2013 BUILDING BRIGHT FUTURES INDEX OF ARIZONA’S EARLY CHILDHOOD OPPORTUNITIES v TABLE OF CONTENTS EXECUTIVE SUMMARY ...................................................................... 4 ESSAY ..............................................................................................................6 DATA SUMMARY ............................................................................... 16 STATEWIDE DATA SET ............................................................................ 33 COUNTY DATA SETS ........................................................................ 39 ACKNOWLEDGEMENTS ....................................................................... 100 Building Bright Futures 2013 | 3 EXECUTIVE SUMMARY Discussions on improving student achievement, bolstering economic development and enhancing the quality of life for all Arizonans often focus on the need to close the achievement gap in K-12 education. However, research suggests that these achievement gaps are the result of school readiness gaps that existed when children started kindergarten.1,2 Most of a child’s brain develops before they enter school. The quality of a child’s interactions with the adults in their lives largely determines whether their bodies and minds develop in healthy ways that promote learning. In order to prevent achievement gaps – and reduce the need for costlier interventions later on – we need to focus some of our educational reform efforts on giving children birth to 5 years old the tools they need to succeed in kindergarten and beyond. First Things First was created by Arizonans to help ensure that all children in our state have the opportunity to start school prepared to be successful. Each year, the statewide First Things First Board and its affiliated regional partnership councils make decisions about which early childhood strategies to fund that will impact school readiness for Arizona’s children. First Things First is not alone in this mission. Thousands of early childhood stakeholders – including parents, child care and health providers, educators, businesses, philanthropists, policymakers and elected leaders – are partners in school readiness efforts. 1. Promoting Effective Early Learning: What Every Policymaker and Educator Should Know. (2007). New York, NY: National Center for Children in Poverty. 2. The Condition of Education 2004 (NCES 2004-077), Indicator 8. (2004). Washington, DC: U.S. Department of Education, National Center for Education Statistics. 4 | First Things First Decisions made by all early childhood stakeholders must be based on facts – about how our children are doing, the resources communities have, and what children in different areas need. Building Bright Futures is a valuable tool to inform those discussions. This biennial assessment describes the status of children in several ways: Smiling All the Way to School, our essay section (pages 6 to 15), describes the little known links between children’s oral health and its impact on school performance. Oral health has the potential to affect children’s development, well-being and learning. In fact, U.S. students miss about 51 million school hours each year due to dental disease.3 The information presented in the essay reveals that: • Tooth decay is the most common chronic childhood illness in the U.S., surpassing asthma and hay fever; 4 • In 2009, more than 30 percent of Arizona’s toddlers and preschoolers had untreated tooth decay, and approximately 71 percent of the state’s 4-year-olds had never seen a dentist;5 and, • Young kids and their families need resources to learn good oral hygiene habits and access to preventive oral health care in order to prevent problems in primary teeth that can take a bite out of their learning later on. 3. National Institute of Dental and Craniofacial Research,U.S. Department of Health and Human Services. (2000). Oral Health in America: A Report of the Surgeon General. Rockville, Maryland. 4. National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services. (2000). Oral Health in America: A Report of the Surgeon General. Rockville, Maryland. 5. Arizona Department of Health Services Oral Health Survey, Preschool Children (2008-2009). Our Data Summary section (pages 16 to 31) paints a picture of the overall status of children statewide. Perhaps most alarming of the statistics is that – not only does Arizona have a disproportionately high rate of children living in poverty (about 30% compared to 26% nationally) – the rate of child poverty in Arizona is increasing faster than the national rate.6 7 Children in poverty face an increased risk for a number of poor developmental and health outcomes, and early exposure to poverty may have particularly pronounced and lasting effects. Children who experience poverty in preschool years have lower rates of school completion than those who experience poverty only in later years,8 and there is increasing evidence that early exposures to the stressors of poverty can have lifelong health consequences.9 In addition, families and caregivers experiencing poverty may face greater challenges in supporting their child’s healthy development and learning. Some significant data points include: • Children exposed to high quality early learning are more ready for kindergarten and do better in school. But, the high cost of child care makes it very difficult for low-income families to afford quality early learning for their children. For example, the estimated median income in 2011 for single women with one or more children was $26,500. A single mother at this income level would spend 35 percent of her income on care for a preschooler and 39 percent on care of an infant. • In Arizona in 2012, an estimated 12 percent of young children (birth to 5) lived in the household of their grandparent(s),10 a figure 6 The Annie E. Casey Foundation (2013). KIDS COUNT Data Center, Table 43, Accessed at http://datacenter.kidscount.org. 7 American Community Survey, single-year estimates, Table B17001 8. Brooks-Gunn, J. & Duncan, G. (1997). The effects of poverty on children. The Future of Children. 7(2). pp. 55-71 9. Shonkoff, Boyce & McEwen (2009) 10. US Census Bureau (2013). American Community Survey 1-year Estimates, Tables B09001 and B10001 that has grown steadily over the past few years. Statewide, 30 percent of grandparentled households have no parent of the children present.11 Nearly one in four (23%) of Arizona grandparents who report that they have primary responsibility for their grandchildren live at or below the poverty level.12 Assuring that the needs of kinship care families are recognized and addressed is an important part of developing the early childhood system. Lack of proper nutrition can impact a child’s healthy brain development, sometimes in permanent ways. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides additional food resources for postpartum mothers, infants and children under age 5. Across Arizona, more than half (53%) of all mothers, infants, and children are eligible for WIC assistance, but only about 70 percent of the eligible mothers, infants, and children actually participate in the WIC program.13 Finally, our Statewide and County Data Sets (pages 33 to 99) offer at-a-glance information about the status of children under 6 throughout Arizona in four crucial areas: demographics, economics, education and health. Taken together, all of this information provides significant insight to the challenges facing young children in Arizona – challenges that threaten their well-being today and their school success tomorrow. Building Bright Futures is a tool to begin a public dialogue on what our children need to succeed in kindergarten and beyond, and the crucial role that all Arizonans play in ensuring that our kids are ready for school and set for life. 11. US Census Bureau (2012). American Community Survey 5-year Estimates (2007-2011), Table S1001 12. US Census Bureau (2012). American Community Survey 5-year Estimates (2007-2011), Table S1002 13. Source: WIC Needs Assessment, 2/22/13. ADHS Building Bright Futures 2013 | 5 ESSAY 6 | First Things First Smiling All the Way to School: Oral Health Impacts Health and Learning An essential component of child well-being is good oral health and the absence of tooth decay. Untreated tooth decay is the most common chronic disease among children in the United States, causing pain and infections that may lead to other serious problems with eating, speaking, playing and learning.14 Tooth decay (dental caries) is five times more common than asthma and seven times more common than hay fever.15 The American Academy of Pediatrics estimates that half of all children in the U.S. will develop caries, and some will experience severe dental disease. Oral health means more than healthy teeth – it includes the oral, dental, and craniofacial tissues we need for essential human functions such as to speak, chew, smile, smell, taste, swallow, and convey a world of feelings and emotions through facial expressions. These tissues also protect us from microbial infections and are a barrier to other environmental exposures.16 What Is Tooth Decay? Children begin to get their first teeth at around 6 months old, and by the time they are about 3, children will have the complete set of 20 primary teeth. Although not permanent, these teeth are an essential component of a child’s well-being. Healthy first teeth are needed to bite and chew food, develop speech, develop the jaw bones and face muscles, and to hold space for and guide adult teeth into proper position.17 In addition, a healthy smile supports growth of a child’s selfesteem.18 Undetected and untreated tooth decay can interrupt all of these needs, lead to pain, and negatively impact development of adult teeth leading to longlasting effects, including bone loss and systemic infections.19 20 Certain bacteria found in the human mouth that lead to dental decay are transferred from one person to another, usually mother to child, through any activity that transfers 14 Centers for Disease Control and Prevention: Division of Oral Health, Children’s Oral Health. Accessed from http://www.cdc.gov/OralHealth/children_adults/child.htm 15 National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services. (2000). Oral Health in America: A Report of the Surgeon General. Rockville, Maryland. 16 National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services. (2000). Oral Health in America: A Report of the Surgeon General. Rockville, Maryland. 17 Arizona Department of Health Services. (2012) Oral Health Findings, Arizona Preschool Children, Fact Sheet #1 (Publication 2-OH-069 REV. 3/12). 18 National Maternal and Child Oral Health Resource Center, Georgetown University. (2013). Oral Health and Learning: When Children’s Oral Health Suffers, So Does Their Ability to Learn. Washington, DC. 19 National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services. (2000) Oral Health in America: A Report of the Surgeon General. Rockville, Maryland. 20 Delta Dental Plans Association, Oral Health Library, Infants and Toddlers and Children. Accessed from http://oralhealth.deltadental.com Building Bright Futures 2013 | 7 minute particles of saliva from one mouth to another. This could occur by sharing a spoon or toothbrush, biting off a piece of food for their child, placing the child’s pacifier in their own mouth, or even by kissing. In the presence of sugar and some other carbohydrates, some bacteria in the mouth produce acids, particularly lactic acid, which breaks down the enamel on the teeth. A cavity results when the decay forms a hole in the tooth. 21 A young child’s primary teeth are particularly vulnerable to the decay process, which is why tooth decay is now the most common infectious childhood disease in the U.S. 22 doses of fluoride helps to prevent tooth decay, such as cleaning with fluoridated toothpaste, fluoride varnishes applied by health care professionals and drinking fluoridated water. 