Our Children Need More Equitable Health Systems
February 15, 2024
by Kim Firth, Program Director, Endowment for Health
New Hampshire is better when all our children thrive, and our children thrive when they have strong communities, healthy families, and policies that support them.
This year’s data update from the New Hampshire Child Well-Being Data Hub indicates that our state is on the right track, and indicators reveal low child poverty rates, high rates of insured children, and good maternal health. But when these indicators are separated by income, race/ethnicity, or geography, a problem emerges: inequity, often exacerbated due to a lack of funding for affordable housing, healthcare, economic support, and food programs. These are symptoms of larger causes: generational poverty, lack of educational and economic development opportunities, and structural racism. Though overall indicators show that New Hampshire is a great place to grow up, the inequity is in the details – and the details tell us that many Granite State families are struggling.
Our children are struggling, too. The national child and adolescent mental health emergency, declared by the American Academy of Pediatrics and other national associations, has not bypassed the Granite State. A leading cause of death for New Hampshire youth ages 10-24 is suicide. Studies show that girls, children from communities of color, LGBTQ+ youth, and youth with disabilities are disproportionately affected by mental health challenges. And even if families can overcome long waiting lists for services and the cost of care, there is no guarantee that they will receive mental health care that is culturally relevant. The inequities built into our policies and systems are leaving some of our kids behind.
To create a more equitable mental health care system, we need to adopt solutions that center the experiences, perspectives, needs, and strengths of children, youth, and families – especially those who face significant behavioral health inequities. And we need to recognize and address the interconnected nature of the challenges that New Hampshire families face.
New Hampshire organizations are working to build solutions, and to provide an immeasurable amount of hope. There is hope because so many are working so hard to ensure equitable mental healthcare access for youth. There is hope because young people are using their creativity to create powerful art that helps to address mental health stigma. There is hope because New Hampshire is investing in our children’s system of care. Now, more than ever, children’s mental health care in New Hampshire is better coordinated across systems, and the array of mental health care services is more robust, especially for children with the most acute needs.
And there is hope because we are not done yet.
To address the workforce shortage in our community mental health system, we need smart investments in loan repayment and programs that build up a pipeline of diverse talent. We need to address low insurance reimbursement rates, which limit providers who take insurance and keep mental health professionals’ salaries artificially low.
To connect families to care, we need to address affordability and waiting lists, and implement more robust culturally responsive care.
We are on our way. The New Hampshire Health Assessment and Improvement Plan promotes approaches that eliminate inequities and reduce disparities. Its four tenets – access to opportunity, community, health status and outcomes, and social connectedness – address the interconnected nature of these challenges.
We all have a role to play in addressing the children’s mental health crisis in the Granite State, and in promoting a more equitable system of care that works better for everyone. New Hampshire is better when all our kids can thrive – and that takes all of us.
Please read on to discover We Are Here, a video project to learn from youth and family members from historically marginalized communities, and the providers that serve them. Also, check out the resource section for training opportunities, information about the 6th Annual Magnify Voices Expressive Arts Contest, and other ways you can take action.