First webinar of annual health forum shows much work needed to improve the lives of Ky. children; effects of covid-19 still unknown

Kentucky has several very bad rankings when it comes to children's well-being. This was among the slides Kentucky Youth Advocates Executive Director Terry Brooks showed during the forum.

By Melissa Patrick
Kentucky Health News

The first of five webinars focusing on efforts to reduce disease and unhealthy behaviors that often begin in childhood opened with a slew of data that shows the state has much work to do, with an expectation that the pandemic is only going to make things worse.  

Nevertheless, Kentucky Youth Advocates Executive Director Terry Brooks offered a message of hope, saying that programs and policies to protect children 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, referring to divided government in both capitals. "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 said 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 for the last two or three years, it has been almost 100 percent successful in getting its priority bills passed, getting 90% of the votes in the House and Senate. "Things can get done," he said.

The webinar was the first in a monthly series that is serving as the Foundation for a Healthy Kentucky's annual policy forum, due to the coronavirus pandemic. The next webinar, "Intervening Early," will be held at 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.

Another KYA slide shows two of the best and worst things about Kentucky kids.

Brooks opened the meeting by painting a broad picture of what it means to be a child in Kentucky, 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 who lack full time, year round employment -- and that's before the pandemic began. 

"It is a reasonable hypothesis that the pandemic will exacerbate current trend lines," Brooks said.

He noted that the figures have racial and ethnic disparities. While one-fifth of Kentucky's white children live in poverty, that is true of about one-third of the state's Hispanic and Black children. "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, noting 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 noted that Kentucky has one of the nation's highest rates 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 his audience that such events in the life of a child are "adverse childhood experiences" that 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 and 17 are either overweight or obese, the second highest rate in the nation. He called for local and state action to address this issue that will have lasting effects on the state's children. 

More concern about teen suicide

Dr. Hatim Omar, a retired University of Kentucky professor and founder of the Stop Youth Suicide Campaign, said that before the pandemic there had been a sharp increase in the percentage of teens suffering from depression, anxiety, suicidal ideas 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 to 12 percent of Kentucky's kids saying they had attempted suicide over the past 12 months. He said suicide attempts among African American children have tripled in the last three years.

The pandemic can't help. Omar said that when teens are asked for one word to describe how they feel about it, the top three answers were anger, frustration and confusion. 

"The key for us as grownups, 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," Omar said.

From slide presentation by Dr. Hatim Omar

He urged parents to be authentic in interactions wit their teens, and hug them, saying that children that age don't usually like such physical contact with parents, but this is a time that they do.

"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 is 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." 

Some teens are health activists

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 working to get bills passed that would stop corporal punishment in Kentucky schools and raise the tax on electronic cigarettes.

Robinson said he has also worked to educate his fellow students about the dangers of e-cigarettes, and on projects to decrease childhood obesity in his community, such as the Longest Day of Play, which has 1,200 participants and 200 volunteers.

Dr. Henrietta Bada, maternal and child health director with the Kentucky Department of Public Health, told the webinar audience that many risk factors affect the health and well-being of children, but 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.

Brooks, in closing remarks, 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 [of health]; 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 state Medicaid Commissioner Lisa Lee; Anthony Zipple, senior associate, Open Minds; Allison Miller, family learning specialist, National Center for Families Learning; and Dr. Julia Richerson, a pediatrician at Family Health Center Iroquois in Louisville. The moderator will be Tracey Antle, chief operating officer of Cumberland Family Medical Center. The webinars are free, but registration is required for "attending" each one.