25 In early childhood, the main oral health goal is emergence of healthy primary teeth and prevention of tooth decay. Partners in achieving this goal for a child are parents and other caregivers, the oral health care delivery system including insurers, and other supporters, such as First Things First. No Laughing Matter for Arizona Promotion of oral health in young children begins before birth. It is important for pregnant women to have their teeth cleaned and examined and to have any needed dental or gum disease treated before their baby is born. 23 24 Even prior to emergence of their child’s primary teeth, families and other caregivers can help enhance their child’s oral health and prevent tooth decay by providing age appropriate healthy nutrition, basic oral hygiene and ensuring that their child receives regular dental check-ups starting after the first tooth erupts and no later than age 1. In addition, exposure of primary teeth to appropriate 21 American Academy of Pediatric Dentistry. (2012). Guideline on Infant Oral Health Care. Chicago, IL. 22 Centers for Disease Control and Prevention: Division of Oral Health, Children’s Oral Health. Accessed from http://www.cdc.gov/OralHealth/children_adults/child.htm In this essay, we will review the prevalence of early childhood tooth decay, the link between oral health and school performance, what First Things First and other system partners are doing to increase access to preventive oral health care for children birth to 5 years old, and what parents, providers and policymakers can do to keep young kids healthy and smiling all the way to school! In the U.S., approximately 28 percent of children ages 2 to 4 have tooth decay and 16 percent have untreated tooth decay. As described in Table 1, Arizona’s young children fare worse: in 2009, an estimated 37 percent of children ages 2 to 4 had tooth decay and nearly one in three in this age group (30%) had untreated decay. By age 4, it is estimated that more than half of Arizona’s young children (52%) had experienced dental decay. In addition, professional care is necessary for maintaining oral health, yet in Arizona, approximately 71 percent of 4-year-olds had never visited a dentist.26 National and state studies indicate that the prevalence of tooth decay is higher among children from low-income households and some racial and ethnic groups, suggesting particular vulnerability for certain populations of young children. For example, children in poverty suffer twice as much from dental caries as their more affluent peers, and their disease is more likely to be untreated, in part because children in poverty are more likely to lack health insurance and 23 American Academy of Pediatric Dentistry. (2012). Guideline on Infant Oral Health Care. Chicago, IL. 25 American Academy of Pediatric Dentistry. (2012). Guideline on Infant Oral Health Care. Chicago, IL. 24 Association of State & Territorial Dental Directors. (2012). Best Practices Approaches: Perinatal Oral Health. Accessed from http://www.astdd.org/perinatal-oral-health 26 Arizona Department of Health Services Oral Health Survey, Preschool Children (2008-2009); estimated percent based on a sample of 984 children. 8 | First Things First Table 1: Estimated Prevalence of Tooth Decay in Arizona Children Under Age 5 Have Experienced Tooth Decay Have Untreated Tooth Decay Age Under Two 3% 3% Two 16% 15% Three 32% 28% Four 52% 40% Age Two-Four 37% 30% Source: Arizona Department of Health Services Oral Health Survey, Preschool Children (2008-2009) access to regular preventive care and because low-income families may be unaware of the importance of oral health for young children.27 28 In Arizona, 10 percent of children birth to 5 lack health insurance. Nationally, children without health insurance are 2.5 times less likely than insured children to receive dental care. For each child without medical insurance, there are almost three children without dental insurance. Children from families without dental insurance are 3 times more likely to have dental needs than children with either public or private insurance. 29 Having health insurance does not always mean children will receive the care they need. 27 National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services. (2000). Oral Health in America: A Report of the Surgeon General. Rockville, Maryland. As recently as 2009 in Arizona, nearly 50 percent of children enrolled in the state’s public health insurance system – the Arizona Health Care Cost Containment System (AHCCCS) – with coverage for oral health care services did not utilize their coverage. 30 The Arizona Department of Health Services survey showed that 46 percent of families whose children had not seen a dentist in the previous year listed child did not need care as the primary reason (followed by dentist won’t see – 34%, can’t afford – 12%, and transportation – 1%). This indicates a lack of understanding on the part of parents and other caregivers of the importance of routine preventative oral health care, in addition to a lack of resources as the reason so many children are not receiving services. 28 American Academy of Pediatrics. (2008). National Summit on Children’s Oral Health: A New Era of Collaboration. Accessed from http://www2.aap.org/commpeds/dochs/ oralhealth/SummitOralHealth.html 29 National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services. (2000). Oral Health in America: A Report of the Surgeon General. Rockville, Maryland. 30 Pew Charitable Trusts. (2011). The State of Children’s Dental Health: Making Coverage Matter (State Fact Sheet, Arizona). Accessed from http://www.pewstates.org/research/statefact-sheets/childrens-dental-health-arizona-85899373147 Building Bright Futures 2013 | 9 Other Factors That Impact Young Childrens’ Access to Oral Health Care Shortage of Dentists Although the Arizona State Board of Dental Examiners reports more than 3,600 licensed dentists in the state in fiscal year 2013, Arizona has a shortage of general dentists in many locations, especially rural areas. One in four Arizona residents is living in an identified Dental Health Professional Shortage Area.31 Another factor impacting access is that general dentists have limited training in treating young children and may be reluctant or uncomfortable treating children under age 5, especially those with special needs.32 33 The clear advantage of pediatric dentists is their specialized training in the oral health care of children; unfortunately, as throughout the U.S., there is a significant shortage of pediatric dentists in Arizona. 31 Arizona Department of Health Services, Dental Health Professional Shortage Areas. (2012). Accessed from http:// www.azdhs.gov/hsd/shortage/hpsa/dental-hpsa.htm 32 Mouradian, W. (2001). The Face of a Child: Children’s Oral Health and Dental Education. Journal of Dental Education, 65, no. 9, 821-831. 33 National Maternal and Child Oral Health Resource Center, Georgetown University. (2011). Oral Health for Children and Adolescents with Special Health Care Needs: A Resource Guide. Washington, DC. 10 | First Things First In 2004, Arizona law was changed to create a specially licensed cadre of dental hygienists – Affiliated Practice Dental Hygienists – allowed to practice independently under certain conditions. Follow-up legislation in 2007 allowed these special hygienists to be reimbursed by public health insurance. Unfortunately, relatively few hygienists have applied for this special designation. Also, they are required to partner with a dentist, and few dentists have stepped forward to assume this responsibility. Treatment Not Covered by Insurance Payment to oral health providers for services is through the patient’s private dental insurance, the state’s public health insurance system (AHCCCS), or directly from the patient. Some dentists provide services at reduced costs for those who are lower-income and uninsured, but it can be challenging for an individual or family to identify these practitioners, especially because of the limited number of patients and/ or the types of services the practitioners can afford to deliver for free or at reduced cost. Even private dental insurance can result in a significant cost burden for individuals and families because of significant co-pays or deductibles or non-coverage of certain services. For those with public health insurance, finding a dentist who will accept AHCCCS insurance can sometimes be problematic, since AHCCCS requires that providers become approved to deliver services to their patients. In addition to sometimes limiting the number of new providers that they will allow to become certified, the process itself can be cumbersome and difficult (for example, dentists must apply and be approved by each health plan participating in AHCCCS). Adding to this challenge, the reimbursement rates paid to dentists by AHCCCS have not kept pace with inflation, which discourages dentists from participating. Tooth Decay Takes a Bite Out of Learning Poor oral health can have a detrimental effect on children’s quality of life, their performance at school, and their success in life. In fact, more than 51 million school hours are lost each year to dental-related illness. 34 As previously noted, young children in Arizona are more likely to experience tooth decay and are less likely to see a dentist before they enter kindergarten. The presence of decay and the lack of professional care increase the risk that decay will worsen. Left untreated, decay can cause failure to thrive, speech delays, interference with sleep, lack of social interaction, decreased self-esteem, increased anxiety and depression, and problems with a child’s permanent teeth. In addition, pain and suffering due to untreated diseases can lead to problems in eating, speaking, and attending to learning.35 36 Inadequate nutrition (from not being able 34 National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services. (2000). Oral Health in America: A Report of the Surgeon General. Rockville, Maryland. 35 National Maternal and Child Oral Health Resource Center, Georgetown University. (2013). Oral Health and Learning: When Children’s Oral Health Suffers, So Does Their Ability to Learn. Washington, DC. 36 National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services. (2000). Oral Health in America: A Report of the Surgeon General. Rockville, Maryland. to bite/chew and from decreased appetite) negatively affects children’s school performance, their ability to concentrate, perform complex tasks, and their behavior. In addition, children and adolescents with oral health problems are more likely to feel worthless and inferior, shy, unhappy, sad or depressed and are less likely to be friendly compared with those without oral health problems. 37 Children are often unable to verbalize their oral pain. Teachers may notice a child who is having difficulty attending to tasks or who is demonstrating the effects of pain – anxiety, fatigue, irritability, depression and withdrawal from normal activities. However, teachers may not understand the cause of such behavior if they are unaware that a child has an oral health problem.38 The easiest way to ensure that dental problems don’t interfere with children’s learning is to prevent problems before they occur, treat problems early when they do occur, and impart good oral hygiene habits in children as their first teeth develop. Filling the Gap A number of system partners work to expand access to oral health care for low-income families. There are 18 Federally Qualified Health Centers (FQHCs) in Arizona that deliver primary preventative and clinical health care services on a sliding fee scale determined by family income. Federal funds offset the cost of care for lower income patients. Of the 18 FQHCs in Arizona, 16 house a dental clinic and oral health services are provided on a sliding fee scale to patients of all ages. 37 National Maternal and Child Oral Health Resource Center, Georgetown University. (2013). Oral Health and Learning: When Children’s Oral Health Suffers, So Does Their Ability to Learn. Washington, DC. 38 National Maternal and Child Oral Health Resource Center, Georgetown University. (2013). Oral Health and Learning: When Children’s Oral Health Suffers, So Does Their Ability to Learn. Washington, DC. Building Bright Futures 2013 | 11 Figure 1: First Things First Investment in Oral Health Strategies $5,000,000 $4,000,000 $3,000,000 $2,000,000 $1,000,000 $0 FY’10 FY’11 Arizona has a few free standing dental clinics with dentists and hygienists on staff, some of whom are volunteers, that provide oral health services on a sliding fee scale. The state is also home to two dental schools (AT Still and Midwestern University) and several schools of dental hygiene. These schools allow their students to provide services under supervision for no cost or reduced cost in special designated clinics. FQHCs and public clinics are a wonderful resource to the residents in the communities in which they are located, but they are primarily located in urban areas. Challenges include waitlists and that some families feel there is a stigma attached to a FQHC or public clinic and are therefore reluctant to use the services. Also, the cost of services to the family, even on a sliding fee scale, is sometimes a deterrent especially if the desired care is preventative rather than an acute need. In addition, the oral health services offered in these settings may be limited in type and some do not accept young children. In some rural communities, follow up with a specialist might require several hours travel by car and several appointments to complete. 