Limited access to health care a serious problem for Montana. (Kids Count).High poverty rates and limited access to health care are two major threats to the well-being of Montana's children, more than 50,000 of whom live below the 2001 national poverty threshold The poverty threshold, or poverty line, is the minimum level of income deemed necessary to achieve an adequate standard of living. In practice, like the definition of poverty, the official or common understanding of the poverty line is significantly higher in developed of $16,535 for a family of four. Many of these same children are also among the 41,000 young Montanans who do not have any form of health insurance coverage.
And health care for Montana kids, particularly those in low-income families, will diminish even further if the state Legislature A state legislature may refer to a legislative branch or body of a political subdivision in a federal system.
The following legislatures exist in the following political subdivisions:
Any investments with a maturity of one year or less.
1. Of or relating to a gain or loss on the value of an asset that has been held less than a specified period of time. savings, could actually lead to higher health care costs down the road.
Other important issues affecting Montana families and children in 2003 include low birth weight babies, substance and alcohol abuse, and early care and education for children. These are not short-term problems, but long-term Long-term
Three or more years. In the context of accounting, more than 1 year.
1. Of or relating to a gain or loss in the value of a security that has been held over a specific length of time. Compare short-term. needs deserving de·serv·ing
Worthy, as of reward, praise, or aid.
de·serving·ly adv. of statewide discussion and commitment.
The economic and overall well-being of Montana's children and their families is an important component of the state's economy. Montana KIDS COUNT, funded by the Annie E. Casey Foundation According to their website, "the Annie E. Casey Foundation has worked to build better futures for disadvantaged children and their families in the United States." The foundation is a regular contributor to public broadcasting, including National Public Radio. , is part of the Bureau of Business and Economic Research's commitment to provide policymakers and citizens with data that can inform community, state, and national discussions. Our need to track and monitor the well-being of kids is especially important in view of the health care, education, and economic challenges facing Montana families.
The Bureau recently published the 2002 KIDS COUNT in Montana Data Book. This article offers a summary of some of the report's major findings.
Demographics The attributes of people in a particular geographic area. Used for marketing purposes, population, ethnic origins, religion, spoken language, income and age range are examples of demographic data. of Montana Kids and Families
More than one in four Montanans are under 18 years of age. School-age children and teenagers account for almost three-fourths of the youth population in Montana and almost one-fifth of the state's total population. Between 1990 and 2000, the number of kids in Montana under 18 years of age increased by about 8,000 (Table 1). This small increase is consistent with the overall aging trend of the state's population. The number of children under age 5 actually decreased between 1990 and 2000, a decline that will affect some school district enrollments in the coming years.
White children are the largest racial group in Montana, representing 85 percent of all children. American Indian American Indian
or Native American or Amerindian or indigenous American
Any member of the various aboriginal peoples of the Western Hemisphere, with the exception of the Eskimos (Inuit) and the Aleuts. children are the second-largest group and the largest non-white group, accounting for almost 10 percent of the 230,000 Montana kids 18 and younger. Nationally, American Indian kids represent 1 percent of U.S. youth. In Montana's rural areas, American Indians American Indians: see Americas, antiquity and prehistory of the; Natives, Middle American; Natives, North American; Natives, South American. represent 18 percent of the youth population, compared to less than 4 percent of youth in urban areas of the state.
The American Indian population on tribal rolls and reservations is very young. Children account for 38 percent of the population on reservations, with the, majority 14 years old or younger. This youth demographic pattern has significant implications for these area's school systems and future workforce, and for economic development opportunities. Economic development leading to better employment opportunities and job growth is especially critical in the reservation economies. The higher dropout (1) On magnetic media, a bit that has lost its strength due to a surface defect or recording malfunction. If the bit is in an audio or video file, it might be detected by the error correction circuitry and either corrected or not, but if not, it is often not noticed by the human rates and lower graduation Graduation is the action of receiving or conferring an academic degree or the associated ceremony. The date of event is often called degree day. The event itself is also called commencement, convocation or invocation. rates for American Indian high school students partly reflect the lack of adequate earning and employment incentives in the local job base.
