Racial and ethnic gaps persist in child cancer survival rates

In California, gaps persist in net five-year survival rates among children and youth ages 0-19 diagnosed with cancer between 2003 and 2013. The survival rate among white children is 85 percent, compared to 80 percent for Hispanic/Latino children, 79 percent for Asian/Pacific Islander youth, and 76 percent for African American/black children.

Data at the county level are limited, however variation in gaps across counties is wide. A few counties, such as Sacramento and Contra Costa, show less than a five percentage point gap in cancer survival rates across racial/ethnic groups, but most counties show wider gaps.

The figures below show a selection of counties with data that had a gap wider than 10 percentage points for three race/ethnic groups in California.

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Survival Rate Gap: Hispanic/Latino

The gap in cancer survival rates between white and Hispanic/Latino children is four percentage points at the state level. Counties with gaps greater than 10 percentage points include Napa, Placer, and Tulare.

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Survival Rate Gap: Asian/Pacific Islander

The gap in cancer survival rates between white and Asian/Pacific Islander children is six percentage points at the state level. Counties with gaps greater than 10 percentage points include Riverside, San Joaquin, and Los Angeles.

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Survival Rate Gap: African American/Black

The gap in cancer survival rates between white and African American/black children is nine percentage points at the state level. Counties with gaps greater than 10 percentage points include San Diego, Alameda, Solano, and San Francisco.

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Policy Implications

Early identification of affected children and ready access to pediatric specialty centers for diagnosis and ongoing care are key to cancer survival. Public policy ensuring that all children with cancer have adequate health insurance is essential to providing them with access to equitable, appropriate, and affordable care.

The Affordable Care Act (ACA) addresses cancer and other chronic illnesses by requiring regular, comprehensive preventive care without copayments and by eliminating lifetime caps on care and denials of coverage based on pre-existing conditions. Additional policies could assure that all pediatric cancer patients, regardless of race/ethnicity or family income, have consistent access to affordable health care that is evidence-based, well-coordinated, family-centered, and provided in the context of a medical home. Access to care coordination services is especially important as these children and their families need to navigate and align an array of services.

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Protecting water and air protects children’s health

Children are at greater risk of developing health problems due to pollutants compared to mature adults. Their small body size and developing organs make them more vulnerable to environmental contaminants.

In 2015, California had 1,533 Maximum Contaminant Level (MCL) violations, meaning contamination of drinking water supplies exceeded public health limits. Four Central Valley counties (Fresno, Kern, Madera, and Tulare) were issued 40% of all such violations.

Exposure to contaminants in drinking water can result in numerous adverse health effects for children, such as gastrointestinal disorders, damage to developing organs (particularly the liver, kidneys, and brain), and cancer.

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Five Central Valley counties (Fresno, Kings, Plumas, Tulare, and Kern) averaged particulate matter concentrations that are considered to be potentially harmful, among counties with data in 2014.

Long-term exposure to high levels of particulate matter, commonly found in diesel exhaust, may be related to heart and respiratory disease, along with adverse reproductive or pregnancy outcomes, among other health problems.

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Policy Implications

To protect children’s health, federal and state environmental laws and regulations that limit harmful waste and byproducts of agricultural, industrial, and other practices should be enforced and strengthened. Environmental safeguards can be bolstered by maintaining funding for national, state, and local agencies; increasing collaboration across agencies; and requiring reporting of environmental data to the public. The Environmental Protection Agency has a leadership role in ensuring that we are all protected from environmental risks.

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Over 14,000 CA foster youth facing end to critical services

For more than 14,000 California foster youth between the ages of 16 and 20—nearly a quarter of all those in care in 2015—the transition to adulthood is especially challenging. At age 21, if they had not been reunified with their families or adopted, youth "age out" of the state’s foster care system, and services often end abruptly. Without effective transition planning, these young adults are at increased risk for negative outcomes including unstable housing, low educational and career attainment, early parenthood, substance abuse, physical and mental health problems, and involvement with the criminal justice system.

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Policy Implications

Policies that could enable youth aging out of the foster care system to thrive as adults include ensuring effective implementation of the Federal Affordable Care Act, which extends Medicaid coverage to foster youth until age 26, and the California Fostering Connections to Success Act, which extends foster care services to age 21. In addition, strengthened educational and workforce supports, including support to pursue secondary education, can improve outcomes for youth transitioning out of care.

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May Is National Foster Care Month

National Foster Care Month is a time to acknowledge the foster parents, family members, volunteers, mentors, policymakers, child welfare professionals, and other members of the community who help children and youth in foster care find permanent homes and connections. It is also a time to focus on ways to create a bright future for the more than 400,000 children and youth in foster care in the US.

