 7.9 7.5 7.8 10.4 10.4 11.7 8.2 8.5 12.1 11.1 14.7 9.7 11.7 11.0 12.7 16.8 17.2 12.4 13.1 15.6 14.5 15.9 12.5 14.2 13.2 13.9 13.5 14.9 14.9 9.1 12.3 13.6 14.4 18.6 15.6 15.5 18.7 19.2 17.0 16.3 21.4 24.0 22.7 28.1 27.8 29.6 28.1 26.6 36.5 8.3 8.4 5.7 5.9 5.6 5.4 5.1 5.8 8.1 8.7 9.2 8.0 7.9 8.1 11.5 12.4 16.0 13.9 12.3 12.5 11.7 10.6 10.0 7.0 7.9 5.2 6.7 6.1 7.2 9.0 4.4 4.6 4.9 4.1 4.3 3.9 3.4 4.8 6.4 6.6 8.4 7.5 9.1 7.5 12.3 20.5 24.0 17.0 14.8 15.6 17.7 17.7 19.7 16.8 15.1 16.9 14.2 12.9 15.7 12.8 7.1 6.2 5.1 6.9 6.0 6.3 6.5 6.4 7.7 8.3 8.6 8.3 7.2 7.8 10.0 20.4 15.9 16.6 13.8 15.4 15.8 16.2 16.1 17.8 17.0 16.4 16.6 16.3 14.0 16.5 15.8 17.3 11.7 15.0 10.9 14.8 12.9 11.6 14.8 13.1 18.6 19.8 11.4 8.5 14.4 18.6 24.6 13.9 13.5 14.6 15.3 15.0 12.5 13.7 16.0 17.4 17.0 17.7 14.4 14.9 11.6 15.1 13.3 11.1 12.9 16.1 12.5 12.6 14.9 19.2 20.4 20.2 16.8 19.7 23.0 11.9 9.9 12.2 11.0 9.9 12.4 10.3 14.2 14.4 18.8 18.2 18.9 16.7 18.7 20.8 10.5 10.5 9.3 12.0 15.9 14.8 13.9 11.2 12.8 14.0 12.3 15.8 18.4 17.4 16.2 15.5 14.9 12.5 13.9 12.3 11.4 10.5 9.2 11.0 10.8 10.2 12.1 9.3 8.3 10.1 21.5 28.2 23.8 17.7 20.1 22.5 26.4 25.8 21.5 20.8 14.1 19.3 17.4 19.9 20.5 19.6 13.1 11.0 10.5 10.9 11.3 8.9 10.5 7.9 10.9 8.6 12.3 12.8 8.1 9.9 8.5 7.0 5.7 4.6 6.2 6.3 6.6 8.0 7.4 8.5 6.7 6.5 7.4 6.5 10.2 19.5 21.2 14.7 12.0 13.0 15.2 15.0 13.6 18.6 15.9 13.1 14.8 12.8 13.1 15.3 3.5 5.6 4.6 3.9 2.6 3.8 6.0 4.7 6.9 7.4 7.4 10.7 4.7 4.4 6.8 13.4 9.1 11.7 10.7 14.1 17.0 13.4 11.0 12.0 14.4 11.7 7.5 13.4 12.8 12.0 13.0 12.0 10.4 16.8 17.4 21.5 17.5 15.3 16.4 17.2 16.1 12.4 15.5 16.7 19.6 11.7 8.4 7.1 7.6 9.4 8.8 9.8 6.1 11.4 8.2 9.1 6.6 7.2 5.2 8.3 19.1 20.4 15.8 13.2 12.3 14.4 14.3 14.9 15.0 15.2 15.2 15.0 15.3 16.0 18.0 11.3 12.2 15.8 10.9 10.4 10.4 16.5 12.4 17.8 16.3 15.8 19.8 13.2 10.1 9.5 18.1 18.1 14.1 14.2 15.0 18.0 16.8 15.2 18.3 17.1 18.3 19.9 15.9 15.7 14.9 13.6 14.0 11.0 9.0 9.2 7.8 9.7 7.8 10.1 9.6 8.7 7.8 8.8 7.6 8.0 12.9 15.3 13.7 14.5 12.6 15.1 17.2 14.9 16.6 18.0 19.6 15.1 14.9 15.7 16.6 11.1 12.2 9.0 8.0 9.2 10.2 12.1 14.0 14.9 11.7 13.3 13.4 11.2 10.3 9.8 12.0 12.8 10.8 11.9 13.4 12.2 11.7 14.3 12.4 15.1 16.3 14.7 12.8 11.9 8.6 18.0 16.3 16.6 15.8 15.3 24.3 19.7 14.3 18.3 20.6 22.7 20.1 21.2 19.7 22.5 16.0 16.4 12.8 13.0 14.2 12.9 15.3 16.5 14.3 17.8 17.8 16.4 11.6 11.8 10.6 3.7 5.1 5.0 4.3 4.2 4.0 3.7 3.9 4.4 6.2 6.1 5.6 5.7 5.8 9.2 12.1 16.4 18.5 12.7 18.3 17.6 20.0 20.0 18.1 18.3 17.5 14.4 19.7 15.1 17.9 13.2 14.2 12.2 11.9 14.0 15.2 16.1 14.8 16.6 19.7 21.8 18.4 18.2 17.8 19.8 7.9 6.6 5.1 5.1 6.6 7.7 8.3 6.1 8.8 7.6 8.2 6.2 5.5 5.8 8.6 9.5 9.2 8.2 7.9 7.9 7.9 7.9 7.6 8.1 8.6 8.5 8.3 8.0 8.2 9.5