The youthful orientation of American Indian populations will continue over the next decade, particularly in Montana's reservation counties. In many of these counties, including Glacier glacier, moving mass of ice that survives year to year, formed by the compacting of snow into névé and then into granular ice and set in motion outward and downward by the force of gravity and the stress of its accumulated mass. , Big Horn Big Horn is a tall peak in the Cascade Range in Washington, USA. At 2438+ meters (8,000 feet) in elevation, it is the highest point in Lewis County, Washington. Big Horn, one of the Goat Rocks, is the second highest point on the ridge west of Mt. , and Roosevelt, American Indians make up the majority of the population. This demographic group has experienced high natural population growth, with an annual number of births above the number of deaths. In some of the reservation counties, the white population has actually decreased since the early 1960s because of a higher death rate and out-migration as compared to annual births. These patterns reinforce the importance of the American Indian population as the major demographic force in those counties.
The number of Montana children living in single-parent households increased dramatically during the past decade.
Eighteen percent of children under age 18 were living in single-parent households in 1990, a percentage that increased to just over 21 percent by Census 2000, representing 10,000 more Montana kids in single-parent households. Married-couple households continued to account for a majority of Montana kids' family structures in 2000.
The increased number of parents in the labor force is another major feature of youth demographic shifts over the last 10 years. The percentage of kids under age 18 with both parents in the labor force increased by more than 5 percentage points between 1990 and 2000. Looking at children under the age of 6, there was an almost 7 percentage-point increase--from 58.4 percent in 1990 to 64.9 percent in 2000. With more parents at work, the importance of childcare and early child education increases, whether those services are provided by private or public-funded sources.
Access to Health Care
While some indicators of physical health for Montana's children have moved in a positive direction, other indicators show that access to health care is a serious problem, especially for kids in low-income families where both parents work. Health care access problems and low coverage rates of private health insurance reflect the economic hardships among the state's working-poor families.
In our society, access to health care largely depends on private health insurance coverage. More than 41,000 Montana kids under age 18 had no form of health insurance, public or private, in 2000 (Figure 1). Children who are not covered not covered Health care adjective Referring to a procedure, test or other health service to which a policy holder or insurance beneficiary is not entitled under the terms of the policy or payment system–eg, Medicare. Cf Covered. by health insurance frequently do not have a family doctor and do not have access to standard types of care such as checkups and immunizations unless they were available through public health programs. Children without access to regular health care can develop health conditions that are not treated in a doctor's office through a routine visit, but instead escalate es·ca·late
v. es·ca·lat·ed, es·ca·lat·ing, es·ca·lates
To increase, enlarge, or intensify: escalated the hostilities in the Persian Gulf.
v.intr. and result in emergency room visits and hospitalization hospitalization /hos·pi·tal·iza·tion/ (hos?pi-t'l-i-za´shun)
1. the placing of a patient in a hospital for treatment.
2. the term of confinement in a hospital. .
National data show that uninsured kids are very young, with almost one-third of them 5 years of age and under. A high percentage of uninsured children, almost 84 percent, are in a family where at least one parent works full-time; 31 percent have both parents working. Nationally, 24 percent of children in low-income working families do not have health insurance. In Montana, 30 percent of children in low-income working families are without health insurance (Figure 2). National figures show that low-income children 6 to 11 years of age were more than three times as likely to be in fair or poor health than were higher-income children of the same age (6 percent vs. 2 percent).
The Medicaid health care program for low-income families is an important source of health care support for Montana kids. Twenty-two percent of Montana kids under age 18 relied on Medicaid or the Children Health Insurance Program (CHIP) in 2000, compared to 20 percent for the nation. Sixty percent of Montana kids were covered by private insurance plans provided by employers or purchased by individuals, compared to a national figure of 68 percent.
Almost one in every 10 kids in the state is either participating or eligible to participate in the Medicaid or CHIP programs. Potential cuts in state funding for the Children Health Insurance Program may result in the loss of funds from the federal government. These cuts mean reductions in program enrollment, despite the fact that more than 25,000 Montana kids currently are eligible but not enrolled.
Cutbacks in Medicaid, including provider reimbursements, are hampering efforts to recruit more health care providers into the Medicaid program. Increased controls on prescription drugs prescription drug Prescription medication Pharmacology An FDA-approved drug which must, by federal law or regulation, be dispensed only pursuant to a prescription–eg, finished dose form and active ingredients subject to the provisos of the Federal Food, Drug, , cuts or freezes in provider payments, elimination of benefits, and increased cost sharing all work against increased coverage of health care through Medicaid and CHIP Medicaid, as one of the largest items in the state budget, faces increased program demands when the economy is depressed and incomes fall. As in other states, Montana's state tax revenue shortfall Shortfall
The amount by which the capital required to fulfill a financial obligation exceeds available capital.
