By Manchester InkLink
NH ranks among nation’s best for child well-being—but outcomes vary based on where in the state you live
According to a first-ever comprehensive ranking of U.S. counties released this week by global humanitarian nonprofit Save the Children, New Hampshire ranks third in the country for states whose children have the most protected childhoods.
But across the small state’s 10 counties, data shows, there are stark disparities. Children in New Hampshire’s lowest-ranked county – Sullivan – are nearly two times as likely as children in the highest-ranked county – Grafton – to have their childhoods impacted by negative experiences.
Save the Children’s new report and rankings, titled “The Land of Inopportunity: Closing the Childhood Equity Gap for America’s Kids,” provide both bird’s-eye and granular views of child well-being across the country through both state and county-level data. Researchers have noted the inequities shown in the report have since been “magnified and exacerbated” by the COVID-19 health crisis.
Some child welfare officials in the Granite State worry that conditions caused by the coronavirus could set the state back in its progress. Federal, state and local dollars will be required to reinvest in an entire generation of children, they say.
“This pandemic has really brought to light how vulnerable kids are,” said Mary Lou Beaver, Waypoint’s director of the Children’s Place and Parent Education Center in Concord. “I think we’re going to see some serious issues we’re going to have to deal with as we start to come out of this, as far as kids go.”
Lauren Wool, senior director of community impact at the United Way of the Greater Seacoast, said she feels “the worst is yet to come” in regards to the unfolding of the pandemic’s impact on children and families.
However, the unprecedented crisis has also brought opportunities for more collaboration across organizations, and services increasing access that perhaps wouldn’t have happened otherwise – like virtual meetings with direct service providers.
“I have not seen this level of excitement, movement and willingness to change how we’re doing business in a way that impacts families, and having families at the table, too,” said DonnaLee Lozeau, executive director of Southern New Hampshire Services and former mayor of Nashua.
The Save the Children report states New Hampshire has a 10.1.% child poverty rate, and the rankings of its 10 counties range from the top 50 in the country, down to the 300s. Data for 2,617 U.S. counties are included in the report.
The county rankings are based on four child indicators: child deaths (average of two data sets, 2009-2018 and 2014-2018), child hunger (2017), high school dropout rates (2016-2018), and teen pregnancy (2018). Poverty rates shown are from 2018.
Nikki Gillette, report researcher for Save the Children, said the report shows all across the country there are “pockets of deprivation” next to counties where children are doing very well, demonstrating a zip code can be a determinant for a child’s future. State level data can hide those huge inequities – which exist even within counties – she said; the reason Save the Children decided to take a closer look.
In New Hampshire, Rockingham County – ranking second in the state overall – has the state’s lowest child poverty rate of 6.7%, while Coos County – ranking ninth overall – has a 21% rate, the highest.
In all but seven states, rural childhood poverty rates exceed those of urban childhood poverty, the report says, and the same rings true in the Granite State. The highest rates of poverty are in Sullivan, Coos and Carroll counties.
In the state-level rankings, New Hampshire is No. 1 in the nation for the lowest infant death rates, and despite disparities demonstrated in the report, Save the Children pegs New Hampshire as having a lesser child equity gap than other states.
At the county level, Carroll County has the highest numbers reflecting child mortality, at 53.9 deaths among children under age 18 per 100,000 population.
Sullivan County has an alarming 16% high school dropout rate, and Coos County has the most teen pregnancies per 1,000 females ages 15-19.
Grafton and Rockingham counties rank 33rd and 34th as the best counties for children nationwide, respectively.
New Hampshire’s county rankings
Data shown in the Save the Children report is the most recent available as of April 8, according to researchers.
