In America’s Report Card 2012: Children in the U.S., report by First Focus and Save the Childrento assess the state of children in the United States, America scores its highest grade with a C+ for Health & Safety. This grade was calculated based on factors involving children’s health insurance coverage, access to health care and preventative services, access to medical treatment, and environmental health. Although America performs relatively well when providing for children’s health and safety, there is still room for improvement.

The biggest win for American children comes from the success of increasing children’s health coverage. In 2011, 90.6 percent of children were covered by some form of health insurance. Since employer health coverage for children has actually decreased, this win is mainly credited to Medicaid and theChildren’s Health Insurance Program (CHIP). In the United States, Medicaid covers one-third of all children and one-half of low-income children. CHIP allows children whose families do not qualify for Medicaid assistance but cannot afford health insurance to receive health coverage. Together, these programs help ensure that all children, regardless of their economic status, have access to the services they need and deserve. The Affordable Care Act (ACA) builds on the success of Medicaid and CHIP by ensuring that all children, even those with long-term or serious illnesses, are protected again insurance industry practices that deny coverage because of a preexisting condition. But while all of these programs have contributed to the success of children’s health coverage, we still need to work to cover the last 10 percent. To complete this feat, America will need to address the disparities in health coverage. Children living in poverty and children of color tend to have lower coverage rates and immigrant children face significant barriers when seeking health coverage. America must address these inequalities if we are to reach the goal of universal coverage for kids, an achievement to be proud of.

Although a large percentage of children have access to health coverage, this does not mean they get the care they need. This discrepancy can stem from transportation difficulties, lack of resources, or a shortage of available health care providers. Additionally, the number of doctors accepting Medicaid reimbursements can present obstacles to children in need of services. The largest gaps exist when it comes to children’s oral health, preventative health services, and services in specialized areas such as mental health. To illustrate one of these gaps, in 2010 about 4.3 million children ages 2-17 had unmet dental needs because their families could not afford dental care.

Luckily, steps are being taken to combat these gaps. The Affordable Care Act helps increase preventative services by requiring insurers to cover comprehensive screenings and preventative care for children as defined by the American Academy of Pediatrics “Bright Futures” standards. As more initiatives like this are undertaken, access to care will increase for all children in the U.S.

When it comes to the overall state of children’s health, there are a few issue areas that cause immediate concern. The obesity epidemic among American children is reaching alarming rates: currently, one-in-three children in the United States are overweight or obese. These children are more likely to suffer from heart disease, high blood pressure, diabetes, and asthma during their lifetime. These consequences could cause children in the U.S. to have shorter lifespans than their parents’ generation. In addition, the United States currently ranks 29th in infant mortality rates among industrialized nations. America needs to emphasize proper prenatal care and nutrition for women to help reduce the number of infants who die at birth or soon after because of low birth weights. We also need to increase support for programs such as Healthy Start and the Maternal, Infant, and Early Childhood Visitation Program that work to educate new mothers and families on prenatal and infant care. These programs not only help to reduce the infant mortality rate but also improve the overall health of mothers and children. Lastly, according to the Centers for Disease Control and Prevention, over 500,000 children ages 1-5 have dangerous blood-lead levels. This could come from exposure to lead-based paint or drinking water from lead pipes. Lead exposure can damage a child’s intellectual development and physical health, which is why the American Academy of Pediatrics recommends that all children ages 0-6 be tested for lead. By testing children, elevated levels can be detected early, before the worst effects take hold. This, along with other initiatives to reduce lead exposure, may help keep children safer and healthier.

When it comes to children’s safety, the United States has made vast improvements. Public campaigns on car safety have increased the use of seat belts and booster seats, which help our young people safe when traveling in vehicles. In addition, the rate of youth that are victims of serious crimes, such as rape, homicide, or aggravated assault, has decreased over the last twenty years. The reports of illicit drug use and rates of heavy alcohol consumption among teens have also been decreasing over the last fifteen years. These trends help show that the United States is working towards creating a healthy, safe environment for its children.

Unfortunately, there is still room for significant improvements when it comes to children in the workplace. Child labor laws fail to provide adequate protections against safety risks in the workplace, especially for child farmers. According to the National Institute for Occupational Safety and Health and the Childhood Agricultural Injury Survey, an estimated 16,011 youth were injured on farms in 2009. Unfortunately the Department of Labor recently withdrew proposed safety regulations for farms. Other safety concerns come from the environment itself; in 2010, 67 percent of children lived in counties with pollutant concentrations exceeding one or more air quality standards of the Clean Air Act. To ensure the safety of our children, America needs to put effort into protecting and regulating safety concerns for children.

There are steps that America can take to improve the health and safety of America’s children. We need fully fund the Children’s Health Insurance Program (CHIP) through 2019 so that low-income children can receive affordable, comprehensive, and high-quality health coverage. We can protect the Affordable Care Act’s Maintenance of Effort (MOE) requirement through 2019, which requires states to maintain current eligibility and enrollment requirements for CHIP and Medicaid. We also need to fully fund the Maternal and Child Health (MCH) Title V Block Grant, which provides prenatal health services in supportive, culturally-competent, family and community settings in the Healthy Start Program. To ensure the safety of children in the workplace, we can amend the Fair Labor Standards Act and update safety standards of the Department of Labor. Altogether, these policy recommendations will help make all children in American healthy and safe and pave the way for their healthy growth and development.