Shortfall risk is often combated with an efficient hedging strategy created by a fund, group, institution, or individual. has resulted in program cutbacks that reduce health care access and increase the number of kids and families without insurance coverage.
Drug and alcohol use among Montana's youth is a major health problem. According to according to
1. As stated or indicated by; on the authority of: according to historians.
2. In keeping with: according to instructions.
3. the Montana Youth Risk Behavior Survey The Youth Risk Behavior Survey (YRBS) is a biannual survey of adolescent health risk and health protective behaviors such as smoking, drinking, drug use, diet, and physical activity conducted by the Centers for Disease Control and Prevention. , a survey of high school students conducted by the state Office of Public Instruction, Montana youth have the second highest rate of illicit drug illicit drug Street drug, see there use, the fourth highest rate of alcohol use, and the sixth highest rate of tobacco use in the nation. Loss of life, health problems, disruption disruption /dis·rup·tion/ (dis-rup´shun) a morphologic defect resulting from the extrinsic breakdown of, or interference with, a developmental process. of families and communities, violent behavior and crime, and the wasting of young lives are a few of the problems associated with childhood drug and alcohol abuse.
The oral health of Montana kids is another area in need of attention and resources. Montana has a shortage of dental professionals. Ten counties are without dentists Dentists can refer to one of the following:
Payment made to someone for out-of-pocket expenses has incurred. of about 50 percent to 55 percent of usual charges for adults and around 72 percent for kids, there is a strong reliance on volunteer dental providers. Volunteer dentists and hygienists in Great Falls Great Falls, city (1990 pop. 55,097), seat of Cascade co., N central Mont., second largest city in the state, at the confluence of the Missouri and Sun rivers and near the falls that give the city its name; inc. 1888. , Helena, Missoula, Billings, and Butte Butte, city, United States
Butte (byt), city (1990 pop. 33,336), seat of Silver Bow co., SW Mont.; inc. 1879. It is a trade, ranching, and industrial center. are diligently dil·i·gent
Marked by persevering, painstaking effort. See Synonyms at busy.
[Middle English, from Old French, from Latin d tending to low-income patients -- but waiting lists consistently show 500 to 1,300 patients and waits can be more than a year. Access to oral health care is not guaranteed even for the 60 percent of Montanans with private health insurance; only 20 percent of the plans include dental benefits.
One indicator of children's health Children's Health Definition
Children's health encompasses the physical, mental, emotional, and social well-being of children from infancy through adolescence. that has shown improvement is the rate of immunizations. In 2000, the rate for kids 2 years old and younger was 94 percent. This reflects an increase of 5 percentage points over 1998 and demonstrates the hard work by public health agencies at the state and local levels throughout Montana. Montana's immunization immunization: see immunity; vaccination. rate is considerably higher than the national rate of 71 percent.
Another major success story has been the significant increase in screening rates of newborns for hearing impairment hearing impairment
A reduction or defect in the ability to perceive sound. , a health problem that can lead to socialization socialization /so·cial·iza·tion/ (so?shal-i-za´shun) the process by which society integrates the individual and the individual learns to behave in socially acceptable ways.
n. and learning disabilities in early childhood. Increased efforts by state and local health agencies have resulted in a 78.3 percent screening rate for hearing impairment before discharge from Montana's hospitals in 2000. This compares to a 30 percent rate in 1998. The improvements in screening and immunization rates are testimony to the effective program delivery by Montana's public health network in a tight budget environment.
Health and Safety Indicators
Montana's infant and early childhood health indicators have shown strong improvement over the past decade. Infant mortality rates infant mortality rate
The ratio of the number of deaths in the first year of life to the number of live births occurring in the same population during the same period of time. , child death rates, and births to teenagers have all changed in positive directions. However, the state has seen an increasing number of low birth weight babies -- those weighing less than 5.5 pounds at birth. In 2000, 6.2 percent of all live births in Montana were classified as low birth weight, compared with 5.9 percent in 1995.
