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COLUMN: Gov. Holcomb's greatest challenge



The 2018 Kids Count Data Book, created by the Indiana Youth Institute, highlights Indiana’s continued struggles with infant mortality, parental opioid abuse and child maltreatment. 

The 24th annual Data Book, released Feb. 5, is a compilation of research data the IYL intends to be used to “spark conversations and inform solutions throughout the state.” 

Solutions are sorely needed. The number of child maltreatment victims, which includes neglect, sexual abuse and physical abuse, has increased by 40.6 percent in Indiana from 2012 to 2016. In 2016, nearly 55 percent of these victims were under one year old. The death toll due to child maltreatment more than doubled in the state, increasing from 34 to 70 over the past year. 

Indiana’s 2016 rate of child maltreatment — 18 out of every 1000 children, up from 12.7 in 2012 — is nearly twice the national average. Only two states, Kentucky and Massachusetts, reported higher rates. 

On Dec. 12, Mary Beth Bonaventura sent a letter to Gov. Eric Holcomb offering her resignation as Director of the Indiana Department of Child Services, writing that a continuation of current policies will “all but ensure children will die.” She describes funding and service cuts in the midst of the opioid crisis that had created an environment in which she would only be “complicit in decreasing the safety, permanency and well-being of children who have nowhere else to turn.” 

Gov. Holcomb has since called for a “complete assessment” of the IDCS. 

The Data Book reports an increase of children removed from their home by the IDCS due to caregiver drug and alcohol abuse. The opioid epidemic, which killed 1,518 Hoosiers in 2016, is cited by the Data Book as a possible cause for the influx of children in foster care. 

To aid these children in families affected by opioids, Indiana must continue to invest in harm reduction programs and methadone or buprenorphine addiction therapies and expand access to the overdose reversal drug naloxone. 

Further challenges exist beyond the opioid epidemic. Lack of access to maternal health programs and healthy foods, coupled with Indiana’s startlingly high levels of pollution, poverty, diabetes and obesity, have helped contribute to a state infant mortality rate that has increased from 6.7 deaths per 1,000 live births in 2012 to 7.5 deaths in 2016. 

Holcomb addressed this rate in his State of the State address on Jan. 9, lamenting that 623 infants did not live past the age of one in Indiana in 2016.

“That’s enough to fill 33 kindergarten classrooms or 11 school buses,” Giles Bruce wrote for the Times of Northwest Indiana.

The Indiana State Department of Health released an educational app in Nov. 2017 to try and address this rate, but as Laura Huss reports for Rewire, “the app’s resource list excludes evidence-based family planning clinics and centers, such as Planned Parenthood and All-Options Pregnancy Resource Center, while including crisis pregnancy centers: fake clinics that do not provide medically sound reproductive health care and actively lie to people seeking services.” 

If Holcomb wants to improve the health of Indiana’s infants, even his app will have to do better.

Indiana is not alone in its struggle to provide adequate care to newborns and their mothers. The idiosyncrasies of U.S. politics have allowed the Children’s Health Insurance Program to be used as a congressional bargaining chip, and American families continue to struggle with infant-related healthcare costs and access to maternity leave

While the national infant mortality rate has fallen by 14 percent from 2005 to 2015, the U.S. rate is still far higher than those of other similarly-developed countries. 

In 2018, we must prioritize the health of our nation’s mothers, even if doing so means accomplishing a slew of complicated and costly healthcare reforms at all levels.

If our flaxen-haired demagogue is to be “the most pro-life president in American history,” I hope President Trump addresses the nation’s struggle to keep its infants and mothers alive. 

Holcomb has been more successful at acknowledging and addressing these issues, but our state's healthcare providers and government officials must not become complacent until our obstetric health outcomes improve. 

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