Child poverty: 12.5%; child deaths: 33.5 among children under age 18 per 100,000 population; child hunger: 12.7%; School dropouts: 5.4%; Teen pregnancy: 5.3 births per 1,000 females aged 15-19; National county rank: 33
Child poverty: 6.7%; child deaths: 28 among children under age 18 per 100,000 population; child hunger: 10.1%; School dropouts: 7%; Teen pregnancy: 4.3 births per 1,000 females aged 15-19; National county rank: 34
Child poverty: 11.6%; child deaths: 27.8 among children under age 18 per 100,000 population; child hunger: 12.8%; School dropouts: 12%; Teen pregnancy: 9.4 births per 1,000 females aged 15-19; National county rank: 195
Child poverty: 9%; child deaths: 35.8 among children under age 18 per 100,000 population; child hunger: 11.1%; School dropouts: 10.6%; Teen pregnancy: 7 births per 1,000 females aged 15-19; National county rank: 200
Child poverty: 12.9%; child deaths: 41.9 among children under age 18 per 100,000 population; child hunger: 12.6%; School dropouts: 10.6%; Teen pregnancy: 8.8 births per 1,000 females aged 15-19; National county rank: 224
Child poverty: 10.9%; child deaths: 30.5 among children under age 18 per 100,000 population; child hunger: 11.3%; School dropouts: 14.4%; Teen pregnancy: 6.5 births per 1,000 females aged 15-19; National county rank: 227
Child poverty: 10%; child deaths: 35.6 among children under age 18 per 100,000 population; child hunger: 11.4%; School dropouts: 12%; Teen pregnancy: 10.7 births per 1,000 females aged 15-19; National county rank: 237
Child poverty: 14.3%; child deaths: 53.9 among children under age 18 per 100,000 population; child hunger: 12.4%; School dropouts: 6.3%; Teen pregnancy: 11.6 births per 1,000 females aged 15-19; National county rank: 241
Child poverty: 21%; child deaths: 24 among children under age 18 per 100,000 population; child hunger: 15.4; School dropouts: 7.6%; Teen pregnancy: 18.1 births per 1,000 females aged 15-19; National county rank: 265
Child poverty: 15.2%; child deaths: 24 among children under age 18 per 100,000 population; child hunger: 12.1%; School dropouts: 16%; Teen pregnancy: 15.3 births per 1,000 females aged 15-19; National county rank: 388
Silver livings amid the virus outbreak
New Hampshire’s child welfare system has begun to see improvements since records obtained in 2017 revealed at least 25 child deaths linked to abuse or neglect since 2010, at least eight of whom died under the watch of the state Division for Children, Youth and Families.
Also brought to light were overburdened caseworkers dealing with high numbers of caseloads, and questionable administrative decisions – like the closure of more than 1,500 abuse and neglect investigations over two days. During his tenure, Gov. Chris Sununu has worked to rebuild and restructure the state’s child protection agency.
Following a nationwide search in 2017, Joseph Ribsam came to New Hampshire as DCYF’s new director, from New Jersey.
The state in 2018 created its first ever Office of the Child Advocate, bringing in Moira O’Neill to serve as an independent overseer of the child welfare system.
Across the board, officials say what’s stood out in New Hampshire over the last few years is a collaborative nature across the state and the partnerships that have since formed to better serve children.
In regards to the Save the Children report, O’Neill said, “Rankings are complicated.” A good ranking should not cloak the struggling and vulnerable children who exist across the state, she said, and more work needs to be done to lift them up. However, O’Neill said New Hampshire is “certainly on its way to building out really good child-centric programs and services.”
“Even now in the pandemic, the governor is really committed to keep moving forward on the investment that he’s making in child welfare,” O’Neill said. “The heart of that is building out community-based services.”
O’Neill said amid the virus outbreak, the state has been able to develop a remote and virtual infrastructure for its child welfare system, and “we’re already seeing services in parts of the state we haven’t had before.” She noted a remote juvenile diversion program in the North Country as an example.
Also in the works is a request for proposals currently out for voluntary services, a program “so well-established in other states,” but absent in New Hampshire when O’Neill arrived.
Voluntary services offer intervention and assistance for struggling families before they reach a point of abuse or neglect and ultimately end up in contact with DCYF.