12 | First Things First FY’12 FY’13 FY’14 In addition, a variety of public health agencies provide direct preventative services such as oral health screening, fluoride varnishing and dental sealants to children. These services are delivered in multiple community based locations such as WIC offices, immunization clinics, child care facilities or family resource centers. In some cases, the costs for these services are reimbursed by AHCCCS or private insurance, but generally speaking the costs are picked up by the agencies’ funding, grants or other sources. Teledentistry Teledentistry is a relatively new field with significant capacity to increase patient access to quality and cost effective oral health care, especially in rural areas and other underserved areas. The potential benefits of teledentistry include: convenient treatment not limited by space and time; reduction of patient travel costs and time; increased compliance with treatment plans; reduction of patient anxiety, especially for young kids, since treatment can occur in a familiar setting, such as a child care center; and, it partially addresses the shortage of dentists. 39 39 Arizona Department of Health Services, Office of Oral Health. (2009). Teledentistry in Arizona: Initial Development. Accessed from http://www.azdhs.gov/phs/owch/oralhealth/documents/reports/teledentistry-arizona.pdf FTF’s Role in Promoting Healthy In teledentistry, the patient is at a remote site, Smiles and Students usually with a dental assistant or hygienist, and a dentist is at the hub (home dental office or clinic). First Things First has done its part to expand Or a dentist could be remote, too, and consulting awareness of the importance of oral health for with another dentist or oral health specialist at young children and the prevention of tooth decay. the hub. Imaging and written documents about Through fiscal year 2014, First Things First has the patient and their exam are sent to the hub dedicated almost $11.6 million dollars to grantees via electronic medical record; the consultation across Arizona to conduct community-based oral between the dentist at the hub and the dental health activities (Figure 1). These activities provide team and patient (or family) at the remote site prenatal oral health screening and education, oral takes place through video-conferencing. While health screening and fluoride varnishes for young there are challenges associated children birth to age 5, education with teledentistry – including for families and other caregivers the reliance of the dentist (including professionals) on another’s observations, Since 2010, FTF regarding early childhood oral technology that is subject grantees have health and hygiene, and general to failure, and financing – completed more than outreach and information sharing it nonetheless represents 79,000 oral screenings to raise awareness about the one promising practice in and applied 75,000 importance of early childhood getting oral health care to preventive fluoride oral health. Grantees also work to isolated communities.40 varnishes to the teeth of link families in need of a regular Fast Fact: kids 5 and younger. In Arizona, a 2006-2008 federal grant through ADHS allowed teledentisty to be piloted in several areas, including the Hopi reservation; Apache, Navajo, Coconino and Yavapai counties (including 26 Head Start centers); and, among some low-income communities in Scottsdale. A 2009-2012 extension of the grant expanded those services to include summer camps, pediatric group practices and an obstetrics group practice, partnerships with county health departments, partnership with First Things First, and additional school-based sites. The federal grants funded equipment, training and technical assistance that brought teledentistry services to many areas. In many cases, those services continue through partnerships established with local governments or organizations. ADHS continues to provide technical assistance to these partnerships. 40 Arizona Department of Health Services, Office of Oral Health. (2009). Teledentistry in Arizona: Initial Development. Accessed from http://www.azdhs.gov/phs/owch/oral- health/documents/reports/teledentistry-arizona.pdf dentist to one in the nearby area. First Things First has funded a number of innovative approaches aimed at expanding access to preventive oral health care for young kids in underserved areas. Among these are: • Teledentistry – The FTF Navajo/Apache Regional Council has forged a partnership with a pediatric dental practice in Show Low and purchased the equipment and software necessary to implement teledentistry in eight rural communities during fiscal year 2014, including Alpine, Heber, St. John’s, Springerville and Joseph City. Without these services, families with young children in these communities might need to travel 3-8 hours round trip in order to have their child seenby a dentist. At least two additional First Things First regional councils – in the Navajo Nation and White Mountain Apache Tribe – are working to implement teledentistry by fiscal year 2016. Building Bright Futures 2013 | 13 • Roller Molar – The FTF Pinal Regional Council has partnered with Sun Life Family Health Center to implement the Roller Molar, a mobile dental clinic that is able to bring dental services to some of the most rural areas of the county. • Increasing Reimbursement for Dental Services – Most local health departments do not have the internal capacity to bill insurance companies directly for services provided to residents. ADHS has a program that allows local public health departments to get reimbursement for dental sealants. ADHS then bills AHCCCS when applicable to maintain the funding for services. A pilot program in South Phoenix is testing this approach for fluoride varnishes, so that efforts to provide this crucial component of preventive care through health departments can be sustained. • Access to Providers – First Things First is working with community partners to establish an online registry of dentists who provide free or reduced cost oral health services to families with young children and/or participate in AHCCCS. The website – which also will include educational resources for families and caregivers about the importance of oral health and how to care for young teeth – will launch by summer 2014. Next Steps for FTF First Things First will continue to support efforts to build public awareness of the importance of oral health care to the well-being of young children and its link to their success in school. In addition, First Things First will seek out innovative approaches and community collaborations that expand access to preventive care for all young children, particularly those in underserved areas. First Things First also will serve as a source of information to system partners and policymakers working to enhance the oral health care delivery system for children 5 and younger, and will support efforts to gather more comprehensive and timely information about the oral health of Arizona’s children birth to 5 years old. 14 | First Things First Implications for Families, Practitioners & Policymakers While tooth decay is the most common chronic childhood disease in the U.S., it is also the most preventable. All early childhood stakeholders can play a role in ensuring that young children have access to regular oral screenings and preventive dental care and families have information and options when it comes to meeting their children’s oral health needs. What Families Can Do • An expectant mother can have her teeth cleaned and examined and any needed dental or gum disease treated before her baby is born. • New parents can minimize the spread of decay-causing bacteria to their children by not putting baby’s pacifiers in their mouth and not sharing spoons or other utensils. • Serve children healthy, age-appropriate foods, including breastfeeding until age 1, if possible. Avoid feeding babies and young children sugary and refined carbohydrates (starchy) foods and drinks, even fruit juice. • Do not allow a child to sip juice from a bottle or cup over a period of time or suck on a pacifier dipped in a sugary substance, and place babies to sleep with bottles of water, not milk or other drinks. • Gently clean a baby’s gums daily with a damp soft washcloth and then switch to cleaning with a soft toothbrush twice a day once teeth begin to emerge using a smear of fluoride toothpaste. Once teeth begin appearing, use dental floss between adjacent teeth. • Take children to regular dental check-ups starting when their first tooth appears or and no later than age 1. • If families live in communities that do not have fluoridated water, consider alternatives, such as using fluoride toothpaste, purchasing water with added fluoride, prescribed fluoride supplements, and fluoride varnishes applied by a qualified health care provider. What Communities and Policymakers Can Do • Expand efforts to provide oral health screenings, varnishes and sealants to young children. • Enhance partnerships to provide children’s oral health education to adult caregivers of young children (including child care providers and teachers), and use their leadership role to promote the benefit of children’s oral health care to families. • Increase opportunities for AHCCCS (Medicaid) reimbursement for early childhood screenings and varnishes, including those performed independently by dental hygienists. • Assess opportunities for reimbursement for children’s and pregnant women’s oral health care by federal marketplace and employer sponsored health insurance plans. • Sustain/increase grant funding for innovative practices – such as teledentistry – in rural and other underserved areas. • Develop the professional and paraprofessional workforce to provide preventive oral health services and treatment in traditional and non-traditional settings, including by primary care providers in medical homes. • Increase the proportion of Arizona communities with fluoridated water supplies. • Ensure oral health promotion, disease prevention and oral health care has a presence in health policy at local, state and national levels. Building Bright Futures 2013 | 15 DATA SUMMARY 16 | First Things First Each year, the First Things First statewide Board and regional partnership councils must make decisions about how to prioritize their funding for programs to support children and families in their community. In order to do so, they rely on an array of data that provide an indication of the context in which young children are growing. They then use this information as a starting point for discussions with early childhood stakeholders— including families, educators, service providers and community leaders —on how to maximize the resources in their area and yield the most positive outcomes for our youngest children. Currently, the data are available by county, and while county lines do not always match the boundaries of the First Things First regional councils, the information can be used to look at general geographic trends. Pages 19 to 33 of this document offer a statewide and county-by-county view of major data elements. In the following section, we provide some notable trends across the areas of: • Demographics • Economic Conditions • Education • Health The statewide and county-specific data sets follow this overview. Demographics In the early 2000s, Arizona’s population grew rapidly, fueled in large part by the state’s expanding economy. Statewide, the population of young children (ages 0 to 5) increased by 19 percent from 2000 to 2010. In that period, an increase in the number of young children was seen in all but three counties: Apache, Graham and Greenlee. However, during the economic downturn, this growth slowed. In the state, and in most counties, there are fewer children younger than 3 years old (born between April 2007 and March 2010) than there are children between 3 and 5 years old (born