November 2006

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Of Pennsylvania's 258,000 uninsured children: 126,000 eligible for Medical Assistance, 73,000 eligible for Children's Health Insurance Program, 59,000 ineligible for any coverage.

Strengthen Him So He Does Not Fall
Issues around children and youth in the 2006 election.

-- Dr. Flaura Koplin Winston

In 2004, nearly 1 in 5 children in Pennsylvania (18%) was born into poverty, up from 15% in 2002. These children are poor due to no fault of their own, only to the lottery of their birth. As the youngest citizens of our Commonwealth, they cannot vote, but the actions taken by our elected officials will have a direct effect on their prospects for health and success. They are leaving their future in our hands. As we review the position statements of the candidates, consider our responsibility to ?strengthen him so that he does not fall and become dependent on others." (Leviticus 25:35

What will strengthen the children and youth of our state so that they will not fall into a lifetime of poverty? According to Pennsylvania Partnerships for Children (PPC), ?Every decision facing our legislature affects children." However, children living in poverty and in disadvantaged communities receive a smaller share in the prosperity of a strong economy and experience a greater burden during hard times. We need to ensure that provisions are in place to protect children, regardless of the strength of our economy, as they are the future of Pennsylvania. As W. E. B. Du Bois wrote so eloquently about education in 1903 in "The Talented Tenth," "If you do not lift them up, they will pull you down. Education and work are the levers to uplift a people. Work alone will not do it unless inspired by the right ideals and guided by intelligence. Education must not simply teach work; it must teach Life."

Below are the key issues for children and youth as prioritized by PPC. Please check the PPC website for candidate responses as they become available. The Annie E. Casey Foundation assembled data included below from multiple federal sources in the KIDS COUNT State-Level Data Online Database.

This new database, launched in July 2005, contains more than 75 measures of child well-being.


Background: We live in a high-tech and knowledge-based economy. For our citizens to be successful contributors to this economy, we need to ensure that as children, they receive the education that will provide them with opportunities. Education must begin with ensuring readiness to learn before first grade and must continue to ensure mastery of grade-level knowledge and skills. Despite this, less than half of Pennsylvania's children between the ages of 3 and 5 (43%) were enrolled in pre-kindergarten or kindergarten in 2004. Close to one third of Pennsylvania's eighth graders were below basic level competency in both reading and math in 2005. Nearly 1 in 10 Pennsylvania teens (8%) drop out of high school. (2004) 

Education priority issues 

  1. Early childhood initiatives, especially pre-kindergarten, full-day kindergarten, and small classes in the early grades.
  2. A high school reform agenda focused on rigor, relevance, and support for our students.
  3. A sound school finance system that is focused on equitable and adequate funding of the education provided for all Pennsylvania students and that accounts for the first two priorities above.


Background: Children with health insurance have access to regular and essential healthcare, avoid preventable illnesses, and miss less school. Nearly 19% of Pennsylvania's children in families living below the 100% poverty level had no health insurance in 2004. Overall, 11% of Pennsylvania children age 17 and below (133,600 children) were without health insurance in 2004, up from 7% uninsured in 2000. Of the children covered by insurance, 1 in 3 Pennsylvania children received health insurance through Medical Assistance (925,000 children) or the state's Children's Health Insurance Program (140,000) in 2004. Recent cuts in federal Medicaid funding put an increased burden on our state and threaten the ability of the state to continue and expand health insurance coverage to the state's uninsured children. Approximately half of Medical Assistance dollars come from the federal government while only one-third of the state's Child Health Insurance Program (CHIP) dollars come from the federal government.

Child healthcare priority issues 

  1. Make Pennsylvania's Children's Health Insurance Program available to all Pennsylvania children regardless of family income. 
  2. Those who can afford to pay for a portion of the coverage must do so. Others with higher family incomes can pay the Commonwealth's negotiated cost for coverage.
  3. Create a stable financing system for child health insurance that is not subject to state budget shortfalls or economic downturns.

Youth development (beyond education)

Background: Nearly 1 in 10 Pennsylvania teens are at risk with 9% not attending school and not working in 2004; 11% binge drinking; 8% using marijuana; and 6% using illicit drugs in 2002. Of those who graduate high school, only 29% went on to complete a bachelor's degree by age 25-29. (2004) A Pennsylvania youth development strategy can help our young citizens avoid these risky behaviors and transition to healthy, successful adults. Further, such a comprehensive strategy will re-engage youth who have left school or are struggling.

Youth development priority issues 

  1. High-quality after-school and youth development programs available to all of Pennsylvania's children and youth.
  2. An effective strategy to address the issue of students dropping out of school, those marginally attending school, and re-engage those who have already dropped out.
  3. Career education for youth, parents, educators and the community to enable young people to make informed decisions about their futures and to ensure they have the necessary skills, knowledge and training to be responsible citizens and successful in a career of their choosing.

Family Support and Parent Education

Background: Infants and young children living in poverty with young mothers who have low educational attainment are at risk for abuse, neglect, injury, and school failure. More than 1 in 5 Pennsylvania children are born to mothers with less than 12 year of education. (2003) Support and education for parents during early childhood have demonstrated effectiveness in improving outcomes for these at-risk children.

Family support and parent education priority issues

  1. Implement an action agenda that finances parenting efforts in order to reduce costly out-of-home remedies after there has been abuse or neglect. 
  2. Coordinate efforts to support parents and families through nurse home visits, family resource centers, and increased county efforts on prevention.

As you vote in November, remember that not only are you voting for yourself and your family but also you are voting for the less fortunate children of our state who cannot vote for themselves. Review the position statements of the candidates and ensure that they have a sound plan for the future of our state, our children.

Previous Columns

Raising A Mensch Section Editor: Dr. Flaura Koplin Winston parenting @ pjvoice.com
Dr. Flaura Koplin Winston is a practicing pediatrician, associate professor of pediatrics and Scientific Director of the Center for Injury Research and Prevention at the Children's Hospital of Philadelphia. She welcomes your comments, questions, contributions and suggestions for future columns.