One month into O’Neill’s tenure in 2018, a father in Derry killed himself and his 6-year-old son by carbon monoxide poisoning. There were warning signs, O’Neill said, and to this day she wonders if voluntary services could have helped that child.
“Going forward, the whole state will be served (with voluntary services), and that’s earth-shattering,” she said.
Progress is being made, but “we can’t assume just because we’re saying all of these things that it means we’re there,” O’Neill said. “There are casualties in the meantime.”
Ribsam said the state is about to “blow the door open” for voluntary services, which could be critical to improving child and family well-being statewide.
“If we really want kids and families to thrive, we have to get to them before they ever get to DCYF’s doors,” he said. “The child protection system can never be the system that really fixes and gets ahead of things. As we see revenues decline, I know DCYF is a priority, but we also need to prioritize kids and families in their communities, where they are, so we don’t have to get involved at all.”
Ribsam said the coronavirus aside, “it’s been a really exciting time to be working in New Hampshire.” He dovetailed off O’Neill’s remarks that while there are certainly limitations to virtual services, the system going forward can now use remote and virtual connection to augment and improve face-to-face interaction. For example, DCYF purchased iPhones so foster children could stay connected with their birth parents via FaceTime during the stay-at-home order.
The new virtual infrastructure, Ribsam said, could be “transformational” for the system.
Joelyn Drennan, senior program manager at the New Hampshire Children’s Trust, said the virtual services appearing during the virus outbreak have been able to bridge disparities and gaps that existed prior, especially those in rural areas.
“If you can do a home visit virtually, you can reach so many more families,” Drennan said. “I really hope that is something that will stay. It’s a very economical way to expand services. A lot of families disengage in services because of transportation issues, for example. But if the appointment comes to them, they’re more likely to engage and we’re more likely to see improvements in outcomes.”
The “digital divide” poses a challenge for the expansion of virtual services, as some low-income families and neighborhoods don’t have WiFi connection – demonstrated by the mobilization of schools to get students connected when learning went remote. Some districts deployed school buses into neighborhoods equipped with WiFi hotspots.
Lozeau, of Southern New Hampshire Services, said New Hampshire’s child protection and well-being system is going through a “transformative time,” citing an investment by state officials and agencies she hasn’t seen before.
“We have an opportunity right now because of some of the barriers that have been moved in the system to help families in a very different way,” she said.
Wave of concerns
While the state’s efforts to serve children and families during the virus outbreak has been strong, dire concerns remain. Perhaps the most grave is the reality that calls to DCYF reporting suspected child abuse and neglect have plummeted since schools shifted to remote learning and teachers no longer have eyes on kids.
During the week of May 26, calls to DCYF were down 52% from medical professionals and 47% from schools over this time last year. And while overall call volume is down, the agency has seen an uptick in allegations of lack of supervision, caretaker substance abuse and domestic violence since the COVID-19 emergency began.
As summer camps and day programs convene, and students hopefully return to school buildings in the fall, Ribsam said, DCYF expects to see a surge of new reports.
“A large part of our current concern is the decreased call volume, and what that tells us about kids we might not be seeing, where we’re unable to intervene,” he said.
Ribsam said it’s not unusual for rates of child abuse and domestic violence to increase on the backend of a crisis. He saw the same thing in New Jersey after Hurricane Sandy, he said.
Joy Barrett is CEO of the Granite State Children’s Alliance, which oversees child advocacy centers around the state. A child’s visit to a CAC is indicative of them experiencing felony-level physical or sexual abuse, or having witnessed a traumatic event or crime, Barrett said.
“Awareness is important for Granite Staters, to be aware child abuse happens here, and it happens to the tune of 2,100 kids at child advocacy centers every year,” she said.
The GSCA recently launched an awareness campaign emphasizing “stay at home isn’t safe at home for some kids.” Because children are not being seen regularly by teachers, coaches or medical professionals right now, more abuse and neglect is likely flying under the radar. She reminded that in New Hampshire, all adults are mandated by law to report suspected child abuse or neglect.
