The Foundation for a Healthy Community is Healthy Children

By Dianne Cooney Miner, PhD, RN, FAAN, Dean, Wegmans School of Nursing, St. John Fisher College; Bob Thompson, MS, Vice President of Community Health Engagement, Excellus BlueCross BlueShield; Fran Weisberg, Community Fellow, Center for Community Engagement, St. John Fisher College; and Thomas McInerny, MD, FAAP, immediate past president of the American Academy of Pediatrics (AAP) and Professor Emeritus in the Department of Pediatrics at the University of Rochester Medical Center and Golisano Children’s Hospital.

The Children’s Agenda is celebrating its 10th anniversary with 10 blog posts from community leaders committed to making the next 10+ years a decade of dramatic change and achievement for kids. Click here to learn more. This month’s installment focuses on the importance of supporting solutions for children’s health, because their well-being impacts the well-being of our entire community and our collective future.

We are individuals from different positions in health care with a common perspective on what needs to change for the betterment of our community. From these different positions—in community health planning, health insurance, nursing education, and primary care—we have led and continue to lead local, regional, state, and national organizations.

Our experiences and expertise fuel a collective belief that advocacy for children may be the most critical factor to ensure the health of our community.

In fact, we each work with The Children’s Agenda in different capacities—on their board, in community initiatives, in partnership with them and other leading Rochester institutions—because of this belief. Advocacy and systemic change focused on children is what we need to make our Greater Rochester community healthier.

Here’s why:

  • Children’s health is the foundation of adult health, and thereby our community’s health.
  • Children’s health is poor in Rochester when compared with other similar communities.
  • Children’s health is especially influenced by determinants beyond medical care. In other words, environment and culture influence health more so than medicine or even genetics.
  • We know how to help and change many of these determinants, but as a community we need to make the choice to do that.

Reflecting back on the most important lessons of his career in an interview in Health Affairs in 2004, former Surgeon General, Dr. C. Everett Koop, stated: “In the long run, child health is about advocacy.” The American Academy of Pediatrics acknowledged in a policy statement in 2013, “Increasingly the major threats to the healthy development of America’s children stem from problems that cannot be adequately addressed by the practice model alone.”

We support and work with The Children’s Agenda because they advocate for what is needed most and works best to improve children’s health. In our community, we do not lack innovative and effective solutions. We lack the collective will to prioritize those solutions for all kids.

We have much more to do to help children and families be healthy in our nation.

“Millennial Morbidities” are the most important current diseases and causes of harm to children in the United States and in our community. They include: mental health problems, violence, child abuse, and socioeconomic disparities—including child poverty, obesity, teen pregnancy, and injury.

  • About 20 percent of our children suffer from diagnosable mental illness each year.
  • Nearly six million children are reported to be abused or neglected each year; five children die each day in the U.S. from child abuse.
  • Over one in three children and youth are overweight or obese.
  • Homicide is the leading cause of death for urban youth.

In Monroe County, our child health data are about on par with the U.S. data above. In the city of Rochester, though, our child health data are worse than Monroe County or the nation as a whole.

Beyond these palpable concerns for the health of our children, there is abundant evidence that adult health is significantly tied to childhood health. We know, for example, that an adolescent who is overweight or obese is more likely to be overweight or obese as an adult. As a further illustration, most behavior and mental health problems have their origins in childhood. Child abuse and neglect have ramifications not just during childhood, but for a lifetime.

The issues we see for children are just “the tip of the iceberg” for adult health issues, which we don’t yet see and that will cause suffering, real expenses, and decreased productivity.

It is becoming increasingly clear that economic, social, and educational policies are, in fact, all health policy for children. High school graduation, an outcome traditionally thought to be an educational issue, has exceptionally important health impacts: Youth who drop out of high school have shorter life expectancies, less access to medical care, and poorer adult health status. Education is a crucial path to health. Evidence suggests that children who have high-quality early education experiences reduce their risk for adult cardiovascular risk conditions like hypertension and the metabolic syndrome—a constellation of symptoms that include high blood sugar and excess abdominal fat.