between April 2004 and March 2007). Population projections produced by the Arizona Department of Administration estimate that the number of children birth to 5 in the state has decreased by about two percent since the 2010 census was conducted. In 2012, births rose statewide for the first time since 2007, and projections estimate that this growth will continue. More than half a million children under the age of 6 live in Arizona. Sixty-two percent of these children live in Maricopa County, and 14 percent live in Pima County. The remaining 24 percent live in the other thirteen counties in Arizona. Building Bright Futures 2013 | 17 Table 2: Census 2010 Population Under Age 6, by Ethnicity Total population, ages 0 to 5 Hispanic or Latino White Arizona 546,609 45% 40% 4% 5% 7% Apache 7,171 8% 14% 0.1% 75% 3% Cochise 10,125 47% 42% 4% 0.5% 6% Coconino 10,777 22% 36% 1% 36% 5% Gila 3,657 28% 42% 0.3% 28% 2% Graham 3,830 34% 44% 0.5% 18% 3% Greenlee 794 55% 40% 1% 2% 2% 1,227 50% 24% 1% 21% 4% Maricopa 339,217 45% 40% 5% 2% 8% Mohave 13,218 27% 65% 1% 3% 4% Navajo 10,550 15% 32% 0.4% 49% 4% Pima 74,796 53% 34% 3% 3% 6% Pinal 36,181 38% 49% 3% 5% 5% Santa Cruz 4,435 94% 6% 0.1% 0.1% 1% Yavapai 12,583 30% 64% 1% 2% 4% Yuma 18,048 76% 19% 1% 1% 3% La Paz Black or American African Indian American Other Source: 2010 US Census, Table PCT12 Note: “Other” includes non-Hispanic children of two or more races About 16 percent of all Arizona households have one or more children under the age of 6 years old. The percentage of households with young children varies between counties across the state. Only about one in 10 households in La Paz County has at least one young child, but this rises to one in five in Apache, Graham, Navajo, Pinal, Santa Cruz and Yuma counties. Nearly half (45%) of the state’s children under the age of 6 are Hispanic. In Santa Cruz County, the vast majority (94%) of young children are Hispanic, and Hispanic children compose about threequarters (76%) of the population under 6 in Yuma County. In Apache County, three-quarters of young children are American Indian; in Navajo County, about half are American Indian. In three counties, more than one-third of the children under the age of 6 live with at least one foreign-born parent: Maricopa County (34%); Santa Cruz County (49%); and Yuma County (45%). 18 | First Things First Table 3: Living arrangements for children birth to five in Arizona Living with two married parents or step-parents Living with one unmarried parent or step-parent Living with relative(s), but not with parent(s) or step-parent(s) Living with unrelated person(s) Arizona 61% 36% 4% 2% Apache 38% 53% 22% 1% Cochise 64% 32% 4% 1% Coconino 49% 46% 7% 3% Gila 51% 45% 4% 2% Graham 64% 32% 5% 1% Greenlee 46% 47% 6% 8% La Paz 32% 63% 15% 1% Maricopa 62% 34% 3% 2% Mohave 62% 34% 6% 1% Navajo 46% 46% 10% 7% Pima 57% 39% 5% 3% Pinal 68% 29% 2% 2% Santa Cruz 58% 38% 5% 2% Yavapai 61% 34% 5% 4% Yuma 57% 41% 2% 2% Source: 2010 US Census, Table PCT12 Note: “Other” includes non-Hispanic children of two or more races Statewide, the majority of children birth to 5 (61%) are living with two married parents or stepparents. However, in Apache and La Paz counties, the majority of young children are living with single parents. In Apache County, almost 1 in 10 children are living with a relative, with no parent present in the home. Non-parental relatives who provide “kinship care” for children (such as aunts, uncles, siblings, grandparents) are becoming recognized as an important group in need of special support. Grandparents, in particular, may face special challenges. In Arizona in 2012, an estimated 12 percent of young children (ages 0 to 5) lived in the household of their grandparent(s).41 Over the past few years, the percentage of young children in a grandparent’s household grew from 10 percent in 2006 to 13 percent in 2011. In the United States as a whole, 41 US Census Bureau (2013). American Community Survey 1-year Estimates, Tables B09001 and B10001 Building Bright Futures 2013 | 19 Figure 2: Percent of children (0-5) living in a grandparent’s household 15% Arizona U.S. 0% 2006 2007 2008 2009 2010 2011 2012 somewhat fewer young children live in a grandparent’s household. Nationally, the trend has also been increasing over the past few years: The percentage of young children in grandparent households has increased from 9 percent in 2006 to 11 percent in 2012. Some of these children are in multi-generational families, formed, for example, by adolescent mothers still living at home, or adult children moving back to a parent’s home. Others are in families with grandparents who have primary responsibility for raising them; statewide, 30 percent of grandparent-led households have no parent of the children present.42 Nearly one in four (23%) of Arizona grandparents who report that they have primary responsibility for their grandchildren live at or below the poverty level.43 Assuring that the needs of kinship care families are recognized and addressed is an important part of developing the early childhood system. Accomplishing this will likely require inclusion of non-traditional partners, such as elder services, and innovative collaborations with existing partners, such as the legal and health care systems. Economic Conditions Children in poverty face an increased risk for a number of poor developmental and health outcomes, including impulsiveness, anxiety, depression, reduced verbal ability, asthma, obesity and diabetes.44 45 46 47 Early exposure to poverty may have particularly pronounced effects. Children who experience poverty in preschool years have lower rates of school completion 42 US Census Bureau (2012). American Community Survey 5-year Estimates (2007-2011), Table S1001 43 US Census Bureau (2012). American Community Survey 5-year Estimates (2007-2011), Table S1002 44 Evans, G. (2004). The environment of childhood poverty. American Psychologist, 59 (2), 77-92 45 American Psychological Association, Effects of Poverty, Hunger and Homelessness on Children and Youth, accessed at http://www.apa.org/pi/families/poverty.aspx?item=2 accessed 9-9-2013 46 Shonkoff, J., Boyce, W., & McEwen, B. (2009). Neuroscience, molecular biology, and the childhood roots of health disparities: Building a new framework for health promotion and disease prevention. JAMA. 301(21), 2252-2259. 47 Drewnowski, A. & Specter, S. (2004). Poverty and obesity: The role of energy density and energy costs. American Journal of Clinical Nutrition. 79, 6-16. 20 | First Things First Figure 3: Poverty Rate for Young Children (Ages 0-5) Percent of Children (0-5) Living in Poverty 30% 27% 26% 23% 23% 21% 2008 Arizona 2009 26% 25% 2010 30% 2011 26% 2012 U.S. Source: American Community Survey, single-year estimates, Table B17001 than those who experience poverty only in later years,48 and there is increasing evidence that early exposures to the stressors of poverty can have lifelong health consequences.49 Alarmingly, the rates of child poverty have been increasing in Arizona. About 30 percent of young children under the age of 6 currently live in poverty in the state. Arizona ranks among the states with the highest rates for childhood poverty: 42nd out of the 50 states.50 Single-year estimates from the American Community Survey show that, over the past five years, the poverty rate for young children has increased faster in Arizona than it has nationwide. In 2008, 23 percent of Arizona’s children under 6 lived in poverty, compared to 21 percent of all children under 6 in the United States. By 2012, Arizona’s under-6 poverty rate increased to 30 percent, compared to 26 percent nationally. Five-year averages (2007 to 2011) show that at least 30 percent of young children are living in poverty in six counties in Arizona (Apache, Gila, La Paz, Mohave, Navajo and Santa Cruz). In Apache County, half of all children under the age of 6 are living in poverty. The lowest rates of child poverty are seen in Pinal (20%) and Greenlee (16%) counties. 48 Brooks-Gunn, J. & Duncan, G. (1997). The effects of poverty on children. The Future of Children. 7(2). pp. 55-71 49 Shonkoff, Boyce & McEwen (2009) 50 The Annie E. Casey Foundation (2013). KIDS COUNT Data Center, Table 43, Accessed at http://datacenter.kidscount.org. Building Bright Futures 2013 | 21 Child poverty in Arizona is distributed disproportionately across ethnic groups. According to the National Center for Children in Poverty,51 • 15% of young non-Hispanic white children in Arizona live in poor families. • 35% of young black children in Arizona live in poor families. • 36% of young Hispanic children in Arizona live in poor families. • 47% of young American Indian children in Arizona live in poor families. High unemployment contributes to the high poverty rate in the state. Although there has been a general decrease in unemployment rates across the state and counties since 2010, the Arizona 2012 unemployment rate (8.3%) continued to be above the national average (7.3%). In fact, unemployment has continued to rise in the three counties with the highest jobless rates: Apache County (17% to 19.6%), Santa Cruz County (17.1% to 17.2%) and Yuma County (26.2% to 27.5%). The most populous county, Maricopa, had an unemployment rate (7.1%), which is below the national average, and Greenlee County had the lowest rate in Arizona in 2012, at only 6 percent. Single mothers face particular challenges in the state. Half of single female householders in Arizona earn less than $26,500, which is substantially less than the median income of single male householders ($38,100). Children living in poverty experience a number of pronounced challenges, including a higher risk of homelessness and food insecurity. 51 National Center for Children in Poverty (2013). Arizona Demographics of Young, Poor Children, 2011. Accessed at http://www.nccp.org/profiles/AZ_profile_9.html 22 | First Things First Homelessness Homeless families are the fastest growing segment of homeless people in the US,52 and this trend has also been seen in Arizona. According to the annual report on homelessness,53 just over 4,000 families in Arizona experienced homelessness during SFY 2012. This represents approximately 4,800 adults, and 5,800 children. The majority of homeless families across the US and in Arizona consist of a single mother with young children. About 38 percent (over 2,200) of the homeless children in Arizona are under 5 years old. These estimates are based on Homeless Management Information Systems data compiled from families residing in homeless programs throughout the state, and are likely to underestimate the problem of young children without stable, adequate housing. Preliminary data for 2012 from the Arizona Department of Education Homeless Education Office shows 31,682 children pre-K to 12th grade reported as homeless (a 4.4% increase from 2011), only 22 percent of whom were living in shelters.54 About three-quarters of the pre-K and older children were living doubled-up, that is, living temporarily with another family. Poverty and the lack of affordable housing are the principal causes of family homelessness.55 More than 40 percent of the homeless population in Arizona is homeless for the first time due to job loss, foreclosure or eviction, with lack of affordable child care cited as a major barrier to stable employment income.56 52 The 2010 Annual Homeless Assessment Report to Congress. US Department of Housing and Urban Development. Accessed at https://www.onecpd.info/resources/ documents/2010homelessassessmentreport.pdf 53, 54 Homelessness in Arizona Annual Report 2012. Arizona Department of Economic Security. 