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013


voices4kids.org


61

APPENDIX

Children in Substitute Care, 50 Largest Counties (June of each fiscal year)

1997

1998

1999 2000

2001 2002 2003 2004 2005 2006 2007 2008 2009

2010

2011

2012

2013

Adams 153 143 123 101 92 86 76 86 100 106 110 101 85 119 126 112 105 Boone 18 16 8 5 3 15 7 11 14 16 20 31 35 47 54 72 84 Bureau 27 27 32 27 21 25 21 25 23 29 27 25 29 28 31 39 37 Champaign 550 485 433 377 369 337 325 380 336 377 405 427 417 403 371 381 383 Christian 40 33 23 30 24 23 26 41 59 59 46 38 49 44 51 98 88 Clinton 33 35 30 21 20 19 20 19 18 19 25 33 39 31 24 29 29 Coles 104 101 85 73 65 48 58 65 65 67 56 48 52 48 33 17 30 Cook 37,731 34,090 27,227 20,850 17,237 14,559 12,227 10,486 9,467 8,232 7,142 6,839 6,256 5,821 5,669 5,287 5,215 DeKalb 62 64 64 60 62 78 96 95 88 72 55 44 45 41 53 88 98 DuPage 338 304 288 235 191 164 136 145 128 147 144 175 196 174 194 359 335 Effingham 36 29 21 17 20 23 21 32 32 38 43 37 29 39 39 40 40 Franklin 34 32 25 38 44 44 45 82 69 60 71 75 70 85 105 93 89 Fulton 91 88 81 63 46 42 49 63 59 47 45 33 34 36 53 66 58 Grundy 16 17 19 11 10 7 9 18 9 7 6 17 16 23 23 21 28 Henry 52 56 48 56 45 45 50 46 44 42 36 28 40 30 34 68 82 Jackson 62 60 65 53 49 62 55 62 60 68 69 70 83 80 69 71 64 Jefferson 71 69 94 84 82 85 76 76 74 101 113 112 121 124 99 100 127 Kane 526 476 397 378 347 270 237 224 232 252 259 272 267 245 279 304 343 Kankakee 324 332 307 254 227 177 165 134 131 161 151 179 164 154 141 202 212 Kendall 20 23 21 24 30 14 13 10 9 11 15 11 23 17 26 81 82 Knox 107 125 112 111 100 81 76 69 61 86 99 94 75 83 70 67 77 Lake 777 742 676 557 480 441 375 302 324 324 297 302 333 361 365 390 441 LaSalle 155 151 179 160 175 132 105 103 129 139 136 141 163 161 166 90 91 Lee 48 39 42 55 60 57 43 34 45 37 33 28 38 64 59 51 45 Livingston 74 60 81 68 67 46 42 59 58 50 44 25 42 52 85 68 54 Logan 68 62 49 43 47 53 64 77 70 67 68 63 73 77 79 76 58 Macon 453 382 325 255 231 228 205 180 187 198 221 316 335 335 315 251 242 Macoupin 38 30 31 30 28 26 34 37 42 32 25 21 31 29 43 52 55 Madison 436 411 379 317 326 346 297 279 275 325 319 388 463 570 661 501 472 Marion 77 62 87 92 109 92 100 99 110 113 91 109 110 