Conversely, childhood experiences like violence in the home, mental illness in a parent, emotional neglect, and parental separation or divorce (known as “adverse childhood experiences” or ACES) lead to toxic stress, which has a devastating link to infant mortality and increases the risk for a whole spectrum of adult health problems. These include heart disease, liver disease, depression, smoking, and unintended and teen pregnancies, in a strong and graded fashion. Overlay poverty and kids’ health trajectory further deteriorates.

In fact, toxic stress and its link to premature births and subsequent infant mortality was featured in a recent episode of the new documentary series from PBS, America By the Numbers. You can learn more about this kind of stress, which impacts many Rochester mothers and is passed down to their children, by watching WXXI’s Need To Know with Dr. Jeff Kaczorowski, joined by America By the Numbers’ host Maria Hinojosa shortly before the airing of the episode.

So what can we do? As our own Frederick Douglass once said, “It is better to build strong children than to repair broken men.” Now is our time. Our children are only children for a short while. A three-year-old is only three for one year.

The Children’s Agenda advocates for programs and policies that offer every child a fair chance to live a healthy life.

Here are some right-now solutions we can all champion through support of The Children’s Agenda:

  • Expand access to evidence-based home visitation and effective parenting programs for young families.
  • Make high-quality early childhood education experiences, like three- and four-year-old pre-K, available for all kids.
  • Increase child care subsidy funding to lift children and families out of poverty and increase affordability of high-quality child care for working parents.
  • Enact and really implement school policies and approaches that help children to be healthy and promote positive behaviors, especially for children who have experienced trauma and violence in their homes and neighborhoods.

We have joined with The Children’s Agenda and its leadership to improve the health of our children and our community. There are answers to the health problems facing our community and our children. They are needed now—your advocacy and help can get us there.

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This Tuesday, Vote for Kids

By Larry Marx, Executive Director, The Children’s Agenda

A new national public opinion poll released last week by the Children’s Leadership Council finds strong support for increasing funding for effective programs that improve the lives of children and youth across the age spectrum, from birth to adulthood.

An overwhelming 79 percent of Americans favor investing more in programs that support children’s education, healthcare, nutrition and well-being. A solid majority of Republicans (59 percent) join with overwhelming majorities of independents (82 percent) and Democrats (93 percent) in calling on Congress to make children’s programs and services a higher budget priority.

The Children’s Agenda, a nonpartisan advocacy organization, has asked our candidates for the state legislature and Governor where they stand on critically important children’s issues.  View their responses to The Children’s Agenda’s nonpartisan candidate questionnaire here to learn about their plans for Nurse-Family Partnership, quality after school programs, child care subsidies for working families, changes to the juvenile justice system, and other important issues.

Elections matter.  The actions taken by the leaders we vote into office this Tuesday, November 4th – or their inaction – broadly affect the outcomes in children’s health, education and overall success in life.

The Children’s Leadership Council — a coalition of more than 50 of the nation’s leading child and youth advocacy organizations, commissioned Hart Research Associates to conduct the poll, which used telephone interviews with a nationally representative sample of over 800 Americans age 18 and older. The margin of error is plus or minus 3.5 percent.

The Children’s Agenda is heartened by these findings. It is our strong belief—backed by decades of evidence—that cutting services and supports to our nation’s children is not only unjust, it is short-sighted. The well-being of our youth today impacts the health of our nation now and in the decades to come.

Our community must be one in which the place where a child starts out does not dictate where she ends up. A child who has grown up in poverty can make it out of poverty, and an abused child can heal from the abuse. Most importantly, poverty and abuse can be prevented, too, not just remediated – but children can’t do either on their own. Nor should they be expected to. This is why elected officials have an obligation to support, protect and defend programs that invest in and assist children, youth and their families. Americans everywhere, including greater Rochester, are asking for no less.

Among the results of the nationwide poll:

  • By a strong margin, Americans say that investing more in children’s health, education and well-being should be a higher priority today than reducing taxes.
  • As we near national mid-term Congressional elections, 52 percent of poll respondents who are registered voters said they would be more likely to support a candidate who favored increasing funding for programs and services to address children’s needs, with only 10 percent saying they would be less likely to favor such a candidate.

