The key to a healthy child starts in the first months after conception, before even leaving the womb.
In the first trimester of pregnancy, babies are most susceptible to substances, such as alcohol, drugs and certain medicines, as well as certain illnesses. Women who receive prenatal care are less likely to delivery prematurely, or have a baby with low birth weight.
Johnson County health officials have made prenatal care a focus in recent years, and their efforts have paid off.
Prenatal care is just one area where Johnson County has improved, according to a new report on child well-being. The Indiana Youth Institute has released its annual report on child health. The data shows that while Johnson County is improving in areas, such as the percentage of children living in poverty and families receiving federal assistance, thousands of kids are still struggling.
“We all know kids. We have these personal perspectives on how kids in our area are doing. But the perceptions don’t reflect the realities of the challenges facing Hoosier kids,” said Tami Silverman, president and CEO of the Indiana Youth Institute. “The reason we put this data together is so that we have a real assessment on how all kids are doing, from the county up to the state level.”
The Kids Count report is compiled annually from hundreds of national and statewide sources. Each state has a different group that puts it together, and here that falls to the Indiana Youth Institute. The organization promotes health development of children and youth in Indiana, working with dozens of institutions and in communities throughout the state.
For the institute, the Kids Count data presents an evidence-based picture of how all children are living.
“If you don’t see kids who are hungry or kids who are struggling with suicide, if you haven’t heard one of those stories, you may understand that it happens but it doesn’t happen to the kids in your neighborhood,” Silverman said. “As we’re starting these conversations on what we can do to address some of these issues, it needs to start from a place of true evidence and information.”
The data looked at economic well-being, health, early childhood issues, such as availability of health care, and child safety. Statewide, the data showed that child abuse and neglect rates have increased every year since 2011, one in five Indiana kids live in poverty and that nearly 20 percent of high school students have seriously considered suicide.
“There were some highlights in several different areas, in terms of bullying and teen pregnancy rates. But at the same time, there are some really big challenges that we’re facing,” Silverman said.
Similarly, the results in Johnson County show communities making improvements in important areas while still struggling, Silverman said.
Child poverty is down, as is the number of families in need of food stamps or temporary financial assistance. Median household income has crept up to a four-year high, of $62,147.
One major success has been women and prenatal care. Locally, 77 percent of all expectant mothers received care in the first trimester. In 2012, only 68 percent of women had received it.
For the past four years, local health officials have put an emphasis on educating mothers-to-be about the importance of prenatal care.
Partnership for a Healthier Johnson County has formed an action team dedicated specifically to maternal and child health. The team helps organize Great Expectations, a quarterly free childbirth education programs to learn about breastfeeding, nutrition, warning signs of complications and other issues.
Another session helps women prepare for labor and delivery, and how to keep yourself and your baby healthy following birth.
In the same vein, the Kids Count data showed that Johnson County has made strides in helping women quit smoking during pregnancy. Smoking during pregnancy has been shown to increase the chances of miscarriage, premature birth, low birth weight, infant death and other birth defects.
Smoking cessation help for pregnant women has been a focal point for Partnership for a Healthier Johnson County. At community events, they offer people free information on how they can quit smoking, and what nicotine and other harmful chemicals in cigarette smoke can do to a developing baby, said Nancy Voris, tobacco coordinator for Partnership for a Healthier Johnson County.
“Our message, totally, is that a developing baby should not be exposed to any nicotine, whatsoever,” she said.
The message appears to be working. Johnson County reported 13.7 percent of mothers-to-be smoked during their pregnancy in 2015. Though still higher than health officials would prefer, that figure was 17.2 percent of mothers in 2012 and has been dropping for several years.
But the fact that there are still so many women smoking while pregnant is a problem that needs to be remedied, Voris said.
“If you look around at the ‘doughnut’ counties like Hamilton, their percentage is around 2 percent. That’s our goal — we want to get down to single digits, and just keep going down from there,” she said.
Officials can look to other areas outlined in the report to find additional needs, as well.
The county had an increased number of low birthweight babies in 2015. The report stated that 147 babies born in 2015 — 7.8 percent of all births — had abnormally low birthweights. Children with low birthweight are more likely to have respiratory issues, bleeding in the brain and problems with their intestines.
The Kids Count data revealed needs in other areas as well, such as the availability of child care.
In 2016, the county had 51 licensed child care options, including child care centers, homes and ministries. For every 100 kids ages 0 to 5 living in the county, only 21.5 slots were available, putting a strain on parents who work.
The report also showed Johnson County seeing an uptick in the number of children in need of help from the state department of child services. in 2015, 154 children were in need of services, up from 120 children the year before.
The department of child services substantiated 283 cases of neglect, sexual or physical abuse in 2015, the most since 300 such cases were found in 2012.
With the release of the data for this year, the Indiana Youth Institute hopes that local officials and leaders can use it to help approach the issues that are impacting Johnson County, Silverman said.
“We’ve seen some improvements, but we need to be clear-eyed that there is work to be done,” she said.