Innovation Ecosystem

Seeing the whole kid through a lens of equity

The latest annual Rhode Island Kids Count Factbook seeks to frame the conversation around kids and family by connecting outcomes in health, education and economic wellbeing in terms of wealth, racial and ethnic disparities

Image courtesy of Rhode Island Kids Count

The cover of the 2020 Rhode Island Kids Count Factbook.

By Richard Asinof
Posted 4/20/20
ConvergenceRI conducts an in-depth interview with Elizabeth Burke Bryant, the long-time executive director of Rhode Island Kids Count, following the virtual release of the annual Factbook.
How will the coronavirus pandemic reshape the demands for behavioral health services for children and families in Rhode Island? How will telehealth reshape the delivery of health care services? Will there be an increased call for toxic stress screening by pediatricians? Will measuring of what’s known as allostatic load become a new vital sign indicator?
Hearing children’s voices in song has always been a unique part of the Rhode Island Kids Count Factbook celebration. Despite the closure of schools and the imposition of social distancing requirements, what is the potential to create a virtual chorus of children’s voices as a regular feature of programming focused on the health and wellbeing of children and families in Rhode Island?

PROVIDENCE – One of the most important rites of spring in Rhode Island fell victim to the coronavirus pandemic. The annual release of the Rhode Island Kids Count Factbook, held every year during the first week in April as a celebratory breakfast, an in-person gathering at the Crowne Plaza in Warwick, was forced to move a virtual platform this year.

Instead of the boisterous large gathering at which elected officials were saluted, an overflowing crowd was serenaded by an elementary school chorus, and keynote speakers advocated on behalf of the needs of children and families in Rhode Island, the launch was done on social media.

“We released our Factbook this year electronically, as we normally do the first week in April, and we have been pleased with the responses that people are using the data and policy information contained in our Factbook to inform their work,” said Elizabeth Burke Bryant, the executive director of Rhode Island Kids Count. “In this time of the pandemic, we were pleased by the positive response of people using this year’s Factbook in so many ways to improve the lives of kids and families.”

For more than two decades, the Factbook has served as an indispensable tool for policy-makers and decision-makers and reporters, a longitudinal dataset that tracks the health and wellbeing of Rhode Island’s children and families, providing plenty of oomph to the adage: what gets measured gets done.

In numerous stories each year, ConvergenceRI counts on the Rhode Island Kids Count Factbook to provide the accurate data to support the reporting on health, education, innovation and economic development.

The maestro behind the production of the Rhode Island Kids Count Factbook is Burke Bryant, an indefatigable champion of children, who has been serving since 1994 as the long-time executive director of Rhode Island Kids Count.

Burke Bryant herself would be the first to acknowledge the importance of the collaborative team of staff and volunteers that are responsible for the production and data analysis of the rich data resource.

Burke Bryant is a formidable, determined and positive advocate for all things related to promoting the wellbeing of kids, as many legislators will testify to and praise her efforts as well as her constant vigilance at the State House.

In a lengthy interview with ConvergenceRI the week following the online release of the Factbook, Burke Bryant insisted on being able to highlight all the important findings from this year’s Factbook before answering questions, to make sure that the key trends were the focus of the story.

Here are the key messages that Burke Bryant sought to highlight in the interview, focused on this year’s findings.

• On the positive side of the ledger, 98 percent of children in Rhode Island are covered by health insurance plans. “That is an important gateway to all kinds of critical coverage and preventive care – all of that we know matter to children’s health outcomes,” Burke Bryant said. “We are in striking distance of reaching 100 percent coverage.”

• RIte Smiles, the dental care coverage plan under Rhode Island Medicaid, has continued to show significant increases in the number of dentists participating in the program. In 2019, there were 312 unduplicated dentists in 176 practice locations participating in RIte Smiles. “We always say that the mouth and the brain are all part of the body when we think about comprehensive health care,” Burke Bryant said.

• In terms of needing improvement, the latest data analysis showed that slightly more than half, or only 56 percent, of Rhode Island women reported having a dental visit during their pregnancy. “That’s an area that we would like to see keep going up,” Burke Bryant said.

When asked about the potential correlation of low reimbursement rates provided to dentists through Medicaid and how it might impact the availability of dental care for children, Burke Bryant said that the Factbook had not specifically looked at information on reimbursement rates. “There are many areas of the health care world where rates obviously matter,” she said.

• One disturbing trend being tracked by the Factbook is obesity in children. Looking at clinical and related billing code data from 2018, the analysis showed that 13 percent of Rhode Island children between the ages of 2-17 were overweight and 17 percent were obese. “When you add these two percentages together, find that a significant percentage of Rhode Island children are either overweight or obese,” Burke Bryant said. “I think this is a really important indicator to continue to track.”

• Another disturbing trend identified has been the significant increase in the number of high school students who are using e-cigarettes, with 30 percent reporting use of e-cigarettes in 2019, a jump from 20 percent in 2017.

Burke Bryant also said the data tracked in the Factbook revealed that there was an increase in the misuse of prescription drugs between 2017 and 2019.

• A further area of concern identified in the Factbook was the racial and ethnic disparities in maternal health and infant outcomes. The Rhode Island infant mortality rate between 2014 and 2018 for black infants was 10.6 deaths per 1,000 births, which was more than three times the white infant mortality rate of 3.3 deaths per 1,000 births.

“We have a very strong commitment to equity and closing racial and ethnic disparities that are prevalent in Rhode Island that are unacceptable,” Burke Bryant said. “It is critical to acknowledge systemic racism and to work to identify and remove systemic barriers that keep these unacceptable disparities persisting.”

• The increasing demand for children’s mental health services was another trend highlighted by the 2020 Factbook. In Rhode Island, one in five children ages 6-17, or 20 percent, have a diagnosable mental health problem. And, one in 10 has a significant functional impairment.

“We want the focus to be on prevention, and in making sure that families have access to the kinds of behavioral health resources that they need for their children,” Burke Bryant said. In FY 2019, she continued, some 26 percent, or 31,394 children under the age of 19 enrolled in RIte Care had a mental health diagnosis. Further, according to the data for FY 2019, approximately 1,000 children involved with Medicaid were hospitalized due to a mental health related condition.

“I think this is a pressing issue,” Burke Bryant continued. “We need to ensure that children with behavioral health conditions and issues can get the care that they need,” adding that this was an increasing concern as a result of the COVID-19 pandemic.

Next year in Warwick again?
In terms of what the post-pandemic world may look like and how it may alter plans for future Rhode Island Kids Count Factbooks, Burke Bryant said: “We will not necessarily be changing our categories but looking at things we might want to add.”

Burke Bryant said that Rhode Island Kids Count would maintain its long-time commitment to showing all of its indicators in terms of racial and ethnic disparities, and how education, housing, economic wellbeing and health all fit together in looking at the whole kid.

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