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How Healthy Is Health Care for California’s Children?
California Children Enrolled in Medi-Cal, by Percent, 2020
The latest data on children’s health care in California are now available on KidsData. The health care topic includes 25 indicators covering health insurance, timely medical care, usual source of health care, prevalence of medical homes, and school-based health centers and services.
Learn more about:
- Health care data. For example, monthly averages in 2020 show that nearly half of children were enrolled in Medi-Cal, establishing it as a critical system for maintaining children’s health in California.
- Why this topic is important. Every child should receive high-quality health care that is accessible, family-centered, culturally competent, coordinated, continuous, compassionate, and comprehensive, according to the American Academy of Pediatrics.
- How children are faring. For instance, children had access to 291 school health centers in 2021, up from 153 in 2009; 23 of the state’s 58 counties did not have any school health centers in 2021.
- Policy implications that could improve children’s health care. For example, measures that strengthen investment in public insurance programs serving children would help ensure continuous insurance coverage for all children.
Children’s Health Resources
A Medi-Cal Enrollment Update, from the California Department of Health Care Services, reports that about 395,000 children experienced re-enrollment churn, or re-applications after experiencing a break in aid, from July 2019 to June 2020 (see slide 27). Re-enrollment churn may result in gaps of coverage for children. For a national perspective on churn, see “Medicaid Churning and Continuity of Care: Evidence and Policy Considerations Before and After the COVID-19 Pandemic” from the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services.
“The Impact of the Pandemic on Households With CYSHCN,” a new family snapshot from the American Academy of Pediatrics and partners, suggests that pediatric health care providers might want to inquire about persistent challenges with child development and education, economic stress, and family stress even after the pandemic. These insights are based on questionnaire responses from caregivers raising children and youth with special health care needs (CYSHCN).
“Counting Little Kids Is a Big Challenge for the U.S. Census,” a Wall Street Journal article, shares evidence and expertise from researchers at PRB and other organizations to show that the most disadvantaged children are least likely to be counted, though they are most in need.
New on KidsData
Our homepage now offers easily accessible links to three KidsData collections—Well-Being During the Pandemic, Safeguards for Youth, and Youth in Schools—as well as to recently released data.
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Quick Tip: Create Customized Profiles
Build a custom data profile for your region by following these simple steps:
- On the KidsData website, select the Data by Region tab. Click into a county, city, school district, or legislative district of your choice.
- Click on the “Create Custom Profile” option near your selected location’s name.
- Expand the options by clicking on the plus signs, and then select the indicators you want included in your data profile.

- Click “Submit” to see your custom profile.
Use these profiles to highlight the most important aspects of children’s well-being in your region for reports, advocacy, and community needs assessments.
Recently Released Data
We recently released data about unemployment. See links to the latest here.
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Youth Suicide Rates Rise in California
Suicide Increased Among Youth Ages 15 to 24 in California and the United States, 1999-2019
The suicide rate for youth in California and the United States was increasing even before COVID-19 entered the picture in 2020. Since then, the pandemic’s extended social isolation and other stressors have presented newly compounding risk factors for suicide along with more common factors such as mental illness, access to lethal means, poor family communication, and exposure to others’ suicidal behavior.
In California, suicide rates for young people ages 15 to 24 increased from 6.9 per 100,000 youth in 2007-2009 to 8.9 per 100,000 youth in 2017-2019, a nearly 30% increase.
In 2019, the number of suicides among California youth differed greatly by age, gender, and race/ethnicity. Counts don’t provide us with information on prevalence as rates do, but the sheer numbers indicate populations that may need greater attention from advocates, policymakers, and us all.
Learn more about youth suicide.
Children’s Health Resources
A new data toolkit, “Utilizing Data to Improve Child Wellbeing Through Community Action,” shares existing data sources and best practices for monitoring child adversity, health, development, and well-being. It includes the Child Well-Being Data Matrix, which identifies 27 data sources that may be useful to collect data about California children.
