Report: Washington ranks near the top in terms of child health

In this Oct. 4, 2017, file photo, Dr. Albert Maguire, right, checks the eyes of Misa Kaabali, 8, at the Children's Hospital of Philadelphia. Washington state ranks 5th in tersm of child health in a new study based on a range of economic, health, community and educational metrics. (Bill West / AP)

Washington fares better than most U.S. states in taking care of its children, especially when it comes to health, according to a new report by Kids Count.

But child advocates say those gains could be hurt if the Census Bureau doesn’t take steps to make sure children are accurately counted in the 2020 decennial census.

Just 3 percent of Washington children did not have health insurance in 2016, according to the report, published last week by the Annie E. Casey Foundation. County-level data isn’t yet available for that year, but Spokane historically has had a slightly lower rate of uninsured kids than the state as a whole.

Overall, Washington ranked 15th nationally in overall childhood well-being, based on a range of economic, health, community and educational metrics. The state ranked fifth in health and 26th in education, just below Wyoming.

Kids Count is a national partnership between the foundation and local child advocacy groups. In Washington, it works with Seattle-based Children’s Alliance and the Washington Budget and Policy Center, a liberal group.

Paola Maranan, executive director of Children’s Alliance, said Washington is doing well overall to expand programs like Apple Health and early childhood education.

“We’re seeing the results of smart investments in kids,” Maranan said. “We end up both cutting the uninsurance rate and the racial and ethnic gap in insurance coverage.”

She said ongoing work is needed to ensure children in rural areas and in Eastern Washington have access to school-readiness programs, which influence elementary school test scores and reading levels. Persistent gaps between white students and students of color also remain an issue, she said.

“We have a long way to go to make sure all 3- and 4-year-olds in our state have access to preschool,” said Misha Werschkul, executive director of the Washington Budget and Policy Center.

Her takeaway from the report was that Washington is about in the “middle of the pack” on childhood well-being, with health insurance coverage as a notable outlier. Particularly in Eastern Washington, access to good jobs for parents was the factor driving many other indicators, she said.

Funding and support for children’s programs often relies on census data, and young children in particular often are undercounted, according to the U.S. Census Bureau.

A 2017 Census Bureau report on the 2010 census estimated 1 million children younger than 5 were not counted, about 4.6 percent of the children in that age group. That rate has increased since the 1980 census, while adults were likely to be slightly overcounted in 2010.

About half the undercounted children lived in a household that also was not counted, the bureau found, suggesting that some factors, like not speaking English, account for both adult and child undercounts.

Maranan said the Census Bureau’s decision to add a question asking whether respondents were U.S. citizens was likely to further chill responses from people who already are undercounted, undermining the quality of the data.

“The goal of the census is to count all people in the borders of the United States,” Maranan said, not to determine whether they’re here legally.

Children living with grandparents, aunts, uncles or nonrelatives were more likely to be undercounted, as were black, Native American and Alaska Native children. In some cases, Werschkul said, households may simply forget to count infants or toddlers, as improbable as it sounds.

She said the Census Bureau should invest in outreach efforts and partner with community groups who have established relationships in areas where children are not likely to be counted, which include rural areas and communities with high numbers of immigrants.

“It’s about political representation in D.C., it’s about adequate funding for the services, health care and education in our state, and it’s also about the ability to track how we’re doing as a state in projects like the data book,” Werschkul said.