Accidents, especially motor vehicle crashes, are the single most frequent cause of death for Montana children. Other violent causes, notably suicides and to a less degree homicides, become major specific causes of death for kids as they become older.
Alcohol and motor vehicle crashes are significant causes of injury and death to Montana teenagers. Of the 5,437 vehicle crashes involving teenagers in 2001, about 5 percent, or 271 accidents, involved teenage drivers who had been drinking. There were 17 fatal crashes that involved alcohol and teenage drivers.
The 2001 Montana Youth Risk Behavior Survey of high school students reported that 41 percent of the students surveyed had consumed con·sume
v. con·sumed, con·sum·ing, con·sumes
1. To take in as food; eat or drink up. See Synonyms at eat.
a. five or more alcoholic alcoholic /al·co·hol·ic/ (al?kah-hol´ik)
1. pertaining to or containing alcohol.
2. a person suffering from alcoholism.
1. drinks in a sitting at least once during the past 30 days. Drinking is directly related to traffic fatalities; about 37 percent of all traffic fatalities for all age groups in Montana are alcohol related. Many older Montanans classified as at-risk from acute drinking say they began drinking in high school.
Children in Montana are much more likely to drive when they have been drinking than the national average and are more likely to be in a vehicle driven by someone who has been drinking alcohol.
Along with riskprevention efforts, discussions are ongoing in the 2003 Legislature to modify Montana's drunken drunk·en
1. Delirious with or as if with strong drink; intoxicated.
2. Habitually drunk.
3. Of, involving, or occurring during intoxication: a drunken brawl. driving laws. According to Mothers Against Drunk Driving Mothers Against Drunk Driving (MADD) is a nonprofit organization with more than 600 chapters nationwide. MADD seeks to find effective solutions to the problems of drunk driving and underage drinking, while also supporting those persons whose relatives and friends have been killed by drunk , Montana ranks at the bottom of all states in terms of drinking and driving, alcohol-related fatalities, prevention legislation, and DUI driving under the influence (DUI) n. commonly called "drunk driving," it refers to operating a motor vehicle while one's blood alcohol content is above the legal limit set by statute, which supposedly is the level at which a person cannot drive safely. penalties. The Legislature is considering a variety of measures to enact tougher alcohol-related laws, including reducing the threshold at which drivers are deemed too drunk to drive from the current blood-alcohol limit of 0.1 to 0.08.
Social and Economic Opportunities
Poverty and lack of health care access are obviously affected by the performance of the Montana economy. And the economy did experience a slowdown For articles with similar titles, see Slow Down (disambiguation).
A slowdown is an industrial action in which employees perform their duties but seek to reduce productivity or efficiency in their performance of these duties. in early 2001, mostly because of shutdowns and layoffs at several large industrial facilities. Post-Sept. 11 economic impacts on tourism, travel, and other industries, as well as slower job growth, have contributed to a lack of improvement in the economic indicators Economic indicators
The key statistics of the economy that reveal the direction the economy is heading in; for example, the unemployment rate and the inflation rate. of family well-being into 2002. Montana's slow but steady employment growth, combined with lackluster lack·lus·ter
Lacking brightness, luster, or vitality; dull. See Synonyms at dull.
Adj. 1. lackluster - lacking brilliance or vitality; "a dull lackluster life"; "a lusterless performance" growth in family income and earnings, represent lower wages and lower family incomes for many working parents in Montana.
Montana's consistently low standing in national rankings of job earnings and household incomes have not improved dramatically. Median household income The median household income is commonly used to provide data about geographic areas and divides households into two equal segments with the first half of households earning less than the median household income and the other half earning more. of $32,045 in 2000 represented an annual average growth rate of 2 percent since 1997, hardly enough growth to pull the state up in the national rankings. Per-capita income grew just 2 percent between 1999 and 2000, making Montana workers among the lowest paid in the nation.
Reservation counties have some of the lowest income levels in the state despite strong population growth. Montana had eight counties (Figure 3) in 1998 where 60 percent or more of the population was at or below 200 percent of the federal poverty level, or below $33,060 for a family of two adults and two children. Four of those eight counties were American Indian reservation counties.