Suicide Prevention Modules from the Prevention Institute and the Center for Law and Social Policy offer strategies and tools to prevent suicide during periods of major social upheaval.
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Discrimination Against Caregivers Increased During Pandemic
Change in Race/Ethnicity Discrimination Against Caregivers During the COVID-19 Pandemic, March 2021
Increased racism has been widely reported in the media during the COVID-19 pandemic, and the latest data support those reports. Children may experience racism directly or witness it against their caregivers. Direct and indirect racism impact health, blunt well-being, and undercut health equity—addressing them is fundamental to improving children’s health and well-being.
Caregivers who responded to the questionnaire, Family Experiences During the COVID-19 Pandemic, compared their experiences of racism before and during the pandemic. In March 2021, nearly one in three caregivers in California who had ever experienced race/ethnicity discrimination reported experiencing increased racism since the pandemic began, while just over half reported no change, and about one in six reported a decrease. Asian caregivers more often reported experiencing an increase in racism during the pandemic compared with all other race/ethnicities (44% compared with 31%).
On the questionnaire from November 2020, a caregiver shared, “Social challenges are the greatest challenge I have faced since [the pandemic began] and I don’t want my child to face racism or discrimination.”
Children’s Health Equity Resources
“The Impact of Racism on Child and Adolescent Health,” a policy statement from the American Academy of Pediatrics, offers guidance in clinical practice, workforce development, community engagement, and public policy settings to address the effects of racism on children.
The National Institute for Children’s Health Quality compiled resources that address maternal and child health equity.
Do No Harm Guide: Applying Equity Awareness in Data Visualization, a research report from the Urban Institute, provides in-depth guidance on centering equity in data-work and communications.
Recently Released Data
We recently released data about family structure and immigrants. See links to the latest here.
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Childhood Cancer Survival Rates Vary by Race/Ethnicity
Five-Year Cancer Survival Rate Among California Children Ages 0 to 19 by Race/Ethnicity, 2006-2016
Treatment of childhood cancer, including leukemia and lymphoma, has improved markedly in recent decades, though survivors often need continued specialized care and may have a higher risk of developing other chronic health conditions. Because of the substantial burden of their disease, children battling cancer may also face psychological challenges, low educational attainment, and long-term quality of life issues. Cancer outcomes differ by race/ethnicity as well as other factors such as socioeconomic status and geographic location. Public policy and practices can help ensure equitable access to high-quality care during treatment and beyond.
In California, 83% of children ages 0 to 19 who were diagnosed between 2006 and 2016 were expected to survive cancer for at least five years. However, five-year survival rates varied by race/ethnicity, ranging from 79% for African American/Black children to 85% for White children. Eighty-one percent of Asian/Pacific Islander and Hispanic/Latino children and 84% of American Indian/Alaska Native children battling cancer survived the disease for at least five years.
Learn more about childhood cancer in California.
Children’s Health Resource
The 2021 Kids Count Data Book by the Annie E. Casey Foundation features state rankings on the overall well-being of children and on specific areas such as education and health.
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New Data on Family Experiences During Pandemic
Today, KidsData released the latest data from the Family Experiences During the COVID-19 Pandemic questionnaire. These data are the second wave of findings from the multi-wave questionnaire.
As the COVID-19 pandemic passed the one-year mark, caregivers in households with children reflected on their experiences in:
- 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)
The second wave of the questionnaire covers the period from March 22, 2021, to April 12, 2021. These data join the first wave of findings from Nov. 9, 2020, to Dec. 11, 2020.
Key findings from the latest data:
Education, Health Care, and Social Activities
About the same percentage of caregivers in both waves reported disruptions since the pandemic began, including closed child care centers (16% in wave 1, 17% in wave 2), canceled medical and dental appointments (29% in both waves), and canceled sports and after-school activities (36% in wave 1, 33% in wave 2).
Child and Caregiver Safety
Almost one-quarter (23%) of caregivers reported spanking, slapping, or hitting their child at least once in the last seven days. One-third (33%) of caregivers reported physical or emotional intimate partner violence during the pandemic.