Invest in Kids & Youth: Would you favor or oppose Congress increasing federal funding for programs and services and services to address children's needs in areas such as early childhood education, healthcare, nutrition, and children's well-being?  61% Strongly favor, 18% favor, 6% oppose, 10% strongly oppose.

When it comes to supporting vulnerable populations, Americans do not see it as an “either or” proposition: 63 percent say that the aging of the baby boom generation means we need to invest more in children today, not cut programs for kids, because “the best way to provide a secure retirement [for seniors] is to ensure that we have productive workers contributing to the economy in the future.”

These findings come as our nation continues to experience a slow recovery marked by stagnant wages, rising costs, inadequate public programs and growing economic inequality. Children and young people shoulder much of the burden: nearly one in five children and young adults in our country live in poverty. In Monroe County, it’s worse – one out of every four children – and it’s every other child in the City of Rochester who live in poverty today. That’s unacceptable.

The good news: smart investments work. New Census Bureau data show that federal anti- poverty programs like the Supplemental Nutritional Assistance Program (SNAP), the Earned Income Tax Credit and the Child Tax Credit lifted millions of children out of poverty last year. The new poll results indicate that the majority of Americans also believe these supports are essential in helping families navigate today’s economy.

In the months ahead, the New York State legislature will debate the worthiness of further investments across the cradle-to-career continuum, including evidence-based home visitation programs like the Nurse-Family Partnership Program, child care subsidies for low-income working families, high quality afterschool programs for school age youth, and jobs for youth. These are all part of the solution to the questions that will dominate public discussion in our community, state and nation over the new few years: poverty, inequality, and economic and social mobility.

The Children’s Agenda believes that we must do more than just talk or theorize about these critical issues. We must act. We know what works. To make a difference in children’s lives, we need to sufficiently commit to what works at every level – government, business, and nonprofits – to what works. Improving children’s health, education and well-being is not just the right thing to do—it is one of the smartest investments we can make for our nation’s future.

So on Tuesday, November 4th, Vote for Kids. The Children’s Agenda joins the Children’s Leadership Council and American voters in expecting our leaders to make smart, effective investments across the age spectrum from birth to young adulthood, and across the issue spectrum—from children’s health and nutrition to early care and education, violence prevention, supports to youth transitioning out of foster care and juvenile justice, and economic security programs for vulnerable children and families. Check out how the candidates on your ballot this Tuesday plan to act on the most critical issues affecting our children and youth.

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Improving Our City By Making Kids a Business Priority

By Sandy Parker, President & CEO of the Rochester Business Alliance, and Jim Brush, CEO of Sentry Safe

The Children’s Agenda is celebrating its 10th anniversary with 10 blog posts from community leaders committed to making the next 10+ years a decade of dramatic change and achievement for kids. Click here to learn more. This month’s installment is about the business imperative for accelerating progress on children’s issues.

Imagine our community becomes known throughout the country over the next 10 years for the best workforce, customers, resource management, and quality of life:

  • Our workforce: Enviable levels of productivity, with absenteeism, turnover, recruitment, and HR expenses among the lowest in the country. A future workforce in the pipeline that’s developing the right skills to match next-wave 21st century jobs.
  • Our customers: Prosperous, with growing levels of income and the wealth to save, spend, and invest.
  • Our resource management: Cost-effective systems that waste little, and returns on investment from the most proactive uses of scarce dollars.
  • Our quality of life: Great schools for all, little crime, and the vibrant arts, culture, and great outdoors we’re already known for, driving business decisions to locate locally.

All of this is achievable. But it requires focus—including transformational change in the local climate for children, youth, and families.

In Monroe County over the last decade, progress in many areas regarding children’s physical, mental, and social well-being—which has a direct and sometimes immediate impact on our workforce, customers, resource management, and quality of life—has been frustrating. That’s not because we don’t have good programs here. And it’s not because it’s a mystery which solutions have outcomes proven to work best for children and youth.

