Innovation Ecosystem

Do kids count?

A decade of fact-based data detailing what is happening to kids and families in RI

Image courtesy of RI Kids Count

The front cover illustration of last year’s 2023 Rhode Island Kids Count Factbook.

By Richard Asinof
Posted 5/13/24
The diligent reporting by ConvergenceRI on a decade covering the Rhode Island KIDS COUNT Factbook demonstrates the difficulty in changing the budget narrative when it comes to investing in the future of Rhode Island’s children and families
When will the details of how Steward Health Care mismanaged the delivery of care be made public, forcing the Massachusetts Attorney General to prosecute the corporate officers for fraud? How can older Rhode Islanders protect themselves from being gouged by increasing drug costs for treatments for chronic diseases? Are commercial insurance companies compiling data on the increases in immunological ailments such as Multiple Sclerosis in women in Rhode Island? With the nomination of Dr. Jerome Larkin as the new director of the R.I. Department of Health, how will the agency attempt to redefine its role in promoting the public health of Rhode Islanders as well as its support for health equity zones?
Health care delivery will move front and center in the next few weeks as part of the ongoing public conversation. At the same time, the decision by a number of journalists in the Rhode Island media – Amy Russo and Brian Amaral – to depart their newspapers and find work outside the journalistic enterprise bespeaks of changes underway within the misinformation highway that is today’s media enterprise. In Boston, Felice Freyer has also stepped away from her job as a health care reporter at The Boston Globe.
In health care, the willingness of nurses and doctors to walk away from the their jobs within the health care industry was known as the “great resignation.” What will they label what is now underway as what appears to be quality journalists stepping away from the fray?

WARWICK – On Monday morning, May 6, ConvergenceRI attended what can best be described as an old-fashioned revival meeting. The gathering was filled with singing and sermonizing and exhortations from the pulpit, celebrating the release of 2024 Rhode Island KIDS COUNT Factbook, a literal Bible of data trends documenting the health and economic outcomes for the state’s children and families.

The sold-out breakfast assemblage at the Crowne Plaza had the distinct feel of a rollicking church service. Paige Clausius-Parks, executive director of Rhode Island KIDS COUNT, served as the minister of a passionate flock of advocates, elected officials, and agency workers who were the congregation. Repeatedly, in her uplifting soprano voice, Clausius-Parks called upon the congregants to translate the data trends from words into policy actions.

The speakers included Wujuudat Balogun, the board co-chair of Young Voice, Tricia Rose, Chancellor’s Professor of Africana Studies and Director of the Center for the Study of Race and Ethnicity in America, and Marion Orr, Board Chairperson of Rhode Island KIDS COUNT. The voices of diversity in Rhode Island were full-throated, loud and proud. In his speech, R.I. House Speaker Joseph Shekarchi testified how the passion he felt in the room was palpable.

The release of the 2024 Rhode Island KIDS COUNT Factbook marked the 30th anniversary of the data compendium – and with it, three decades of seizing the day by translating data into policy decisions and actions to invest in the future of Rhode Island, its children.

For sure, the 2024 data trends did not offer up any real surprises. Rhode Island is transitioning from a majority White state into a majority 'minority' state, and with that demographic change, all the shortcomings in health, education, and economic outcomes fall predictably upon poor people of color. The state’s birth rate continues to fall, and the increasing wealth gap continues to drive a wedge between the haves and the have-nots.

The limits of reporting.  
In the midst of the celebration, Clausius-Parks asked those in attendance who had been at some 20 previous Factbook celebrations to stand up, and ConvergenceRI rose to his feet, supported by his trekking poles.

Over the past decade, ConvergenceRI has consistently reported on the annual Rhode Island KIDS COUNT Factbook release jamboree, creating an indelible, incontrovertible record of the data trends, painting a compelling landscape by the numbers of the challenges facing the state’s children.

Here is an overview of the coverage by ConvergenceRI:

  •      In 2014, 10 years ago, the ConvergenceRI headline declared: “The good, the bad, and the urgent: RI Kids Count Factbook details why children need to be a critical part of the state’s future investment strategy.”

The story had begun: In 2018, minority children will become the majority children in Rhode Island, reflecting the changing demographics and the rise of our culturally diverse community. “Racial and ethnic disparities in education are evident before children enter kindergarten and persist through high school and college,” the Factbook had said. The gap was magnified by the fact that Rhode Island had the fifth-lowest birth rate in the nation between 2002 and 2012; Rhode Island’s child population had decreased by 12 percent, from 247,822 to 216,962.