Positive Childhood Experiences
A higher percentage of African American/Black caregivers reported that their child had a caring adult outside the home (94%) than White (82%) and Hispanic/Latino (79%) caregivers.
About the Data
In the Family Experiences During the COVID-19 Pandemic questionnaire, caregivers were asked to reflect on life disruptions and the emotional and behavioral consequences of the COVID-19 pandemic. The data cover 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. We expect to share a third wave of findings in the coming months.
Learn more about the questionnaire and its collaborators who made it possible in About the Data Source.
Using the Data in Your Work
We hope these data are useful in your work with children and youth to address the effects of the COVID-19 pandemic. If you would like to share how you are using these data, please reach out to us at [email protected].
Additional Resource on the COVID-19 Pandemic
For a national perspective on the Family Experiences During the COVID-19 Pandemic questionnaire, see Family Snapshots: Life During the Pandemic from the American Academy of Pediatrics, in partnership with the Centers for Disease Control and Prevention (CDC), Prevent Child Abuse America, and Tufts Medical Center. They recently released two new snapshots on child discipline and intimate partner violence during the pandemic.
Children’s Health Resources
“Creating Safe, Stable, Nurturing Relationships and Environments for Children” is a new resource from the California Essentials for Childhood Initiative that elevates prevention strategies and highlights findings from the CDC’s Awareness, Commitment, and Norms Survey.
Physical Punishment: Attitudes, Behaviors, and Norms Associated with Its Use Across the US is a new report from Prevent Child Abuse America that shares findings from a survey given to U.S. adults about physical punishment and offers new insights for policy, intervention, and social norms change.
Community Safety Realized: Public Health Pathways to Preventing Violence is a new tool from Prevention Institute and Big Cities Health Coalition to advance community-driven, multi-sector approaches grounded in racial justice to prevent violence and establish pathways to safety.
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Air Quality and Lead Exposure Endanger California Children’s Health
Children in the Inland Empire Suffered Months of Poor Air Quality in 2019
Days With Unhealthy Ground-Level Ozone Concentrations in California Counties, 2019
Air pollution is a serious threat to children’s health, with links to adverse birth outcomes, obesity, cardiovascular and respiratory diseases, and cancer. It can also be associated with deficits in cognitive and behavioral development.
Counties in the Inland Empire recorded the most days with
unhealthy ground-level ozone concentrations in 2019, followed by neighboring counties in Southern California and the Central Valley. Children in San Bernardino County spent nearly three out of every 10 days in 2019 with unhealthy air (109 days). Riverside County had 64 days with unhealthy air, and Tulare County had 59 days. By contrast, 15 counties did not record any unhealthy air days, and nine counties lacked data.
At Least 7,000 California Children Had Elevated Blood Lead Levels in 2018; Undercounts Obscure Magnitude of the Problem
California Children Ages 0 to 5 With Elevated Blood Lead Levels, 2018
Childhood exposure to any level of lead is linked to lifelong adverse effects on physical, neurological, cognitive, academic, and economic outcomes. No amount of lead in the blood is considered safe.
In 2018, 7,141 California children ages 0 to 5 were reported to have
elevated blood levels, including 1,291 children with blood levels at 9.5 micrograms or higher. These numbers are substantial undercounts. Though state regulations require lead screening for every child enrolled in Medi-Cal, the state’s Medicaid Program, many children are not screened. Between fiscal years 2009-10 and 2017-18, fewer than 27% of Medi-Cal enrollees ages 1 to 2 received all of their required lead screenings, according to a report by the California State Auditor.
Learn more about lead poisoning.
Additional Resource
U.S. children exposed to air pollution and household lead face a higher risk of incarceration and lower incomes in adulthood, according to a new study by Robert Manduca of the University of Michigan and Robert J. Sampson of Harvard University. This research is a part of a special issue in the journal, Population and Environment, summarized
here.
