Child Well-Being

Examining the disadvantages and burdens that children carry with them from outside school that affect their ability to perform in school

Topic Score

2018 Equity Score 25.75 Score is an average of this topic's indicator scores


The eight indicators in this topic quantify racial disparities in child well-being, and suggest ways we can make progress toward equitable outcomes. The indicator reports that follow will allow the City of St. Louis and all stakeholders to evaluate policies from a fact-based, verifiable perspective. We’ll be able to learn from the data, see what’s working and what’s falling short, and use these insights to double down on good investments and experiment with new policies.

The Child Well-being topic examines the disadvantages and burdens that children carry with them from outside school that affect their ability to perform in school.

Today, children in St. Louis do not start off on an even playing field.

Black children are more likely to live in poverty than children of any other race. This means they are more likely to live in substandard housing and experience food insecurity. Due to economic inequities covered elsewhere in this report, their caretakers are more likely to be stretched thin by working long hours. Black children are more likely to experience place-based disadvantages such as exposure to crime and environmental issues, which result in higher levels of trauma and other negative health impacts.

Black children are more likely to have significant health issues. They are more likely to visit emergency rooms for injuries, illnesses, and diseases of all kinds. In particular, black children are far more likely to experience illnesses that are known to impact attendance and performance in school, including asthma and lead poisoning. 

Black children are more likely to have negative interactions with punitive institutions and less likely to have positive interactions with supportive institutions. Black children have higher contact with the courts for delinquency and are less likely to attend school.

Many of these challenges are interconnected, making the need to address the disparities all the more urgent.

For the Equity Indicators Project, the measures chosen focus on racial disparities. The indicators are reflective of the Ferguson Commission’s calls to action around child well-being. Due to the constraints of this project, not all calls to action related to child well-being are addressed within the scope of this project. 


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What is our equity score for this topic?


The higher the score on a scale from 1 to 100, the closer we are toward achieving equity. The lower the score, the greater the disparity.

Which Calls to Action from the Ferguson Commission report are reflected in this topic?

The Ferguson Commission priorities include supporting the whole child by reducing child poverty, ending childhood hunger, and supporting childhood health. Specific calls to action include:

  • Deliver Trauma-Informed Care through the design of hospital-community partnerships to help heal young people impacted by violence with case management, mentorship, and evidenced-based trauma interventions.
  • Increase Health Insurance Coverage and Access by ensuring the Children’s Health Insurance Program is reauthorized.
  • End Hunger for Children and Families through the expansion of government nutritional assistance programs, coordinating food programs, and making those programs easier to navigate. 
  • Establish School-Based Health Centers in the region that include access to mental health, case management, and reproductive health. 
  • Enhance Support Services’ Ability to Support Youth through review of the Missouri Family Support Division and creation of a Discounted Youth Transit Pass.
  • Create School-Based Early Warning Systems through investing at the school level in a quarterly, early-warning and coordinated community response system capable of tracking and responding to all students’ successes and challenges. 

What institutions and organizations were assessed to understand Child Well-being?

While most of the indicators in this topic do not assess specific institutions or organizations, Chronic Absenteeism measures children who attend public or charter schools in St. Louis, and Juvenile Referrals studies children who interact with the St. Louis City Family Court.

Where did the data come from?

The data used in this topic comes from the American Community Survey, the Missouri Department of Health and Senior Services, the Missouri Department of Elementary and Secondary Education, and the St. Louis City Family Court.

What stakeholders were consulted?

Stakeholders consulted include the Regional Early Childhood Council, Juvenile Court administrators, the City of St. Louis Department of Health, and STL Youth Jobs.

What metrics are missing and why?

Metrics that are missing from this report, but are important to measuring racial disparities in child well-being, include family housing instability and youth mental health. We know anecdotally that students are changing schools often as a result of their families being forced to move and are experiencing homelessness.

There is few quantitative estimates of mental illness, but qualitatively we know that there is limited access to mental health assessments and that there are waiting lists for treatment. The St. Louis Mental Health Board has determined there is unmet need for behavioral health programs and services, particularly for youth. They estimate 24% of youth have mental health challenges that would qualify for diagnosis and that over 3,500 have a mental illness with severe impact.

Child Well-Being Indicators

Number Indicator Equity Score
1 Child Poverty
Black children are nearly four times as likely as white children to live in households with incomes at or below the poverty line. 
2 Child Food Insecurity
Black households with children are nearly six times as likely as white households with children to receive food stamps.
3 Emergency Room Visits
Black children are four times as likely as white children to visit emergency rooms.
4 Child Asthma
Black children are more than ten times as likely as white children to visit emergency rooms for asthma-related complications.
5 Child Lead Poisoning
Black children are nearly twice as likely as white children to test positive for elevated blood lead levels.
6 Chronic Absenteeism
Black students are 56% more likely than white students to be chronically absent.
7 Juvenile Referrals to Court
Black children are nearly five times as likely as white children to be referred to juvenile court. 
8 Youth STD Rates
Black youth are nearly ten times as likely as white youth to be diagnosed with chlamydia.
  2018 Equity Score 25.75


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