116 118 150 111 McDonough 59 54 44 27 19 20 21 20 21 21 19 18 23 34 40 54 34 McHenry 93 84 76 58 65 60 43 63 80 85 84 94 97 99 107 150 124 McLean 300 346 365 424 288 248 261 241 247 268 310 340 308 343 318 266 224 Monroe 10 8 7 7 11 7 5 11 7 10 10 14 17 18 23 24 22 Montgomery 22 24 18 23 18 13 18 25 25 17 17 34 45 40 35 48 47 Morgan 70 72 66 53 50 41 43 52 54 42 41 34 47 57 54 42 52 Ogle 29 30 27 45 43 34 25 23 18 16 24 20 37 28 28 49 58 Peoria 984 957 995 1,053 992 891 796 754 738 744 694 699 712 670 709 628 673 Randolph 31 29 28 42 39 39 32 32 27 33 45 44 44 31 25 24 Rock Island 318 329 339 282 246 226 206 182 165 200 247 257 249 262 288 229 190 Saint Clair 894 771 603 548 459 433 405 405 406 346 357 376 376 364 393 501 467 Sangamon 485 421 366 343 331 298 298 322 351 390 359 393 395 366 351 363 390 Stephenson 116 117 79 72 49 52 41 48 52 64 61 81 106 107 94 95 86 Tazewell 97 93 91 102 134 139 129 126 148 155 142 199 210 248 275 259 246 Vermilion 314 325 308 237 220 200 202 195 216 220 250 240 234 226 258 180 161 Whiteside 130 114 116 103 94 82 75 74 74 73 66 71 81 95 89 50 42 Will 529 454 391 323 278 258 295 308 331 360 370 420 450 374 350 622 619 Williamson 76 75 60 79 92 83 92 98 122 134 144 154 132 140 139 111 131 Winnebago 721 724 676 651 657 637 569 633 680 742 692 728 787 789 820 795 898 Woodford 36 32 25 20 14 10 11 19 21 18 19 34 27 33 29 65 52 All other counties 797 751 645 629 633 613 710 782 816 812 805 761 877 964 989 1,061 1,035 Statewide* 50,843 46,240 38,108 30,682 26,353 22,882 20,144 18,457 17,595 16,706 15,544 15,660 15,473 15,192 15,224 15,099 14,945

* Statewide totals include out-of-state placements and data with missing geo-codes.

62



voices4kids.org

APPENDIX

Teen Births as Percentage of All Births, 50 Largest Counties

1993

Adams Boone Bureau Champaign Christian Clinton Coles Cook Chicago Suburbs DeKalb DuPage Effingham Franklin Fulton Grundy Henry Jackson Jefferson Kane Kankakee Kendall Knox Lake LaSalle Lee Livingston Logan Macon Macoupin Madison Marion McDonough McHenry McLean Monroe Montgomery Morgan Ogle Peoria Randolph Rock Island Saint Clair Sangamon Stephenson Tazewell Vermilion Whiteside Will Williamson Winnebago Woodford Statewide

