Data Across 50 States Show Struggles with Poverty, Health Indicators, But Hopes for Recovery Remain, Annie E. Casey Foundation Finds

The number of Arkansas’s children going without health insurance surged dramatically between 2018 and 2019, continuing a troubling decline in children’s health care coverage. Arkansas has also seen an increase in the percentage of low-birth-weight babies and in the child and teen death rate over the past decade. That’s according to the 2021 KIDS COUNT® Data Book, a 50-state report of recent household data developed by the Annie E. Casey Foundation analyzing how families have fared between the Great Recession and the COVID-19 crisis.

Every child needs food, health care, safe and stable housing, and access to education. But this year’s Data Book shows nearly a decade of progress could be erased by the COVID-19 pandemic unless policymakers act boldly to sustain the beginnings of a recovery from the coronavirus crisis.

Many states in the South and West that rank toward the bottom in the Data Book are also states that have seen the worst outcomes during the pandemic. Arkansas is included in this assessment, with bottom 10 rankings in six of the 16 well-being indicators. Arkansas’s overall ranking did rise to 39 though, compared to last year’s ranking of 40. Arkansas-specific data on a wide range of indicators can be accessed via the KIDS COUNT Data Center.

Racist policies, like a criminal justice system that over polices and prosecutes Black, Indigenous and People of Color (BIPOC), as well as health care policies and practices that fail to address the needs of BIPOC, perpetuate inequity and barriers to economic progress. Without passing anti-racist policies and solutions, we will continue to see disparities across most indicators, at both the national and state levels. In Arkansas, for example, 39% of our Black children and 27% of our Hispanic children live in poverty. By comparison, 16% of Arkansas’s non-Hispanic white children live in poverty.

“The data paint a precarious picture for Arkansas’s children, even before the pandemic,” said Rich Huddleston, executive director of Arkansas Advocates for Children and Families, Arkansas’s member of the KIDS COUNT network. “It is critical we make bold policy changes to improve outcomes for kids as we come out of the current crisis.”

The Data Book shows simply returning to a pre-pandemic level of support for children and families would shortchange millions of kids and fail to address persistent racial and ethnic disparities.

Sixteen indicators measuring four domains — economic well-being, education, health, and family and community context — are used by the Annie E. Casey Foundation in each year’s Data Book to assess child well-being. The annual KIDS COUNT data and rankings represent the most recent information available but do not capture the impact of the past year:

• ECONOMIC WELL-BEING (Arkansas ranked 34th): In 2019, 151,000 (22%) of Arkansas’s children lived in households with an income below the poverty line. While the state has improved on this measure since 2010, more than one in five children in Arkansas continue to live in poverty, ranking us near the bottom of the states at 46th.
• EDUCATION (Arkansas ranked 35th): In 2017–19, 41,000 children ages 3-4 were not in school. Though there were several years where this indicator showed improvement, Arkansas has lost ground over the last decade. In 2009-11, 49% of young kids were in school, and Arkansas was ranked 16th in the nation; in 2019, only 47% of young children were in school, and Arkansas dropped to 20th in the national ranking.
• HEALTH (Arkansas ranked 41st): The number of children in Arkansas without health insurance rose from 34,000 in 2018 to 43,000 in 2019, marking the third straight year of an increase in this figure. This mirrors a national increase in children without health insurance, though it has been especially noteworthy in Arkansas where our national ranking dropped from 23rd in 2010 to 29th in 2019.
• FAMILY AND COMMUNITY CONTEXT (Arkansas ranked 42nd): In 2019, 67,000 children (10%) lived in high poverty areas, an improvement from 17% in 2010. Arkansas has also seen a decrease in the percentage of kids in families with a head-of-household who lacks a high school diploma (11% in 2019, down from 16% in 2010).

Survey data from the last year add to the story of Arkansas’s children and families in this moment:

• During the pandemic, in 2020, 23% of households with children in Arkansas weren’t sure they would be able to pay their rent or mortgage. By March 2021, this figure had fallen, but only marginally, to 21%. Alarmingly, the percentage of adults living in households with children and who felt down, depressed or hopeless increased from 26% in 2020 to 33% in March 2021. This suggests that families are continuing to struggle with the economic fallout of the COVID-19 pandemic.

“The COVID-19 pandemic is the most extraordinary crisis to hit families in decades,” said Lisa Hamilton, president and CEO of the Annie E. Casey Foundation. “Deliberate policy decisions can help them recover, and we’re already seeing the beginnings of that. Policymakers should use this moment to repair the damage the pandemic has caused — and to address long-standing inequities it has exacerbated.”

Investing in children, families and communities is a priority to ensure an equitable and expansive recovery. Several of the Annie E. Casey Foundation’s suggestions have already been enacted in the American Rescue Plan, and additional recommendations include:

• Congress should make the expansion of the child tax credit permanent. The child tax credit has long had bipartisan support, so lawmakers should find common cause and ensure the largest one-year drop ever in child poverty is not followed by a surge.
• State and local governments should prioritize the recovery of hard-hit communities of color. BIPOC communities have been hit hardest by the COVID-19 pandemic due in part to systemic barriers to health care and economic security. Recovery efforts must help address the needs of those most impacted today and help respond to longstanding structural inequities.
• States should expand income support that helps families care for their children. Permanently extending unemployment insurance eligibility to contract, gig and other workers and expanding state tax credits would benefit parents and children.
• States that have not done so should expand Medicaid under the Affordable Care Act. The American Rescue Plan offers incentives to do so. As Arkansas already has expanded Medicaid under the ACA, AACF recommends the following to reverse the recent declines in health care coverage for children:
  • Adopt continuous eligibility for ARKids A. One-year continuous eligibility would ensure that a child’s coverage is not terminated within a single year because of fluctuations in family income that are common for low-income families. Arkansas already has this policy in place for children with slightly higher family incomes enrolled in Arkansas Medicaid ARKids-B.
  • Adopt presumptive eligibility for Medicaid for children and pregnant women. Presumptive eligibility would allow Arkansas to temporarily enroll persons in Medicaid while waiting for their full applications to be processed. Presumptive eligibility on a provisional applicational allows the children and pregnant women to begin receiving services immediately without having to wait for the full Medicaid application to be processed.
  • Conduct ARKids First outreach and enrollment, especially targeting immigrant families.
  • Provide one-year postpartum Medicaid coverage for mothers instead of the current 60 days.
  • In the proposed ARHOME waiver the state will soon submit to the federal government, do not repeat the mistakes of the past by imposing any requirements that would make it more burdensome for families to maintain health care coverage under Arkansas’s Medicaid expansion.
• States should strengthen public schools and pathways to post-secondary education and training. AACF further recommends the state reassess its approach to education in light of the pandemic and focus on research-proven strategies that will help children who lost ground during the pandemic while closing longstanding opportunity gaps for the state’s BIPOC students.