Hospitalizations for Mental Health Issues Were Rising Before Pandemic

Rate of Hospitalizations for Mental Health Issues in California From 2002 to 2019, by Age Group


Hospitalization rates for mental health issues were rising in the years prior to the COVID-19 pandemic. In 2019, the rate of hospital discharges for mental health issues in California among teens ages 15 to 19 was 9.8 per 1,000 teens, a 46% increase from 2007 and more than triple the rate for children ages 5 to 14. Positive emotional health is critical to equipping young people for the challenges of growing up and living as healthy adults, yet the pandemic led to many new stressors for children, including disruptions and socioeconomic shifts These added strains have only heightened the need for funding and training to expand programs of mental wellness.

Webinars

Much of the data on KidsData.org come from U.S. Census Bureau products as well as other federal data sources. Two upcoming webinars provide insight on these important data sources that underly our understanding of children’s health and well-being.

Learn from data users of the American Community Survey (ACS) and U.S. Census Bureau staff about key ACS data issues and applications at the “ACS Data Users Conference,” organized by the U.S. Census Bureau and PRB. This virtual event will take place May 18-20, 2021. Register here.

Learn about changes in public data and best practices in using data at “Public Data: Making Sense of the New Normal,” organized by the Association of Public Data Users. This virtual event will take place July 26-29, 2021. Register here.

Join Prevent Child Abuse America for “Transforming Our Tomorrow: 2021 Prevent Child Abuse America Virtual Conference” to explore community needs and the impacts of our work. This virtual event will take place August 10-12, 2021. Register here.

Recently Released Data

All data from the first wave of the Family Experiences During the COVID-19 Pandemic questionnaire are now on KidsData.org! See links to the latest here.


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Child and Family Well-Being During the COVID-19 Pandemic

Child and Family Well-Being During the COVID-19 Pandemic provides quick access to data available on kidsdata.org that describe life disruptions as well as emotional and behavioral consequences of the COVID-19 pandemic. The data help measure the impact of the pandemic on children and caregivers, builds understanding of how families are faring, and suggests where support might be most needed.

Access data on the COVID-19 pandemic and its effect on critical areas of children’s health and well-being:

Data are available for California and seven regions within California. At the state level, findings are broken down by family income level, race/ethnicity, and the presence of a child with special health care needs in the household. Visit the topic summary page for more information and links to additional research.

Data will be released as they become available. Sign up to receive KidsData News and data alerts for all the latest updates.

About the Data Source

The data come from a national questionnaire covering a wide range of content areas to help inform on the impact of the pandemic. The questionnaire, Family Experiences During the COVID-19 Pandemic, was designed by the American Academy of Pediatrics (AAP), in collaboration with the Centers for Disease Control and Prevention (CDC), Prevent Child Abuse America (PCAA), and Tufts Medical Center, Healthy Outcomes from Positive Experiences (HOPE). Findings from the questionnaire are intended to inform experts at AAP, CDC, PCAA, and HOPE on the effects of the pandemic on families and help them produce resources for medical practitioners, caregivers, and others.

In California, the Lucile Packard Foundation for Children’s Health (LPFCH) and the California Department of Public Health Essentials for Childhood Initiative (EfC) led by the California Department of Public Health, Injury and Violence Prevention Branch and California Department of Social Services, Office of Child Abuse Prevention, funded an oversample of the questionnaire to produce findings at the sub-state level and about children with special health care needs. Findings will inform policy makers, program leaders, advocates, and others about how experiences varied within California and to what extent families with children with special health care needs faced greater challenges.

Questionnaire Development and Administration

Researchers and subject matter experts, with input from families, guided questionnaire development. Many questions were derived from established surveys including the Behavioral Risk Factor Surveillance System and the National Survey of Children’s Health.

The questionnaire was administered by YouGov.com, a data analytics company. Respondents were recruited from an internet panel of over two million U.S. panelists. Panelist recruitment has been designed to achieve a sample representative of demographics reported by U.S. Census data. The questionnaire was administered from November 9 to December 11, 2020 and will be administered two more times in the coming months.

Questionnaire Sample

In California, 1,526 parents and caregivers who had at least one child under age 18 in the household responded to the questionnaire. Of those, 29% had at least one child with a special health care need in the household. Children with special health care needs have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and require health and related services of a type or amount beyond that required by children generally.

