Children Who Are Sick Can’t Succeed

Good health is the foundation of children’s growth and learning. The COVID-19 pandemic, which touches all areas of a child’s health, has highlighted existing weaknesses within Florida’s infrastructure meant to support the health of its children. Children in child care settings have increased exposure to transmissible diseases, more children have fallen into poverty and struggle with housing and food insecurity, and mental health has worsened for children across the state.

Preventative medicine and access to medical professionals when sick are critical to helping children develop and thrive. Programs are available to provide free and low-cost health services for children and families in need. Services including maternal and infant programs, KidCare, dental care, and Medicaid keep low-income children and families out of expensive emergency rooms for issues preventable with regular medical care. These programs also help keep the family well, while identifying medical issues early on – leading to quicker resolutions and better outcomes.

Hunger and Homelessness is an Increasing Problem

Children who experience hunger and homelessness are at an increased risk of both physical and mental health issues. The Florida Department of Education reports that in 2020-2021, there were almost 64,000 youth experiencing homelessness. Almost 6,000 youth were unaccompanied, not in custody of a guardian. One in 6 children in Florida face food insecurity, without a stable source of meals. COVID-19 made these issues even worse, with reports finding that the number of children facing hunger is twice as high as before the pandemic (28% compared to 14% pre-COVID-19). These families have no choice but to sacrifice healthcare, housing, and education to survive, severely impacting childrens’ behavioral and mental health, limiting their development, and contributing to chronic health problems such as diabetes and heart disease– the leading cause of death in the US.

When children do not have access to stable housing and food security, they are at an increased risk for physical and mental health problems. Almost half (45%) of youth experiencing homelessness have depression, compared to 27% of youth that are housed. Children who experience homelessness are sick twice as much as housed children, experience higher risks of substance abuse, and are often unable to sleep. These conditions impair a child’s ability to perform well in school, harms their social and intellectual development, and worsens long-term health as they become adults. Over 200,000 additional Florida children fell into poverty as a result of the COVID-19 pandemic. While Florida families are still feeling the economic repercussions, programs that provide rental and nutrition assistance, such as the Families First Coronavirus Response Act and the OUR Florida program, stopped accepting applications. This has left Florida families, still vulnerable and recovering, without resources and without help.

Access to secure housing and food are integral to the health of children and are the cornerstones to their development. Without programs that will assist families struggling with economic hardship, especially in the wake of COVID-19, children are at an increased risk of health issues that can follow them into adulthood.

Losing a Caregiver Negatively Impacts Children’s Mental Health

Losing a family member and/or a primary caregiver has severe consequences on a child’s long-term physical and mental health, including higher rates of depression, post-trauamtic stress, substance abuse, and suicide. Children live with these tragedies for the entirety of their lives, suffering increased risk for further negative events. Losing a parent can put children at a higher risk of financial, food, and housing insecurity.

More than 12,500 children in Florida have lost at least one primary caregiver to COVID-19. Thousands of Florida families are having to grapple with the emotional trauma of losing a loved one as well as the financial strain of a lost source of income and often overwhelming medical bills. More than 8,600 Florida children have experienced the death of a caregiver. This loss was especially hard on children of color. In Florida, around 70% of children who lost a caregiver to COVID-19 are Hispanic, Black, or Asian, despite comprising roughly 38% of Florida’s population. Experts say that children who experience losing a caregiver or other adverse childhood events are at a far greater risk of developing emotional and mental health conditions, such as depression, anxiety, and suicidal thoughts.

Racial Disparities in Florida’s Healthcare System Hurts Families and Communities of Color

Racial disparities in healthcare access and treatment exist throughout the country, and Florida is not an exception. According to the CDC, Black women in America are three times more likely to die from pregnancy-related issues than white women. In Florida, Black mothers are more likely than their White peers to not receive prenatal care or have their infant impacted by maternal complications. In fact, Black infants are almost three times as likely to die than White infants in the state. When mothers do not have access to adequate health care, both the mothers and babies are at risk for serious health complications. Disparities in access to and the quality of care have negative impacts on communities of color. Health policy reform is needed to ensure people of all races have equitable access to healthcare, and that healthcare professionals are trained to meet the unique needs of every individual without bias interfering with practices.

Florida’s Insurance Crisis and Medicaid

In 2019, 7.6% of Florida’s children did not have insurance, far exceeding the national average. The state also saw a decrease in the number of children enrolled in employer-sponsored plans, Affordable Care Act plans, and Florida KidCare, the state’s version of the national Child Health Insurance Program (CHIP).

Florida KidCare is a health insurance program that provides health coverage for Florida’s children from birth until 18 years of age. Programs included in KidCare are Medicaid, MediKids, Florida Healthy Kids, and the Children’s Medical Services Health Plan. Current eligibility requirements for KidCare require families to have an income below 200% of the Federal Poverty Level (FPL). In 2020, 32.9% of Floridians had an income below 200% of the FPL. In 2022, this amount is about $4,600 per month for a family of 4, compared to an estimated $6,900 monthly cost of living in Florida. Programs such as KidCare need to expand eligibility requirements, including the expansion of Medicaid, to include families earning below 300% FPL. This ensures children will have access to health insurance and can have preventative doctor’s visits. Nationally, three-quarters of children who lost health insurance in 2017 were from states that have chosen not to expand Medicaid coverage, Florida being one of them. Florida ranks 41st out of 50 states for the percentage of children that do not have health insurance. Children in Florida who lose a caregiver especially struggle to have health insurance.