See resources from the US Department of Health & Human Services »

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April Is Child Abuse Prevention Month

In 2015, two-thirds of California children (67 percent) involved in a substantiated case of maltreatment suffered general neglect. General neglect occurs when a parent, guardian, or caregiver fails to provide adequate food, shelter, medical care, or supervision for a child, but no physical injury happens. More severe types of maltreatment—severe neglect, physical abuse, and sexual abuse—were inflicted upon 18 percent of children involved in substantiated cases in 2015.

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Policy Implications

Providing an accessible system of mental health, substance abuse, and other supportive services for families with children at risk of maltreatment could help prevent child abuse and neglect. In addition, increasing collaboration across public and private sectors such as local and state government, education, health care, nonprofit, and the media could help ensure that all children have safe, stable, nurturing relationships and environments.

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See resources from the Office of Child Abuse Prevention »

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Webinar Q&A: Childhood Adversity—Data to Help Advocate for Change

In a March 29 webinar, panelists from kidsdata.org and the California Department of Public Health discussed how to describe the burden of childhood adversity in your community, how to frame your message most effectively, and how to engage and mobilize your community to address the roots and effects of childhood adversity. Attendees responded to the panelists’ presentations with questions about how best to integrate the information into their work.


Marissa GTW headshotMarissa Abbott, MPH
 – California Epidemiologic Investigation Service (Cal-EIS) Fellow, Injury Surveillance and Epidemiology Section, Safe and Active Communities Branch, California Department of Public Health


Turk-Bicacki_Lori GTW headshotLori Turk-Bicakci, Ph.D. – Senior Manager, Data and Research, Lucile Packard Foundation for Children’s Health



Download the full list of responses to questions that were posed during both the live March 29 webinar and the registration period. The first five of 26 responses are below.

How do we best begin a community dialogue about Adverse Childhood Experiences (ACEs)?

ACEs provide a valuable frame to highlight how trauma is an intersectional issue. When approaching various stakeholders, you can try to frame your presentations in terms of how ACEs might matter to them in their personal and professional domains. It is also important to stress the idea that addressing adversity is not simply a personal issue but also a broader community responsibility.

There are several different ways to begin a community dialogue about ACEs. One approach is to start by identifying champions who can help you think about how to engage the community in conversations about adversity and trauma. Another important step is to convene and engage these champions and “supporters” around the issue, build baseline awareness about ACEs in the community, and leverage relationships in order to expand and engage your target audiences.


Can you give us an example of how you integrate values with ACEs facts?

We are trying to create a “new” public narrative grounded in values and beliefs that support safe, stable, nurturing relationships and environments for all parents and children. In contrast, the current dominant value frame for child maltreatment includes value statements such as: 1) parenting is a family issue–not a government or community problem; and 2) bad parents and children are to blame.

To create a “new” public narrative, we need to propose another set of values that focuses on our shared responsibility for the wellbeing of children and the possibility for pro-active solutions.  The ACEs “facts,” as seen in the broader set of adversity indicators, support the notion that parenting is not simply an isolated family matter.  Instead, the data suggest that the toxic stresses and traumas experienced by children and families are shaped not only by family history and the immediate family dysfunctions, but also by the cumulative past and present environments in which they live, work, grow, and play. Adverse environments include unsafe and violent neighborhoods, poor quality education, persistent poverty, lack of opportunity, and limited job prospects.

The value of shared responsibility can be premised on the notion that we are all responsible for recognizing and addressing these unjust and preventable inequalities. This premise allows us to re-frame the dialogue from simply blaming parents to looking at the potential structural and systemic ways that families are affected.  In this frame, government has an important role to play to address these inequalities and provide families and children with the supports they need to prevent, stop, mitigate, and recover from adversity and toxic stress.


What are some sample messages grounded in values and beliefs that help shift from an individual to a community frame?

Some of the messages grounded in shared responsibility start with value frames stressing a shared worldview: 1) we all want the best for our children; 2) parenting can be difficult–we all need help at some time; 3) investing in children is good for all of us/we all benefit when children succeed (e.g., paying into social security); 4) America’s “can do” spirit should prevail (we can solve these problems if we work together); and 5) focus on innovative solutions (we can find creative ways to solve problems).


Are there future plans to incorporate into kidsdata.org additional adversities that are not classified ACEs per se, such as neighborhood violence, housing, or employment discrimination?