14.0 13.1 11.7 13.5 14.5 13.9 12.9 9.2 12.6 11.3 12.7 14.2 12.0 10.2 10.7 10.2 11.1 12.7 8.9 11.0 8.9 12.1 14.3 11.9 10.4 10.8 9.5 8.2 8.0 8.6 8.0 10.3 10.9 9.2 11.6 11.0 12.9 12.9 13.9 11.8 12.1 12.0 13.1 9.7 9.0 7.6 8.6 8.7 8.0 7.3 10.5 10.9 11.7 10.5 10.8 10.4 9.4 9.6 9.4 9.3 9.6 8.2 8.7 9.0 9.0 8.3 9.8 8.5 13.0 16.2 15.4 11.9 15.5 13.8 13.2 14.4 12.1 11.6 15.0 14.9 11.7 11.1 13.5 14.9 13.5 10.8 11.3 11.0 8.2 10.8 13.6 10.0 9.8 8.3 7.8 8.0 7.5 7.2 10.3 9.2 9.2 7.0 15.0 16.4 15.5 14.3 15.9 12.7 16.4 15.1 12.8 12.6 11.8 10.4 9.1 12.3 10.5 11.8 10.1 14.4 14.6 14.5 14.4 14.2 14.1 13.6 12.9 12.3 11.7 10.9 11.1 10.7 11.2 11.2 10.8 10.2 18.6 18.8 18.7 18.4 18.2 18.0 17.1 16.0 15.4 14.4 13.5 13.7 13.3 13.7 13.6 12.8 12.0 7.6 7.8 8.1 8.4 8.3 8.2 8.4 8.3 7.9 7.8 7.4 7.4 7.3 7.7 7.8 8.1 7.6 6.5 9.7 8.5 10.0 9.6 10.6 9.5 8.0 8.2 7.2 6.6 7.4 6.4 7.0 7.4 6.2 7.0 3.7 3.7 3.8 4.0 4.1 4.5 4.3 4.5 4.4 4.4 4.0 4.1 4.1 4.7 4.4 4.3 4.2 11.0 9.5 12.3 13.1 9.8 13.1 10.2 13.4 7.9 9.3 9.8 9.8 8.3 11.0 10.4 11.5 9.2 16.9 16.6 17.9 15.8 18.1 18.2 15.9 16.4 14.8 16.6 11.9 11.5 10.4 15.4 13.2 16.4 10.7 14.8 15.9 14.6 13.1 15.8 15.9 17.7 10.4 13.3 13.3 10.3 13.7 10.2 9.4 14.0 15.1 13.1 13.3 10.9 13.6 11.2 11.8 9.3 8.7 6.9 8.1 7.9 7.3 8.0 6.9 5.2 6.7 4.2 7.0 11.2 13.3 13.7 12.2 11.3 10.9 10.1 12.1 12.9 9.8 10.3 6.7 8.5 11.2 11.3 10.6 13.4 10.3 14.1 13.0 14.4 15.6 13.5 12.2 11.4 9.9 10.9 7.5 10.8 8.7 9.8 8.7 11.5 10.3 19.5 17.2 19.7 16.0 18.2 14.9 13.5 17.6 14.9 15.1 14.8 15.4 14.3 14.2 13.5 14.4 14.3 11.3 11.3 11.5 11.4 11.2 11.1 10.7 9.9 9.1 8.7 8.3 8.7 8.9 8.6 8.8 9.1 8.3 16.3 16.8 17.3 16.1 15.7 16.2 15.3 15.3 14.5 13.7 14.5 12.2 11.1 11.5 11.8 12.4 13.5 8.0 7.7 7.8 8.2 7.6 5.8 6.6 4.8 5.1 3.6 3.0 4.5 3.8 4.0 3.2 4.3 4.2 13.8 18.2 18.9 13.5 15.6 13.9 13.0 12.3 12.6 10.8 10.6 11.4 14.7 13.8 14.5 14.1 11.6 8.3 8.4 8.7 8.2 7.7 8.1 8.3 7.7 7.7 6.9 6.7 6.7 7.1 7.1 7.4 7.4 7.9 12.0 12.0 12.0 12.8 12.3 12.6 13.4 11.6 11.6 11.7 10.1 8.4 9.5 9.5 11.1 11.6 11.8 11.4 11.6 10.0 11.8 13.0 12.2 12.2 12.5 10.1 7.8 10.6 8.0 10.7 11.8 12.0 9.9 14.2 11.3 12.7 9.7 13.3 13.2 13.3 13.1 14.5 11.7 9.7 8.9 9.2 11.2 9.8 