dipesh navsaria (copy)

Dr. Dipesh Navsaria is seen in 2011 at the University of Wisconsin School of Medicine and Public Health’s free student-run clinic at the Salvation Army Family and Women's Shelter in Madison. A recent report ranked Wisconsin 28th for children's health.

Courtesy of Parker Hoerz

Wisconsin is 12th in the country in overall child well-being, according to a report recently released by the Annie E. Casey Foundation.

But that data also shows that Wisconsin ranks 28th among states for children’s health, with African-American kids facing rates twice as bad as white and Latino children in several categories.

“The overall data really masks the significant racial and ethnic disparities that we have in our state,” said Ken Taylor, executive director of the Wisconsin Council on Children and Families.

The 2017 Kids Count Data Book looks at data up through 2015 and ranks states according to overall child well-being, based on performance in four categories: economic well-being, family and community, education and health.

Wisconsin’s lowest ranking was in the health category.

“This is unfortunate because the state was once a national leader in children’s health,” the report said.

That category looked at percentages of low birth weight babies, children without health insurance, child and teen deaths and teens who abuse alcohol and drugs. Wisconsin dropped in the rankings for all four categories this year. 

Because the rankings are relative to other states, dropping in rankings doesn’t necessarily mean Wisconsin is getting worse, Taylor said. It could be that other states are getting better, faster.

That’s the case with health insurance. Even though the state has reduced the number of uninsured children, other states have passed Wisconsin by, Taylor said. There are 46,000 uninsured children in Wisconsin, which represents a 20 percent decrease in the number of uninsured children since 2010.

WCCF credits the improvement to the Affordable Care Act (ACA) and the Children’s Health Insurance Program (CHIP), but cited the state's refusal to accept more federal support to expand Medicaid as a reason Wisconsin is lagging nationally.

In other areas, Wisconsin is actually getting worse, Taylor said. The percentage of low birth weight babies born in the state has rose from 7 percent to 7.3 percent between 2010 and 2015.

But there was variation among races, and data accompanying the report shows that African-American children in Wisconsin fared the worst in the low birth weight and child and teen death rate categories, with rates over double those of white and Latino populations for 2015 data.

“Despite tremendous gains during the economic recovery for children of all races and income levels, inequities among children remain deep and stubbornly persistent,” the report said.

A 2014 Kids Data report looked at factors like reading proficiency, birth weight and poverty. and ranked Wisconsin last among states for the status of African-American kids.

“That tells a very different story than the overall story,” Taylor said.

For the low birth weight category, 6.2 percent of whites and 6.7 percent of Latino babies were born at 5.5 pounds or less. The rate for African-American babies was over twice that at 14.4 percent, a number that’s been rising over the past several years.

Low birth weight is connected to higher risk of developmental problems, short and long-term disabilities, and risk of infant mortality, the report said.

African-Americans also suffered higher rates of infant mortality, defined as the death of a child in the first year of life, with a rate of 15.3 deaths per 1,000 live births, making it one of the worst infant mortality rates for African Americans in the nation. Only Oregon had a worse rate in 2015 at 15.7 deaths per 1,000 live births.

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The Kids Count data was not broken down by county, but for the past 30 years, African-American infants in Dane County have been two to three times more likely to die in the first year of life than white infants. In 2016, provisional estimates put Dane County’s infant mortality rate for African-Americans at 17.6, worse than country estimates for Serbia (5.9), Botswana (8.6) and Syria (15.2).

Higher mortality rates for African-Americans also extended to child and teen death rates per 100,000. The rate for whites was 20 per 100,000, and for Latinos 17 per 100,000. But again, African Americans experienced a rate over twice that, at 51 deaths per 100,000.

Data for teen drug and alcohol abuse was not broken down by race for Wisconsin, but 2014 data at a national level in the report shows that 4 percent African-Americans teens abused drugs or alcohol, while whites were at 5 percent and Latinos at 6 percent.

One category where African-American children fared equally or better than Latinos and Whites was health insurance. Three percent of African-American and white children are uninsured in Wisconsin, and 6 percent of Latinos.

This illustrates one of Taylor’s points: health care is not the only factor contributing to health.

The Kids Count report should be taken holistically, Taylor said, because healthcare is connected with the other categories in the report like economic well-being and education. In fact, according the to the UW Population Health Institute, clinical care only contributes to 20 percent of overall health outcomes

“We know that other factors beyond just whether you have access to health care are actually more important,” Taylor said.

Health behavior, economic levels, education and unemployment are all social determinants with an effect on health, he said.

Overall, Taylor said that “while we should rightly celebrate that we are a top-tier state when it comes to well being of kids,” Wisconsin needs to recognize its intense disparities.

“The racial and ethnic disparities that we have are not in keeping with how Wisconsinites tend to think of ourselves,” Taylor said. “We have to confront that disconnect and act … We need to talk about it absolutely, but we need to start doing things.”

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