55 Homeless Families with Children, July 2009. National Coalition for the Homeless. Accessed at http://www. nationalhomeless.org/factsheets/families.html 56 Homelessness in Arizona Annual Report 2012. Arizona Department of Economic Security. Food Insecurity Food insecurity remains a very real problem for Arizona families. The USDA maintains several measures of food insecurity for households across the nation. In “food secure” households, all household members have access at all times to enough food to enable a healthy and active lifestyle. “Food insecure” households experience times during the year when household members lack or are uncertain of their ability to acquire enough food due to lack of sufficient funds or other resources for food.57 According to the 2011 Child Food Insecurity Report, nearly one in three, or about half a million, children under the age of 18 are food insecure in Arizona. Arizona’s food insecurity rates among children rank third highest in the country, only behind New Mexico and the District of Columbia. Nationwide, approximately 23 percent of children are food insecure (an increase from 19% reported in 2010).58 Across the country, over 10 percent of heads of households reported that they could not feed their children balanced meals due to a lack of resources for food, and nearly 16 percent reported that they ran out of food due to a lack of money to buy more. Certain Arizona communities face particular challenges regarding food insecurity.59 According to Feeding America’s 2011 analysis, about 43 percent of children in Yuma County were rated food insecure; La Paz, Santa Cruz, Gila, Navajo and Apache counties all had child food insecurity rates estimated at between 30 and 40 percent.60 57 Coleman-Jensen, A., Nord, M., & Singh, A. (2013). Household Food Security in the United States in 2012 (ERR-155). United States Department of Agriculture. 58 Feeding America (2013). Map the Meal Gap: Highlights of finding for overall and child food insecurity, 2011. 59 Coleman-Jensen, A., Nord, M., & Singh, A. (2013). Household Food Security in the United States in 2012: Statistical Supplement (AP-061). United States Department of Agriculture. 60 Feeding America (2013). Map the Meal Gap, 2011. Accessed at http://feedingamerica.org/hunger-in-america/hungerstudies/map-the-meal-gap.aspx Families may cope with food insecurity through participation in federal food assistance programs such as the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The percentage of families with children in Arizona participating in SNAP increased in response to the economic recession. According to the American Community Survey, nearly 200,000 families (23.5%) with children under 18 received SNAP Table 4: Food Insecure Children in Arizona Counties Percent of Children Experiencing Food Insecurity Arizona 30% Apache 39% Cochise 26% Coconino 26% Gila 51% Graham 31% Greenlee 28% La Paz 29% Maricopa 32% Mohave 25% Navajo 29% Pima 35% Pinal 25% Santa Cruz 39% Yavapai 27% Yuma 43% Source: Feeding America (2013) Map the Meal Gap, 2011. Building Bright Futures 2013 | 23 benefits in 2011 (up from 14 percent in 2008).61 In eight counties in Arizona, more than one in three households with children participated in SNAP in 2011: Apache (36%); Gila (33%); Graham (40%); La Paz (34%); Navajo (41%); Santa Cruz (38%); Yavapai (33%); and, Yuma (32%).62 The WIC program provides additional food resources for postpartum mothers, infants and children under 5. Across Arizona, more than half (53%) of all mothers, infants and children are eligible for WIC assistance. In Apache and Navajo Counties, 71 percent of all mothers, infants and children are WIC eligible; in Coconino, La Paz, Mohave, Yuma, Yavapai, Cochise, Graham, Greenlee and Santa Cruz Counties, approximately 60 percent of all mothers, infants and children qualify for WIC assistance. Across Arizona, only about 70 percent of the eligible mothers, infants and children actually participate in the WIC program.63 As communities and First Things First regional partnership councils work to build systems and programs that address the challenges young children face in their regions, it is important to keep in mind that early childhood interventions can have a critical role in reducing the impact of poverty on children’s lives. 61 US Census Bureau (2012). American Community Survey 3-year Estimates (2009-2011), Table B22002 . US Census Bureau (2009).American Community Survey 3-year Estimates (2006-2008), Table B22002 . 62 US Census Bureau (2012). American Community Survey 3-year Estimates (2009-2011), Table B22002 . 63 Source: WIC Needs Assessment, 2/22/13. ADHS Table 5: WIC Eligibility Rates in Arizona Counties Mothers, Infants and Children WIC Eligible Mothers, Infants and Children Percent WIC Eligible Arizona 556,882 296,497 53% Apache & Navajo 17,586 12,414 71% Cochise, Graham, Greenlee & Santa Cruz 18,217 10,724 59% Coconino 10,305 6,434 62% Gila & Pinal 41,051 20,004 49% La Paz & Mohave 14,634 9,337 64% Maricopa 347,730 176,346 51% Pima 76,481 42,906 56% Yavapai 13,130 7,868 60% Yuma 17,749 10,466 59% Source: WIC Needs Assessment, 2/22/13. ADHS. 24 | First Things First Education Arizona does not yet have a systematic way of assessing how prepared children are when they enter kindergarten. Children who start out behind typically remain behind, and so developing such an assessment is critical to identifying children who may be struggling and supporting them as they enter elementary school. Looking at test scores in elementary grades across Arizona highlights the importance of giving our young children a better start in their education. In 2013, the Arizona Department of Education (ADE), working in collaboration with the State Board of Education, First Things First and the Virginia G. Piper Charitable Trust, began to move forward on developing and implementing a Kindergarten Developmental Inventory (KDI), which will provide educators and families with a user-friendly, effective resource for generating clear information on where kindergarten children are in their learning and where they need to go next. The KDI tool will be piloted beginning in 2016. Beginning in third grade, the primary in-school performance of current students in the public elementary schools in the state is measured by the Arizona Institute to Measure Standards (AIMS).64 The AIMS is used to track how well students are performing compared to state standards, and the results directly impact students’ future progress in school and graduation. As of the 2013-2014 school year, Arizona Revised Statute §15-701 states that a student will be held back if they are not reading well enough by the end of third grade. Exceptions exist for students with learning disabilities, English language learners and those with reading deficiencies. In 2013, one quarter of all third-graders did not pass the reading section of the AIMS, and one third did not pass the math section. However, the percentage of third-grade children passing reading and math sections of the AIMS has increased somewhat since 2010. 64 For more information on the AIMS test, see Arizona Department of Education’s Website: http://www.ade.az.gov/AIMS/students.asp Figure 4: Percent of third-graders passing the AIMS tests 73% 65% 76% 68% 69% 75% 75% 68% Math Reading 2010 2011 2012 2013 Source: Arizona Department of Education (August 2013) www.azed.gov/researchpolicy/aimsresults Building Bright Futures 2013 | 25 Table 6: Cost of Full-Time Child Care in Child Care Centers, Compared to Median Family Income Infants (under 1 year old) Children Children 1 or 2 years old 3 to 5 years old Median daily charge $41.00 $36.98 $32.00 Estimated median annual charge $10,250 $9,245 $8,000 Median annual family income $60,200 $60,200 $60,200 17% 15% 13% Cost of care for one child as a percent of family income Sources: American Community Survey 2007-2011, Table B19126; Child Care Market Rate Survey 2012 Scores on national tests corroborate concerns raised by students’ AIMS reading performance. The National Assessment of Educational Progress (NAEP)65 is an assessment of mathematics, reading, writing and science performance for America’s children in 4th and 8th grades. In 2011, the average reading score for Arizona’s fourth graders was below the national average, and placed Arizona in the bottom ten of all states on the NAEP’s basic reading assessment. Only 26 percent of fourth grade students in Arizona scored at or above proficient reading assessment level on the NAEP. In 2013, the average reading score for Arizona’s fourth graders remained below the national average, with 28 percent of fourth grade students scoring at or above proficient reading assessment level on the NAEP. Arizona, however, made significant gains in 2013 in math, with 40 percent of fourth graders scoring at or above proficient, comparable to the national public school average.66 Research shows that early reading experiences, opportunities to build vocabularies and literacy 65 The NAEP test is a product of U.S. Department of Education National and State results can be found at http://nces.ed.gov/ nationsreportcard/about/ 66 Some gains were shown in math, however, with 34 % of fourth graders rated at or above proficient in 2011 (up from 28 % in 2009). The average math score for Arizona’s fourth graders was not statistically different from the national fourth grade average. 26 | First Things First rich environments are the most effective ways to support the literacy development of young children.67 These findings demonstrate the importance of early education, which can support early literacy and other basic skills. According to KidsCount, in 2011, only 48 percent of Arizona’s children ages 3-5 were enrolled in some form of early education (nursery school, preschool or kindergarten) compared to the national average of 60 percent. Arizona ranks 48th in the nation for its low proportion of children enrolled in an early education program.68 Increasing the number of Arizona families who have access to high quality and affordable early education is critical to improving educational outcomes for Arizona’s children. Children who start school prepared to learn are more likely to graduate high school and go on to further education, increasing their future opportunities. At the state level, a low level of adult educational attainment has been shown to be related to low levels of child well-being.69 In Arizona, about 15 67 First Things First (2012) Read All About It: School Success Rooted in Early Language and Literacy. Retrieved from http: www.azftf.gov/WhoWeAre/Board/Documents/Policy_Brief_ Q1-2012.pdf (April, 2012) 68 The Annie E. Casey Foundation (2013). KIDS COUNT Data Center, Table 5109. Accessed at http://datacenter.kidscount.org 69 Annie E. Casey Foundation. (2012). Analyzing State Differences percent of adults have less than a high school education. More than a quarter of all adults have less than a high school education in Apache County (27%), Santa Cruz County (29%), and Yuma County (28%). Low levels of educational attainment also drive poverty levels. In the state as a whole, the poverty rate among those with a college degree was 4.5 percent, compared to over three times that rate (14.1%) for high school graduates, and nearly seven times that rate (28.7%) for adults without a high school education.70 Cost may be a major barrier for families looking for early education opportunities. The U.S. Department of Health and Human Services (HHS) recommends that parents spend no more than 10 percent of their family income on child care.71 However, to secure regulated center-based child care, more than half the families in Arizona (those at median income or below) would need to exceed this recommendation for all age groups (Table 6).72 73 It is important to note that the percentages in Table 6 are reflective of families with only one young child in need of full-time care. Families with more than one child under age 5 requiring child care would exceed the HHS recommendation by a substantially higher percentage. Moreover, the percentages above were calculated with the average median income for all families. Single parent homes, particularly in Child Well-being. O’Hare, W., Mather, M., & Dupuis, G. Accessed at http://fcd-us.org/sites/default/files/Analyzing%20 State%20Differences%20in%20Child%20WellBeing.pdf 70 2011 ACS 5-Year Estimates, Table B17003. Retrieved from: http://www.factfinder2.census.gov 71 U.S. Department of Health and Human Services, Child Care Bureau (2008). Child Care and Development Fund: Report of state and territory plans: FY 2008-2009. Section 3.5.5 – Affordable co-payments, p. 89. Accessed at http:// www.researchconnections.org/childcare/resources/14784/pdf 72 According to the American Community Survey, the estimated median family income for all households with at least one child (ages 0 to 17) in Arizona in 2011 was $60,200. This is likely an overestimate of the median income of parents of young children because income generally increases with the age of the children. 