This commentary originally ran in the Kansas Reflector on May 9, 2022. About the authors: Dr. Tiffany Anderson, superintendent of Topeka USD 501, and Dr. Shannon Portillo, associate dean and professor at the University of Kansas, served as co-chairs of the Governor’s Commission on Racial Equity and Justice; David Jordan, president and CEO of the United Methodist Health Ministry Fund, chaired the subcommittee on healthcare.
Investing in the earliest years of a child’s life — through supporting mothers and children — is an evidence-based approach to improving education, economic, health and social outcomes for a person’s entire life.
The Governor’s Commission on Racial Equity and Justice examined maternal and child health, early childhood development and child care to understand how to address systemic issues that affect education attainment, economic opportunity and health across Kansas. To address opportunity gaps, the commission’s final report made recommendations in the areas of early education and care and maternal and child health care.
Maternal and child health are early indicators of future public health challenges, which is why it’s critical for mothers and children to have the healthiest start to life. In Kansas, mothers and children of color and from low-income households are more likely to be left behind, making it important to address inequities prenatally.
Addressing disparities can begin earlier with implementation of programs for parents, community members, and providers that focus on birth equity, training providers to avoid implicit bias as part of the birthing process and empowering parents to seek culturally appropriate care. The Kansas Department of Health and Environment should partner with community-based groups like the Kansas Birth Equity Network to offer their evidence-based birth equity training to mothers and families.
The commission recognizes the important role culturally competent providers play in improving care before, during and after pregnancy and recommends Medicaid increase access to culturally competent care by prioritizing recognition and reimbursement of credentialed members of the health care team, such as community health workers, home visitors, doulas and lactation consultants.
One commission recommendation came to fruition thanks to the leadership of Gov. Laura Kelly and the Legislature. Postpartum Medicaid coverage has been extended from 60 days to 12 months, ensuring 9,000 mothers retain access to health care when the mother is still at risk for complications, including pregnancy-related death.
To ensure Medicaid coverage improves health outcomes, the commission recommended broadening Medicaid coverage to include comprehensive maternal benefits. These investments are central to the health of new mothers and babies and recognize that social drivers of health, such as food insecurity, can be addressed by linking Medicaid beneficiaries to nutrition assistance and breastfeeding supports through SNAP and WIC.
Evidence-backed interventions such as home-visiting, early literacy promotion, and robust care coordination would foster optimal child development and strengthen nurturing caregiver-child relationships.
To give a data starting point to track Kansas’ efforts to address disparities, the state should publicly report measures of maternal and child health disaggregated by race and ethnicity as well as service location.
Kansas is one of the states where the uninsured rate for kids is increasing, and it disproportionately affects children of color. The uninsurance rate for Kansas children rose from 4.6% in 2016 to 5.8% in 2019. Kansas could decrease the number of uninsured children by enabling continuous coverage for children ages 0 to 5 and streamlining the eligibility process. Consistent coverage would improve access to regular and timely check-ups.
Investing in early learning and development can have significant return on investment. According to the Heckman equation, investment in and access to high-quality early learning and child care will improve student success and career achievement, especially for our most vulnerable students. It will also reduce state spending on education, health and criminal justice.
The commission often heard that Kansas child care is in crisis. It’s expensive and in short supply.
Kansas could prioritize using American Rescue Plan funds to strengthen the child care system, focusing resources on communities of color and vulnerable communities. Kansas should maximize Child Care Development Funding from the federal government and explore how to increase participation of families and providers in the child care subsidy program. Increased federal funding and use of child care subsidies can strengthen the system and make high-quality child care more accessible.
Through the Kansas Child Day Care Assistance Credit, businesses provide child care or help employees locate it. To improve access to services, Kansas should expand the types of businesses eligible for this credit and eliminate the reduction of benefits that occurs after the first year when covering the cost of on-site care.
The health and well-being of Kansas mothers and children is critical to the health of our state. By making policy changes to support expanded maternal care, and high-quality health care and child care for our youngest Kansans, we can reduce disparities for people of color in our state.
About the series
In June 2020, Governor Laura Kelly signed Executive Order 20-48, forming the Governor’s Commission on Racial Equity and Justice. The Commission studied issues of racial equity and justice across systems in Kansas, focusing first on policing and law enforcement and then on economic systems, education, and health care. The Commission developed recommendations for state agencies, the Legislature, and local governments. Through the end of 2022, Commissioners will dig deeper into the Commission’s recommendations in a monthly series.