As a pediatrician by training, I’m profoundly concerned by the state of our children’s well-being. Following years of decline, mortality rates among children have risen. One in 25 American five-year-olds will not live to celebrate their 40th birthday. Then there’s the devastating CDC report issued earlier this year, describing the mental health crisis adolescents now face. Here in North Carolina, the 2023 NC Child Health Report Card shows that 67 children (ages 0-18) in our state died by suicide last year. If national studies are any indication, no doubt many, many more have seriously contemplated ending their lives.
It’s one thing to read the data. It’s quite another to see it firsthand – or to hear stories from families and communities that have been affected. For nearly two years now, the leadership team at Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has been on a statewide “listening tour” to learn more about the challenges and opportunities in our communities. This Extra Miles Tour has now taken us to nearly every county in the state. From urban areas to small towns to rural crossroads, concern about the health of young people has become a top priority.
But here’s the real takeaway: North Carolinians want to focus on the opportunities for change. We’re uncovering plenty of great ideas that need help coming to fruition, and plenty of strategic innovations at the local level just waiting to be shared, tried elsewhere and scaled up.
Those are conversations our state wants to have. From Murphy to Manteo, our communities are eager to talk about the challenges our children and young people face, because we understand that talking reveals opportunity. It generates ideas. It spreads the word.
Let’s Talk About the Whole Person
When it comes to the health of our children, we need to serve the whole child. This isn’t as simple as thinking in terms of mental and physical health – it means fully embracing how mental and physical health are intertwined.
Nothing expresses the importance of talking boldly about the needs of children and adolescents quite like the name of the organization we visited in Morven, NC (in Anson County): HOLLA! (short for Helping Our Loved Ones Learn and Achieve). And nothing speaks to the importance of taking a “whole-person approach” to childhood well-being more than the flurry of activity it hosts.
Executive Director Leon Gatewood founded the organization in 2005 to help address the fact that only three out of 10 Black children in the community were reading at grade level. His vision was to create a space that would provide a strong community foundation to put children on the path to success. Today, HOLLA! offers lessons in gardening and healthy eating; tennis camps; theatrical performances (Gatewood and the children he works with especially love putting on The Lion King) and other activities that prime students to thrive for the long term. An onsite media center even provides free access to computers and the internet – two resources that are vital to academic success these days.
HOLLA!’s diverse array of programming is guided by the understanding that healthy bodies and a strong sense of community contribute to a young person’s strength of mind.
When we visited Troy, NC, we learned about FirstHealth of the Carolinas’ work to bring dental care into area schools. In addition to two permanently established facilities in Montgomery County middle schools, FirstHealth also operates an innovative portable clinic that rotates around other area schools. Children don’t have to sit in a cramped van; the equipment comes to them, setting up in unused classrooms or other spaces. FirstHealth delivers access to exams, X-rays, cleanings, sealants, silver diamine fluoride treatments and restorative care, right there in a familiar environment where students feel most comfortable. This approach lowers roadblocks to routine care (like cost and access to transportation) while also minimizing student time outside the classroom. Dr. Sharon Harrell was quick to add that, despite its portability, this dental program offers the same high tech, state-of-the-art services as any other practice, thanks in large part to grants through the Blue Cross and Blue Shield of North Carolina Foundation and other organizations.
“We are able to roll out the red carpet for people who don’t often have a red carpet rolled out for them,” she told us, proudly.
How did FirstHealth come to prioritize childhood dental health? Through conversation, of course. The hospital reached out to area schools to find out where the unmet needs were. Dental care rose to the top. Since the program launched in 1998, it has served more than 30,000 patients. In its first year of operation, 70% of the patients it served had never seen a dentist or had not seen one in more than a year. Today, most cases focus on preventative, rather than restorative, care.
