Earlier this year, staff from Public Health Management Corporation’s Community Health Data Base and Children’s Futures partnered to develop a survey assessing the health and well-being of children residing in Mercer County, New Jersey. This telephone survey was conducted in 1,001 households about a selected child 0-17 years of age. Information was collected about a variety of child health and well-being indicators such as health status and chronic health conditions; usual source of care and utilization of care; child care and after-school activities; positive social skills; neighborhood amenities and support; and community safety and school safety. The following article presents selected key highlights from this survey. 

Health Status and Access to Care

In Mercer County, the overwhelming majority of children are in excellent, very good, or good health, have health insurance coverage, and have a regular source of healthcare. However, nearly one-fifth of children in the area have ever been diagnosed with asthma and more than one-quarter have visited the emergency room within the past year. Disparities by geographic region, race/ethnicity, and poverty status exist for many of these health and access indicators.

In Mercer County, approximately 5% of children 0-17 years are in fair or poor health, representing about 3,900 children in the county. More specifically:

• One in ten Latino children (10.7%) is in fair or poor health, while 5.1% of Black children and 3.0% of White children are in fair or poor health (Figure 1).
• Children living below 150% of the Federal Poverty Level (12.0%) are four times more likely than children living at or above poverty (2.7%) to be in fair or poor health (Figure 1).

In Mercer County, approximately 16,000 children 0-17 years (18.5%) have a history of asthma. More specifically:

• Older children are more likely than younger children to have ever had asthma—23.0% of children 13-17 years, 18.2% of children 6-12 years, and 14.6% of children 0-5 years.
• Black children (26.2%) are more likely to have ever had asthma compared with Latino (20.0%), Asian (16.8%), and White (14.6%) children.

In Mercer County, approximately 1,600 children 0-17 years (1.9%) do not have any public or private health insurance coverage, and more than 5,600 children of the same age group (6.6%) do not have a regular source of healthcare. More specifically:

• Children living below 150% of the Federal Poverty Level (11.0%) are twice as likely as children living at or above poverty (5.4%) to not have a regular source of care.

More than one-quarter of children 0-17 years residing in Mercer County (27.2%) visited the emergency room at least once in the past year, representing approximately 23,100 children in the county. The primary reason why children visited an emergency room was because the problem happened “after hours” such as the doctor’s office or clinic was closed or it was the weekend or a holiday (40.0%). The second most common reason for an emergency room visit was the problem was too serious for a doctor’s office or clinic (19.6%). More specifically:

• More than two-fifths of Black children (42.0%) and one-third of Latino children (32.2%) have visited the emergency room at least once in the past year, compared with White (19.6%) and Asian (14.5%) children.
• Children living below 150% of the Federal Poverty Level (43.7%) are more likely than children living at or above poverty (22.7%) to have visited the emergency room at least once in the past year.
• Children living within the Trenton area (38.5%) are twice as likely as children living outside of the Trenton area (19.3%) to have visited the emergency room within the past year.

Neighborhood Amenities

One’s neighborhood provides both a physical and social context for child and adolescent development. In Mercer County, 13.2% of children 0-17 years live in neighborhoods without parks or playgrounds and 29.1% of children of the same age group live in neighborhoods without recreation or community centers. More specifically:

• Children living within the Trenton area are more likely (17.2%) to live in neighborhoods without parks or playgrounds compared with children living outside of the Trenton area (10.5%). However, children living within the Trenton area (25.7%) are less likely than children living outside of the Trenton area (31.5%) to live in neighborhoods without recreation or community centers.
• Latino (15.2%), Black (14.7%), and White (13.0%) children are more likely than Asian children (8.6%) to live in neighborhoods without parks or playgrounds. However, Asian (34.2%), Latino (31.9%), and White (30.8%) children are more likely than Black children (22.3%) to live in neighborhoods without recreation or community centers.
• While children living below 150% of the Federal Poverty Level (13.8%) are similarly as likely as children living at or above poverty (13.0%) to live in neighborhoods without parks or playgrounds, children living below poverty (32.2%) are more likely than children living at or above poverty (28.3%) to live in neighborhoods without recreation or community centers.

Neighborhood Support

In Mercer County, 12.2% of children live in communities where neighbors do not watch out for each other’s children, and 10.6% of children live in communities where adults do not trust one another to help their child. More specifically:

• Children living within the Trenton area are more than twice as likely as children living outside of the Trenton area to live in communities where adults do not watch out for each other’s children (18.1% vs. 8.4%, respectively) or do not trust other adults to help their child (18.4% vs. 5.3%, respectively) (Figure 2).
• Latino (19.5%), Black (18.3%), and Asian (13.2%) children are more likely than White children (7.1%) to live in communities where adults do not watch out for each other’s children. Additionally, Latino (21.6%) and Black (14.6%) children are more likely than Asian (6.7%) and White (5.5%) children to live in communities where adults do not trust one another to help their child.
• Children living below 150% of the Federal Poverty Level are more likely than children living at or above poverty to live in communities where adults do not watch out for one another’s children (18.1% vs. 10.8%, respectively) or do not trust one another to help their child (18.0% vs. 8.6%, respectively).

Perceptions of Community and School Safety

In Mercer County, 5.5% of children 0-17 years are perceived to be either rarely or never safe in their community, representing more than 4,700 children in the county. More specifically:

• While girls (5.8%) and boys (5.3%) are similarly as likely to be perceived as either rarely or never safe in their community, children 0-5 years are slightly more likely (7.9%) to be perceived as either rarely or never safe in their community compared with children 6-12 years (4.2%) and children 13-17 years (4.7%).
• Black (12.1%) and Latino (10.9%) children are more likely to be perceived as rarely or never safe in their community in comparison to White children (1.8%).
• Approximately 13% of children living below 150% of the Federal Poverty Level are perceived as rarely or never safe in their community compared with 3.5% of children living at or above poverty.
• Children residing in the Trenton area (12.3%) are twelve times more likely to be perceived as rarely or never safe in their community compared with children living outside of the Trenton area (1.0%).

Conclusion

Findings from the Mercer County Child Health Survey suggest both positive trends as well as challenges for area providers in understanding children’s needs. The overwhelming majority of children living in Mercer County are in excellent, very good, or good health, have health insurance, and have a regular source of care. However, findings from the survey also reveal nearly one in five children has a history of asthma and more than one-quarter of children have visited the emergency room at least once within the past year. Also, less than two-thirds of children live in communities with available recreation or community centers. Many of these survey findings reveal disparities for certain segments of the population or geographic regions of Mercer County. Due to the regionally-specific data collected from the Mercer County Child Health Survey, these findings can be used in a variety of ways such as identifying children’s health and well-being needs; developing tailored programs and services to meet the needs of children and the community; and providing baseline information to monitor future progress towards goals.

For more information about these findings, please contact Nicole Dreisbach at nicoled@phmc.org.

For other findings from the CHDB, please visit our Data Findings section at: http://www.chdbdata.org/datafindings.asp.

Note: The Trenton area includes the following zip codes: 08608, 08609, 08610, 08611, 08618, 08629, and 08638.