Post Author
Emily Blevins
Communications Director
RALEIGH— NC Child and the North Carolina Institute of Medicine released their 2025 NC Child Health Report Card, which reviews and grades 14 key indicators of children’s health.
Since 1997, NC Child and NCIOM have released a biannual report card to provide legislators, public health officials, non-profit leaders, school administrators, and parents with the latest information on child health and well-being. Each edition of the Child Health Report Card also includes a special section that further details the different challenges and opportunities around a key issue area.
The 2023 NC Child Health Report Card had a special focus on youth mental health; the 2025 Report Card continues this focus, however with a particular emphasis on school-based mental health. NCIOM President and CEO Michelle Ries says that the decision to continue that focus in was driven by worsening trends and the need for greater support services. “We know that schools play a vital role in the lives of children,” said Ries. “Schools are where children learn and where they build connections. What happens in school matters for their development and for their health.”
The special section on school-based mental health covers four key areas: access to student mental health support staff, mental health referral services, the connection between physical activity and mental health, and social media and mental health.
“Today’s youth are dealing with rising rates of anxiety, depression, and suicidal ideation—and what happens at school can contribute to those issues through peer pressure and bullying,” said NC Child Executive Director Erica Palmer Smith. However, what happens at school can also help alleviate the challenges young people face. We need to look at the factors contributing to the youth mental health crisis and how to best address them.”
In 2024, there were 1,928 students for each school psychologist in North Carolina, nearly four times the 500:1 ratio recommended by the National Association of School Psychologists. Ries says that the data speaks for itself.
“School psychologists, counselors, and social workers provide vital support for students with developmental, learning-based, and social-emotional needs,” said Ries. “They are often on the frontlines when it comes to prevention, intervention, supporting students in the foster care or juvenile justice system, or helping children who are at-risk”.
“North Carolina faces a youth mental health crisis, and our school systems should be part of the solution to help address students’ needs,” said Dr. Ellen Essick, section chief at NC Health Schools within the North Carolina Department of Public Instruction. “But across our schools, we do not have an adequate school-based mental health system to meet the level of need that we’re seeing.
“The solutions are less about fixing students, teachers, or our schools, and more about fixing a system that’s not supporting our students, teachers, and schools satisfactorily,” said Essick. “That starts with growing our instructional support personnel workforce so that students have meaningful access to school psychologists, counselors, social workers, and nurses.”
NC Child and NCIOM hope that the key findings in the 2025 Child Health Report Card can help guide and inform parents, decision makers, school personnel, and other child health practitioners across the state. “The Child Health Report Card tells us what’s working and where we need to improve so that every child in North Carolina can reach their full potential,” said Smith.
Broadly, the NC Child Health Report Card evaluates 14 different indicators of child health and well-being that span the issues of birth outcomes, access to health care, secure homes and neighborhoods, and health risk factors.
2025 Child Health Report Card grades:
A: Insurance Coverage
B: Breastfeeding; Preconception and Maternal Health Support
C: Teen Births; Health Services Utilizations and Immunizations
D: Oral Health Access; Healthy Eating and Active Living; Tobacco, Alcohol, and Substance Use; Education
F: Birth Outcomes; School Health; Housing and Economic Security; Child Abuse and Neglect; Mental Health
“What we know is that these grades—and their impact on our state’s children—can change for the better,” said Smith. “It’s on each of us to work together to develop and implement solutions that ensure that every North Carolina child has the opportunity to reach their full potential.”
Download the 2025 NC Child Health Report Card here.
About NC Child
NC Child is a 501(c)(3) nonprofit organization that advocates for public policies that improve the lives of all North Carolina children. As the state’s only multi-issue child advocacy organization, NC Child’s work addresses policies that affect the whole child, including health and well-being, early childhood education, and family economic security. NC Child is also a leading source of state-level research and data on the issues affecting children and families, and the organization serves as a trusted and reliable source for policymakers and other child advocates across the state. For more information, visit ncchild.org.
About the North Carolina Institute of Medicine (NCIOM)
The North Carolina Institute of Medicine (NCIOM) is an independent nonprofit organization committed to better health for all North Carolinians. Chartered by the North Carolina General Assembly in 1983, the NCIOM provides nonpartisan information and opportunities for consensus-building on issues of relevance to the health of North Carolina’s population. Visit nciom.org for more information.
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