  •    In 2015, nine years ago, the ConvergenceRI headline declared: “The rite of spring in Rhode Island: Unveiling of the 2015 Rhode Island Kids Count Factbook is ‘opening day’ for policy tussles around children and families.”

The story had begun: The Rhode Island Kids Count annual Factbook turns 21 on Monday, April 13, with a gala celebration celebrating Rhode Island’s children at the Crowne Plaza. “It is very much a ‘rite of spring’ in Rhode Island, with music provided not by Igor Stravinsky but by the 5th Grade Chorus at the Lillian Feinstein Elementary School at Sackett Street in Providence.”

This year’s edition of the Factbook marked its 21st birthday, a coming-of-age milestone, which seemed to have prompted a desire to look back at the progress made and, at the same time, to acknowledge some of the widening disparities and gaps identified.

The story continued: The breadth and depth of the Factbook and its examination of the best available data statewide and in Rhode Island’s 39 cities and towns makes it the go-to source for children’s health and well-being. The Factbook tracks 71 indicators across five large categories: family and community, economic well-being, health, safety and education. It is, quite simply, the place where you can find accessible data snapshots about the current trends in Rhode Island related to children and families.

  •    In 2016, eight years ago, the ConvergenceRI headline declared: “The RI rite of spring: Release of 2016 RI KIDS COUNT Factbook offers a deep dive into the well being of children and families.”

The story had begun: In 2016, under the “Highlights,” the following data facts were synthesized into bite-size nuggets, but they were far from fast-food fare, in terms of their policy implications.

ConverenceRI had then reported on the detailed data findings within the Factbook:

Child population continued to decline in Rhode Island, with 212,555 children under age 18 in Rhode Island in 2014, a drop of 14 percent since 2000. Rhode Island had the fifth lowest birth rate in the U.S., with 10,418 births in 2015. Translated, Rhode Island’s homegrown population is stagnant if not declining.

There were major ongoing shifts in diversity in Rhode Island children and families, with the percent of population identified as “Non-Hispanic White” for the age group from 0 to 4 at 57 percent in 2014, according to U.S. Census Bureau estimates. Translated, “minority” children in Rhode Island will soon be the majority.

Poverty was related to every indicator in the Factbook, and was found to have a negative impact on children both immediately and in the long-term, with one in five children in Rhode Island – some 41,629 children – living in poverty. The economic racial disparities are very pronounced in Rhode Island, with 36 percent of Black children, 47 percent of Hispanic children, and 57 percent of Native American children living in poverty, compared to 15 percent of White children. Translated, the gaps in economic attainment and educational achievement have a distinct racial and ethnic flavor to them.

Safe, affordable, healthy and stable housing are key factors in the well-being of families and children in Rhode Island, but the state has the highest cost burden for housing in New England. Further, Rhode Island has the highest percentage of low-income children living in older housing in the U.S., which poses increased threats of health risks such as lead poisoning and asthma. Translated, developing a strategy to improve the old housing stock and get rid of the lead could lead to improvements in health, education and economic outcomes.

While there were numerous positives on the health-care front, including the continued high rates of health insurance coverage, improved access to dental care, and improvements in reducing the number of children born at the highest risk, there are also some difficult challenges ahead, according to the trends identified – the increased hospitalizations of children related to mental health issues, with 2,744 hospitalizations in 2014 of children with a primary diagnosis of a mental disorder. At Bradley and Butler hospitals, the most common diagnoses for young people being treated in an inpatient setting in FY 2015 were for depressive disorders [48 percent], bipolar disorders [24 percent], anxiety disorders [14 percent], and adjustment disorders [4 percent]. Translated, the increase in hospitalizations of children for mental health issues is the kind of early warning sign that the state needs to invest more resources in mental health and behavioral health for children, sooner rather than later.

Finally, not surprisingly, the Factbook found that there was an increase in the number of babies born with exposure to opioids, given the ongoing epidemic related to substance use in Rhode Island. In 2014, 97 babies were diagnosed with Neonatal Abstinence Syndrome, up from 76 babies in 2013. Of the 97 babies born with NAS, 88 percent were born to White mothers, 34 percent lived in the four urban core cities, and 66 percent lived in the remainder of the state. Translated, the ravages of opioid addiction are a statewide affliction that defies stereotype. 

  •    In 2018, six years ago, the ConvergenceRI headline declared: “What gets measured, gets done: Celebrating 24 years of advocacy based on evidence-based data.”