Just over half of respondents were female (54%) and most were married or in a domestic partnership (69%). Nearly half of respondents were Hispanic (49%), while 28% were white, 9% were Asian, 5% were Black, and 2% were Native American. About the same percentage of respondents had a high school diploma (30%), attended some college or had a two-year degree (29%), or had a four-year or post-graduate degree (30%), while 12% of respondents did not have a high school diploma. Also, about equal shares of respondents reported family incomes under $30,000 (28%) and incomes $100,000 and above (25%). All data were weighted to reflect caregivers for children under age 18 in California.

Data on Family Experiences During the COVID-19 Pandemic

Education, Health Care, and Social Activities

Economic Security

Supportive Services

Emotional and Behavioral Health

Child and Caregiver Safety

Adverse Childhood Experiences

Positive Childhood Experiences

Caring for Children with Special Health Care Needs (CSHCN)

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Four in Ten Families Report Pandemic Negatively Impacted Finances


Many families with children have seen their economic security directly impacted by the COVID-19 pandemic. Even before the pandemic, child poverty was a deep concern among many researchers, practitioners, and advocates because it can alter children’s developmental trajectories in cognitive, socio-emotional, and physical health.

As the pandemic unfolded, some caregivers were forced to cut back on work or lost their jobs, threatening their families’ economic security. Though some families offset income losses by increasing their involvement in social service programs and receiving other aid, we have yet to fully understand the new economic reality for families and its impact on children, but we have some early indications.

The questionnaire, Family Experiences During the COVID-19 Pandemic, offers a look at how the events of the past year shaped family economic security. In California, 43% of caregivers reported that their household’s financial situation had been negatively impacted from March to November 2020. Related, as of November 2020, 33% of caregivers were unemployed, had left the workforce, or reduced their employment.

Some caregivers accessed social safety net resources such as food banks and public health insurance. Notably, 11% of California families used at least one of eight services for the first time between March and November 2020. This first-time use is seen across income levels as caregivers started utilizing social safety net resources for the first time to safeguard their family’s economic security.

A national perspective from this questionnaire is now available! Family snapshots of life during the pandemic in the United States have just been released by the American Academy of Pediatrics (AAP), in collaboration with the Centers for Disease Control and Prevention, Prevent Child Abuse America, and Tufts Medical Center. Visit this new webpage to find an overview of the questionnaire and AAP recommendations based on their findings. It currently includes two snapshots describing financial impact on families and family closeness despite stress. More snapshots are to come!

The Financial Impact of the Pandemic on Families With Children in the United States notes that findings from the questionnaire are concerning: “Higher family economic stress is associated with more family conflicts and higher rates of child abuse and neglect. The Family Stress Model describes how economic hardship contributes to parent psychological distress. This distress can aggravate relationship problems between parents and disrupt parenting practices. These changes often result in increased problematic child behavior and can lead to a vicious cycle with harsher parenting and more difficult child behavioral problems. Policy makers should be advised about the possible consequences for children when household finances can threaten family stability.” Read more.

Latest Data on Child Well-Being During Pandemic

In addition to data about child and caregiver safety, we have additional data on the COVID-19 pandemic and its effect on critical areas of children’s health and well-being.

*Data coming soon.

 

Webinar

Register for the “Family Experiences During COVID-19 Pandemic Data Webinar”

Thursday, April 29, 2021, from 1:00 p.m. – 2:30 p.m. (PST)

Learn more about the questionnaire, Family Experiences During the COVID-19 Pandemic. Drs. Robert Sege from the Healthy Outcomes from Positive Experiences (HOPE) Project at Tufts Medical Center and Lori Turk-Bicakci from the KidsData program at PRB will provide an overview of the questionnaire, summarize California and national findings, share where to access California data and national snapshots, and offer highlights from the HOPE perspective. The webinar is hosted by the Essentials for Childhood Initiative. Register here.

 

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One in Four Caregivers of Special Needs Children Report Physical Discipline in Household

Physical Discipline of Children in California, by Special Health Care Needs Status

Child abuse can cause lifelong physical, emotional, and behavioral problems and may perpetuate intergenerational cycles of family violence. During the COVID-19 pandemic, the strain that families experience can be immense and may affect how children are disciplined and risk their safety. Having a child with a special health care need (CSHCN) in the household may further increase that risk.

