Infants and toddlers generally fare well in New Jersey, but the state still lags in some crucial areas, including a lack of Medicaid payment for some screenings and a higher infant mortality rate for black children than for whites, according to a new national report.
The State of Babies Yearbook: 2019, released Tuesday by the early childhood development nonprofit ZERO TO THREE and children’s research organization Child Trends, ranked New Jersey among the second-best group of states for the youngest children. It looks at 60 indicators of good health, family strength and positive learning experiences.
The goal of the report is to show where states are doing well and what they could do better to help give the youngest children the best possible chance at a successful life. It is especially important to provide good opportunities for the youngest children because research has shown this is the time when children learn to speak and reason, and their interactions and experiences shape their brains.
“What happens during the first few months and years of life has an enormous impact on how a child learns and grows throughout his or her lifetime,” said Cecilia Zalkind, president and CEO of Advocates for Children of New Jersey (ACNJ), a state partner in ZERO TO THREE’s Think Babies campaign. “Positive interactions and early environments during this time of rapid brain development can impact a baby’s future social and emotional development and help them thrive as adults.”
Importance of paid family leave
In New Jersey’s case, the report shows the state scores best in the area of strong families. Two policies that contribute to this are the state’s paid family leave and paid sick leave laws. Gov. Phil Murphy held a public event on Tuesday to mark the first day that employers must allow workers to take a paid sick day — workers began accruing sick time when the law took effect last October and now they can start using those days. Last week, he signed legislation providing more generous family-leave benefits for many workers in the state.
New Jersey also has a lower than average rate of maltreatment of infants and toddlers and a greater than average percentage of families in poverty receiving cash public assistance. Fewer mothers receive late or no prenatal care in New Jersey than the nation as a whole, and the rate of children without health insurance is also lower.
On the other hand, New Jersey infants and toddlers are more likely to live in crowded housing, with an average 18.2 percent of children in crowded housing in the state, versus 15.6 percent nationally. New Jersey consistently ranks among the states with the most expensive housing costs in the nation and one calculation estimates the state needs 155,000 new affordable homes over the next seven years.
Where New Jersey fares worst is in the area of good health. The state has no Medicaid policy that would allow for maternal depression screenings in well-child visits. Medicaid also does not cover social-emotional screenings for young children or for Medicaid Infant-Early Childhood Mental Health consultations or coaching through early childhood education programs.
Checking for early stress
“New Jersey could do better in screening babies for healthy social-emotional development,” Zalkind said. “Children who experience traumatic events at an early age are exposed to stressors that can lead to learning difficulties in school, and physical and mental health issues throughout life.”
“Integration of health into the quality early care and education framework is a critical investment, as babies must be healthy to even attend,” said Fran Gallagher, CEO of the NJ Chapter of the American Academy of Pediatrics. “Babies need pediatric primary care physicians and specialists who provide care promoting prevention and wellness such as routine developmental, and social emotional screenings to identify mental/behavioral health concerns early. Identifying social emotional issues early creates the opportunity to link babies to services needed and provides support for parents/caregivers.”
Gallagher said contributing to the problem is that New Jersey pediatricians are reimbursed with the lowest Medicaid payment rates in the nation. “Medicaid parity with Medicare payment would allow physicians to increase their percentage of children with Medicaid insurance seen, to ensure families have access to critical mental/behavioral health screenings and services to promote healthy social-emotional development as part of each baby’s overall health,” she added.
Fewer than a quarter of young children in New Jersey receive preventive dental care, compared to a national average of 30 percent. And the percentages of infants being breastfed and young children receiving the recommended vaccines also lag the national average. While the state’s overall infant mortality rate is low compared to the national average, black babies in New Jersey are three times more likely to die before their first birthday than white babies.
First Lady Tammy Murphy has prioritized reducing both infant and maternal mortality and eliminating racial disparities in this area through a program called Nurture NJ. Lawmakers have also proposed a package of bills meant to deal with these issues.
Too many face ‘persistent hardships’
“Each of the 310,305 babies in New Jersey was born with a bundle of unlimited potential and the first three years of their life will shape every year that follows,” said Myra Jones-Taylor, chief policy officer of ZERO TO THREE. “But far too many babies face persistent hardships — such as food insecurity, unstable housing, and exposure to violence — that undermine their ability to grow and thrive.”
The state fares well in some other areas. A greater percentage of low- and moderate-income infants and toddlers receive subsidized child care than the national average and a larger proportion of the youngest children who need disability services get them. More New Jersey parents sing to their babies every day than average, although a slightly smaller percentage read to their infants daily in New Jersey than in the nation.
Demographic data on the youngest New Jerseyans shows them to be wealthier and more diverse than the average Americans age 0-3. Some 47 percent of the state’s infants and toddlers are Hispanic, black, Asian or some race other than white, compared with just over half of the nation as a whole. While almost 45 percent of the youngest children in the United States are either living in poverty or in a low-income family, just 35 percent of New Jersey’s infants and toddlers are in a family with limited means. On the other hand, a greater proportion of New Jersey mothers are working — almost 69 percent, compared with 62 percent nationally.