Kentucky saw a 48% reduction in child victims of maltreatment from 2018 to 2022, according to the latest federal data. However, child abuse and neglect in the Commonwealth remains around 60% higher than the national rate.

Shannon Moody, chief policy and strategy officer with Kentucky Youth Advocates, said identifying risk factors around substance abuse, untreated mental health issues and domestic violence can all help reduce child abuse.

"Another risk factor that was identified in this report was inadequate housing. And we know that in Kentucky, especially if we have families who are struggling to maintain housing, that can be a very stressful environment for the entire family and can result in unsafe situations for kids," she said.

Kentucky law requires adults to report suspected cases of abuse. If you are concerned about the safety of a child, call the state's child abuse and neglect hotline at 877-KY-SAFE-1, or 911 in an emergency.

Dr. Melissa Currie, a University of Louisville child abuse pediatrician, said drugs lying around the home and accidentally ingested continue to be a major issue compromising child safety.

"We are seeing just an incredible increase in the number of cases of children ending up in the hospital with ingestions of illicit substances. And that includes legal cannabinoids, but it also includes illicit drugs," she said.

Chris Williams, senior vice president of communications with the nonprofit Kosair for Kids, said more than a decade ago, eight organizations across the state came together with the goal of eliminating child abuse in all 120 Kentucky counties.

"We're making a difference. But we have got to not pull our foot off the accelerator. We've got to continue to speed forward and eradicate child abuse and neglect once and for all," Williams said.

Advocates say policies that would help support victims and reduce child-abuse cases include increased investments for foster care, ensuring students have a safe environment to learn at school, and allowing health-care providers to complete a child abuse and neglect registry check for current or prospective employees.

As Pennsylvania children return to school, health advocates stress the importance of keeping them insured.

The 2023 State of Children's Health in Pennsylvania report found more than 145,000 children are without health insurance.

Becky Ludwick, vice president of public policy at the Pennsylvania Partnerships for Children, said the back-to-school season is an ideal time to raise awareness among parents in Pennsylvania about free and low-cost public health insurance options. She added many children lost Medicaid coverage during unwinding but some have transitioned to the Children's Health Insurance Program.

"There's an increasing number of kids going without health insurance or have lost health insurance over the past year," Ludwick reported. "We just really want to take this time as kids are gearing up to get back into school again, to remind parents on what they can do to get their kids insured. So we're looking really at Medicaid and the Children's Health Insurance Program."

According to Children's Health Insurance Program guidelines, a family of three earning $60,000 annually can enroll in the program for an average monthly premium of $58 per child, with additional copays as needed. No family earns too much to apply.

Ludwick pointed out the American Academy of Pediatrics emphasizes the importance of back-to-school checkups, including routine vaccinations. She stressed enrollment in Medicaid and CHIP is open year-round and recommended parents contact the programs to ensure their children have comprehensive coverage for their health needs.

"We would encourage the families to reach out as quickly as possible on getting their child enrolled through Medicaid or CHIP," Ludwick stated. "In order to get that coverage, to make sure that they are then covered for their yearly physicals, immunization. That also covers mental health services and dental."

Ludwick pointed out recent measles outbreaks have highlighted declining vaccination rates, particularly for the MMR vaccine, which is putting communities at risk. Vaccination coverage among kindergartners in Pennsylvania has declined gradually, with the latest data showing a drop below 95% for the first time in six years.

Oregon aims to make social and emotional health care for young children more available with a new metric.

The Oregon Health Authority has adopted the Child-Level Social Emotional Health Metric, which will improve and incentivize care for kids from birth to age 5 who are on the state's Medicaid program. Oregon is the first state in the country to adopt such a measure.

Andi Walsh, senior health policy adviser for the Children's Institute in Oregon, said social-emotional health is the foundation for everyone's mental health.

"Building the ability to develop relationships, to experience and express emotions, to explore," Walsh outlined. "All of those are components of social-emotional health and all of those are the building blocks for positive mental and physical health later in childhood and adulthood."

Walsh pointed out the country's youth are experiencing a mental health crisis and Oregon is falling behind. A recent ranking from Mental Health America on access to care for youth placed Oregon third to last.

Karra Crane served on the parent advisory group for the Oregon Pediatric Improvement Partnership, which developed this metric. She has experience with a child who needs social-emotional health treatments. Crane shared her experience living in a small town, Roseburg, where waitlists for services can be years long.

"If you've never experienced it you can't imagine what it's like," Crane asserted. "Talking to people that are living it currently is a really good way to help make sure that you're not missing anything that you wouldn't know to look for because you aren't in that fight, essentially."

Walsh stressed the new metric will be especially impactful as the state bans suspension and expulsion from early care and education programs starting in July 2026. She added the goal of the metric is to get involved sooner with kids at risk of developing social-emotional challenges, which are often seen in child care settings and preschool.

"This metric is really meant to try and reach those kids much sooner in a preventative way," Walsh explained. "To start providing them with the services that we know will strengthen those skills and hopefully, theoretically, will prevent those kinds of issues moving forward."

Results of a poll by the Save the Children Action Network show voters of all backgrounds are struggling with the cost of living and want the government to do more to address such needs.

Iowa mirrored the national numbers. The poll showed a large, bipartisan majority of voters want help affording food and grocery prices, and child care costs.

Tiffany Welch, Iowa volunteer leader for Save the Children, said the issues are especially crucial in rural parts of the state and overall in Iowa, food banks and assistance programs are seeing record-breaking numbers of people in need.

"What that equals is one in six Iowa children are currently food insecure, and that is over 110,000 kids," Welch reported. "We are getting ready for back-to-school time but food insecurity is particularity a troublesome problem during the summer."

Gov. Kim Reynolds opted not to participate in a federal food subsidy program for kids this summer but instead make use of on-site food distribution sites. Child advocates have started a petition to encourage the state to participate in the SUN Bucks program next summer.

Christy Gleason, executive director of the Save the Children Action Network, said the group is calling on lawmakers to expand SNAP benefits and other policies affecting kids in the Farm Bill and observed the survey showed voters are making their decisions based on those issues, even during a time of intense polarization.

"Americans from across the political spectrum, from all walks of life, from all kinds of communities, want lawmakers to prioritize policies that help families afford high-quality child care and nutritious food," Gleason emphasized.

The latest Farm Bill, which has already been extended for a year, remains stalled in Congress.