The 22 percent poverty rate of Montana kids is one of the highest in the nation. Fifty thousand Montana children live in families and households where annual income is below the U.S. poverty threshold as defined by the federal Office of Management and Budget The Office of Management and Budget (OMB), formerly the Bureau of the Budget, is an agency of the federal government that evaluates, formulates, and coordinates management procedures and program objectives within and among departments and agencies of the Executive Branch. .
Montana has a much higher proportion of children under age 18 in low-income working families, at 21 percent, compared to 15 percent nationally (Figure 4). Many of Montana's low-income working families are eligible for food stamps food stamp
A stamp or coupon, issued by the government to persons with low incomes, that can be redeemed for food at stores.
Noun 1. . Twenty-seven percent of Montana children in low-income working families received food stamps in 1999, compared to a national percentage of 24 percent (Figure 5).
Some of the social and economic challenges faced by Montana's low-income families and children spill over Verb 1. spill over - overflow with a certain feeling; "The children bubbled over with joy"; "My boss was bubbling over with anger"
bubble over, overflow
seethe, boil - be in an agitated emotional state; "The customer was seething with anger"
2. into play and school activities. National studies have shown that school engagement and involvement in a number of extracurricular activities, including sports and school clubs, are higher for kids from high-income families. Low-income working families need the opportunity, connections, and networks that are available to many middle- and upper-income families, and they need support services support services Psychology Non-health care-related ancillary services–eg, transportation, financial aid, support groups, homemaker services, respite services, and other services like job training, health insurance, child care, housing assistance, and saving incentives that will help them become economically independent.
Early care and education for children offer positive opportunities for overcoming the disadvantages of poverty, low earnings, and associated risk factors such as parents' lack of high school education, reliance upon welfare, and lack of health insurance. The policy challenge is to provide quality childcare and early education at a price that parents, especially families from low-income households, can afford. Lack of affordable and adequate child care can be a real dilemma for working-poor families, especially those where both mom (1) (Messaging-Oriented Middleware) See messaging middleware.
(2) (Microsoft Operations Manager) Software that monitors and captures system and application events throughout the network. and dad need to work to bring in an adequate family income, but they also need the availability and affordability of quality child care to make this happen.
There are long-run benefits to quality child care and early education programs, as research has shown that early care, access to health care, and early learning experiences significantly contribute to later positive outcomes--including success in school and eventually in the job market. The availability of such programs is especially important in Montana's rural counties.
Education and Schooling
The education picture for Montana kids has a number of very positive features. The statewide dropout rate is below the national rate. High school graduation rates are high in Montana, and basic test scores on reading and writing show Montana students performing above the national average.
Dropout rates in Montana schools were slightly below the national rate at 4.2 percent in 2000-2001, compared to an estimated national rate of 5 percent. The dropout rate for American Indian students was 10.4 percent, almost 3 times higher than the 3.5 percent rate for white students. About 2,295 students dropped out of Montana schools in 2000-2001. The 2000-01 dropout rate for Montana students in grades 7 and 8 was 0.5 percent; for Montana high schools, the rate was 4.2 percent. White students represent 87.2 percent of the total school enrollment and 70.6 percent of the dropouts, while minorities represent 12.8 percent of the total school enrollment and 29.4 percent of the dropouts. Graduation rates of Montana students were higher for whites--at 94 percent--compared to American Indian students at 84 percent.
There are a number of proactive ways to reduce the dropout rate:
* Strengthen school readiness by increasing family access to early education programs and access to health care including prenatal care prenatal care,
n the health care provided the mother and fetus before childbirth. ;
* Strengthen parent and family understanding and involvement with teens' motivation and ability to stay in school by increasing parent participation in the planning of dropout programs; through staff development for teachers who work with at-risk youth; and through parent education and family support programs to negotiate conflicts or crises that can encourage children to leave school;
* Focus on risk factors and groups at highest risk of dropping out, including students with family incomes at or below the poverty line; those who lack health insurance; students with under-employed parents; and families who lack adequate child care; and
* Make it harder for students to drop out by strengthening school accountability for keeping young people on track; increasing students' understanding of the connection between education and job opportunities; designing dropout prevention programs to the age and profile of the student; strengthening GED GED
1. general equivalency diploma
2. general educational development
GED (US) n abbr (Scol) (= general educational development) → programs and alternative schools.