73 The annual average costs of child care for regulated centerbased care were calculated using the DES market survey for 2012, assuming that a child spends 250 days in child care. those with a single female householder, typically have a substantially lower median, resulting in a higher cost of child care by percent of median income. Single parent families may also be more likely to need full-time child care than marriedcouple families. For single women with one or more children, the estimated median income in 2011 was $26,500. A single mother at this income level would spend 35 percent of her income on care for a preschooler and 39 percent on care of an infant. In 2012, among children under 6 in Arizona, about 39 percent74 live with a parent who is not in the labor force. The other 61 percent are children living with two parents, both of whom are in the labor force, and children living with a single parent who is in the labor force. Among those who live with two parents, about half (51%) have both parents in the labor force. Among children who live with one parent, about three quarters (76%) have a parent in the labor force. (Note that in the labor force includes all adults who are employed or are looking for employment.) Health Children’s health is a critical factor in school success. Children who are chronically ill miss more days of school than healthy children. When they do attend school, they may have difficulty paying attention in class or staying on top of homework. Research has also shown that infants born prematurely have more difficulties concentrating in school, and show decreased test performance as well as behavior problems associated with difficulties in school. 75 Birth Conditions and Maternal Health The mother’s health during pregnancy and a child’s health at birth are good indicators of a 74 US Census Bureau (2013), American Community Survey V1-year Estimates, Table B23008 75 Bhutta AT, Cleves MA, Casey PH, Cradock MM, Anand KJS. Cognitive and behavioral outcomes of school-aged children who were born preterm: A meta-analysis. Journal of the American Medical Association. 2002;288:728–737. Building Bright Futures 2013 | 27 child’s future health status. Statewide, the incidence of pregnancies with one or more medical risk factors (diabetes, hypertension, anemia, hydramnios, lung disease and others) has increased each year. In 2011, more than one in three births in Arizona had at least one medical risk factor associated with it. In Santa Cruz County, nearly two of every three births had at least one associated risk factor. Before 2011, Yuma County had the lowest rates of medical risk factors during pregnancy, but during 2011, the incidence of diabetes almost tripled (from 68 cases in 2010 to 194 cases in 2011) and the number of mothers smoking tobacco more than doubled (from 26 to 61). Healthy People is a science-based government initiative which provides 10-year national objectives for improving the health of Americans. Healthy People 2020 targets are developed with the use of current health data, baseline measures and areas for specific improvement. The Healthy People 2020 target for all infant deaths is 6.0 infant deaths or fewer per 1,000 live births. Although previously above that Healthy People 2020 target, the Arizona infant mortality rate has been falling over the past five years, and in 2012 was 5.8 per thousand, meeting the target at the state level. Table 7: Births with one or more medical risk factors reported, by mother’s county of residence 2007 2008 2009 2010 2011 Arizona 30% 32% 33% 35% 37% Apache 44% 42% 38% 38% 44% Cochise 27% 38% 47% 43% 40% Coconino 38% 23% 18% 21% 21% Gila 39% 36% 28% 30% 30% Graham 25% 30% 32% 29% 34% Greenlee 22% 32% 23% 34% 35% La Paz 17% 18% 15% 13% 22% Maricopa 25% 30% 32% 34% 25% Mohave 18% 16% 10% 11% 11% Navajo 45% 43% 35% 38% 40% Pima 53% 49% 51% 48% 51% Pinal 27% 29% 28% 32% 36% Santa Cruz 70% 63% 64% 61% 55% Yavapai 45% 37% 41% 39% 42% Yuma 8% 6% 6% 10% 23% Source: Arizona Department of Health Services www.azdhs.gov/plan/menu/for/births.htm 28 | First Things First Figure 5: Arizona Infant Mortality Rate (per 1,000 live births) 6.5 6.7 6.8 6.8 6.3 6.3 5.9 2003 2004 2005 2006 2007 2008 2009 6 2010 5.9 2011 5.8 2012 Source: Arizona Department of Health Services (2012). Arizona Health Status and Vital Statistics Report, 2011, Figure 2C-1; Arizona Department of Health Services (2013). Advance Vital Statistics by County of Residence, Arizona, 2012, Table 2 Low birth weight is the risk factor most closely associated with neonatal death; thus, improvements in infant birth weight can contribute substantially to reductions in the infant mortality rate. The Healthy People 2020 target is 7.8 percent or fewer births where the babies are a low birth weight. The state overall met this target in 2012 (6.9%), but three counties had a higher rate of low-birth-weight births: Coconino County (8.3%), Navajo County (8.3%) and Yavapai County (8.0%). Many of the risk factors for poor birth and neonatal outcomes can be mitigated by good prenatal care, which is most effective if delivered early and throughout pregnancy to provide risk assessment, treatment for medical conditions or risk reduction and education. Research has suggested that the benefits of prenatal care are most pronounced for socioeconomically disadvantaged women, and prenatal care decreases the risk of neonatal mortality, infant mortality, premature births and lowbirth-weight births. Care should ideally begin in the first trimester. Healthy People 2020 sets a target of at least 77.9 percent of mothers receiving prenatal care in the first trimester. Table 8 illustrates the variability in early prenatal care across the state. More than one-third of mothers had no prenatal care in the first trimester in Apache (36%) and Yuma (38%) counties. In addition to early care, it is important that women receive adequate prenatal care throughout their pregnancy, in order to monitor their health and provide them with information for a healthy pregnancy and post-natal period. The American College of Obstetrics and Gynecology (ACOG) recommends at least 13 prenatal visits for a full-term pregnancy; seven visits or fewer prenatal care visits are typically considered an inadequate number. About one in five mothers statewide received fewer than nine prenatal visits (19%). In over half the counties in the state, more than 30 percent of new mothers had fewer than nine visits. In Greenlee and Santa Cruz counties, about half of mothers received fewer than nine prenatal visits. Health Insurance Children’s health insurance status is closely related to whether or not they receive early, regular health care and dental care. As reported in the American Community Survey and the 2010 Census, the Building Bright Futures 2013 | 29 Table 8: Percent of Mothers with Prenatal Care by Trimester of First Visit Prenatal care began in the first trimester Prenatal care began in the second trimester Prenatal care began in the third trimester Mother had no prenatal care Arizona 83% 13% 3% 1% Apache 70% 23% 6% 1% Cochise 80% 13% 4% 3% Coconino 85% 11% 3% 1% Gila 69% 23% 5% 3% Graham 72% 21% 6% 2% Greenlee 82% 18% 0% 0% La Paz 71% 14% 5% 5% Maricopa 86% 10% 2% 1% Mohave 83% 13% 2% 1% Navajo 69% 23% 7% 1% Pima 75% 18% 6% 1% Pinal 84% 12% 2% 1% Santa Cruz 70% 18% 10% 1% Yavapai 82% 14% 3% 1% Yuma 66% 20% 9% 5% Note: All numbers rounded to the nearest tens unit. Numbers in each row may add to less than 100% because of incomplete data. Source: Arizona Department of Health Services www.azdhs.gov/plan/menu/for/births.htm majority of children under the age of 6 in Arizona have some form of health insurance. Approximately 10 percent of young children are without health insurance statewide. However, the proportion of young children without health insurance can vary substantially by county. In Gila County for example, almost one-third (30%) of children under the age of 6 are without health insurance. Policy changes and the economy have affected the status of children using public health insurance dramatically. Children in Arizona are covered by the Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid, through both the Title XIX program Traditional Medicaid and the Proposition 204 expansion of this coverage of up to 100% of the Federal Poverty Level (FPL), as well as the Title XXI program - Arizona’s Children’s Health Insurance Program known as 30 | First Things First KidsCare) (Arizona State Legislature, Joint Legislative Budget Committee, 2010. KidsCare operates as part of the AHCCCS program and provides coverage for children in households with incomes between 100 and 200% of the FPL. However, due to budget cuts at the state level, enrollment in the KidsCare Program was frozen on January 1, 2010, and a waiting list was established. Beginning May 1, 2012 a temporary new program called KidsCare II became available through December 31, 2013, for a limited number of eligible children. KidsCare II is the result of an agreement between AHCCCS, the U.S. Centers for Medicare and Medicaid Services (CMS) and three hospital systems in the state: University of Arizona Health Network, Phoenix Children’s Hospital and Maricopa Integrated Health Systems. The KidsCare II program enrolled children that had been placed on the KidsCare waiting list. The Health Insurance Marketplace opened for enrollment and coverage on October 1, 2013. AHCCCS is working to assist families with children enrolled in the KidsCare II program to either enroll in AHCCCS or transition to the marketplace, as applicable. KidsCare enrollment numbers reflect these policy changes. Population statistics data provided by Arizona Health Care Cost Containment System (AHCCCS) shows a dramatic decrease in the number of children enrolled in KidsCare from 2009 to 2011, during the freeze (from almost 50,000 to less than 17,000). From 2011 to 2013, the number of children enrolled more than doubled, demonstrating that there continued to be a strong need for access to affordable health care for many of Arizona’s families. Figure 6: Number of children (ages 0 to 19) enrolled in KidsCare and KidsCare II, from February 2009 to August 2013 2009 Feb. 59,577 55,154 May 49,485 Aug. 46,784 2011 2010 Nov. 28,782 25,086 22,158 19,165 Aug. Feb. 2012 33,708 Nov. Feb. May Nov. May Aug. Nov. 2013 42,151 Feb. May Aug. Feb. May 16,649 14,238 12,149 10,966 21,883 25,919 35,147 39,210 Aug. 44,723 Source: AHCCCS, KidsCare Population Statistics Historical Index. www.zahcccs.gov/reporting/enrollment/archiveKidsCare.aspx Building Bright Futures 2013 | 31 STATEWIDE DATA SETS State of Arizona Demographic Change Households with young children (0-5) Population of children under age six (as of April 1, 2010) Total number of households 560,000 2,380,990 Households with one or more children under 6 years 546,609 540,000 520,000 384,441 Percent of households with children under 6 years 500,000 16% 480,000 459,141 460,000 Source: 2010 U.S. Census, Summary File 1, P20 440,000 Living arrangements for young children (0-5) 420,000 400,000 Census 2000 Census 2010 2% 1% Living with two married parents or step-parents Increase or decrease from 2000 to 2010 87,468 Increase or decrease from 2000 to 2010 + 19% Living with one unmarried parent or step-parent 36% Living with relative(s), but not with parent(s) and/or step parent(s) Source: 2000 and 2010 U.S. Census , Table P14 61% Population of children under age six, by ethnicity 5% 6% 4% 45% Hispanic or Latino White, not Hispanic Black or African American, not Hispanic American Indian, not Hispanic 40% Other (including children of two or more races), not Hispanic Living with unrelated person(s)/other living arrangements Source: US Census, American Community Survey, 5-year estimates (2007-2011), Tables B05009, B09001, B17006 Young children with grandparent householders Number of children 0-5 living in the household of their grandparent 14% Source: 2010 US Census, Tables P14 and P41 Young children with one or both foreign-born parents Source: 2010 US Census, Tables PCT12H, PCT12I, PCT12J, PCT12K, PCT12L, PCT12M, PCT12N, PCT12O Number of children 0-5 living with foreign-born parent(s) Percent of all children 0-5, who live with foreign-born parent(s) 157,965 30% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B05009 34 | First Things First State of Arizona Economic Change Rates of unemployment, annual averages Employment status of parents of young children 12.0% 10% 32% Children living with two parents, both in labor force Children living with two parents, one in labor force and one not 27% Children living with two parents, neither in labor force Children living with one parent, in labor force 1% 30% Children living with one parent, not in labor force 9.8% 10.0% Median income of families with their own children (0-17), by family type For Married-couple families, with at least one child under 18 8.3% 