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National Race for Results Report Ranks NJ High in Child Well-Being, but Wide Disparities Remain Among Children of Color

Posted on January 16, 2024

Read Alena's Blog on the Race for Results Report

New Jersey Ranks High in Child Well-Being, but Across the Country, Children of Color Face Disparate Outcomes, Jeopardizing Their Well-Being and America’s Future

2024 Race for Results Report Identifies Gaps in Child Well-Being That Persist Across Race and Ethnicity, Caused by Policy Choices That Shortchange Young People

NEWARK, NJ — New Jersey outpaces national statistics when it comes to enrollment in early education, high school graduation rates and the percentage of young adults completing an associate degree or higher. However, those results are in the context of a nationwide failure to equip all children to succeed, with policy choices and lack of support for families resulting in particularly dire outcomes for Black, Latino and American Indian or Alaskan Native.

Read Report: 2024 RACE FOR RESULTS: BUILDING A PATHWAY TO OPPORTUNITY FOR ALL CHILDREN

Key Findings:

  • While 71% of New Jersey’s children were living at or above 200% of the poverty level (approximately $55,000 for a family of 4)  according 2017-2021 data, when broken down by race/ethnicity, only 53% of both non-Hispanic Black or African American children and Hispanic or Latino children were living at or above 200% of the poverty level compared to 87% of non-Hispanic Asian Pacific Islander children and 82% of non-Hispanic White children.
  • In 2022, 38% of New Jersey’s 4th graders scored at or above proficiency in reading. When broken down by race/ethnicity, it is apparent that there are wide disparities as 68% of 4th graders who identify as non-Hispanic Asian and Pacific Islander scored at or above proficient in reading, amongst the highest in the nation, while only 19% of non-Hispanic Black or African American 4th graders are proficient.
  • During 2017-2021 in New Jersey, 69% of children ages 0-17 were reported to be living in 2-parent U.S born families while 82% of children were living in 2-parent immigrant families. This trend remains true for each race/ethnicity group as well. For example, 31% of black children lived in U.S born 2-parents families compared to 69% of black children who lived in 2-parent immigrant families.

“While New Jersey ranks well compared to other states for children living at or above the poverty level, even when broken down by race and ethnicity, it is important for us to compare how New Jersey’s children are doing in relationship with each other. ” said Mary Coogan, president and CEO of Advocates for Children of New Jersey, the state’s member of the KIDS COUNT network. “Key legislation like the state’s expanded child tax credit has helped thousands of families, but we must do more to ensure that children from all corners of the state have the opportunity to thrive.”

The Race for Results index standardizes scores across 12 indicators representing well-being milestones from cradle to career, converting them into a scale ranging from 0 to 1,000 to make it easy to compare and see differences across states and racial and ethnic groups. Indicators are grouped into four areas: early childhood, education and early work experiences, family resources and neighborhood context. Overall child well-being in New Jersey, when broken down by race/ethnicity, ranged from 465 for Black children, to 877 for Asian and Pacific Islander children.

Nationally, Asian and Pacific Islander children have the highest index score at 771, followed by white children at 697 and children of two or more races at 612. Scores for Latino (452), American Indian or Alaska Native (418) and Black children (386) are considerably lower. Calculations of the index for all 50 states show that experiences vary widely depending on where a child lives, from a high of 877 for Asian and Pacific Islander children in New Jersey to a low of 180 for American Indian or Alaska Native children in South Dakota.

Young people are missing critical developmental milestones as a direct result of choices to fail to invest in policies, programs and services that support children, especially in under-resourced communities and communities of color.

The Casey Foundation introduced the Race for Results index in a 2014 report and updated it in 2017. This third edition of the report carries data from the aftermath of the COVID-19 pandemic that demonstrates both the urgency of ensuring all children can thrive, and the promise of policy prescriptions for achieving that goal. Race for Results contends that young people are missing critical developmental milestones as a direct result of choices to not invest in policies, programs and services that support children, especially in under-resourced communities and communities of color.

