Ten Year Trends in Child Well-Being: More Progress Needed for Montana Children

The Annie E. Casey Foundation released the 31st edition of the KIDS COUNT Data Book on June 22, the first edition since Montana Budget & Policy Center began leading the KIDS COUNT effort in Montana. The KIDS COUNT Data Book summarizes 16 key indicators of child well-being for all 50 states across four areas: economic well-being, education, health, and family/community. Because of the availabity of data, the information presented in the KIDS COUNT Data Book lag by at least a year, so it does not capture the increased challenges that Montana children and families, particularly those of color, have faced this year during the COVID-19 pandemic. Instead, this data book provides insight into how child well-being has changed in the last decade, and where progress is needed for Montana children to thrive.

Almost 230,000 children live, learn, and play in Montana. In many ways, child well-being has improved in the last decade – more teens graduate high school and there are fewer teen pregnancies. It is important to pause and reflect on the progress made so far because change happens slowly. It often takes years of sustained effort to change policies and systems. However, many aspects of child well-being remain the same or have gotten worse in the last decade, showing the need for renewed dedication so all children have the opportunity to thrive into adulthood.

Of the four content areas, Montana ranks lowest in economic well-being, indicating that families still struggle financially. The rate of children in poverty has decreased in the last decade, down from 20% in 2010, however one in six children still live in poverty in Montana. Children who live in poverty may not have adequate housing, food, or other essential needs. Children in poverty are also at higher risk for experiencing behavioral, social, and emotional health challenges. The federal poverty level indicates that a family of three is considered living in poverty if they make less than $21,000 per year, but we know that is hardly enough to meet basic needs. Housing represents one of the largest expenses for families, and families who spend more than 30 percent of their income on housing are also at risk to not have enough for other needs like food and clothing. In Montana, one in four (about 54,000) Montana children live in a family with high housing costs. In light of the COVID-19 pandemic and the added challenges of fewer jobs and more economic instability, children living in poverty and with high housing costs are even more vulnerable to not have their basic needs met.

In the health domain, after years of improving Montana’s health insurance coverage and reaching an all-time low of only five percent of uninsured children, more children are uninsured for the second year in a row. This leaves 15,000 children in Montana without coverage. Children without insurance are at risk to not receive preventative well child visits or recommended immunizations. In 2018, over half of all children in Montana were enrolled in Healthy Montana Kids (HMK), the state’s Medicaid and children’s health insurance program (CHIP). With declining coverage in the state, the Montana Department of Public Health and Human Services should find ways to expand outreach and support for families who may be eligible for HMK coverage.

Our communities are strongest when all children have the opportunities they need to thrive. However, many disparities still exist for children of color in Montana. The reality for these children today has been shaped by colonialism, generations of racism, and added barriers to economic and social resources. These structural inequities make it harder for children of color to succeed. Children of color are more likely to live in poverty, live in families that spend more on housing, and go without health insurance. In Montana, about 40 percent of American Indian children live in poverty and 17 percent do not have health insurance. The Indian Health Service (IHS) is a federal program that provides health services for American Indian families. The obligation of the federal government to provide health care to American Indians stems from what is known as its trust responsibility to tribes. To learn more about the federal-tribal trust relationship, see MBPC’s report, “Medicaid Expansion in Indian Country: Effective Strategies for Outreach and Enrollment.” Unfortunately, IHS services are severely limited by a lack of federal funding. IHS receives about $4,000 per person enrolled, which is only half the amount ($8,000) per person on Medicaid. Limited funding means that not every health need of American Indians can be taken care of at an IHS facility, leaving children and families without comprehensive health care coverage through IHS alone. For this reason, families that rely on IHS alone for health coverage are considered uninsured. To address the inequities in health insurance coverage, Montana should improve outreach of the HMK public insurance program to American Indian children who are eligible but not currently enrolled. Children on HMK have health coverage at any facility that participates in the Medicaid program, including IHS facilities. Additionally, fully funding IHS will help ensure more families receive adequate health services, even if not directly improving health insurance coverage. Addressing the structural barriers that have led to present-day disparities is a critical step to seeing all children thrive in Montana.

At Montana KIDS COUNT, we aim to provide timely and reliable data to better understand not only the strengths of child well-being across the state but also identify policy solutions where Montana can make meaningful change for kids. The KIDS COUNT Data Book is just a small glimpse into the lives of children in Montana. More data on child well-being in your Montana community can be found on the KIDS COUNT Data Center.

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