6.0% 6.0% 4.0% 4.1% 3.7% 2.0% 0.0% 2007 2008 $38,100 For families with at least one child under 18, headed by a single female $26,500 2009 2010 2011 2012 Unemployment Rate Source: Arizona Office of Employment and Population Statistics, Local Area Unemployment Statistics (LAUS), in cooperation with the U.S. Dept of Labor, Bureau of Labor Statistics. May 2013. Note: Rates are not seasonally adjusted. Foreclosures, as of May 2013 $73,600 For families with at least one child under 18, headed by a single male 9.4% 8.0% 2006 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B23008 10.4% May 2012 May 2013 3.3 1.3 Number of foreclosures per 1,000 housing units Source: Realty Trac (www.realtytrac.com/statsandtrends/foreclosuretrends/az) Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B19126, 2011 inflation-adjusted dollars, rounded to the nearest hundred dollars. Young children in poverty Number of children (0-5) living in poverty 139,423 Percent of children (0-5) living in poverty 26% Children (0-17) receiving food assistance Households with one or more children (0-17), estimated 785,832 Households with children (0-17), receiving food stamps 154,554 Percent of households with children (0-17) receiving food stamps 20% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B22002 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B17001. Building Bright Futures 2013 | 35 State of Arizona Child Health Number of children enrolled (0-19) in KidsCare Births by year 120,000 100,000 50,000 102,042 102,687 99,215 92,616 44,723 45,000 87,053 85,190 85,725 40,000 35,000 80,000 30,000 60,000 25,000 20,000 40,000 21,883 16,649 15,000 20,000 10,000 0 2006 2007 2008 2009 2010 2011 2012 5,000 0 August 2011 Births by year, by mother's county of residence Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 August 2012 August 2013 Source: AHCCCS Population Statistics, September 2013; www.azahcccs.gov/reporting/ Downloads/KidsCareEnrollment/2013/Aug/KidsCareEnrollmentbyCounty.pdf Note: August 2013 data show children enrolled in KidsCare and KidsCare II. Characteristics of births and women giving birth, 2012 Young children without health insurance Total number of births, 2012 85,725 Mother unmarried 45% Mother 19 years or younger 9% Mother had fewer than 9 prenatal visits 18% Baby had low birth weight (less than 5.5 pounds) 7% Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Births by payor, 2012 3% < 1% AHCCS Indian Health Service (IHS) 42% Private Insurance 53% Self-pay Unknown 2% Source: ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T12-T27 36 | First Things First Number of children 0-5 without health insurance Percent of children 0-5 who have no health insurance 55,919 10% Source: US Census, American Community Survey, 3-year estimates (2009-2011), Table B27001 Note: Date for Greenlee County were not available. State of Arizona Education Estimated number of children served by child care providers on an average day Centers Percent of third-grade students passing Arizona’s Instrument to Measure Standards (AIMS), reading and math Reading 106,222 Certified Group Homes 2,460 Approved Family Homes 6,704 77% 76% 76% 75% 74% Source: Arizona DES, Child Care Market Rate Survey, 2012. 71% Estimated median daily charges by licensed child care providers 75% 2012 2013 73% 73% 72% 75% 71% 70% 69% 68% Median charge for infants under 1 year old Median charge for children ages 1 or 2 Median charge for children ages 3 to 5 Median charge for children ages 6 and up Centers Certified Group Homes Approved Family Homes $41 $26 $22 $37 $32 $29 $25 $25 $25 2009 2010 2011 Math 74% 72% $20 72% 70% 68% 68% $20 69% 68% 65% 66% 64% $20 62% 60% Source: Arizona DES, Child Care Market Rate Survey, 2012. 2009 2010 2011 2012 2013 Source: Arizona Dept of Education, www.azed.gov/researchpolicy/aimsresults Estimated child care capacity, according to providers’ approved numbers of children (all ages) Educational Attainment Estimated capacity in licensed centers 174,887 Estimated capacity in certified group homes 3,003 Estimated capacity in approved family homes 8,057 15% Less than a high-school education 25% 60% High school or GED More than a high-school education Source: Arizona DES, Child Care Market Rate Survey, 2012 These data are for early care and education providers that charge for their services, therefore, it does not include many Head Start and public school programs. It does include certified family homes, licensed child care providers, certified child care group homes, participants in the Child and Adult Care Food Program, and unregulated homes registered with the Child Care Resource and Referral agencies. Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B15002 Building Bright Futures 2013 | 37 v COUNTY DATA SETS Apache Demographic Change Households with young children (0-5) Population of children under age six (as of April 1, 2010) Total number of households 7,700 22,771 Households with one or more children under 6 years 7,653 7,600 Percent of households with children under 6 years 7,500 7,400 7,300 21% Source: 2010 U.S. Census, Summary File 1, P20 7,171 7,200 4,729 7,100 Living arrangements for young children (0-5) 7,000 6,900 Census 2000 9% Census 2010 Increase or decrease from 2000 to 2010 < 1% Living with two married parents or step-parents 38% - 6% Source: 2000 and 2010 U.S. Census , Table P14 Living with one unmarried parent or step-parent Living with relative(s), but not with parent(s) and/or step parent(s) 53% Living with unrelated person(s)/other living arrangements Population of children under age six, by ethnicity 3% 8% Hispanic or Latino 14% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Tables B05009, B09001, B17006 White, not Hispanic < 1% Young children with grandparent householders Black or African American, not Hispanic American Indian, not Hispanic 75% Other (including children of two or more races), not Hispanic Source: 2010 US Census, Tables PCT12H, PCT12I, PCT12J, PCT12K, PCT12L, PCT12M, PCT12N, PCT12O Number of children 0-5 living in the household of their grandparent 32% Source: 2010 US Census, Tables P14 and P41 Young children with one or both foreign-born parents Number of children 0-5 living with foreign-born parent(s) 249 Percent of all children 0-5, who live with foreign-born parent(s) 4% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B05009 40 | First Things First Apache Economic Change Rates of unemployment, annual averages Employment status of parents of young children 19% 25.0% 24% 19% 34% 4% Children living with two parents, both in labor force 20.0% Children living with two parents, one in labor force and one not 15.0% Children living with two parents, neither in labor force 10.0% Children living with one parent, in labor force 5.0% Children living with one parent, not in labor force 15.7% 9.8% 18.8% 19.6% 11.3% 8.5% 0.0% 2006 2007 2008 2009 2010 2011 2012 Unemployment Rate Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B23008 Source: Arizona Office of Employment and Population Statistics, Local Area Unemployment Statistics (LAUS), in cooperation with the U.S. Dept of Labor, Bureau of Labor Statistics. May 2013. Note: Rates are not seasonally adjusted. Median income of families with their own children (0-17), by family type For Married-couple families, with at least one child under 18 17.0% Foreclosures, as of May 2013 $51,400 For families with at least one child under 18, headed by a single male * For families with at least one child under 18, headed by a single female $23,600 May 2012 May 2013 0.4 0.3 Number of foreclosures per 1,000 housing units Source: Realty Trac (www.realtytrac.com/statsandtrends/foreclosuretrends/az) Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B19126, 2011 inflation-adjusted dollars, rounded to the nearest hundred. * Sample too small to produce a stable estimate Young children in poverty Number of children (0-5) living in poverty 3,536 Percent of children (0-5) living in poverty 50% Children (0-17) receiving food assistance Households with one or more children (0-17), estimated 7,121 Households with children (0-17), receiving food stamps 2,389 Percent of households with children (0-17) receiving food stamps 34% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B22002 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B17001. Building Bright Futures 2013 | 41 Apache Child Health Number of children enrolled (0-19) in KidsCare Births by year, by mother’s county of residence 1,400 1,200 1,189 1,149 1,211 1,242 900 1,099 1,071 930 1,000 700 800 600 600 500 400 400 300 200 308 245 200 0 2006 2007 2008 2009 2010 2011 2012 Births by year, by mother's county of residence 930 Mother unmarried 70% Mother 19 years or younger 14% Mother had fewer than 9 prenatal visits 31% Baby had low birth weight (less than 5.5 pounds) 6% Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Births by payor, 2012 1% AHCCS Indian Health Service (IHS) Private Insurance 34% 54% Self-pay Unknown Source: ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T12-T27 | First Things First August 2012 August 2013 Young children without health insurance Total number of births, 2012 1% 0 Source: AHCCCS Population Statistics, September 2013; www.azahcccs.gov/reporting/ Downloads/KidsCareEnrollment/2013/Aug/KidsCareEnrollmentbyCounty.pdf Note: August 2013 data show children enrolled in KidsCare and KidsCare II. Characteristics of births and women giving birth, 2012 10% 100 August 2011 Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 42 843 800 Number of children 0-5 without health insurance Percent of children 0-5 who have no health insurance 1,450 20% Source: US Census, American Community Survey, 3-year estimates (2009-2011), Table B27001 Apache Education Estimated number of children served by child care providers on an average day Centers Percent of third-grade students passing Arizona’s Instrument to Measure Standards (AIMS), reading and math 7,043 Certified Group Homes 117 Approved Family Homes 430 Reading 61% 60% 59% 58% 57% 56% 55% 54% 53% 52% 51% Source: Arizona DES, Child Care Market Rate Survey, 2012.* Estimated median daily charges by licensed child care providers Centers Certified Group Homes Approved Family Homes Median charge for infants under 1 year old $30 $27 $22 Median charge for children ages 1 or 2 $25 $25 $20 Median charge for children ages 3 to 5 $25 $22 $20 Median charge for children ages 6 and up $21 $22 $20 60% 58% 56% 55% 54% 2009 2010 2011 2012 2013 Math 60% 56% 46% 50% 51% 43% 39% 40% 30% 20% 10% 0% 2009 Source: Arizona DES, Child Care Market Rate Survey, 2012.* 2010 2011 2012 2013 Source: Arizona Dept of Education, www.azed.gov/researchpolicy/aimsresults Estimated child care capacity, according to providers’ approved numbers of children (all ages) Educational Attainment Estimated capacity in licensed centers 8,542 Estimated capacity in certified group homes 411 Estimated capacity in approved family homes 537 27% Less than a high-school education 41% High school or GED Source: Arizona DES, Child Care Market Rate Survey, (2012)* These data are for early care and education providers that charge for their services, therefore, it does not include many Head Start and public school programs. It does include certified family homes, licensed child care providers, certified child care group homes, participants in the Child and Adult Care Food Program, and unregulated homes registered with the Child Care Resource and Referral agencies. More than a high-school education 32% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B15002 *Note: Data presented in tables are a compilation of 4 counties: Apache, Coconino, Navajo, and Yavapai. Building Bright Futures 2013 | 43 Cochise Demographic Change Households with young children (0-5) Population of children under age six (as of April 1, 2010) Total number of households 10,200 50,865 Households with one or more children under 6 years 10,125 10,100 10,000 7,272 Percent of households with children under 6 years 9,900 9,800 14% Source: 2010 U.S. Census, Summary File 1, P20 9,700 9,571 9,600 Living arrangements for young children (0-5) 9,500 9,400 9,300 3% 1% 9,200 Census 2000 Living with two married parents or step-parents Census 2010 Increase or decrease from 2000 to 2010 + 6% 32% Living with one unmarried parent or step-parent Source: 2000 and 2010 U.S. Census , Table P14 Living with relative(s), but not with parent(s) and/or step parent(s) 64% Living with unrelated person(s)/other living arrangements Population of children under age six, by ethnicity 1% 6% Hispanic