The story had begun: “The release of the 24thannual Rhode Island KIDS COUNT Factbook on Monday, April 9, at the Crowne Plaza is an important ‘rite of spring,’ celebrating children and evidence-based policy making.”

The story had continued: There is so much information contained in the Factbook that even with the helpful executive summary detailing current trends, it often requires the kind of careful, sustained reading to cull the important facts and their context and nuance.

Among the nuggets and trends shared: the birth rate in Rhode Island is declining, the demographics are changing to reflect a more diverse population, the rate of poverty is declining, the rate of vaccination and health insurance coverage continues to be high, and the incidence of mental health problems continues to increase.

In her interview with ConvergenceRI, [Executive Director Elizabeth Burke] Bryant stressed the importance of the way that data drives policy. “What gets measured gets done,” she said succinctly. “If you are working with the best available data, strategically, it creates a powerful argument.” Prior to the R.I. Kids Count Factbook, Bryant continued, “Too much anecdotal information was being used in terms of child advocacy. The key part of our work was to provide the best available data to inform policymakers on behalf of children and families.”

  •    In 2019, five years ago, the ConvergenceRI headline declared: “A song of facts in the key of life: The release of the 25th annual Rhode Island KIDS COUNT Factbook marks a quarter century of committed advocacy on behalf of the state’s children.”

The story had begun, in part, with a discussion of the key takeaways. The carefully orchestrated release of the Rhode Island Kids Count 2019 Factbook also means that its news will dominate the headlines for at least a day, although translating the dense material into 500-word stories on deadline seems to defy the logic and wealth of the materials, in ConvergenceRI’s opinion. 

Because the Rhode Island Kids Count Factbook measures data over time – 71 data indicators under the broader categories of family, community, economic well-being, health, safety, and education – it captures both a current snapshot as well as a longitudinal context to interpret the meaning.

The trends that appear to leap off the pages of the embargoed version of the 2019 Factbook all seem related to demographic trends: the falling birth rate for Rhode Island and its implications for the future; the quickly growing “minority” population that will soon emerge as the majority population for children in Rhode Island, particularly for children under the age of six; and the relationship of housing to health outcomes.

  •    In 2021, three years ago, the ConvergenceRI headline had declared: “A virtual rite of spring:  The release of the 27th annual Rhode Island KIDS COUNT Factbook is like bearing witness to the blooming of a flowering tree, filled with data constructs.

The story had begun: The cold harsh reality, however, was that facts contained in the annual voluminous Factbook were never cheery, despite the uplifting artwork. The gaps and disparities identified in the lives of kids were always presented in a full frontal display, revealing just how much the state had never quite lived up to its promise to protect mothers and children and parents, documenting the stubborn, persistent racial and ethnic disparities.”

The story had continued: The facts in his year’s edition are no different: In Rhode Island, one in five children ages six to 17 has a diagnosable mental health problem, and one in 10 has significant functional impairment. Yet in 2019, an estimated 36 percent of children, ages three to 17, who needed mental health treatment or counseling, had a problem obtaining needed care. The problem: Mental health systems “tend to be fragmented and crisis-driven with disproportionate spending on high-end care and [a] lack adequate investment in prevention and community-based services,” the Factbook found.

In Rhode Island, in 2019, one in seven children [28,009, or 14 percent] lived in poverty, and 7 percent [13,154 children] lived in extreme poverty, defined as families with incomes below 50 percent of the federal poverty level.

In Rhode Island, in 2019, 15 percent of children ages two to 17 are overweight and 16 percent are obese, for a combined total of 31 percent of children who are overweight or obese. Hispanic children [15 percent overweight and 22 percent obese] and non-Hispanic Black children [16 percent overweight and 20 percent obese] have the highest rates of being overweight and obese, according to the Factbook.

Asthma is the most common chronic condition in children and a leading cause of school absences and hospitalizations for children under 18 in the U.S. Between 2015 and 2019, there were 3,783 emergency department visits in Rhode Island by children ages six and under [at a rate of 9.3 per 1,000], for which asthma was the primary diagnosis. Translated, poor economic opportunities and a lack of safe, affordable housing, combined with toxic stress and food insecurity, are a never-ending plague upon Rhode Island children and families.

  •    In 2022, two years ago, the ConvergenceRI headline had declared: “Putting  women and children first: The latest edition of the Rhode island KIDS COUNT Factook reveals a crisis brewing in youth mental health services, and a growing need for community-based resources.”