9.3 8.8 11.9 15.6 18.6 13.4 14.1 13.0 16.0 12.6 10.6 16.4 12.9 13.1 12.9 16.4 8.9 10.7 11.0 11.7 17.2 20.4 19.3 21.8 19.5 16.4 17.9 17.4 15.1 17.6 14.9 14.3 16.3 17.5 16.9 15.7 14.6 14.9 17.3 15.6 14.9 13.5 16.4 15.5 11.5 9.3 11.7 12.5 10.0 13.7 10.7 9.5 11.7 10.9 15.0 14.0 16.2 14.1 13.6 13.8 13.4 12.9 12.0 11.4 11.1 11.6 11.1 12.1 11.9 11.6 9.6 14.5 19.8 18.8 19.1 17.4 18.4 17.2 16.7 17.6 15.1 15.3 15.4 17.2 14.8 19.2 17.3 15.7 12.0 10.9 11.3 8.5 12.7 10.1 10.8 9.5 12.2 9.4 10.2 8.4 9.2 8.1 7.5 8.9 10.0 4.6 5.5 5.3 5.5 5.0 5.0 5.6 5.9 5.5 5.2 5.1 5.4 5.5 5.3 5.8 5.0 6.1 9.9 9.7 10.7 9.3 8.6 9.8 8.1 7.0 7.0 7.5 6.9 6.6 7.4 6.8 7.4 6.5 6.4 5.5 3.9 3.0 6.8 4.9 7.8 5.6 5.7 5.4 5.3 3.5 4.5 3.5 3.8 4.5 4.0 5.0 15.0 16.3 19.2 18.2 9.4 19.8 15.9 15.2 15.1 12.6 13.2 15.7 15.6 13.0 13.5 12.2 14.3 14.4 15.2 12.5 14.7 14.0 16.4 14.3 12.8 13.9 13.0 13.9 14.1 11.9 9.7 10.3 11.1 12.4 10.0 11.9 11.9 9.4 12.1 10.6 12.2 9.7 7.6 10.4 8.2 8.4 8.6 10.4 9.2 14.1 10.2 18.1 18.1 18.3 16.6 17.6 16.0 13.7 13.8 14.2 11.3 12.9 14.1 13.3 13.0 13.3 12.8 12.5 12.9 10.0 14.2 15.4 13.9 12.3 14.3 12.9 12.8 11.4 11.4 13.7 10.1 14.6 12.8 14.0 12.1 16.9 17.9 17.3 16.0 16.0 15.4 13.7 14.9 14.8 12.8 13.0 13.9 12.4 13.8 13.3 13.9 12.1 19.0 19.2 18.6 18.2 17.4 17.8 17.2 15.2 16.0 13.4 13.7 14.6 13.9 14.6 14.0 13.6 14.3 14.5 14.2 14.7 14.3 13.5 13.6 13.3 12.5 13.3 12.6 11.9 11.5 10.8 10.8 11.8 11.6 10.3 13.3 13.9 14.5 13.8 14.0 15.7 13.3 12.3 14.8 13.1 11.6 13.5 13.0 14.7 13.7 15.6 9.7 11.8 12.7 13.8 13.1 12.7 11.8 11.8 11.4 9.7 8.5 8.0 9.3 8.8 8.8 10.3 9.1 8.0 17.2 19.6 20.8 19.9 20.0 18.2 18.8 17.6 16.1 15.5 17.3 16.4 16.2 14.1 13.5 15.0 15.6 15.8 17.5 18.5 16.4 16.6 14.9 14.9 16.3 14.4 12.4 12.3 12.6 11.9 14.5 11.3 14.1 12.4 8.7 9.3 8.2 8.5 8.6 8.1 7.6 7.1 6.3 5.9 5.4 5.7 6.0 6.3 7.1 6.8 6.1 13.3 14.1 15.9 15.5 14.2 13.8 15.1 15.6 12.4 11.0 11.4 11.1 10.8 8.7 12.9 11.2 12.1 13.1 13.6 13.1 13.6 14.7 13.5 14.0 13.3 12.7 11.5 11.7 11.9 13.4 12.4 13.9 12.7 13.6 6.9 9.0 9.2 8.9 7.4 9.4 8.7 5.1 6.8 5.1 6.1 6.3 6.7 5.9 5.2 6.4 6.9 12.8 13.0 12.9 12.7 12.5 12.4 12.0 11.4 10.9 10.3 9.7 9.9 9.7 10.0 10.1 10.0 9.6