Creative expression. Dental care. Time and space to play. Healthy diets. Access to computers. These are not the sorts of things that come immediately to mind when people think about the health challenges our children face, but they should be. Many children face barriers to these and other resources. This undermines their development and overall well-being in both direct and indirect ways.
Conversation for – and About – the Whole Community
Our conversations about children also need to consider the adults in the room, too. A child’s well-being is only as healthy as the adults who care for them. Blue Cross NC has invested in important work at the community level that’s helping parents and caregivers build skills they need to rise above family crises. Strengthening families keeps households together, and that makes North Carolina stronger.
We also need to talk about the other adults who are so important in their lives: their faith leaders, their scoutmasters, their teachers and others.
When the Extra Miles Tour wound its way to Raeford, NC, we met with representatives from the State Employees Credit Union (SECU) Foundation and Hoke County Schools, who joined forces to create a 24-unit, workforce housing complex specifically for teachers. At one point in time, the county’s public schools were experiencing a teacher turnover rate as high as 40%. The lack of low-cost housing was a significant reason why.
That situation can disrupt continuity of learning. It makes it difficult for faculty to forge nurturing relationships with the children they serve. It puts academic achievement and student well-being at risk. All this is important because education is a fundamental driver of health. Attracting and retaining quality teaching talent will put more Hoke County children on the path toward success and good health.
The partnership between the SECU Foundation and Hoke County Schools is a sustainable model that can serve as a template for how communities can expand affordable housing options for those who have committed their professional lives to serving our children, our families and our communities. In fact, the SECU Foundation has pursued six similar projects across the state, and they want to do many more.
What’s the next step in the SECU’s work to expand the scope of this work? Conversation. That’s why the SECU Foundation is partnering with the Golden LEAF Foundation to host its first ever affordable housing conference, which will bring together financiers and funders and educate stakeholders on opportunities to get involved.
Conversation is the Doorway to Action
To put it simply, we need to talk about our children. How many innovative ideas like the ones shared above will have an even greater impact if they serve as a model for other communities to follow? How many great ideas out there are waiting to happen if they can garner enough support to get off the ground or to scale up? We can’t make those things happen without getting out of our silos and talking to one another.
One recent exchange illustrates the point I’m driving at. When the Extra Miles Tour traveled east to Hyde County, we met Social Services Director Laurie Potter. Ms. Potter described a great opportunity sitting just within reach: an empty building, in excellent condition and sitting on a sizeable parcel of land. She outlined all the possibilities in store if the county could acquire the property and turn it into a multi-use facility. It could help provide a space for children served by the child welfare system. A space for oral care clinics in a county that currently offers no dental services for children beyond fluoride varnishing. A space where affordable and much-needed housing could be built for medical and social services staff.
Here’s what I found so inspiring: After Ms. Potter shared her vision, others in the room chimed in, eager to help her transform that vision into reality. Dr. Dennis Barber (acting director of East Carolina University’s Miller School of Entrepreneurship) explained how the university’s RISE29 community entrepreneurship program specializes in bringing ideas like Laurie’s to life. Joe Rockenstein, CEO of the Ocracoke and Engelhard medical centers, volunteered his own grant writer to help.
Mr. Rockenstein closed the morning’s meeting by adding, “Today’s conversation has made it clear how important it is that we all work together … and going forward I pledge to do just that.”
These words were a testimonial to the power of getting people in the same room to share, listen and brainstorm. Problem solving requires more than good conversation, but conversation is almost always where problem solving starts. Initiating that sort of dialogue is the essence of what Blue Cross NC’s Extra Miles Tour has been all about.
NC Child’s 2023 Child Health Report Card underscores the urgency of keeping conversations like these going. We, as a state, need to find ways to bring more people to the table so we can find realistic solutions and build coalitions ready to transform ideas into action. More things can and will happen as more North Carolinians sit down with one another.
Our children’s health is at stake, and no conversation is more important to the well-being of North Carolina’s families and the long-term strength of our communities.
Featured photo by Bridgette Cyr