The story had begun: “For 28 years, Elizabeth Burke Bryant has ushered in a spring-time celebration of children in Rhode Island, marked by the annual publication of Rhode Island KIDS COUNT Factbook, a data compendium that provides a travel guide – with the best available data – for all the things that you ever wanted to know about children and families in Rhode Island on their journey toward better health and well being.”

The story had continued: More than a news story, more than an event, the annual Factbook celebration is closer to gestalt – where the entirety of the work is much more than the sum of its parts. Its publication is a moment when the walls and barriers and well-entrenched partisan divisions in Rhode Island come tumbling down – at least for 24 hours – to put the focus on kids. Translated, the Factbook gives a powerful political voice to children – a voice not often heeded, because children do not vote, and because they don’t fill the coffers of candidates with donations.

In years past, the Factbook celebration brought together a crowd of politicians and advocates for breakfast at the Crowne Plaza, filling the room with “positive vibrations.” This year, the celebration will be a virtual gathering on Zoom, as the coronavirus pandemic continues to disrupt everything in our lives.

The “genius at work” with the Factbook has been its ability to keep the focus on the data, to promote its use as an “action tool” to create better policies for the future health of kids and families in Rhode Island. For nearly three decades, the Factbook breakfast celebration has been an annual “rite of spring,” similar to the way that osprey return to Rhode Island waters to build their nests and raise the next brood of chicks.

One of the “traditions” of the release of the Factbook has been an annual interview conducted by ConvergenceRI with Elizabeth Burke Bryant, the Rhode Island KIDS COUNT executive director.

In this year’s interview, Burke Bryant did not shy away from talking about some of the big problems facing Rhode Island, identifying the state’s failure to increase Medicaid reimbursement rates for providers – and the deleterious impact the low rates have had on staffing for community-based behavioral health and mental health services for children.

“We are very concerned about the workforce crisis for providers of community-based behavioral health services,” Burke Bryant told ConvergenceRI. “The Medicaid rates have not been increased in more than a decade. In some cases, for Early Intervention, for example, they haven’t been increased for 20 years.”

  •    In 2023, one year ago, the ConvergenceRI headline had declared: “Convergence, not silos: The week beginning May 15 may determine the future directions of Rhode Island.”

The story had begun:  On Monday morning, May 15, Rhode Island Kids Count will release its 2023 Factbook at a public gathering, the first such one in three years, an assembly that marks the transition of Paige Clausius-Parks, taking the helm as the organization’s new executive director, following the retirement of Elizabeth Burke Bryant after more than two decades steering the Rhode Island’s data ship.

More than 400 have registered to attend the ceremony, which has become an annual rite of spring when the gospel of facts about the health and well being of children and families in Rhode Island is published and presented to the state’s top elected officials.

As the 2023 Factbook’s 18-page executive summary makes perfectly clear, the safety net in Rhode Island has been shredded. In 2022, in Rhode Island, some 65 percent – 6,346 newborns out of a total of 10,115 babies born – ‘had developmental, socio-economic and/or health factors that potentially put them at risk for poor outcomes later in life.”

The question is: Will the elected officials take heed – and take action – when it comes to mending Rhode Island’s broken safety net?

The budget season is now upon us 
The legislative debate focused on the budget for FY2025 will move into high gear during the next two weeks, with much attention focused on the driving needs of highway bridge reconstruction and how that will impact the future state plans to tax and spend revenue. 

Lost in the discussion (stuck in the traffic?) is the failure by the General Assembly to raise the Medicaid rates for providers during the past decade, which has undercut the ability of the health care delivery system to sustain its economic enterprise, to staff hospitals and nursing homes, and to provide mental health services for children and families. The bankruptcy of Steward Health Care, the apparent greed of the private equity owners of Roger Williams Medical Center and Our Lady of Fatima hospitals, and the too-long waiting lines for Early Intervention services for children, are poignant reminders about the fact that health care is not about manufacturing widgets. 

Despite the valiant efforts by community agencies and advocates to try and force the Governor and the General Assembly to invest the needed services for children at risk, despite the fact-based data contained in a decade of Rhode Island KIDS COUNT Factbooks, there appears to be an unwillingness to spend the money to change the dynamics around children and families and prosperity in Rhode Island.

The questions remain: Do kids count? Will the lobbying tactic of moms with their children in strollers, 'Strolling Thunder,' change the hearts and minds -- and votes -- of legislative leaders when it comes to spending more money on children?  How does a decade of fact-based data trends change the financial and political equation? 







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