In addition to indicators in the Childhood Adversity and Resilience topic, kidsdata.org has over 550 other indicators of children’s health and wellness, and many of them measure the extent of adversity. For example, we have data on poverty, housing instability, food insecurity­­­­, and child abuse/neglect. This summer, we expect to add additional community-level indicators related to poverty.

We would also like to add indicators that demonstrate resilience and that measure types of resources that support children’s health and wellness. An example of a supportive resource is school-based health centers, for which we currently show counts on our site. Please let us know if you are aware of a data source that measures resilience or quantifies supportive resources for counties in California.


Does kidsdata.org provide tangible materials for organizations to share with their community?

Kidsdata.org does not provide tangible materials about childhood adversity and resilience such as screening tools. However, you can generate fact sheets for any county, city, school district, and legislative district for which we have data that include a variety of indicators related to childhood adversity, health, and wellness.

For additional materials specifically related to adversity and resilience, we recommend reviewing the Research and Links section at the bottom of each indicator page and checking the Centers for Disease Control and Prevention (CDC) Essentials for Childhood website.


Download the full list of responses to questions that were posed during both the live March 29 webinar and the registration period.

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Health care for 7 in 10 CA children funded by Medicaid or CHIP

Proposed cuts and changes to public health insurance programs would have a disproportionate effect on California kids compared with kids in the nation as a whole. During fiscal year 2016, more than 7 in 10 California children used federal funds from Medicaid or the Children’s Health Insurance Program (CHIP) for health care coverage, according to the latest data now available on Kidsdata. Nationwide, fewer than 6 in 10 children used Medicaid or CHIP funds during the same time period. In California, both sources of funding support the Medi-Cal program.

Loss of Medicaid or reductions in benefits could lead to higher insurance premiums and out-of-pocket costs for low-income families, increased numbers of uninsured or underinsured children, more emergency room visits and hospitalizations, increased school absences and resultant lower academic achievement, and, invariably, lost lives.

Decisions in Washington, DC impact California children. Policy options that could improve children’s health care include supporting efforts to ensure continuous, comprehensive insurance coverage for all children and reinforcing the capacity and financial viability of safety-net providers. On March 24, legislative leaders decided to discontinue advancing the American Health Care Act, a replacement for the Affordable Care Act (ACA or Obamacare), but changes to health care and other social services remain a probability. Voice your opinion and contact your U.S. Representatives and Senators to #KeepKidsCovered.

Helpful Links

Enrollment in Health and Nutrition Safety Net Programs Among California’s Children, Public Policy Institute of California

Children’s Health Insurance Program (CHIP): Accomplishments, Challenges, and Policy Recommendations, Pediatrics

Children’s Health Programs in California: Promoting a Lifetime of Health and Well-Being, California Budget and Policy Center

Medicaid Block Grant Would Slash Federal Funding, Shift Costs to States, and Leave Millions More Uninsured, Center on Budget and Policy Priorities

Kidsdata Tip

Are you interested in learning how to use childhood adversity data to advocate for change? Our recent webinar has information that you won’t want to miss. Download the slides or watch the recording on our blog.

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Archived Webinar: Childhood Adversity—Data to Help Advocate for Change

The recording and slides for the March 29 webinar, Childhood Adversity: Data to Help Advocate for Change, are now available.

In this webinar, panelist Marissa Abbott of the California Department of Public Health discussed how to describe the burden of childhood adversity in your community, how to frame your message most effectively, and how to engage and mobilize your community to address the roots and effects of childhood adversity.

In addition, panelist Lori Turk-Bicakci of kidsdata.org led participants on a virtual tour of Kidsdata’s Childhood Adversity and Resilience data, research, and policy recommendations.

View the webinar recording:
View the webinar slides:

Download presentation slides.

Already using Kidsdata to address childhood adversity in your community? Share your story with us.

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Kidsdata on the Air

Thanks Kidsdata, for helping me give a clear, accurate picture of Novato kids’ mental and physical health.

When Marian Schinske, Founder and Executive Director of NovatoSpririt, looks for data to illustrate the need for her youth athletic scholarship program, she always turns to Kidsdata as her source for reliable information. During a recent interview with KWMR Radio, a local Marin County station, Marian used Kidsdata to inform listeners of the state of children’s mental and physical health in the city of Novato:

“I recently did some research about the overall health of NovatoSpirit kids through a wonderful resource called kidsdata.org, which is a program of the Lucile Packard Foundation for Children’s Health. I found that compared to children living elsewhere in Marin, Novato children may be less healthy and more vulnerable. For example, childhood obesity rates in Novato are higher than Marin County’s average rate. In Novato Unified School District, about one out of every three children in the 5th, 7th, and 9th grades is overweight, and physical fitness among Novato school kids decreased in recent years. Also, suicidal ideation, which means having thoughts about suicide, occurs more frequently amongst kids in Novato than amongst others county-wide. The most vulnerable time for all kids, everywhere, is the 9th grade, where 23 percent of Novato Unified School District children reported suicidal ideation. So sadly, 1 out of 5 high school freshmen here contemplates suicide. To me, this fact alone shows that all children here need more attention, guidance, empathy, and opportunity.”