We believe our lack of progress stems from “rowing in different directions”—working in isolation without an integrated plan to do the right things at the scale they’re needed. Our community needs to move away from the fragmented approach we have on so many issues to realize efficiencies that a more focused approach can yield to help fund our efforts. We’re committed to make that change happen:

We support ROC the Future. This umbrella community coalition works to improve “cradle-to-career” outcomes for Rochester City School District students. It’s based on a successful model for rowing in the same direction (StriveTogether) which over the years has produced tangible improvements in K-12 academic outcomes in places like Cincinnati and Seattle. Staffed locally in part by The Children’s Agenda, Center for Governmental Research, Children’s Institute and others, ROC the Future brings together the County, City, and School District with businesses, higher education, funders, service providers and others for greater coordination and alignment of existing priorities, goals, measures, and programs. Long-term, sustainable progress is elusive without such strategic collaboration—and without business support in this collaboration, we’ll continue our current unacceptable grades in reading and math, high school graduation rates, and readiness for college or career.

We focus support on programs that help move the needle on both the business climate and children’s health, education, and success. Well-established evidence shows that high-quality child care opportunities for low-income working families lead to:

  • Additional sales for every $1 invested (America’s Edge);
  • New jobs (the early child care sector employs 7,500 people now in Monroe County);
  • Reduced absenteeism of 20-30% and turnover reductions between 37-60 (Cornell study);
  • Decreased disciplinary actions on the job by 17.8% (Cornell study);

as well as improved academic readiness for children, better health, and long-term success. That’s why the RBA Community Coalition successfully championed increased state funding for this program as one of our top five priorities for local jobs and economic development earlier this year. But even with 200 more kids from low income working families likely to receive child care, The Children’s Agenda estimates that at least another 8,200 local children still can’t access the subsidies they need. Public policies that force a trade-off between jobs and families, between sacrificing what’s best for your employer or what’s best for your children, are policies that fail both the local business and children’s climate.

Another example is the Nurse-Family Partnership program (NFP). This year marks a milestone in this critical program, pairing low-income, first-time moms and their families with specially-trained nurses visiting in their homes from pregnancy until child age two. NFP has helped more than 1,000 families (1,085) since Monroe County establish the program here with United Way and the support of the Brush family 8 years ago. What difference has that made? According to the best evidence:

  • Three fewer infant deaths;
  • 52 fewer second births to young mothers and 69 fewer preterm births;
  • 216 fewer person-years of youth substance abuse;
  • 311 fewer youth arrests;
  • 506 fewer child maltreatment incidents; and
  • 599 fewer violent crimes.

That’s moving the needle. But NFP—along with other evidence-based home visitation programs like Building Healthy Children and Parents as Teachers—aren’t funded locally to fully meet the need. Our focused advocacy can change that.

We invite the business community to join us in support of The Children’s Agenda.Business leaders support many programs, partner with many schools, and give to many organizations. But we treat these projects in isolation from each other rather than as parts of an integrated whole, and we see these efforts as charitable activities secondary to our primary goal of advancing our businesses. To combat this disjointed approach, we invite the business community to focus and join us in advocating for what children need most and what works best—across the entire cradle-to-career continuum. We have to move away from short-term, reactive thinking and spending, and create business plans for the best use of the next available dollar, both public and private.

Our business climate depends in part on the local kids’ climate. Business leaders can support these programs together with The Children’s Agenda’s advocacy, or ROC the Future. But we need a business-like approach focused on climate change for kids, rowing in the same direction, with all hands on deck.

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Practicing Our Faith by Pursuing Systemic Change for Children

By Sr. Beth LeValley, SSJ (Greater Rochester Community of Churches/Faith in Action Network), Rev. Dr. Marvin McMickle (President, Colgate Rochester Crozer Divinity School), and Dr. Muhammad Shafiq (Executive Director, Hickey Center for Interfaith Studies and Dialogue at Nazareth College).

The Children’s Agenda is celebrating its 10th anniversary with 10 blog posts from community leaders committed to making the next 10+ years a decade of dramatic change and achievement for kids. Click here to learn more. This month’s installment is about the call for every person of faith to take action to improve our children’s health and well-being.

In each of our holy books, followers are instructed to care for others, especially the vulnerable. Who is most vulnerable if not our children?

