North Carolina is among the states where the child population has increased, but nationwide numbers suggest a decline in children, which could potentially impact education, health care, and the workforce.

According to a report by the Annie E. Casey Foundation, more than 1 million children were not reported in the 2020 census.

Nathan Dollar, director of Carolina demography at the Carolina Population Center, suggested it could be linked to fertility rates in the country among many other factors.

"Two-point-one child is considered replacement," Dollar explained. "In 2010 the U.S. fell below replacement fertility, and has continued to decline since."

The study suggested it is possible the child population could increase, but it is not likely to change the trend. A low fertility rate also highlights the importance of immigration as a means of population and economic growth.

The Annie E. Casey report found the decline in child population varies across different states and demographics. Rural areas are particularly at risk, and Dollar noted they are already struggling to address the issue in North Carolina with overall population decline in some places.

"This is harder felt in rural areas in North Carolina," Dollar pointed out. "They are dealing with K-12 consolidation, strains on health care which are already insufficient in those areas."

The total number of births in the United States has fallen 16% since 2007. Dollar added the numbers present a complex issue but moving forward, it is important to consider what this means in caring for the aging population and children.

Tens of thousands of children in Pennsylvania are still missing out on essential health care coverage, according to a new report.

The "State of Children's Health" report revealed Pennsylvania has the fifth-highest number of uninsured children in the nation.

Becky Ludwick, vice president of public policy at Pennsylvania Partnerships for Children, said factors like race, where you live and family income play big roles in whether children have health insurance. And while the number of uninsured kids has stayed relatively steady, a stable uninsured rate does not signal there has been progress.

"There's still a little over 5% of kids who don't have health insurance in the state of Pennsylvania," Ludwick pointed out. "What that translates into, in terms of the number of kids is, we are seeing that 147,000 Pennsylvania children do not have coverage."

In Pennsylvania, younger children are more likely to be uninsured than school-aged children. Ludwick added one possible solution is the Department of Human Services' recent federal approval of continuous Medicaid coverage for kids up to age 6.

Ludwick noted the Medicaid "unwinding" process, to re-qualify families for coverage after the pandemic public-health emergency officially ended, did not significantly increase the number of uninsured children in the state. But her organization initially worried about a greater disruption when renewals resumed.

"Fortunately, what the numbers yielded were that eight out of 10 kids that went through the Medicaid unwinding process were either able to keep their Medicaid coverage, or they were able to transfer coverage over to CHIP, or to plans through PENNIE," Ludwick outlined.

Ludwick added nearly half of Pennsylvania's children depend on Medicaid, the Children's Health Insurance Program or plans from PENNIE, the state's insurance marketplace, for their health insurance, emphasizing the critical importance of these programs not only to children but to parents and policymakers.

Whooping cough, or pertussis, is making a comeback and a Tennessee medical expert stressed the preventable, highly contagious bacterial infection requires urgent attention.

The Centers for Disease Control and Prevention reported, year-to-date, Tennessee has recorded more than 200 cases, while more than 25,000 cases have been reported nationwide.

Dr. Anthony Flores, professor of pediatrics and director of pediatric infectious diseases at Vanderbilt University Medical Center, said rising cases are largely due to vaccine hesitancy, and taking action now is essential to combat the serious illness.

"I think of our severe cases that we're seeing here in Tennessee, and nationwide as well, almost all of those severe hospitalized cases are in unvaccinated children," Flores explained. "I think the lower vaccination rate, kind of the periodicity with which we see whooping cough come back and surges, are contributing to the current numbers we're seeing."

Flores noted typical symptoms include a runny nose and low-grade fever, although fever is less prominent. The cough can develop and persist for weeks, becoming particularly bothersome in older children and adults. The name "whooping cough" comes from the severe coughing fits, which cause difficulty breathing, followed by a "whoop" sound as the afflicted person gasps for air.

Flores pointed out in newborns, especially before they begin receiving their initial vaccinations at 2, 4, and 6 months, their protection relies solely on the antibodies passed to them by the mother during pregnancy.

"In pregnant women, it's actually recommended that if they haven't received a booster, that they receive a booster in their third trimester, and that's again to pass on those antibodies to the newborn baby," Flores emphasized. "But then what can protect them from severe disease?"

Flores recommended children receive the whooping cough vaccine as part of their routine immunizations. He added as they grow, they get booster shots, and adults receive a different formulation called Tdap every 10 years to maintain immunity. He added it is important to follow a schedule to prevent waning immunity over time.


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CLARIFICATION: We updated language to clarify the timing for when the study's authors began tracking certain outcome measures for children within the foster care system. (9:30 a.m. CST, Nov. 22, 2024)

This Saturday is National Adoption Day and the latest findings showed Minnesota has made progress in helping kids in the foster care system secure a better future.

Aaron Sojourner, labor economist at the W.E. Upjohn Institute for Employment Research, helped lead a study of reforms Minnesota approved in 2015. He said states often provide financial support to children in foster care but support ends when a child is adopted or placed in a kin guardianship.

Minnesota decided to continue payments to households who take a child in permanently. Sojourner pointed out three years after foster cases started, positive outcomes became clear.

"The kids were scoring much higher on standardized achievement tests," Sojourner reported. "They were experiencing less turnover in schools and school instability."

He noted the incentives also boosted the chances of kids age 6 and older exiting the foster care system and moving into permanent home settings by 29%. Sojourner added while the results are encouraging, it is just one aspect of the child welfare landscape. Other research has shown racial disparities in Minnesota's foster care system, especially when looking at reducing entry rates.

Sojourner stressed if state lawmakers revisit the extended monthly payments in budget talks, they will need to realize the long-term payoff from these investments.

"The state is paying more money now but they're going to reap the benefits down the road," Sojourner contended. "In terms of increased earnings and employment."

His team's study said prolonged exposure to foster care is tied to poor transitions into adulthood, including homelessness.


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