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North Carolina has a mixed track record on health issues affecting women and children, ranking among the best in some categories but among the worst in others, according to a national report out last week.

Minnesota-based United Health Foundation produced the “America’s Health Rankings Health of Women and Children Report,” based on analysis of health care, health outcomes and health-risk data.

With an overall rank of 30th in the report, North Carolina boasts a low rate of women dying in childbirth, a high percentage of babies born in “baby-friendly facilities” and a nation-leading rate of children under 5 receiving developmental screening. The state was also among the best for percentage of children receiving immunizations, including for the sexually transmitted human papilla virus that causes cervical cancer.

That’s the good news.

But the report ranked the state near the bottom for intimate partner violence, high death-rate among newborns and neighborhood recreation opportunities for growing children.

Generally the state ranked middle to low for women’s and infant’s health issues, but middle to high for children’s health.

Regional health trends

Despite the lackluster composite ranking nationally, North Carolina was a star among Southern states in the report, with 12th-ranked Virginia the only one in the region performing better.

The composite rankings in the study show strong regional trends. While Southern states held 12 of the bottom 13 positions, the six New England states claimed the top four spots and all ranked 11th or better.

Many Western states ranked close to the top, though Nevada, Arizona and New Mexico scored similarly to the Southern states. Northeastern and Midwestern states mostly scored in the middle, though Minnesota and Iowa ranked in the top 10.

Limitations

The study describes itself as a “call to action,” but just how much it means can be open to interpretation. Several categories judged had no data available from some states, Some of the data categories are close to current, but others are older. And some of it is subject to criticism for questionable collection methods.

For North Carolinians worried about the negative aspects of the report, a grain of salt could be in order. A good example might be the ranking for rates of intimate partner violence, a category that includes domestic violence, stalking and sexual assault.

The report used a 2010 study by the Centers for Disease Control that randomly cold-called Americans to survey them about whether they had experienced any of these issues.

The CDC study even acknowledges the serious limitations of this approach in its conclusions. For the most part, populations living in shelters, college dorms or on military bases could not be contacted.

The method also created response challenges specific to the question, since a respondent might be more reluctant to admit surviving any of these problems if others were present with them during the phone call.

As a result, the six-year-old CDC study may not be a very good indicator of whether North Carolina has a more serious problem with intimate partner violence than other states.

Intimate Partner Violence

While the low ranking may be subject to debate, the state has plenty of room to improve its policies on intimate partner violence, according to Amily McCool, the legal and policy director for the North Carolina Coalition Against Domestic Violence, who talked with Carolina Public Press by phone Wednesday.

“We have fantastic advocates working with survivors of domestic violence within the resources they’ve been given,” she said. But state lawmakers haven’t increased funding for domestic violence programs in years. During that time the state’s population has expanded, a recession and job dislocation have increased the economic stressors that increase risk for domestic violence and costs for providing the same levels of surface have increased.

“Regardless of where the state should be ranked,” McCool said, “We’re (worse) than we damn well should be.”

The limitations to the 2010 CDC study also may not have helped North Carolina’s ranking, she said. In a state with many colleges, large military bases and substantial domestic violence shelter programs, not properly measuring those populations could have made North Carolina look better than it should.

McCool noted that other states have also been more proactive in giving law enforcement the necessary tools to keep firearms out of the hands of abusers and keep them from getting them back.

Looking at the recent report and the 2010 data on which it’s based, McCool downplayed the specific ranking and findings on intimate partner violence and emphasized the overall message.

“It’s more for me a wake-up call,” she said.

Frank Taylor

Frank Taylor is the managing editor of Carolina Public Press. Contact him at ftaylor@carolinapublicpress.org.

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