The Casey Foundation makes several recommendations in Race for Results toward improving outcomes for all children:

  • Congress should expand the federal child tax credit. The temporary, pandemic-era expansion of the CTC lifted 2.1 million children out of poverty, with the share of kids in poverty falling to 5.2% in 2021, the lowest rate on record.
  • States and Congress should expand the earned income tax credit.
  • Lawmakers should consider baby bonds and children’s savings accounts — programs that contribute public funds to dedicated accounts to help families save for their children’s future.
  • Policymakers must create targeted programs and policies that can close well-being gaps for young people of color because universal policies are important, but insufficient, for continued progress.

The 2024 Race for Results report is available at http://www.aecf.org.

Did you know NJ kids are above the national average, but there’s still work to be done at home

Posted on January 11, 2024

Alena Siddiqui Data Analyst

By Alena Siddiqui

For more information on this topic or kids count data, contact Alena at asiddiqui@acnj.org

Did You Know Blog Banner

On January 10, 2024, the Annie E. Casey Foundation released its 2024 Race for Results policy report. This report comes ten years after the first Race for Results report in 2014, and through a variety of indicators illustrates the well-being of young people living in the United States. The data is broken down by race, ethnicity, and immigrant family status, which illustrates a more detailed view of the diversity in the United States.

The policy report provides an Overall Index which gives a combined score out of 1,000 possible index points for each racial/ethnic group. New Jersey is doing quite well for each racial/ethnic group compared to the United States as a whole (Table 1). Non-Hispanic Asian and Pacific Islander young people living in New Jersey have the highest overall index in the country. New Jersey’s young non-Hispanic American Indian or Alaska Native population has the second-highest overall index in the country. Despite New Jersey’s children faring better than many across the nation, it is crucial for policymakers and the community at large to compare the state’s children to each other to understand where help is needed and then create actionable change. The indicators chosen for this report are reflective of different facets of a child’s life broken into four categories: early childhood, education and early work experiences, family resources, and neighborhood context. Over the next few weeks, ACNJ will be spotlighting some data points from each of these categories.

Race for Results blog Table 1

Family Resources

Based on data collected during 2017-2021, about 71% of children in New Jersey are living at or above 200% of the poverty level, an increase from 68% in 2012-2016. For a family of four, 200% of the poverty level is approximately $55,000. When that data is broken down by race/ethnicity, we see disparities. For instance, 87% of non-Hispanic Asian and Pacific Islander children and 82% of non-Hispanic White children were living at or above 200% of the poverty level. Also, of the children who are Hispanic/Latino or of non-Hispanic Black or African American background, only 5 of every 10 are living at or above 200% of the poverty level. While this is an increase from 2012-2016, as non-Hispanic Black or African American children were at 48% and Hispanic/Latino children were at 45%, the statistics show that equitable work needs to be done to address these racial/ethnic disparities. When categorized by family type, 74% of children in U.S. born families are living at or above 200% of the poverty level compared to 66% of children in immigrant families.

Neighborhood Context

Another interesting indicator related to poverty is the percentage of children living in low-poverty areas. Low-poverty areas are those areas where less than 20% of families have incomes below the poverty level. The reason the Annie E. Casey Foundation included this indicator is because past policies, like redlining, have led to families of color more often living in high-poverty neighborhoods. In 2017-2021, 8 of every 10 children in New Jersey were living in low-poverty areas (Table 2). This table shows the same trend where children living in New Jersey, while doing better than their counterparts nationwide, still need help to escape systemic poverty. Also, 85% of children in U.S. born families and 80% of children in immigrant families living in the Garden State are in low-poverty areas compared to nationally, where the numbers are 80% and 76% respectively.

Race for Results blog Table 2

The 2024 Race for Results report has many other interesting indicators which show the well-being of our children. You can learn more about the report and access it here.

Read our latest updates on kids count data.

Did you know NJ Kids Count data shows WIC participation is not where it should be?

