Montana and Missoula County are no different.
Seventeen percent of all Montana children age 18 and under live in poverty. However, 38 percent of Native American children 18 and under live in poverty in our state. Yet, Native Americans are only 6 percent of our total population.
50 percent of the federal poverty level - is increasing and has reached a statewide level of 8 percent.
Access to health care influences children’s health status. If a family doesn’t have health insurance or the ability to pay for health care, children often develop health problems that worsen over time. Health care serves to educate families about prevention measures. Well-child checkups that screen and detect problems at early ages prevent long-term problems. Simple health problems can become major ones if they are not found early.
Montana’s numbers for health insurance for children overall has increased, but we still rank poorly at No. 41 in the nation. The rate of coverage for children under 18 who live in poverty has worsened. This fall Congress proposed an increase in funding for the State Children’s Health Insurance Program (SCHIP), which provides health insurance in Montana to low-income children.
President Bush vetoed this SCHIP funding bill twice. Unable to override the veto, Congress voted in December to fund SCHIP at current levels and President Bush signed the bill; however, no additional children can be added to the program.
Montana’s legislators were all very supportive of SCHIP, especially Sen. Max Baucus, who was one of the initial sponsors of the SCHIP legislation and remains a strong advocate today. Our congressional delegation recognizes the importance of taking care of our children, who are our future.
Health indicators are nationally recognized measurements that tell us how healthy a population is. Montana’s Kids Count Data Book for 2007 lists eight key indicators from Right Start Data, which is compiled by the Annie E. Casey Foundation and compares Montana to other states. The indicators center on factors that affect the conditions under which children are born.
One indicator shows that, although Montana’s teen birth rate overall is about equal to the rest of the U.S., the rate of total births to teens who were already mothers is on the rise. Also, our rate of preterm babies is increasing and the percent of low-birth-weight babies has increased. In addition, Missoula County reported almost 10 percent of all the child abuse/neglect cases in the state in 2006.
The U.S. ranks last among other industrialized nations on two of the most important health indicators, infant mortality and longevity. The infant mortality rate in the U.S. (six per 1,000 live births) is 20 percent higher than Canada and 100 percent higher than Japan. Montana’s rate is 6.2 deaths per 1,000 live births and Missoula County’s is 5.1 deaths per 1,000 live births.
The United States does not rate well on longevity either. In fact, the U.S. ranks 30th in life expectancy, behind these other rich nations: Japan, Canada, Germany, France, Italy and the United Kingdom.
How can we be one of the richest countries in the world and have such a dismal public health picture? What is the “gap” all about?
The gap, the difference between the rich and the poor in both our country and in Missoula County is growing. This socioeconomic factor is one of the most powerful determinants of health, because it can influence the extent to which other factors provide protection.
If we view this concept as “population health,” it is easier to recognize that the effects of poverty are reflected in multiple risk factors for poor health, including decreased access to care, poor nutrition, inadequate housing and increased exposure to environmental threats. On the flip side, wealth can provide protection against all of these factors.
Equity makes a difference. The Institute of Medicine in the United States issued a report stating that “more egalitarian societies (i.e., those with a less steep differential between the richest and the poorest) have better average health, because a dollar at the bottom 'buys' more health than a dollar at the top.” (Institute of Medicine 2003:59). Relative poverty is bad for your health!
Missoula has been chosen three years in a row as one of 100 Best Communities for Young People. Our city-county government, private and corporate individuals are supportive and passionate about their commitment to infants, children and youth in our county.
Some of the unique programs include: the Follow the Child program, which works with foster care children to ensure they have health care and support and do not “fall through the cracks” when they are placed in foster care; the Flagship program, which is a tremendous after-school program in jeopardy of losing funding; the Maternal Child Health home visiting program for at-risk mothers and children; Early Head Start, which provides a comprehensive child development program for very young children; the Parenting Place, which provides respite care and parenting classes in its quest to prevent child abuse and neglect; WIC, the nutrition program for pregnant women and their children; the Missoula Forum for Children and Youth, which promotes positive youth development, prevention of substance abuse, prevention of teen pregnancy, and promotion of health literacy; and the United Way, which will soon launch its campaign to promote positive parenting and strength in families.
Many more are at work throughout our county. Supporting these programs fiscally and in other ways is crucial for the population health of our community.
We can be proud to be living in Missoula County, but it is important for us to remember, every child matters! Closing the “gap” between rich and poor, between health and illness, and removing the barriers of racism and classism will make all the difference in how bright our future is.
Each month the Missoulian Health page features a column by the Healthy Start Council of the Missoula Forum for Children and Youth, a coalition of groups and individuals working collaboratively to help Missoula’s kids grow up to be healthy and resilient. Missoula City-County Health Department is a founding member of the Healthy Start Council which provides many public health services through three divisions: Environmental Health, Health Promotion, and Health Services. Julie Serstad is the director of health services and can be reached at 258-4986.
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