The questionnaire, Family Experiences During the COVID-19 Pandemic, sheds light on the extent of child safety and abuse in households in November 2020. In California, 17% of caregivers reported that they spanked, slapped, or hit a child in their household in the previous week. In households including CSHCN, one in four caregivers reported these forms of punishment compared with one in seven caregivers in other households.

Similar patterns emerge in the prevalence of intimate partner violence (IPV) in the household. Since the start of the pandemic, 12% of caregivers reported that they experienced physical IPV. One in five caregivers who had a CSHCN in the household reported physical IPV compared with about one in twelve caregivers in other households.

Prevent Child Abuse America notes that multiple and interacting factors contribute to abuse, including substance abuse in the household, caregivers’ poor emotional health, and economic stress. By focusing on prevention, all children can grow and thrive in safe, stable, and nurturing relationships and environments. The organization shares that National Child Abuse Prevention Month is “a time to plant the seeds of a better tomorrow for all children and families.”

Latest Data on Child Well-Being During Pandemic

In addition to data about child and caregiver safety, we have additional data on the COVID-19 pandemic and its effect on critical areas of children’s health and well-being.

*Data coming soon.

Webinar

Register for the “Family Experiences During COVID-19 Pandemic Data Webinar”

Thursday, April 29, 2021, from 1:00 p.m. – 2:30 p.m. (PST)

Learn more about the questionnaire, Family Experiences During the COVID-19 Pandemic. Drs. Robert Sege from the Healthy Outcomes from Positive Experiences (HOPE) Project at Tufts Medical Center and Lori Turk-Bicakci from the KidsData program at PRB will provide an overview of the questionnaire, summarize California and national findings, share where to access California data and national snapshots, and offer highlights from the HOPE perspective. The webinar is hosted by the Essentials for Childhood Initiative. Register here.

April Is Child Abuse Prevention Month

Best Practice Guidelines for California’s Child Abuse Prevention Councils (CAPCs) offers a comprehensive approach to addressing child abuse and promoting prevention, shared by the California Office of Child Abuse Prevention and Strategies 2.0. CAPCs’ role is to be the catalyst, convener, and coordinator of prevention efforts at the county level.

Reframing Childhood Adversity: Promoting Upstream Approaches helps professionals communicate about child well-being and adversity, shared by the FrameWorks Institute, Prevent Child Abuse America, and the newly merged Alliance for Strong Families and Communities and Council on Accreditation.

Recently Released Data

We recently released data about emotional health and the COVID-19 pandemic. In 2019, there were more than 27,000 hospital discharges for mental health issues among California youth ages 15 to 19. See links to the latest here.

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Families Report Stress, Positive Experiences During Pandemic

A Special Message to KidsData News Subscribers

It’s official! KidsData is now part of PRB, a nonprofit, nonpartisan organization with a strong legacy of leveraging data to track progress and identify issues affecting the health and well-being of children and families. We couldn’t be more pleased to reintroduce you to KidsData, now powered by PRB.

PRB and KidsData have been technical partners since 2008 and share a strong dedication to transforming data into insights that inform policy and program decisions that can help children lead healthy, productive lives.

We’re excited to be working together and honored that you’ve joined us as we embark on the next stage of our journey to further strengthen our capacity to provide actionable information about California kids.

On behalf of the entire PRB and KidsData team, we thank you for your continued support and for being part of the KidsData community!

All the best,

Lori Turk-Bicakci, Senior Program Director of KidsData, PRB
Linda A.Jacobsen, Vice President of U.S. Programs, PRB


Family Experiences During the COVID-19 Pandemic

Families have confronted unprecedented challenges during the COVID-19 pandemic but also have found moments of joy. Positive experiences buffer the hardships associated with supporting children’s remote education, emotional and health care needs, and more. Though families have experienced the pandemic differently—and some devastatingly— by geographic region, race/ethnicity, income level, and other factors, no family is left untouched. The questionnaire, Family Experiences During the COVID-19 Pandemic, helps us understand those experiences.

In California, more than one-quarter of caregivers (27%) reported in November 2020 that helping their children with schoolwork was a stressful yet positive experience that brought them closer together. Nearly all caregivers joined their children in recreational activities (94%), including playing outdoor sports, going for walks, and reading together. Regardless of income level, race/ethnicity, or presence of a child with a special health care need, caregivers engaged with their children at similar levels. These bright spots give us hope for family well-being as we emerge from the pandemic.