Conference
Be a part of the conversation on using public data to understand our communities during this period of immense challenges arising from COVID-19 and political polarization. The conference, “Public Data: Making Sense of the New Normal,” is organized by the Association of Public Data Users and takes place July 26-29, 2021. Register here.
Recently Released Data
We recently released data about asthma and teen sexual health. See links to the latest here.
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Nearly 10,000 Homeless Youth in California Lack Shelter
Number of Sheltered and Unsheltered Homeless Youth Ages 0 to 24 in California, 2020
Almost 10,000 youth and young adults who are experiencing homelessness in California are unsheltered. During the January 2020 annual homelessness Point-in-Time Count, 9,510 youth ages 0 to 24 were unsheltered while an additional 2,662 youth were homeless but sheltered. These 12,000+ youth were also without a parent or guardian while homeless. Sheltered youth were counted in emergency shelters, transitional housing programs, or safe havens; unsheltered youth were staying in a place not ordinarily used for sleeping.
Los Angeles, Santa Clara, and San Francisco counties found the highest number of youth ages 0 to 24 who were homeless and unsheltered in California in January 2020.
Youth who experience homelessness are more likely than other young people to face hunger and malnutrition, physical and mental health issues, developmental delays, and academic problems.
Job Posting
PRB is hiring! Support data and administrative work on KidsData and other projects at PRB. We are looking for a full-time research assistant located in California or Washington, DC.
Read more.
Children’s Health Resources
Mapping Child Opportunity is a new, interactive map from diversitydatakids to give community leaders and policymakers tools to create conditions for all children to thrive.
Transforming Practice with HOPE (Healthy Outcomes from Positive Experiences), a new journal article in Maternal and Child Health, translates research findings about the effects of positive childhood experiences for clinical and organizational settings.
Recently Released Data
We recently released data about air quality. See links to the latest here.
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The Pandemic’s Impact on Caregivers of Children With Special Health Care Needs
Frequency of California Caregivers Feeling Overwhelmed While Providing Medical and Therapeutic Care for Children With Special Health Care Needs, March to November 2020
Families who have a child with a special health care need (CSHCN) have experienced substantial challenges during the coronavirus pandemic. CSHCN have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition. They require health and related services of a type or amount beyond that required by children generally. These requirements may add strain to daily family functioning.
The questionnaire, Family Experiences During the COVID-19 Pandemic, offers a look at how families coped with caring for their CSHCN during the pandemic. To collect and share information about these children and their needs, a section of the questionnaire is dedicated to asking about experiences specifically among families with CSHCN. In addition, all questionnaire findings on KidsData compare responses of caregivers with at least one CSHCN to those without.
Between March and November 2020, more than half of caregivers sometimes, fairly often, or very often felt overwhelmed by the day-to-day demands of providing medical or therapeutic care for their CSHCN between March and November 2020. Notably, in the week prior to responding to the questionnaire, 14% of caregivers had to provide medical care that would normally be provided by others.
The Lucile Packard Foundation for Children’s Health invests in creating a more efficient system that ensures high-quality, coordinated, family-centered care to improve health outcomes for children and enhance quality of life for families. A series of webinars and publications supported by the foundation share strategies that state Medicaid agencies have implemented during the pandemic, including expanded access to services for CSHCN. Additional resources for families, caregivers, state agency staff, and advocates offer information about caring for CSHCN during the pandemic.
Webinar Posted
The webinar and slide deck for “Family Experiences During COVID-19 Pandemic Data” are now posted! On April 29, the California Essentials for Childhood (EfC) Initiative hosted a webinar that featured findings from wave one of the Family Experiences During COVID-19 Pandemic questionnaire. Drs. Robert Sege from the HOPE Project at Tufts Medical Center and Lori Turk-Bicakci from the KidsData program at PRB shared both national and California-level findings about child and caregiver experiences.
Recently Released Data
We recently released data on homelessness and lead poisoning. See links to the latest here.
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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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