Faith leaders delivering signed letters to New York State and Monroe County officials

Faith leaders delivering signed letters to New York State and Monroe County officials

The three of us come from different traditions, but we stand united in our common concern for the children of Monroe County. Week after week in our places of worship, we see so much promise and hope in their beautiful faces. Yet we also see stress and other effects of poverty, inadequate education, structural racism, and poor health care that impact the whole family.

Moved by compassion, we offer families emotional and spiritual support as well as material aid in the form of food, clothing, and other essentials. But our job is not done unless we also speak publicly about these pervasive struggles, and seek changes to public policy and funding that will enable these precious children to live with dignity.

We are all involved in The Children’s Agenda’s Interfaith Collaborative because we are compelled to practice our faith not just in our mosques, temples, and churches, but also by taking our commitment to justice and compassion to the public sphere, to legislative chambers, budget hearings, and other public forums.

Building on Greater Rochester’s rich history of interfaith dialogue and cooperation, this is a group that adds action-oriented collaboration. The passion and moral strength of faith community members, combined with The Children’s Agenda’s policy expertise and focus on evidence-based solutions, creates a formidable force.

The Children’s Agenda has an “all-hands-on-deck” attitude toward organizing champions to advocate for the programs and services that work for our young people. Local faith leaders have spoken out on behalf of vulnerable children for many years. Now, with the support of The Children’s Agenda’s Interfaith Collaborative, we are more effective as we coordinate efforts and speak with a unified voice.

The Children’s Agenda, which is celebrating its 10th “birthday” in 2014, offers a concrete way for faith communities to express their support for children through the annual Children’s Interfaith Weekend, planned this year for October 17-19, or an alternative October weekend. Last year, 93 congregations—Christian, Muslim, Jewish, Hindu, and Buddhist—held their own worship services to pray for children, learn how local children are faring, and identify actions to take.

For many congregants, the action involved signing a letter requesting increased County funding for child care subsidies for low-income, working families. Recent media stories remind us what can happen when child care is unreliable and parents are forced to choose between holding down a job and caring for their children. Child care subsidies, which supplement parent co-payments, enable families to choose high-quality care settings that prepare children for school and allow parents to be more reliable and productive employees. Investments in young children benefit not just that individual child and his/her parents, but our whole community by helping prevent problems like school failure, juvenile crime, and teen pregnancy. Children who receive high-quality child care early in life are much more likely to graduate from high school and college.

Despite ample research demonstrating the value of early care, the number of child care subsidies available locally has been cut in half, from 13,950 in 2001 to 6,747 in 2013.

During the 2014 Children’s Interfaith Weekend, many congregations will sign advocacy letters directed to New York State officials requesting increased state funding for child care assistance.

We invite you to join us, in both prayer and action. If you are a leader or a member of a faith community, contact The Children’s Agenda to get started.

We encourage faith communities to register for the Children’s Interfaith Weekend and add their voice to others as we pursue proven changes that will improve the health and well-being of local children and youth.

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Local Leaders: What Will the Next Decade Bring for Children?

What impact do kids have on the business environment? How can people of faith make a difference outside of their churches, mosques, and temples? With all of the policies and programs active in our community to help children thrive, why aren’t we making more progress? And what can we do today that will make our society—and our children’s lives—better in 2024?

In celebration of our tenth anniversary, The Children’s Agenda is harnessing the thinking of leaders in our community to answer these questions and more. Our ultimate goal? To make progress in how people—like you—can join us in removing the most pressing systemic barriers to help improve the lives of children and youth in our community. We want to make the next 10+ years a decade of change—so all our children bloom in mind, body, and spirit.  

We started this idea in June with our post from guest authors Rod Cox-Cooper and Jackie Campbell of the Black Male Achievement Coalition. They addressed the problems we face with race and disparity on both a local and national level, and called for our whole community to collaborate and “push forward without apology.”

Over the next ten months, you’ll hear from leaders of diverse sectors in our community—like health care, business, faith, education, and others. They’ll share their experiences and insights around improving the success of our county’s youth—and what you can do to help.

Check back soon for the next post from a leader driving change for kids.

Interested in joining the conversation? Write to us in the comment field below. You can also connect with us on Facebook and Twitter.

