As a neonatologist based in Kansas City, I have recently witnessed the debate over what occurs during pregnancy from many points of view in Missouri, Kansas and across the country. However, caring for newborns every day, I feel we do not discuss often enough the health of children who have already been born. I see the stark contrast: Policy efforts to sustain pregnancy at all costs quickly transform into “Pull yourself up by your bootstraps” as soon as the umbilical cord is cut.
Last month, Kansans took to the polls and sent our lawmakers a resounding message: It is time to stop attacking reproductive rights and instead focus on protecting the health and well-being of children after birth. As a pediatrician, I would like to offer up some ways we can be champions of pro-child policies.
Pro-child policies should include improved access to quality primary, subspecialty, mental and behavioral health care for children and families, including Medicaid expansion. The Affordable Care Act allows states to opt in to an expanded Medicaid program that provides affordable coverage to millions of families. Yet Kansas lawmakers continue to reject expansion. And even after Missouri voters passed expansion, the General Assembly had to be forced by the state Supreme Court to allow low-income families to apply for the program.
Worse still, mental health does not have coverage equal to that for physical health. This is just one of the significant barriers in our current pediatric mental health crisis. Pro-child policies would include comprehensive, affordable coverage for physical and mental health care for children and families.
Pro-child policies should include maternal health. With the significant maternal mortality rates in Missouri and Kansas — ranking 12th and 17th highest in the nation respectively, according to the Kaiser Family Foundation — exacerbated by racial disparities for both mothers and infants — pro-child policies would include extension of Medicaid postpartum coverage from 60 days to 12 months. This was just recently included and passed in the Kansas budget, and will include access to physical and mental health care services during a critical time that directly impacts mothers, babies and families. We must build on this accomplishment and ensure coverage for all new families. Pro-child policies should include food security, access to medical and mental health care, and protection against gun and domestic violence.
Pro-child policies should enhance food security. Federal child care nutrition programs are designed to support children’s and families’ access to healthy and nutritious foods. Healthy food is the fuel for the developing brain and is foundational for child development, education and health outcomes. This begins with maternal health and nutrition prior to conception. Being pro-child means ensuring children have the nutrition they need to thrive.
Pro-child policies should focus on injury prevention, including protection of children from gun violence. Children should feel safe in the places where they learn, grow and play through commonsense public health approaches, similar to those required for prevention of motor vehicle accidents. This includes policies that ensure that firearms are traceable, their owners educated and their impact on our communities measurable. Crucially, these pro-child policies should include all children and mitigate systemic racism, discrimination and disparities. Pro-child policies would be equitable, regardless of race, color, religion, sex (including sexual orientation, gender identity or pregnancy), national origin, age, disability and medical history.
Many aspects of our children’s health and growth are set in the first three years of life, when their brains are developing faster than any other time in life. The return on investment in children is immeasurable. Policies that support injury prevention and basic needs such as health care, food, education and early intervention go a long way toward reducing illness and health disparities in the future.
Enacting pro-child policies focused on the health and well-being of our children is cost-effective and the right thing to do. It is time we prioritize the health of all children and families in Kansas, Missouri and across the country.
About the author: Dena K. Hubbard is a pediatrician and neonatologist in Kansas City and board member of the Kansas Chapter of the American Academy of Pediatrics.
