Md. ranks 19th in nation in well-being of children

9.1 percent of babies born at low weight, annual report finds

June 13, 2008|By Rona Marech | Rona Marech,SUN REPORTER

Maryland has a lower percentage of children living in poverty than any other state, but, despite its wealth, ranks only 19th in the nation in the well-being of its children, according to the Annie E. Casey Foundation's 2008 Kids Count Data Book released yesterday. That gap is the fourth-largest in the nation.

Most notably, 9.1 percent of Maryland babies had a low birth weight - and the state ranked 39th nationwide on this measure based on 2005 data. In 2000, the share of babies with a low birth weight was 8.6 percent. Figures for 2006, which are not part of the report but have been released by the state, show the problem getting worse.

Maryland's 2005 infant mortality rate was 7.3 deaths per 1,000 live births, which places the state at 31st nationally. The report also shows that Maryland has the second-highest arrest rate for a violent offense for youth ages 10 to 15.

"We're an extraordinarily underperforming state in terms of how we're serving children," said Matthew Joseph, the executive director of Advocates for Children and Youth, the Kids Count organization for Maryland. "It's below what you would expect based on its wealth."

Low-birth-weight babies are associated with developmental and health problems and cost the state a lot of money, Joseph said.

"Something is happening that's making it harder for women to get access to health care," he said. A report that his organization completed in March showed that declining percentages of women statewide were entering prenatal care early in their pregnancies.

"There clearly are major barriers for women to get health care before, during and after childbirth," said Dr. Joshua M. Sharfstein, Baltimore's health commissioner. One problem might be that it can take women a while to get access to health care once they are pregnant, and they can lose health care eligibility after pregnancy, he said. Though quick fixes are elusive, some states, such as Massachusetts, have made significant progress in this regard, Sharfstein said.

The city is developing a strategy to improve birth outcomes and is expecting to unveil a plan by the fall, Sharfstein said. He said he hopes, for example, to link women to health care before they become pregnant and to make family planning more accessible.

The gap between wealth and the well-being of children exists because Maryland makes poor investment choices when it comes to spending money on them, Joseph said. In the area of juvenile justice, he said, the state is overinvesting in kids in institutions and underspending on community-based programs, which he says have a lower recidivism rate.

"There is recognition of that, but Maryland is being very slow to actually take action," he said.

An essay on juvenile justice reform, which accompanies the Data Book, promotes Missouri's model of small facilities, environments without cells or uniforms, well-trained youth workers and close case management. Youths stay close to their families and are offered transitional assistance when they leave the facilities. In Maryland, some of those critical elements are missing, Joseph said.

Juvenile Services Secretary Donald W. DeVore views the Missouri model as "terrific" but is promoting a slightly different approach to juvenile justice. Like Missouri, Maryland favors eliminating large institutions, treating children close to home and developing strong post-release treatment for children when they return to their communities, he said. In addition, the state is making an effort, where possible, to offer children intensive, community-based services, including in-home, skill-building therapies for children and their families.

"We're using what has worked in Missouri, but we're trying to improve on it because times change and new things come out," said DeVore.

The report also showed that since 2000, Maryland has made little progress in its death rate for those ages 15 to 19, which is 66 per 100,000. Also, the share of children living in families in which no parent has a full-time, year-round job remains unchanged, at 28 percent. The percentage of children in single-parent families also barely shifted - from 33 percent in 2000 to 32 percent in 2006.

The state has seen an improvement since 2000 in several areas, including the percentage of teenagers who are high school dropouts. In 2000, 11 percent of students ages 16 to 19 left school; that figure dropped to 6 percent in 2006.

Nationwide, the data show that child well-being has improved slightly since 2000. There were five areas of improvement: child death rate, teen death rate, teen birth rate, high school dropout rate and the percentage of teens not in school and not working. The infant mortality rate did not shift. The report showed declines nationally in four areas: low-birth-weight babies, children living in families in which no parent is employed full time, children in poverty and children in single-parent families.

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