The challenges of improving health care access and alleviating poverty for Montana kids are interrelated in·ter·re·late
tr. & intr.v. in·ter·re·lat·ed, in·ter·re·lat·ing, in·ter·re·lates
To place in or come into mutual relationship.
in . Kids from low-income families face the greatest limitations on access to health care. They are also at highest risk of losing whatever access they may have, however limited, as cutbacks come to public health programs.
Montana's continued poor performance in national rankings of poverty and health care access is not intractable intractable /in·trac·ta·ble/ (in-trak´tah-b'l) resistant to cure, relief, or control.
1. Difficult to manage or govern; stubborn.
2. . There are private and public actions and policies which, combined with political commitment, can begin to address these problems. Policy actions for reducing the child-poverty rate include more education and job training for low-income parents; strengthening the safety net of income, health, nutrition, early care, and education programs; and increasing take-home earnings through a strengthened federal Earned Income Tax Credit The United States federal Earned Income Tax Credit (EITC) is a refundable tax credit that reduces or eliminates the taxes that low-income married working people pay (such as payroll taxes) and also frequently operates as a wage subsidy for low-income workers. and the creation of jobs with benefits for low-wage workers. The lack of year-round full-time employment and the high proportion of single parent families reflect obstacles to economic security as a component of stable families. Part-time jobs without benefits undermine economic security. Increasing the stability and overall well-being of families depends on effective economic development combined with wise family support policies for low-wage parents making the transition to g reater economic security.
Table 1 Selected Demographic Characteristics for Montana Children, 1990 and 2000 STATE SUMMARY STATISTICS FOR THE POPULATION UNDER AGE 18 1990 2000 Number Percent Number Percent Total population 799,065 902,195 Population under age 18 222,104 100.0% 230,062 100.0% Males under age 18 114,288 51.5% 118,245 51.4% Females under age 18 107,816 48.5% 111,817 48.6% Children under age 5 59,257 26.7% 54,869 23.8% Children ages 5 to 17 162,847 73.3% 175,193 76.2% LIVING ARRANGEMENTS Population under age 18 222,104 100.0% 230,062 100.0% Children living in 219,987 99.0% 228,432 99.3% households Children living in 2,117 1.0% 1,630 0.7% group quarters Own children living in 39,430 17.8% 49,140 21.4% single-parent households Own children living in 168,497 75.9% 162,502 70.6% married-couple households Grandparents living with N/A N/A 11,098 own grandchildren Grandparents responsible N/A N/A 6,053 for own grandchildren PARENTAL EMPLOYMENT Own children underage 18 214,074 100.0% 218,232 100.0% All parents in labor force 141,760 66.2% 156,213 71.6% No parents in labor force 16,653 7.8% 13,871 6.4% Own children under age 6 69,712 100.0% 63,486 100.0% All parents in labor force 40,740 58.4% 41,216 64.9% No parents in labor force 6,911 9.9% 4,770 7.5% Source: U.S. Census Bureau, U.S. Department of Commerce, 2000. Figure 1 Kids Under 18 without Private or Public Health Insurance Montana 18% U.S. 12% Sources: U.S. Department of Health and Human Services and Montana Department of Public Health and Human Services. Note: Table made from bar graph Figure 2 Children Living in Low-Income Working Families without Health Insurance, 1999 Montana 30% U.S. 24% Source: KIDS COUNT Data Book, Annie E. Casey Foundation, 2002. Note: Table made from bar graph Figure 4 Percent of Montana Children under Age 18 in Low-Income Working Families, 1999 Montana 21% United States 15% Source: KIDS COUNT Data Book, Annie E. Casey Foundation, 2002. Note: Table made from bar graph Figure 5 Montana Children in Low-income Working Families Receiving Food Stamps, 1999 Montana 27% United States 24% Source: KIDS COUNT Data Book, Annie E. Casey Foundation, 2002. Note: Table made from bar graph
The KIDS COUNT in Montana 2002 Data Book is available online at www.bber.umt.edu/KidsCountMT.
Steve Seninger is the Bureau's director of economic analysis and Barbara Wainwright Wainwright, town (1991 pop. 4,732), E Alta., Canada, SE of Edmonton and near the Sask. border. It is a trade center and railroad division point for an oil and natural gas area. It has oil refineries, grain elevators, and flour mills. Nearby is a military base. is the Bureau's marketing director.