When she’s not behind the microphone, Marian uses Kidsdata for grant proposals and presentations to city and school district officials across Marin County. She also uses Kidsdata in her annual reports for NovatoSpirit’s Board of Directors and donors.

“What’s great about Kidsdata is that I am able to tailor the information to the interests of my listeners and readers,” she says. “Everyone who has encountered the data has been very surprised. They have no idea that children could be so vulnerable, especially here in Marin County. Kidsdata gives some very eye-opening information that can encourage others to view Novato’s children with more empathy and understanding.”

For more stories from our users, visit our Data in Action page. Have a story of your own? Submit it using our online form or email us at Kidsdata@lpfch.org.

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1/3 of CA children who need mental health treatment fail to receive it

Thirty-seven percent of California children who need mental health treatment failed to receive it, according to the most recent data available on kidsdata.org. Madera, Merced, Monterey, and Tulare counties had the lowest rates of all counties with available data, with nearly half of children who need mental health treatment failing to receive it in the previous 12 months.

Screening, early identification, and treatment are critical, as untreated mental illness can disrupt children’s development, academic achievement, and their ability to lead healthy, productive lives.

Policy options that could support mental health care services include ensuring that mental health funding is aligned with high-risk populations, improving coordinated, cross-sector strategies by integrating mental health services with other systems, promoting mental health training for pediatricians, and expanding the workforce of qualified mental health professionals serving youth.

Related Data

Children’s Emotional Health

Community Connectedness

Disconnected Youth

School Connectedness

Youth Alcohol, Tobacco, and Other Drug Use

Youth Alcohol, Tobacco, and Other Drug Use

Helpful Links

Centers for Disease Control and Prevention: Mental Health

National Institute of Mental Health: Child and Adolescent Mental Health

Overlooked and Underserved: “Action Signs” for Identifying Children with Unmet Mental Health Needs, Pediatrics

Supportive Relationships and Active Skill-Building Strengthen the Foundations of Resilience, National Scientific Council on the Developing Child

Three Out of Four Children with Mental Health Needs in California Do Not Receive Treatment Despite Having Health Care Coverage, UCLA Center for Health Policy Research

Stanford Center for Youth Mental Health and Wellbeing

Kidsdata Tip

Join Kidsdata and the California Department of Public Health on March 29 for a webinar on Childhood Adversity: Data to Help Advocate for Change. Read more and register.

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Webinar: Childhood Adversity—Data to Help Advocate for Change

Date: Wednesday, March 29, 2017

Time: 10:30 to 11:30 a.m. PT

Childhood adversity, such as child abuse and exposure to violence and poverty, can have negative long-term impacts on health and well being. In this webinar, our panelists will discuss how to describe the burden of childhood adversity in your community, how to frame your message most effectively, and how to engage and mobilize your community to address the roots and effects of childhood adversity.

Panelists will also lead participants on a virtual tour of Kidsdata’s Childhood Adversity and Resilience data, research, and policy recommendations.


Marissa Abbott

Marissa is a California Epidemiologic Investigation Service (Cal-EIS) Fellow at the California Department of Public Health. She is placed in the Safe and Active Communities Branch and primarily supports the CDC-funded California Essentials for Childhood Initiative, a child maltreatment prevention project. Prior to her fellowship, Marissa completed her Master of Public Health (MPH) degree at the University of Rochester School of Medicine and Dentistry as a part of their 3-2 Program.

Nathan Porter

Nathan is Data Manager at the Lucile Packard Foundation for Children’s Health, where he works on kidsdata.org, a public service website that allows users to easily find, customize, and share data on more than 600 measures of child health and well being. Kidsdata.org makes it simple to incorporate trusted data for every county, city, school district, and legislative district in California into reports, presentations, articles, grant proposals, policy decisions, and advocacy work.

Childhood Adversity and Resilience Data

Childhood Adversity and Resilience

Children with Two or More Adverse Experiences

Children Who Are Usually/Always Resilient

Prevalence of Childhood Hardships

Prevalence of Adverse Childhood Experiences

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