Posted on January 10, 2024

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By Hannah Korn-Heilner, Policy Associate

For more information on this topic, contact Hannah at hkornheilner@acnj.org

olivia headshot 2

By Olivia Carrara, Leontine Young Fellow

For more information on this topic, contact Olivia at ocarrara@acnj.org

Did You Know Blog Banner

The Supplemental Nutrition Program for Women, Infants, and Children, commonly known as WIC, provides supplemental nutritious food to pregnant, breastfeeding, and postpartum women, and to infants and children up to the age of five in New Jersey households, with incomes up to 185% of the federal poverty level, which is $55,500 for a family of four. WIC also provides nutrition education and counseling, breastfeeding education and support, immunization screening and referrals, referrals for free or reduced-cost health care, and referrals to health or social services. New Jersey’s WIC enrollment increased 9% between 2022 and 2023, while the state participation rate increased 11%. Despite these increases, the number of women, infants, and children actually participating remains lower than the number of those enrolled. ACNJ Kids Count data for 2023 shows that 184,181 women, infants, and children were enrolled in WIC, but only 166,839 were actually participating.

In 2023, members of ACNJ’s Melinated Mom’s Parent Leadership Council interviewed parents across the state about their experiences raising young children in New Jersey. Five parents from Essex, Camden, Burlington, and Hudson Counties shared how beneficial the WIC program has been to their families, providing critical funds to purchase formula and other necessities such as milk, eggs, and fruits. Parents appreciated the healthy food options and the opportunity to meet with a dietician who suggested helpful recipes. Parents indicated that the application process was easy–one parent even mentioned receiving the application in the hospital, allowing the benefits to start quickly without having to make a trip to the WIC office. In recent years, WIC transitioned to e-cards, which alleviates parents from the need to pick up their check at the WIC office each month. Parents report that the e-cards make it easier to purchase food in stores.

Parents also shared ways to improve WIC. They cited a need for all formulas to be allowable under WIC, including special formulas made for babies with particular dietary requirements. Parents also recommended that WIC expand its food options to include a wider variety of choices so that they can have greater autonomy over what they are feeding their families.

ACNJ’s Maternal and Infant Health Workgroup recommended that the NJ Department of Health, which implements the State’s WIC Program, maintain the flexible policies put in place during COVID, increase benefit levels and eligibility, and increase outreach and enrollment. While ACNJ applauds state officials for their willingness to brainstorm ways to make the WIC Program more accessible, it recognizes that many of the regulations are set at the federal level. In 2023, the Maternal and Infant Workgroup submitted comments in support of the U.S. Department of Agriculture’s proposed changes to allow for the usage of WIC benefits in online shopping and food delivery transactions.

Recently the WIC for Kids Act was re-introduced (H.R. 5757), expanding eligibility and improving enrollment by allowing families already enrolled in similar social service programs such as SNAP, Medicaid, and Head Start to be deemed eligible for WIC. Federal funding for WIC may see significant cuts under current federal appropriations bills, creating waiting lists for some and ending eligibility for others. See congress.gov for more specific details.

Read our latest updates on maternal and infant health.

Take Action: Urge Governor Murphy to sign the child care enrollment bill S2478/A4177.

Posted on January 9, 2024

GREAT NEWS! The S2478/A4177 Child Care Enrollment bill would extend the duration of a law requiring certain provider subsidy payments for child care services to be based on enrollment.

And now, it is headed to the Governor’s desk…

Urge Governor Murphy to say “YES” to small businesses, working families and their children by signing A4177/S2478 into law!

When signed into law, this bill will:
•    Continue to provide center-based and family child care programs with one stable source of funding;
•    Provide support to help programs attract and retain teachers and other staff;
•    Reduce the chances of program closings due to financial volatility;
•    Support working families who need stable child care.

Did you know there are only 80 doula service providers registered with NJ FamilyCare?

Posted on December 20, 2023

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By Diane Dellanno
Policy Analyst

For more information on this topic, contact Diane at ddellanno@acnj.org

Footnotes:
  1. Kenneth J. Gruber et. al., Impact of Doulas on Healthy Birth Outcomes, 22 J. Perinatal Education, 49, 50–51; National Partnership for Women and Families, Improving our Maternity Care Now: Four Care Models Decisionmakers Must Implement for Healthier Moms and Babies. 7 (Jorge Morales ed. 2020).  ↵
  2. Astier Bey et al., Advancing Birth Justice: Community-Based Doula Models as a Standard of Care for Ending Racial Disparities 16 (2019). ↵
  3.  Visit the NJ Doula Learning Collaborative website for updated list of approved trainings (njdlc.org). ↵
  4. Department of Human Services | First Lady Murphy & Human Services Commissioner Adelman Announce Enhanced NJ FamilyCare Maternal Health Care Reimbursement ↵
  5. Getting Doulas Paid Policy Brief  - HealthConnect One↵
Did You Know Blog Banner

What are Doulas?