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Mayor Warren, Proposed City Budget Recommendations Support Children & Youth

Recently highlighted in a Democrat & Chronicle op-ed piece, Mayor’s Warren’s first proposed budget prioritizes children and takes some promising steps to improve programs and services that serve Rochester’s youth. You can read our review of the proposed budget to gain more insight, but in the meantime, we ask you to:

Thank Mayor Warren for:

  • a re-organization of the Dept. of Recreation and Youth Services (DRYS) that adds 6 full-time staff and expands youth employment and recreational activities;
  • joint ventures between the Public Library, DRYS and the Rochester City School District to promote literacy, plus 6 magnet camps to stem summer reading loss;
  • a $125,000 investment in external evaluations of the Recreation Bureau and Pathways to Peace, a violence-prevention program; and
  • collaboration and alignment with other child-focused initiatives such as ROC the Future and efforts to prioritize young children and their families.

The Children’s Agenda applauds these initiatives and recommends additional next steps.  Write to Mayor Warren and City Council members now to urge them to take the following action for Rochester’s children:

  1. Adopt “Child Impact Statements” beginning in 2015 to assess the impact (positive, negative, or neutral) of City spending and policies on Rochester’s children;
  2. Develop new or revised Key Performance Indicators so that progress toward goals can be measured and reported to the community; and
  3. Further align City resources to leverage the collective impact needed to improve our children’s chances of success in school and life.

The proposed budget makes specific changes that were suggested by The Children’s Agenda in previous years based on our analysis of the City budget.  We are pleased to be a resource to the Mayor and City leaders, and we look forward to continuing to work together to make Rochester a place where all children thrive and succeed.

Let City leaders know that their budget decisions are important to our future.  Thank you!

 

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Combating Racism Requires a Community Response

by Rod Cox-Cooper, Member of the Black Male Achievement Coalition &
Jackie Campbell, Member of the Black Male Achievement Coalition

As the Rochester community continues its quest to combat racism, one must consider the question, “What does a world without disparity, inequity and inequality look like?” In a society where the economic structure was built on free or reduced labor, many would argue, one group always stands to benefit as a result of the control and exploitation of another. Thus, does it benefit America to reduce or prevent systemic problems such as racism and the associated challenges? Is there enough public and political will? These are rhetorical yet real questions.

With ever-increasing disparities and a widening gap between the haves and have-nots, the need for social, political, educational and economic revitalization has never been greater. On both national and local fronts, much needed attention is directed to this “revitalization” as evidenced by the White House’s initiative, My Brother’s Keeper—an effort designed to strengthen support for under-performing black boys. Local efforts like the YWCA’s Stand Against Racism, Facing Race=Embracing Equity, the D&C’s Unite Rochester, and the Black Male Achievement Coalition are all community-level initiatives intended to drive the conversations to raise awareness and positively change outcomes. These programs are bold, positive steps for this community.

However, the problems we have with race and disparity require much more than conversation. Unless the systemic devices and cultural beliefs used to promote racism and disparities are disrupted, attempts to address these evils will further cripple people by creating an increased sense of hopelessness and helplessness. To achieve this needed disruption, a common agenda and alignment of programs and support are essential to the success of any effort used to create systemic change. Equally important is understanding the value of data and evidence to drive decision-making.

The Rochester community has adopted the collective impact framework to address systemic issues such as health and education. Much of this work is being led by The Children’s Agenda. However, broad representation and involvement are fundamental to the success of this effort. The Rochester community must do a better job engaging all the necessary voices, to include parents, neighborhood leaders, clergy and appropriate representation by persons of color. There’s much work to do. We won’t see necessary change in the short-term fix or strategy; this is a long-term effort. The challenges we experience today are the result of intentional, deliberate practices that may have yielded unintended consequences. Regardless of the source, we must overcome them.

Needless to say, in our work we must be specific, deliberate, intentional and informed. We also must be welcoming, inviting and respectful, and value the voices of those who are often closed out the process of engagement and participation. Contrary to popular belief, there’s not a “limited pool of contributors” (that is, persons of diverse backgrounds and experiences); rather, there’s a limited pool of people who have the wherewithal to drive real change. The goal is to identify the right people, not always the best known people.

If we wish to see the kind of change many in this community have been seeking for so long, we must continue to push forward without apology.

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