KIDS COUNT Data Center

The circumstances and conditions under which a baby is born have lifelong implications. A child whose mother receives little or no prenatal care is far more likely to experience chronic health problems than other children whose mothers did receive prenatal care. A woman who smokes or drinks during pregnancy may visit long-term damage on the children she bears. An infant born into a family that is poor faces a considerably greater risk of not reaching his or her full potential.

In The Right Start, we highlight the particular challenges faced by newborns and their parents in states and in the nation’s major urban areas. We are especially interested in the implications for the millions of kids born into families living in the toughest neighborhoods of our biggest cities.

This KIDS COUNT Right Start data contain no earth-shattering surprises. On one level, it simply records the predictable: A greater percentage of kids born in America’s big cities are born with high risk factors than is true for America as a whole or for more affluent suburbs in particular.

While this may not merit banner headlines, the facts here deserve more attention than they have so far received. For one thing, the extent of disparity between the “life starts” of some inner-city kids and the rest of our children amounts to an assault on our national confidence in the principle of equal opportunity. Pregnant women in the nation’s capital, for example, are twice as likely to go without timely prenatal care than the national average. Nearly twice as many of the babies born in Baltimore are a lower birthweight than is normal for the rest of the country. Births in Detroit are fifty percent more likely to be premature than births elsewhere in America. An infant in Cleveland is twice as likely to be born to an unmarried mother than are other American children.

Even within the universe of big cities, the disparities in birth circumstances are startling. A baby born in Phoenix is four times more likely to have a mom who didn’t finish high school than is a newborn in Seattle. And a pregnant woman in Ft. Worth is four times more likely to go without timely prenatal care than her counterpart in Oakland.

The data and comparisons presented in The Right Start do not lend themselves to simple and certain answers, but they do pose crucial questions. Foremost among these is the following: What variables or factors are most helpful in explaining the patterns we find in the birth data presented in this KIDS COUNT report? Part of the answer lies in the broad dynamics of race and class. America’s large cities are home to a disproportionate share of the country’s low-income and minority populations. The disadvantages of poverty and discrimination lie behind many of the negative urban indicators presented in these tables. That said, however, there are some other correlations that may be equally instructive in interpreting data, framing problems, and advancing solutions. For the past several years, the Casey Foundation has increasingly centered its work on the proposition that children do best when their families do well, and families do better when they live in supportive neighborhoods. Stated negatively, kids fare the worst when families are weak, and families are weakest in those communities that lack access to economic opportunity, positive social networks, and quality public education and service systems.

Neighborhoods like these—neighborhoods that are tough places for families to form and flourish—can be found throughout American cities, counties, and suburbs. But they are far more common in our central urban areas and more common in some cities than in others. In our analysis, it is the prevalence of these isolated, disinvested neighborhoods in major metropolitan areas that explains why so many cities produce such alarming statistics on family risk factors and such terrible numbers on birth measures.

This place-based, family-centered theory has led us to conclude that improving prospects for the kids most at risk in the United States means nothing less than working to rebuild family-supporting opportunities, initiatives, and values in the very neighborhoods where families are now faring the worst. Over the next decade, the Casey Foundation will work with local partners on precisely this approach in many of the cities that recorded the most disturbing numbers in this report.

Whether or not our interpretation of these numbers is persuasive or our approach to the underlying problems is sound, one fact remains beyond debate: The disparity in opportunity represented by the statistics in The Right Start is unacceptable. It is a threat to our cities, our economy, our future, and our basic democratic values. Somehow, we must find a way to ensure that more of our children get a decent and more equal start on the promise of a productive and fulfilling American life.

Douglas W. Nelson
President
The Annie E. Casey Foundation