Doulas are non-clinical support workers who provide continuous emotional, informational and physical support for individuals before, during and after labor. This includes explanations and guidance on medical procedures, lactation support, physical comfort measures during labor, education on coping skills and infant care, and encouragement of bodily autonomy and personal advocacy in the medical institution.

Community-based doulas are often of and from the same communities as their clients.  As trusted members of the community, they help to bridge language and cultural barriers to pregnancy care and education.

Benefits of Doulas

There are widely noted health benefits to using doula services1  including:

  • Reduce contributing factors of maternal mortality and morbidity in health care settings, particularly for Black women.
  • Decreased risk of cesarean birth.
  • Decreased usage of pain medication or epidural anesthesia.
  • Lower rate of vacuum- or forceps-assisted birth.
  • Increased rates of breastfeeding initiation, particularly among low-income and racially/ethnically diverse individuals.
  • Decrease in length of birthing time.
  • Increased Apgar scores for infants at birth.

Doulas can be particularly beneficial for Black, Indigenous and People of Color (BIPOC) with low incomes, who are more likely to have negative birth experiences.2

However, economic insecurity or lack of health insurance coverage means doula care is often out of reach for the families who need it the most. 

The Issue

Due to inadequate compensation structures for this model of care, access to and availability of community-based doulas are lacking throughout New Jersey.

Doulas in New Jersey

As of January 2021, doulas and doula agencies have been able to enroll as Medicaid/NJ FamilyCare providers in fee-for-services (FFS) and managed care. NJ FamilyCare doula care can only be provided by those doulas who have completed NJ Department of Human Services and NJ Department of Health training.3 The current doula reimbursement rate for standard care is  $1,165, which includes up to 8 visits in the prenatal or postpartum period and attendance at the delivery for labor support.

All pregnant, birthing and postpartum individuals are eligible for doula care, regardless of medical complexity. Services are available starting in the prenatal period and up to 180 days postpartum. Doula services may be provided in the community, in clinicians’ offices, or in hospitals.

As of September 2023, 80 individuals and agencies are registered as FFS providers with NJ FamilyCare.

Issues Preventing Access to Doula Care

  1. The number of doulas in NJ is not sufficient to serve all the families that may potentially want to access doula care. There are approximately 30,000 Medicaid-covered births annually.4 NJ currently has 80 doulas who are able to bill Medicaid for their services. The availability of doulas that can bill Medicaid is not evenly distributed across the state creating geographic disparities.  Since the average caseload of a doula is 3 to 4 birthing people per month, NJ will need at least 3,000 doulas to be able to sufficiently serve the Medicaid birthing population.
  2. There is a lack of scholarship opportunities to become trained as a doula.  Scholarship programs need to be created to encourage more persons to enter the profession. There is also a need to recruit more organizations to provide the approved training.
  3. The Medicaid application and billing process are not designed for the community-based doula population. To become recognized as a Medicaid FFS provider is lengthy (72 pages), written for medical professionals and difficult to complete.
  4. The reimbursement rate for doula care lags far behind the average fee for private pay doulas. Most private doulas charge rates upwards of $2,000 per client.5 The standard fee a NJ doula can receive from Medicaid is $1,165.

As of September 2023,

80

doula care providers
are registered with
NJ FamilyCare.

NJ will need at least

3,000

doulas to sufficiently
serve the Medicaid
birthing population.

Without a pathway toward adequate and reliable compensation and strategic investments in workforce development, the community-based doula labor supply will remain too low to meet the communities' demand.

Recommendations

  1. Increase the reimbursement rate for Medicaid doulas for both standard and enhanced care. 
  2. Simplify the application process for doulas to become approved by Medicaid.
  3. Increase training and scholarship opportunities for persons interested in becoming a doula.
  4. Develop a sustainable community-based doula program that provides fair, equitable, and sustainable compensation to their doulas as well as regular pay, health benefits, and paid leave.
Read our latest updates on maternal and infant health.