Delaware's percentage of children without health insurance dropped to 4% (8,000 kids), according to the 2022 KIDS COUNT Data Book, a 50-state report of recent household data developed by the Annie E. Casey Foundation that analyzes how children and families are faring.
However, children in America are in the midst of a mental health crisis, struggling with anxiety and depression at unprecedented levels. This year's resource focuses on youth mental health, concurring with a recent assessment by the U.S. surgeon general that conditions amount to a youth "mental health pandemic."
Released today, the report sheds light on the health, economic and other challenges affecting American children as well as how those challenges are more likely to affect children of color.
The COVID-19 pandemic is, at its core, a public health crisis that requires health care- and health coverage-focused solutions. Data from 2016-2020 reflect that at a rate of 4%, fewer of Delaware's children are without health insurance, a rate lower than the U.S. average rate of 5%. But COVID-19 posed both direct and indirect threats to the health and wellness of Delaware's children. In addition to concerns about contracting the virus, many families also coped with social isolation, job loss, inadequate amounts of food and disruptions to in-person learning. These and other stressors associated with the pandemic impacted families' health service utilization, mental health and more.
"During the pandemic, Delaware experienced an increase in the number of children enrolled in Medicaid/Children's Health Insurance Program (CHIP) due to a continuous enrollment policy change, something that may have favorably impacted access to health services during this time," said Janice Barlow, director of KIDS COUNT in Delaware. "However, geographic analysis of health coverage data reveals that children residing in Kent County are disproportionately likely to lack health insuance than their peers in the balance of the state. This gives us insight on where to target health coverage recruitment and retention efforts next."
The Data Book reports that children across America, and in more than 40 states and the District of Columbia, were more likely to encounter anxiety or depression during the first year of the COVID-19 crisis than previously, with the national figure jumping 26%, from 9.4% of children ages 3-17 (5.8 million kids) to 11.8% (7.3 million) between 2016 and 2020, the year COVID-19 swept across the United States. This increase represents 1.5 million more children who are struggling to make it through the day. In Delaware, data show an increase of 32.7% from 9.8% (17,000 kids) to 13% (23,000 kids) from 2016 to 2020.
Racial and ethnic disparities contribute to disproportionately troubling mental health and wellness conditions among children of color. Nine percent of high schoolers overall but 12% of Black students, 13% of students of two or more races and 26% of American Indian or Native Alaskan high schoolers attempted suicide in the year previous to the most recent federal survey. Further, many LGBTQ young people are encountering challenges as they seek mental health support. Among heterosexual high school students of all races and ethnicities, 6% attempted suicide; the share was 23% for gay, lesbian or bisexual students.
"Delaware leaders recognized that the mental health crisis started well before the pandemic, but was exacerbated by COVID-19, and have been working to enhance supports for child mental health," Barlow said. "In this year's session, policymakers passed legislation to add mental health supports to middle schools through the state, to establish and implement mental health education for students in kindergarten thru 12th grade and to require health plans to cover annual behavioral well-checks."
Each year, the Data Book presents national and state data from 16 indicators in four domains - economic well-being, education, health, and family and community factors - and ranks the states according to how children are faring overall. The data in this year's report are a mix of pre-pandemic and more recent figures and are the latest available.
"Mental health is just as important as physical health in a child's ability to thrive," said Lisa Hamilton, president and CEO of the Annie E. Casey Foundation. "As our nation continues to navigate the fallout from the COVID crisis, policymakers must do more to ensure all kids have access to the care and support they need to cope and live full loves."
The Annie E. Casey Foundation calls for lawmakers to heed the surgeon general's warning and respond by developing programs and policies to ease mental health burdens on children and their families. They urge policymakers to:
- Prioritize meeting kids' basic needs. Youth who grow up in poverty are two to three times more likely to develop mental health conditions than their peers. Children need a solid foundation of nutritious food, stable housing and safe neighborhoods - and their families need financial stability - to foster positive mental health and wellness.
- Ensure every child has access to the mental health care they need, when and where they need it. Schools should increase the presence of social workers, psychologists and other mental health professionals on staff and strive to meet the 250-to-1 ratio of students to counselors recommended by the American School Counselor Association, and they can work with local health care providers and local and state governments to make additional federal resources available and coordinate treatment.
- Bolster mental health care that takes into account young people's experiences and identities. It should be trauma informed - designed to promote a child's healing and emotional security - and culturally relevant to the child's life. It should be informed by the latest evidence and research and should be geared toward early intervention, which can be especially important in the absence of a formal diagnosis of mental illness.
