Heartbreaking realities and policy solutions

The North Carolina Child Fatality Task Force deals with the heartbreaking realities of child deaths to spare North Carolina families from ever having to experience the agony of losing of a child.

Some of those realities the Task Force has dealt with this past year include the following:

• Firearm deaths for children skyrocketed in 2020 and 2021, with a firearm-related mortality rate in 2021 that was a 231% increase from the rate in 2012, and 1.5 times higher than the national average. A 2021 CDC survey showed 30% of North Carolina high school students reporting that it would take them less than an hour to get and be ready to fire a loaded gun without a parent or other adult’s permission.
• Youth suicide rates in 2021 were the highest of two decades, with guns used as the lethal means in most of those suicides. A CDC survey showed that 22% of North Carolina high school students had seriously considered attempting suicide and 43% of high school students said they felt sad or hopeless.
• Infant mortality rates remain unchanged but stubbornly high, putting North Carolina among a group of states with the highest rates. In 2021, 820 infants in our state died before reaching their first birthday, with leading causes of infant death related to prematurity and low birthweight, perinatal conditions, birth defects, and maternal complications. Areas of the state where rates are highest are areas with higher social determinant risk factors like poverty or unemployment.

In February, the Task Force submitted its 2023 Annual Report to the governor and General Assembly containing legislative recommendations to prevent child deaths and support child well-being.  

There truly are things we can do to prevent many child deaths. The Task Force has recommended a number of ways that laws and state funding can save lives. Here are a few:

• Recurring state funding to increase the numbers of school nurses, social workers, counselors, and psychologists. These professionals have a critical role in identifying and supporting children who may be struggling or are in crisis. Not only can they connect with kids one-on-one for counseling, but they can connect families to community resources to address various needs. The numbers of these professionals in North Carolina schools is far below nationally recommended ratios. For example, right now we have only a quarter of the recommended number of school social workers. [Find more information on this fact sheet.]
• Legislation to launch and fund a statewide firearm safe storage education and awareness initiative. In the ten years between 2012 and 2021, over 600 North Carolina children died from firearm injuries. Data is clear that many North Carolina gun owners do not store their guns safely and that safe storage practices saves lives. The initiative recommended by the Task Force would follow and build on a one-year safe storage media campaign being launched by the Department of Public Safety. It would involve the provision of outreach and technical assistance to help communities launch locally tailored initiatives using trusted community messengers to help gun owners understand and act on the importance of safely storing a firearm. [Find more information on this fact sheet.]
• Legislation to strengthen and restructure the statewide child fatality prevention system. The Task Force is part of a broader statewide child fatality prevention system that includes local child death review teams in every county plus state review teams. The system’s goal is to better understand the circumstances surrounding child deaths to identify and implement strategies to prevent future child deaths. But our current system is unusually large and complex. It has challenges related to duplication of efforts and also gaps in data collection, analysis, and reporting. It also lacks centralized coordination and support. Our state is one of only two who have not participated in a national data system that would enable us to have a much better understanding of child deaths to help inform policy and prevention efforts at the state and local level. [More information on this fact sheet.]
• State funding for strategies aimed at reducing infant mortality. The Task Force is recommending funding directed to NC Medicaid for doula services and incentivizing group prenatal care—two healthcare strategies known to produce better birth outcomes. The Task Force also recommends funding to increase NC Medicaid’s reimbursement rate for obstetrical care providers, currently reimbursed at a rate well below the national average. The goal is to increase the number of providers who will take Medicaid patients at a time when many more are needed, especially in rural areas. In a typical year, more than 100 babies die in an unsafe sleep environment in our state, and the Task Force is also recommending an increase in funding for programming to prevent such deaths. [More information on funding for safe sleep on this fact sheet.]

There is reason for hope. Right now there are several bills in motion in the 2023 legislative session that address Task Force recommendations, and we are anxiously waiting to see whether the 2023 Appropriations Act will include Task Force funding priorities.

The unique composition of the Task Force, which was created by state statute and includes experts in child health and safety, state agency leaders, and ten state legislators, has proven to be effective in advancing legislation to save kids’ lives for more than three decades.

Let’s hope that we’ll look back on 2023 as a year when we saw North Carolina leaders enact laws and funding recommended by the Task Force. We must do all we can to spare North Carolina families the heartbreak of losing a child.