In 2019, 17.5% of middle and high school students in Florida did not have a doctor’s visit in the past year. Reasons for not visiting the doctor vary, but lack of health insurance may be the most common. Even with insurance, 44% of US adults avoid necessary medical care due to its cost. Without expanded Medicaid coverage, low-income families are forced to forego medical care.. A lack of affordable health care can worsen health outcomes for low-income patients and– as a direct result of missing routine and preventative care– increase use of emergency care. This directly raises the price of emergency care for all patients, and leaves low-income families reliant on less-effective aid programs funded entirely by Florida taxpayers. Expanding Medicaid is the sensible choice for Florida taxpayers, allowing Floridians to actually use the programs they already pay for, removing “double-dip” taxation for Florida’s own programs, and improving health outcomes while ensuring low-income families can stay healthy enough to advance.

Preventive Doctor and Dental Visits are Crucial to the Health of Children

When children do not have access to medical and dental healthcare, their overall well-being suffers. Students with dental issues that go untreated due to limited access to affordable dental care have lower Grade Point Averages and miss more school. Children without access to healthcare also can have a harder time developing physically and emotionally and may develop preventable conditions that can have lasting effects into adulthood.

Florida ranks 45th out of the 50 states and Puerto Rico in the number of children receiving a preventative medical and dental visit in the past year. Fifty percent of children with Medicaid visited a dentist in the past year, compared to 67% with private dental insurance. Additionally, Florida ranks 32nd in low birth weight babies and 28th in the number of infant deaths. When children do not have access to preventive health care visits, there are serious health consequences that can impact their school performance. Conditions such as asthma, vision problems, hearing problems, and behavioral problems, when left untreated, lead to less school engagement, being held back in school, and poorer school performance.

Failure to keep children healthy impacts the quality of life of children and their families. Education, family stress, mental illness and long-term outcomes are all rooted in the health of the child. To ensure the best outcomes for Florida’s children and Florida’s future, we must invest in children’s health care.

Access to dental services are vital to ensuring the health of children. However, only 43.1% of Florida children received any dental service in 2020, much lower than the national average (52.3%). Tooth decay is considered to be an epidemic among Florida’s children that’s five times more common than asthma. More than 23% of 3rd graders in Florida have untreated cavities. Children who encounter the greatest barriers to receiving dental care are Medicaid recipients, those with low income, people of color and those for whom English is not their primary language. Not having access to dental services can create negative long-term consequences. Untreated dental pain impairs a child’s ability to learn in school, and poor oral health affects the next generation through pregnancy complications. Florida must improve children’s access to quality oral health care.

Support

  • Improve access to quality oral health care. In 2023, in partnership with Floridians for Dental Access, a statewide public information campaign will highlight that 1 in 5 Florida children suffer from treatable dental conditions which impact academic performance in both GPA and attendance, leads to as many as 150,000 emergency room visits and costs taxpayers more than $600 million annually, and can cause permanent impairment and death.
  • Improve and expand maternal and infant health care especially focused on disparities due to historical racial and income inequities.
  • Increase KidCare health insurance eligibility limits to 300 percent of the federal poverty line which is equal to an annual income of $83,250 for a family of four.
  • Strengthen families, reduce infant death and the instances of poverty, and improve children’s performance in school by mandating a 12 week paid parental leave for infant/adoptive parents.

Legislation

American Children’s Campaign Priority Bill Highlights

Additional Resources

  • Kids Count Data Center Florida Health Indicators—Annie E. Casey Foundation. Reports Florida specific statistics on all issues facing health care for children.
  • Snapshot of Children’s Coverage: Florida—Georgetown University Health Policy Institute. Illustrates how children in Florida are covered by Medicaid, CHIP and the ACA.

  • Hidden Pain– Covid Collaborative. Documents the number of caregivers in the U.S. who died from COVID-19, provides an overview of possible long-term effects on children, and provides recommendations to support children who lost a caregiver.

  • Oral Health Care System: Florida—American Dental Association. Provides an overview of Florida’s oral health care system. As of 2014, Florida ranks below the national average in the percentage of dentists participating in Medicaid for child dental services.
  • Shattered smiles: Florida kids face dental crisis—Panama City News Herald. Though adequate dental care has been guaranteed by the Medicaid program in federal law since 1972, the reality of accessing dental care in Florida is much less secure, especially in rural or urban poor communities.

  • Roadmap for Oral Health -Oral Health Florida Healthy Mouth Healthy Body. Sets policy recommendations for ensuring children have access to adequate dental care.

  • By The Numbers-Floridians for Dental Access. Explores the lack of access to quality oral health care in Florida.

Disclaimer: These links to third-party websites are provided as a convenience and for informational purposes only. They do not constitute an endorsement or approval by American Children’s Campaign or its affiliate organizations and partners.