“We really need a call to action to the general public that you might be the person who can make the difference for that child right now,” she said.
Barrett said New Hampshire’s latest ranking is a “congratulatory moment signaling that most children are well in New Hampshire,” but, “the reality is there are many that are not.”
“We need to leverage what makes us rank well to help all of the kids here,” she said.
Beaver, of the Children’s Place and Parent Education Center in Concord, is gravely concerned about the pandemic’s impacts on childcare and early childhood education.
“Trauma can have an impact for an entire lifespan and for many of the younger kids, especially those we serve, these are the formative years when the most brain growth is taking place,” she said.
Beaver expects childcare centers – some of which may not survive the crisis – will have to bring in behavioral and mental health consults for both children and families when buildings reopen.
“Two months or more in quarantine is going to take its toll,” she said. “I really am concerned about what’s going on behind closed doors that we’re not aware of.”
Federal Head Start programs focus on the lowest-income children of a community, and ready them for public school entry, specifically kindergarten. After the virus outbreak passes, Beaver said, the state is going to have to see a major investment in childcare and early childhood education.
“For every dollar you invest, you get a return of seven or more dollars,” Beaver said. “If we support children and their families as a whole unit as they grow, those kids have a really much better chance of becoming better productive members of society and adding to the economy. It just makes sense.”
Solutions and resources
Many New Hampshire partners have risen to the challenge to meet the increasing needs of families amid the state’s multi-year opioid epidemic, and now an unemployment crisis. And some are beginning to see a return on their investment.
The United Way of the Greater Seacoast has early childhood coalitions in the cities of Somersworth and Rochester, convening parents with various community partners.
In Somersworth, a small city, nearly 50% of students are eligible for free or reduced lunch, and prior to the coalition launch, the percentage of students scoring below the developmental range associated with early reading success was 44%.
Liz Belsito, coordinator of the Somersworth Ready Together Coalition for the United Way, said teachers at Somersworth’s elementary schools were seeing nearly half of students not hitting literacy thresholds, and some entering school who didn’t know how to use utensils or hold books properly.
The coalition quickly recognized that much of child well-being starts with parent well-being.
“Since then, we’ve really focused on a lot of family and parent engagement,” Belsito said, noting not all parents view schools as “allies.” That, she said, has required a lot of trust-building across the community.
The coalition has since implemented kindergarten teacher home visits, parent focus groups, and soon hopes to launch an Adverse Childhood Experiences Response Team similar to the existing one in Manchester.
Wool, also of the United Way, said the coalition in Rochester has reconvened two or three times over the years, but “certainly gained traction” this time around.
“What’s been exciting is the readiness of a community to come together around a shared goal,” she said.
Families in Rochester, Wool said, see the resources available, but feel strongly there’s an absence of a central location – like a family resource center – where they could access childcare, healthcare, and social/emotional support.
“(Parents) are going to be part of the design of anything this cross-sector initiative endeavors to action,” Wool said. “I think we’re onto something.”
Wool noted the relationships already built by these coalitions are “how we will recover from this crisis.”
The New Hampshire Children’s Trust works with 16 designated family resource centers across the state. Executive Director Cliff Simmonds said he expects heightened activity at the centers over the coming months, and the organization will soon launch a robust awareness campaign, “so that we can get to folks who may not realize the resources are there in their communities.”
“There’s going to be a lot of people looking to get back to work, but they’re not going to have all of the daycare options, for example,” he said. “And then people who realize they’re not getting their jobs back. It’s a good time for us to get out there and wave our hand to say, ‘There are resources and it’s OK to use them.’”
For additional information, visit DCYF’s COVID-19 resources for children and families at https://www.dhhs.nh.gov/dcyf/. The Save the Children report can be viewed at https://www.savethechildren.org/childhood.
Reporter Hadley Barndollar is a 2020 Inequality in America press fellow for Save the Children.
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