Healthy Outcomes from Positive Experiences, HOPE, offers a framework to think about the importance of positive experiences amidst tremendous challenge. The four building blocks of HOPE—relationships, environment, engagement, and opportunities for social emotional development—form an important foundation for families to persevere through this unpredictable pandemic.

Loren McCullough, from HOPE, shares more about positive experiences during challenging times: “Parents in California are working hard to find opportunities for levity, joy, and togetherness for their children, even in a time when stress is high and options are limited. Across the state, the majority of parents are engaging with their children in meaningful ways, developing an important relational framework that can help support resilience. Using a HOPEful lens to note how positive experiences are present in these communities can help parents and providers to bolster these experiences in struggling families or communities.”


Children’s Health Resources

The American Academy of Pediatrics offers suggestions for exploring the outdoors with children and summarize the benefits of being outside in Getting Children and Teens Outside While Physical Distancing for COVID-19.

A new resource, Strategies for Trauma-Informed School Communities: Practices to Improve Resiliency in School-Aged Children and Address Adverse Childhood Experiences, shares information about trauma-informed school policies and practices that improve resiliency in school-age children and youth.

 


Recently Released Data

We recently released data about injuries. See links to the latest here.

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A Health Care System that Supports Children with Special Health Care Needs and Their Families

A parent shares an example of a “care map,” which illustrates the complicated web of medical care and coverage, as well as educational and support services needed for children with special health care needs and their families. A parent shares an example of a “care map,” which illustrates the complicated web of medical care and coverage, as well as educational and support services needed for children with special health care needs and their families.

In California, 14% of children have a special health care need. Kidsdata released updated data on children with special health care needs that describe their characteristics, access to services, level of insurance coverage, and quality of their care. The data also describe the impact of having a special health care need on children and families.

Guest author, Allison Gray, MA, from the Lucile Packard Foundation for Children’s Health, shares how a more family-centered and coordinated system of health care can ease the family experience.

Core to the Maternal and Child Health Bureau’s definition of children with special health care needs (CSHCN) is the need for care “beyond that required by children generally.” While it is understood that this means more doctor’s appointments, therapies, services, hospitalizations, and potentially a need for additional in-home care for the child, the impact on parents, caregivers, and families often is overlooked. Parents strive to do everything they can to ensure the best care for their child. In addition to day-to-day care, they are faced with navigating a fragmented system, coordinating across multiple providers who do not communicate with one another, and figuring out confusing health insurance policies and payments among other tasks on a long to-do list. Many of the challenges families face are due to shortfalls in our complex health care system.

Some parents reduce work hours in order to manage their child’s care, and in other cases parents leave the workforce entirely. Many families experience financial hardship as a result. Broader implications may include the stalling of careers and an economic impact. The latest data show that 19% of CSHCN in California had family members cut back or stop working because of their children’s health needs in 2016-2019. Anecdotal data suggest that the current public health crisis has resulted in a significant exacerbation of the challenges around employment and caregiving for these families.

Now more than ever, a more family-centered and coordinated system of care is required to ease the burden on families of CSHCN. Best expressed in a Viewpoint on family burden and medical complexity by Meg Comeau of the Center for Innovation in Social Work & Health at the Boston University School of Social Work, a national organization that works to advance the health and well-being of vulnerable populations, “…these burdens are not caused by my child or any of my family members. They are not the direct result of my complex caregiving responsibilities. They are the result of deficits in the systems that surround us; the systems that are supposedly designed to support us.”

Visit the Lucile Packard Foundation for Children’s Health website to learn more about how their program for CSHCN is investing in a more efficient system that ensures high-quality, coordinated, family-centered care that will improve health outcomes for children and enhance quality of life for families.

Resources on Children with Special Health Care Needs

National Care Coordination Standards for Children and Youth with Special Health Care Needs
These Standards help state officials and other stakeholders develop and strengthen high-quality care coordination for children. It includes identifying and assessing needs, engaging families, and building a strong and supportive care coordination workforce.

An Almost Complete List of Services Used by Families and Children with Special Health Care Needs
Children with chronic and complex health conditions and their families require access to a wide array of health care and other services to function optimally. This list can be used for care mapping, care planning, resource database creation, and referral system development.

The Lucile Packard Foundation for Children’s Health continually updates a curated list of COVID-19 Resources for Children with Special Health Care Needs.

