New Analysis from Citizens’ Committee for Children Points to Key Areas in Need of Protection and Expansion in 2020

Released February 5, 2020

CCC’s Child Well-being Index illustrates need for immediate action in State budget negotiations
to address unmet needs of children and families

New York, NY — A new report calls attention to the communities where government investments in health and human services are failing to meet the needs of New York City’s children and families.

The new report, “Child & Family Well-Being in New York City: Ranking Risks and Resources Across 59 Community Districts,” is the newest edition of Citizens’ Committee for Children of New York’s (CCC) annual well-being index (formerly referred to as the Community Risk Ranking). The analysis provides a deeper understanding of the stark community-level disparities children and families experience – both in terms of outcomes and the services and supports designed to ensure children’s health and well-being and families’ upward economic mobility.

“If the Governor is truly committed to structurally reforming health care and producing better outcomes for New Yorkers, the State budget must not be balanced as he has proposed. The State Executive Budget exacerbates unmet needs, setting up a situation where an entire population may well develop costly, complex needs as adults,” said Jennifer March, executive director of Citizens’ Committee for Children of New York. “The Governor’s proposals would decimate the health and human services infrastructure and cripple the ability of local governments, New York City in particular, to address families’ desperate needs for support around housing, child care, child abuse and neglect prevention, and behavioral health. All of these community-based services are critical to promoting child well-being, achieving good child health and mental health, and ultimately lifting children and their families out of poverty.”

The State has described its Medicaid Redesign process as intended to integrate New York’s health and human services infrastructure in order better address the social determinants of health for low-income New Yorkers and reduce runaway costs. Research demonstrates that social determinants of health – such as income, housing conditions, access to affordable child care and nutritional food, and more — have a cumulative impact on health outcomes and overall well-being. CCC’s Child and Family Well-being report supports a framework for examining social determinants of health and other risk factors that may be linked to both risk and resilience later in life.

Despite the continued risks many NYC families and children face, Governor Cuomo’s proposed budget includes deep reductions in Medicaid spending; reduced State reimbursements for TANF; decreases in child welfare and after school resources; and reductions in reimbursement for children’s behavioral health care, among others. New York City officials estimate that the State’s Executive Budget proposals would result in over $1.4 Billion in cost shifts to the City with potential for additional cuts coming from a Medicaid Redesign discussion.

By measuring 18 indicators across six domains of well-being (economic security, housing, health, education, youth, and family and community) CCC’s Child and Family Well-being index is designed to illustrate where risk factors cluster and draw attention to communities across the city where barriers to child and family well-being are great or are few. Key findings include:

• Families continue to experience stark disparities in health outcomes across communities. Infants were over eleven times more likely to die before their first birthday in East Flatbush, which ranked highest risk in the Health domain, compared to Midtown Manhattan which ranked lowest risk.
• In Mott Haven, which ranked highest risk in the Economic Security domain, children were over 18 times more likely to live in poverty than children in Greenwich Village. While Greenwich Village ranked lowest in risk, there were still nearly 12% of parents experiencing employment instability.
• Hunts Point families experienced substantial disparities in the Education domain at every level of education, from enrollment in early educational programs, to pass rates on ELA and Math tests, and high school graduation rates.
• In University Heights, which ranked highest risk in the Housing domain, nearly four out of every ten households spent at least half of their income on rent, compared to about two in ten households in Midtown, which ranked lowest risk in this domain.

• Housing support services are present in several but not all districts ranking in the “high risk” category in the Housing domain. There is no longer a Homebase homelessness prevention location within Morrisania in the Bronx, a district where 447 families with children resided prior to living in shelter in 2017. Citywide, over 20,000 children sleep in homeless shelters nightly.
• Family food and nutrition assistance programs (i.e. SNAP, WIC) are absent in communities ranking highest risk in the Health domain such as Queens Village and Howard Beach in Queens. Sixty percent of the 117,000 babies born citywide in 2017 were born to mothers likely income eligible for nutrition programs.
• Demand for early education programming outstrips supply citywide, and especially in communities with many young children in families working in low-paying sectors. There are around 430,000 children under age four citywide, and only 20% are served in the City-funded early education system.
• The number of students served in school-based health and mental health centers varies greatly, from more than 9,700 students for the one clinic in Ridgewood, Queens, to 262 students for every one clinic in Williamsbridge, Bronx. In the past year, about 83,000 NYC high school students reported feeling so sad or hopeless every day for two or more weeks that they stopped doing some usual activities.

“We know that early and consistent investments in children’s services help children thrive into adulthood, and yet far too many children and families lack access to essential supports that address multiple risks to their well-being,” said Bijan Kimiagar, CCC’s associate executive director for research. “Our report calls attention to the important role government plays in making budget and legislative choices that determine whether communities and ultimately children and families have access to the health and human services supports they need.”

CCC is calling on Governor Cuomo and the State Legislator to address the following in the budget negotiation process:

• Oppose the cost shifts to New York City;
• Place a moratorium on any cuts to children’s behavioral health care and fulfill the State’s commitment to fully fund and implement the Children’s Medicaid Redesign plan;
• Reject proposals from MRT II that would adversely impact vulnerable New Yorkers, and ensure the MRT II committee has children’s human service and children’s health and behavioral health care experts and consumers as members;
• Pass Home Stability Support legislation, creating a statewide rental subsidy;
• Increase investments in childcare subsidies, the early education workforce, Early Intervention, and universal pre-kindergarten as well as afterschool programming.

“New York’s children did not create the State’s budget deficit nor should they or their families shoulder the burden of budget cuts now,” said Jennifer March. “The State of New York must ensure that the budget prioritizes early and consistent investments in children – these investments result not only in positive outcomes for children but better long-term outcomes for all New Yorkers and importantly, such investments are in the best interest of the State’s fiscal health.”

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