By Melissa Patrick
Kentucky Health News
The first of five webinars focusing on policies and programs that reduce the chances of disease and unhealthy behaviors that often begin in childhood opened with a slew of data that shows the state has much work to do in this arena, with an expectation that the pandemic is only going to make things worse.
But not to despair, Terry Brooks, executive director of Kentucky Youth Advocates, offered a message of hope, saying that such programs and policies are ones that generally have widespread support.
"I'm sure that we all are aware that there is an element of toxicity and bifurcation in Frankfort and Washington these days," said Brooks. " I frankly think that's an opportunity instead of an obstacle because what we have consistently found is that kids . . . provide a common ground for legislators and the administration to work with."
Brooks explained that KYA works to create a consensus agenda around children's issues that is based on a limited number of common ground priorities before each legislative session and that for the last two to three years, they have been almost 100 percent successful in getting those priority bills passed, with 90% of the vote in the House and Senate. "Things can get done," he said.
The webinars are part of the Foundation for a Healthy Kentucky's annual policy forum, which will be offered in a free monthly webinar series this year due to the coronavirus pandemic. The next webinar titled "Intervening Early" will be held 2 p.m. ET Monday, Oct. 19.
The foundation is partnering with KYA on this year's Howard L. Bost Memorial Health Policy Forum, which held its first webinar, titled "State of Child Health in Kentucky," Sept. 21.
"We're focusing on programs and policies that help move Kentucky kids away from substance use, suicide and other risky behaviors and toward more natural, healthy behaviors that will benefit them throughout their lives," said Ben Chandler, president and CEO of the foundation.
Brooks opened the meeting by painting a broad picture of what it means to be a child in the commonwealth, citing data from the
Kids Count Data Book on children's well being, released annually by the
Annie E. Casey Foundation and KYA. The latest report shows Kentucky ranks 37th for overall child well-being.
While the economic well-being of the state's children has shown slight improvement over the last few years, Brooks said Kentucky still has at least one in five children living in poverty and one-third of them live with parents that lack full time, year round employment -- and that's before the pandemic began.
He added that it is also important to acknowledge that disparities exist around race and ethnicity, noting that while one-fifth of Kentucky's white children live in poverty, about one-third of the state's Hispanic and Black children live in poverty.
"There are clearly systemic factors at play when Black and Hispanic children are more likely than their white peers to be poor," he said.
Brooks also expressed concern about the pandemic's effect on education, which has forced schools into an extended period of virtual learning.
Brooks said there has been "too much happy talk and too little real talk" about education in Kentucky, pointing out that prior to the pandemic 65% of the state's fourth graders were not minimally proficient in reading and 71% of the state's eighth graders were not minimally proficient at math -- and that these numbers are even higher for Black and Hispanic children.
He said Kentucky has the highest rate in the nation of children with incarcerated parents and the highest rate of children being raised by kin outside the foster care system, almost 100,000 of them. Brooks reminded the listeners that such events in the live of a child are considered "adverse childhood experiences" and have the potential for serious long-term impacts, including a shortened life, if not countered with protective factors that build resilience.
He also pointed out that 38% of Kentucky's children between 10-17 are either overweight or obese, the second highest rate in the nation. And again, he called for local and state action to address this issue that will have lasting effects on the state's children.
Brooks encouraged those attending the webinar to view the Kids Count data as "formative rather than summative," especially during the pandemic.
"That, frankly is always the case, but never more than in the midst of covid," he said. " No one and I emphasize that no one can truly predict how the pandemic will impact these numbers, but I do think it is a reasonable hypothesis to suggest that the pandemic will exacerbate current trend lines. In other words, I think what these numbers are suggesting will fit the post covid landscape, but perhaps be intensified."
Dr. Hatim Omar, retired professor at the University of Kentucky and founder of the Stop Youth Suicide Campaign, said prior to covid, there had been a sharp increase in the percentage of teens suffering from depression, anxiety, suicidal ideation and suicide attempts over the past few years.
He said data from the latest Youth Risk Behavior Surveillance System survey is "the most disturbing since I've started working with preventing youth suicide 22 years ago," with 10-12 percent of Kentucky's kids saying they had attempted suicide over the past 12 months. Further, he said over the last three years there has been a three-fold increase in suicide attempts among African American children.
As for how teens feel about the coronavirus, when asked to use one word to describe their feelings about the virus, Omar said their top three answers were anger, frustration and confusion.
"The key for us as grown ups, adult parents and teachers and anybody who deals with teens, the most important thing for us to remember is that teenagers will not remember what we said, they will remember how we made them feel later in life," Omar said, while reminding parents to hug their teens and to be authentic in their interactions with them, even amidst their own stress and anxieties.
"But most importantly," he said. "be available to our kids."
Omar offered a list of things to pay attention to and encouraged parents and guardians to not delay in seeking help. For example, he said seek help if your teen sleeping too much, or barely sleeping at all; if they're eating too much or not eating at all; if they are more irritable than usual or are feeling sad and fearful; if they are thinking thoughts that scare you; if they can't find a way to relax; if they have no motivation to do anything; if they are isolated all of the time or spending all of their time on social media and not doing anything else; or if they are fighting with parents and friends or feeling unsafe.
"Really, this is a time where we shouldn't wait long, we should seek professional help for our kids," he said. "Because if we don't, then ultimately we'll end up with increased levels of suicide."
Dr. Henrietta Bada, director, Maternal and Child Health Division with the Kentucky Department of Public Health, said that while there are many risk factors that affect the health and well-being of a child, there are also numerous protective factors that can mitigate those threats, even at a very early age.
For example, she pointed to the importance of a healthy pregnancy and creating wholesome attachments in a nurturing family and home environment as ways to mitigate risk and build resilience in children.
Kentucky offers a voluntary home-visitation program called Kentucky Health Access Nurturing Development Services, or Kentucky HANDS, that is designed to help the state's high-risk mothers with these early interventions.
Bada said "exposure to violence, trauma or adverse childhood experiences is the single most prevalent risk factor for children today" and that repeated exposure to such experiences creates 'toxic stress," decreases resilience and can lead to death and disabilities in adults.
"Knowing what we know now we can do better in preventing, mitigating and treating toxic stress," she said.
Ben Robinson, a senior at Daviess County High School and a member of the KYA student advocate team, talked about the importance of youth involvement to improve the health of Kentucky's children. Robinson said he had lobbied to get the Tobacco-21 bill passed and is currently working to get bills passed that would stop corporal punishment in Kentucky schools and to increase the e-cigarette tax. He has also worked to educate his fellow-students about the dangers of vaping and on projects to decrease childhood obesity in his community.
During his closing remarks, Brooks with KYA summed it up when he said: "Let's make sure that among the takeaways of this 2020 Bost Forum is a profound recognition -- whether it's obesity or vaccines, hard to cover kids or little boys and little girls inundated with life's traumas -- we have to ensure that Kentucky's health policy attends to core issues and social determinants, that Kentucky's health policy for kids is about local action and state action, that health policy depends on big time players like the foundation, but it also depends on each of us. And yes, that means you."
Click here to register for the Oct. 19 webinar. The panelists will be: Lisa Lee, commissioner, state Department for Medicaid Services; Anthony Zipple, senior associate, Open Minds; Allison Miller, family learning specialist, National Center for Families Learning; and Dr. Julia Richerson, pediatrician, Family Health Center Iroquois. The moderator will be Tracey Antle, chief operating officer, Cumberland Family Medical Center. The webinars are free, but registration is required for "attending" each one."
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