Children’s Health Resources

2020-21 California County Scorecard of Children’s Well-Being
Children Now released an interactive tool that delivers data on how kids are doing in each of California’s 58 counties. It tracks 39 key indicators of children’s well-being – over time, by race/ethnicity, and relative to other counties – from prenatal to the transition to adulthood.

Recently Released Data

We recently released data about Children with Special Health Care Needs and Childhood Adversity. See links to the latest here.

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Licensed Child Care Remains Challenging for Many Families

Licensed Family Child Care Homes Offering Evening, Weekend or Overnight Care in California, 2019

Image of licensed family child care homes offering evening, weekend, or overnight care in california

Licensed child care continues to be unavailable and unaffordable for many families in California. While nearly 37,000 child care centers and family child care homes were licensed in California offering nearly one million spaces in 2019, caring for children outside the home remained a challenge. For caregivers who work non-traditional hours, the challenge may be even greater.

Among licensed facilities in 2019,

  • 2% of child care centers and 41% of family home care offered evening, weekend, and/or overnight care
  • 82% of each type of facility offered part-time schedules
  • Child care centers cost over $17,000 yearly for full-time infant care and over $12,000 for preschooler care while family home care facilities cost around $11,000 for either age group (in 2018)

Since the pandemic began, child care has been impacted in ways we are only beginning to understand. Based on a study conducted by the California Child Care Resource and Referral Network, 43% of respondents reported in June and July 2020 that their child care was different than what they had been planning to use before the pandemic. Cultivating and expanding a mixed delivery care system that serves all families has only increased in importance through this period.

Webinar

Creating Compelling Messaging with ACEs Data
Date: January 20, 2021, 10:30 AM – 12:00 PM
Host: Essentials for Childhood (EfC) Initiative

Speakers from Berkeley Media Studies Group, ACEs Connection, and kidsdata.org will offer guidance on effectively communicating about adverse childhood experiences. Register here.

Children’s Health Resources

The CDC recently released a report that raises concern for child abuse victims. The report found that during the pandemic the total number of emergency department visits related to child abuse and neglect in the U.S. decreased, but the percentage of such visits resulting in hospitalization increased, compared with 2019.

The Lucile Packard Foundation for Children’s Health continually updates a curated list of COVID-19 Resources for Children with Special Health Care Needs.

Recently Released Data

We recently released data about Early Care and Education. See links to the latest here.

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California Sets Bold Goal to Cut Burden of ACEs in Half Within Next Generation

A new report from the California Office of Surgeon General provides vision and guidance on reducing the impact of adverse childhood experiences (ACEs). Roadmap for Resilience: The California Surgeon General’s Report on Adverse Childhood Experiences, Toxic Stress, and Health covers four areas:

  • The science, scope, and impacts of ACEs and toxic stress
  • Primary, secondary, and tertiary strategies to prevent harmful exposures, facilitate early detection and intervention, and lessen the severity and progression of resulting diseases or social outcomes
  • State tools and strategies to address ACEs and toxic stress including case studies and systems-level implementation considerations
  • California’s next steps to advance evidence-based interventions and cross-sector approaches to prevent and mitigate the impacts of ACEs

The report focuses on cross-sector strategies in health care, public health, social services, early childhood, education, and justice. In addition to providing a framework for a shared understanding, language, and vision to align efforts, it also highlights current practices that address ACEs as a public health crisis.

See kidsdata.org’s Childhood Adversity and Resilience topic for data describing the number and types of adverse experiences among children in California.

 

Webinar

Creating Compelling Messaging with ACEs Data
Date: January 20, 2021, 10:30 AM – 12:00 PM
Host: Essentials for Childhood (EfC) Initiative

Speakers from Berkeley Media Studies Group, ACEs Connection, and kidsdata.org will address the practical application of the report: “Adverse Childhood Experiences Data Report: Behavioral Risk Factor Surveillance System (BRFSS), 2011-2017: An Overview of Adverse Childhood Experiences in California.” Register here.

 

Recently Released Data

We recently released data about homelessness. Almost 12,000 California youth ages 0 to 24 were homeless on one night in January 2019. See links to the latest here.

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Quick Tip: Definition, Source & Notes

Compelling data go beyond the numbers. All 600+ indicators on kidsdata.org include definitions, data sources, and notes to help interpret the data.

Click on the “Definition, Source & Notes” link on any indicator page:

In this section, find a sample sentence that shows how to talk about the data, a link to the data source, and additional information to understand findings.

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