1994

1995

1996

1997

1998

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009


voices4kids.org


APPENDIX

Reported Crimes Against Children, 50 Largest Counties, per 100,000 people

1998– 2000

1999– 2001

2000– 2002

2001– 2003

2002– 2004

2003– 2005

Adams Boone Bureau Champaign Christian Clinton Coles Cook DeKalb DuPage Effingham Franklin Fulton Grundy Henry Jackson Jefferson Kane Kankakee Kendall Knox Lake LaSalle Lee Livingston Logan Macon Macoupin Madison Marion McDonough McHenry McLean Monroe Montgomery Morgan Ogle Peoria Randolph Rock Island Saint Clair Sangamon Stephenson Tazewell Vermilion Whiteside Will Williamson Winnebago Woodford Statewide

365.0 319.8 236.3 211.5 150.0 99.1 81.3 76.3 82.7 74.7 65.7 52.7 342.6 307.9 305.5 269.1 211.6 193.3 157.6 154.5 143.1 161.3 150.6 137.4 213.0 215.6 188.2 126.4 63.8 19.1 10.5 14.3 16.2 12.4 19.1 23.8 417.0 416.8 459.6 477.2 513.2 496.3 504.9 484.9 459.2 445.4 413.1 386.5 31.0 29.3 26.5 32.4 27.7 33.4 35.5 39.4 36.6 29.0 24.2 20.3 159.4 156.5 149.7 167.0 175.7 186.5 186.8 154.1 110.4 58.8 22.0 8.1 43.1 54.2 94.4 126.4 157.6 176.8 180.1 196.8 173.7 176.4 132.8 100.9 512.9 511.2 534.0 521.1 548.5 559.0 542.7 507.9 468.1 428.4 399.5 362.4 218.5 189.3 143.5 99.0 88.5 106.1 113.1 98.9 82.9 65.9 57.4 62.1 85.9 78.3 67.2 59.9 55.4 53.3 51.4 55.1 61.9 67.2 73.0 76.1 318.8 261.9 216.7 204.7 204.4 231.4 266.5 278.7 250.8 217.6 207.9 174.9 13.6 20.6 22.3 20.6 31.6 31.5 75.5 84.8 92.5 47.5 25.4 19.4 73.0 69.8 55.2 35.4 22.3 27.7 29.7 37.9 32.6 24.5 26.2 37.8 160.3 161.6 181.8 184.8 188.3 169.7 149.4 133.3 104.7 64.0 30.0 30.9 163.4 280.2 373.2 417.9 441.1 476.7 476.8 425.7 371.1 333.9 242.5 189.3

2006– 2008

2007– 2009

2008– 2010

2009– 2011

224.9 220.0 190.8 144.2 98.5 79.0 74.6 79.6 77.5 73.3 90.6 86.9 221.6 222.3 219.3 203.9 198.5 192.5 180.3 159.1 137.1 124.3 147.6 138.2 194.3 208.5 210.9 325.7 414.7 552.0 581.4 598.4 614.5 652.2 683.4 674.5 188.1 182.2 188.6 192.5 177.9 151.5 128.0 129.1 141.2 156.6 150.8 125.7 305.2 268.5 296.5 274.2 272.8 285.2 305.0 316.7 306.8 286.7 273.5 239.3 307.9 239.2 242.0 258.8 297.5 338.1 419.0 499.5 505.4 475.0 464.4 487.2 54.4 56.7 58.5 63.2 47.5 45.5 45.0 42.3 38.9 32.8 44.8 49.5 111.6 101.5 92.4 78.9 70.2 63.9 60.8 55.3 54.0 57.4 68.5 86.1 191.8 161.2 147.7 121.3 138.1 130.8 120.0 113.4 114.3 114.4 111.7 103.1 47.6 26.9 20.5 22.4 20.9 21.8 19.2 18.9 15.7 18.5 23.2 22.9 21.7 17.9 12.2 16.8 13.9 12.9 9.9 9.8 8.0 7.8 12.1 13.8 318.0 312.5 316.3 305.1 311.5 313.9 304.8 288.1 268.9 250.1 238.4 221.2

NOTE Three-year moving averages.

SOURCE Illinois Criminal Justice Information Authority; based on data from Illinois State Police.


2005– 2007

23.3 19.6 16.4 14.7 14.2 15.8 18.6 18.7 20.5 18.3 23.2 41.1 433.2 253.4 44.1 26.7 24.2 35.0 38.3 35.8 33.3 25.8 26.0 17.9 80.1 81.1 83.9 82.8 79.8 81.5 82.5 87.6 82.2 83.4 85.3 78.3 226.8 134.8 73.8 75.2 76.9 67.4 65.3 64.2 65.8 64.6 54.3 44.7 188.2 195.6 196.0 194.9 153.1 122.1 91.7 103.3 97.5 94.0 97.1 98.0 51.3 85.3 107.6 108.5 110.0 124.1 148.5 128.5 128.2 110.7 114.1 129.9 77.0 79.2 83.6 78.4 70.7 66.9 68.6 68.9 74.5 73.3 84.9 86.3 67.2 49.2 39.1 35.0 35.1 42.5 53.7 58.9 50.4 38.8 40.6 62.7 17.5 26.9 33.5 43.2 40.8 41.9 36.2 32.4 29.5 22.8 31.8 43.6 382.2 466.2 484.6 494.2 448.6 454.5 425.5 421.9 392.7 355.6 333.5 295.8 637.2 700.3 740.6 712.2 679.8 651.5 597.7 570.9 479.3 341.4 177.9 95.1 452.0 414.1 421.6 437.8 478.4 470.2 447.9 419.7 398.9 389.5 342.0 269.1 119.2 111.7 86.6 72.5 63.0 63.1 71.6 91.2 85.0 69.9 48.0 36.3 453.8 458.3 411.0 358.0 303.5 288.2 280.1 249.9 217.2 176.0 170.4 177.7 101.4 83.4 83.9 53.5 41.0 17.5 28.5 28.6 27.7 19.4 18.6 22.9 11.1 12.1 9.1 8.1 9.1 8.1 5.1 1.0 8.1 14.2 24.5 26.5 34.1 34.3 34.6 32.0 31.4 32.7 39.3 51.7 63.8 77.2 89.0 80.9 154.2 102.6 56.4 58.5 64.0 78.4 107.8 141.2 158.9 158.4 120.2 107.5 27.0 28.7 32.8 38.8 41.1 34.0 24.7 14.6 16.5 15.2 14.1 17.1 60.9 126.7 230.7 270.2 309.6 231.2 156.2 82.6 82.8 68.4 66.9 97.6 152.1 140.8 149.7 174.5 154.6 147.7 128.9 129.6 125.5 127.2 124.2 109.7 195.0 186.9 166.3 118.5 86.6 92.3 102.4 102.8 88.0 74.9 75.6 65.9 893.4 895.5 802.4 691.7 604.9 587.5 558.7 532.8 525.4 507.8 526.7 483.0 26.6 36.3 34.5 34.7 21.1 29.2 27.2 30.3 20.3 16.3 13.1 17.0

64

2004– 2006

voices4kids.org

KIDS COUNT Data Center The Annie E. Casey’s Foundation’s updated KIDS COUNT Data Center is an online, searchable database that provides access to hundreds of national, state, and local-level child well-being indicators related to education, employment and income, health, poverty, and youth risk factors. New site features include improved search options; more attractive and easier to create tables, maps and graphs; and better ways to share information through social media on how children are faring. MOBILE SITE

All indicators currently found on the KIDS COUNT Data Center can be accessed quickly and easily anytime, anywhere on your mobile device at: mobile.kidscount.org Access the Illinois KIDS COUNT profile page at: datacenter.kidscount.org/data#IL

Special thanks to the KINETIK team for the design and production of this report. All photographs are of Illinois kids and families and were obtained from a photography contest sponsored by Voices. The findings and conclusions presented in this report are those of Voices for Illinois Children alone and do not necessarily reflect the opinions of the Annie E. Casey Foundation. Permission to copy, disseminate, or otherwise use information from the Illinois Kids Count 2014 report is granted so long as appropriate acknowledgment is given.

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