or Latino 4% White, not Hispanic 47% 42% Black or African American, not Hispanic American Indian, not Hispanic Other (including children of two or more races), not Hispanic Source: US Census, American Community Survey, 5-year estimates (2007-2011), Tables B05009, B09001, B17006 Young children with grandparent householders Number of children 0-5 living in the household of their grandparent 15% Source: 2010 US Census, Tables P14 and P41 Source: 2010 US Census, Tables PCT12H, PCT12I, PCT12J, PCT12K, PCT12L, PCT12M, PCT12N, PCT12O Young children with one or both foreign-born parents Number of children 0-5 living with foreign-born parent(s) Percent of all children 0-5, who live with foreign-born parent(s) 2,628 27% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B05009 44 | First Things First Cochise Economic Change Rates of unemployment, annual averages Employment status of parents of young children 10.0% 9% 9.0% 31% 24% 1% 35% Children living with two parents, both in labor force 8.0% Children living with two parents, one in labor force and one not 6.0% Children living with two parents, neither in labor force 4.0% Children living with one parent, in labor force 2.0% Children living with one parent, not in labor force 7.0% 5.0% 8.8% 8.8% 2010 2011 7.9% 8.2% 5.7% 4.4% 3.9% 3.0% 1.0% 0.0% 2006 2007 2008 2009 2012 Unemployment Rate Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B23008 Median income of families with their own children (0-17), by family type For Married-couple families, with at least one child under 18 Source: Arizona Office of Employment and Population Statistics, Local Area Unemployment Statistics (LAUS), in cooperation with the U.S. Dept of Labor, Bureau of Labor Statistics. May 2013. Note: Rates are not seasonally adjusted. Foreclosures, as of May 2013 $65,100 For families with at least one child under 18, headed by a single male $38,900 For families with at least one child under 18, headed by a single female $22,800 May 2012 May 2013 2.1 1.5 Number of foreclosures per 1,000 housing units Source: Realty Trac (www.realtytrac.com/statsandtrends/foreclosuretrends/az) Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B19126, 2011 inflation-adjusted dollars, rounded to the nearest hundred. Young children in poverty Number of children (0-5) living in poverty 2,619 Percent of children (0-5) living in poverty 26% Children (0-17) receiving food assistance Households with one or more children (0-17), estimated 15,376 Households with children (0-17), receiving food stamps 3,504 Percent of households with children (0-17) receiving food stamps 23% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B22002 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B17001. Building Bright Futures 2013 | 45 Cochise Child Health Number of children enrolled (0-19) in KidsCare Births by year, by mother’s county of residence 1,900 1,850 1,860 700 1,846 1,781 1,781 500 1,750 1,704 1,700 1,664 377 400 300 1,650 254 200 1,600 1,550 2006 2007 2008 2009 2010 2011 2012 Births by year, by mother's county of residence 1,704 38% Mother 19 years or younger 10% Mother had fewer than 9 prenatal visits 22% Baby had low birth weight (less than 5.5 pounds) 7% Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Births by payor, 2012 1% AHCCS 44% Indian Health Service (IHS) Private Insurance 52% Self-pay Unknown 0% Source: ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T12-T27 | First Things First August 2012 August 2013 Young children without health insurance Mother unmarried 3% 0 Source: AHCCCS Population Statistics, September 2013; www.azahcccs.gov/reporting/ Downloads/KidsCareEnrollment/2013/Aug/KidsCareEnrollmentbyCounty.pdf Note: August 2013 data show children enrolled in KidsCare and KidsCare II. Characteristics of births and women giving birth, 2012 Total number of births, 2012 100 August 2011 Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 46 586 600 1,808 1,800 Number of children 0-5 without health insurance 838 Percent of children 0-5 who have no health insurance 8% Source: US Census, American Community Survey, 3-year estimates (2009-2011), Table B27001 Cochise Education Estimated number of children served by child care providers on an average day Centers Percent of third-grade students passing Arizona’s Instrument to Measure Standards (AIMS), reading and math 1,732 Certified Group Homes Reading 74 Approved Family Homes 74% 73% 73% 72% 72% 71% 71% 70% 70% 69% 69% 664 Source: Arizona DES, Child Care Market Rate Survey, 2012.* Estimated median daily charges by licensed child care providers Centers Certified Group Homes Approved Family Homes Median charge for infants under 1 year old $32 $26 $24 Median charge for children ages 1 or 2 $31 70% 70% 2009 2010 70% $24 $28 Median charge for children ages 6 and up $22 $22 2011 2012 68% $24 64% 64% 62% $22 71% 2013 70% 66% Median charge for children ages 3 to 5 71% Math 72% $25 73% 66% 60% 60% $24 65% 58% 56% 54% Source: Arizona DES, Child Care Market Rate Survey, 2012.* 2009 2010 2011 2012 2013 Source: Arizona Dept of Education, www.azed.gov/researchpolicy/aimsresults Estimated child care capacity, according to providers’ approved numbers of children (all ages) Educational Attainment Estimated capacity in licensed centers 2,673 Estimated capacity in certified group homes 80 Estimated capacity in approved family homes 785 15% Less than a high-school education 25% 60% High school or GED More than a high-school education Source: Arizona DES, Child Care Market Rate Survey, (2012)* These data are for early care and education providers that charge for their services, therefore, it does not include many Head Start and public school programs. It does include certified family homes, licensed child care providers, certified child care group homes, participants in the Child and Adult Care Food Program, and unregulated homes registered with the Child Care Resource and Referral agencies. Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B15002 *Note: Data presented in tables are a compilation of 4 counties: Cochise, Graham, Greenlee, and Santa Cruz. Building Bright Futures 2013 | 47 Coconino Demographic Change Households with young children (0-5) Population of children under age six (as of April 1, 2010) Total number of households 11,000 Households with one or more children under 6 years 10,777 10,800 46,711 Percent of households with children under 6 years 10,600 10,400 7,474 16% Source: 2010 U.S. Census, Summary File 1, P20 10,200 10,117 Living arrangements for young children (0-5) 10,000 9,800 3% 2% 9,600 Census 2000 Living with two married parents or step-parents Census 2010 49% Increase or decrease from 2000 to 2010 + 7% 46% Living with one unmarried parent or step-parent Living with relative(s), but not with parent(s) and/or step parent(s) Source: 2000 and 2010 U.S. Census , Table P14 Living with unrelated person(s)/other living arrangements Population of children under age six, by ethnicity 5% 22% Hispanic or Latino Source: US Census, American Community Survey, 5-year estimates (2007-2011), Tables B05009, B09001, B17006 Young children with grandparent householders White, not Hispanic 36% Black or African American, not Hispanic Number of children 0-5 living in the household of their grandparent 21% American Indian, not Hispanic Source: 2010 US Census, Tables P14 and P41 1% 36% Other (including children of two or more races), not Hispanic Source: 2010 US Census, Tables PCT12H, PCT12I, PCT12J, PCT12K, PCT12L, PCT12M, PCT12N, PCT12O Young children with one or both foreign-born parents Number of children 0-5 living with foreign-born parent(s) Percent of all children 0-5, who live with foreign-born parent(s) 1,113 11% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B05009 48 | First Things First Coconino Economic Change Rates of unemployment, annual averages Employment status of parents of young children 15% 12.0% 32% 34% 18% 1% Children living with two parents, both in labor force 10.0% Children living with two parents, one in labor force and one not 8.0% Children living with two parents, neither in labor force 6.0% Children living with one parent, in labor force 4.0% Children living with one parent, not in labor force 2.0% 9.7% 3.6% 0.0% 2006 For Married-couple families, with at least one child under 18 8.1% 5.4% 4.3% 2007 2008 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B23008 Median income of families with their own children (0-17), by family type 9.2% 8.5% 2009 2010 2011 2012 Unemployment Rate Source: Arizona Office of Employment and Population Statistics, Local Area Unemployment Statistics (LAUS), in cooperation with the U.S. Dept of Labor, Bureau of Labor Statistics. May 2013. Note: Rates are not seasonally adjusted. Foreclosures, as of May 2013 $77,800 For families with at least one child under 18, headed by a single male $35,600 For families with at least one child under 18, headed by a single female $24,600 May 2012 May 2013 1.4 1.2 Number of foreclosures per 1,000 housing units Source: Realty Trac (www.realtytrac.com/statsandtrends/foreclosuretrends/az) Children (0-17) receiving food assistance Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B19126, 2011 inflation-adjusted dollars, rounded to the nearest hundred. Young children in poverty Number of children (0-5) living in poverty 2,469 Percent of children (0-5) living in poverty 24% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B17001. Households with one or more children (0-17), estimated 14,598 Households with children (0-17), receiving food stamps 2,932 Percent of households with children (0-17) receiving food stamps 20% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B22002 Building Bright Futures 2013 | 49 Coconino Child Health Number of children enrolled (0-19) in KidsCare Births by year, by mother’s county of residence 2,500 2,132 2,062 2,000 1200 1,985 1,894 1,775 1,771 1,689 1000 1,500 800 1,000 600 500 400 328 401 200 0 2006 2007 2008 2009 2010 2011 2012 Births by year, by mother's county of residence 1,689 52% Mother 19 years or younger 10% Mother had fewer than 9 prenatal visits 19% Baby had low birth weight (less than 5.5 pounds) 8% Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Births by payor, 2012 0% AHCCS 34% Indian Health Service (IHS) 47% Private Insurance Self-pay Unknown 17% Source: ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T12-T27 | First Things First August 2013 Young children without health insurance Mother unmarried 2% August 2012 Source: AHCCCS Population Statistics, September 2013; www.azahcccs.gov/reporting/ Downloads/KidsCareEnrollment/2013/Aug/KidsCareEnrollmentbyCounty.pdf Note: August 2013 data show children enrolled in KidsCare and KidsCare II. Characteristics of births and women giving birth, 2012 Total number of births, 2012 0 August 2011 Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 50 1,102 Number of children 0-5 without health insurance 889 Percent of children 0-5 who have no health insurance 9% Source: US Census, American Community Survey, 3-year estimates (2009-2011), Table B27001 Coconino Education Estimated number of children served by child care providers on an average day Centers Percent of third-grade students passing Arizona’s Instrument to Measure Standards (AIMS),reading and math 7,043 Certified Group Homes 117 Approved Family Homes 430 Reading 70% 69% 68% 67% 68% 69% 66% Source: Arizona DES, Child Care Market Rate Survey, 2012.* 64% Estimated median daily charges by licensed child care providers 62% 62% 60% 58% Centers Certified Group Homes Approved Family Homes Median charge for infants under 1 year old $30 $27 $22 Median charge for children ages 1 or 2 $25 $25 $20 Median charge for children ages 3 to 5 $25 $22 $20 Median charge for children ages 6 and up $21 $22 2009 2010 2011 2012 2013 Math 68% 66% 66% 65% 64% 62% 60% 60% 58% 58% $20 64% 56% 54% 2009 Source: Arizona DES, Child Care Market Rate Survey, 2012.* 2010 2011 2012 2013 Source: Arizona Dept of Education, www.azed.gov/researchpolicy/aimsresults Estimated child care capacity, according to providers’ approved numbers of children (all ages) Educational Attainment Estimated capacity in licensed centers 8,542 Estimated capacity in certified group homes 411 Estimated capacity in approved family homes 13% Less than a high-school education 22% High school or GED 537 More than a high-school education 65% Source: Arizona DES, Child Care Market Rate Survey, (2012)* These data are for early care and education providers that charge for their services, therefore, it does not include many Head Start and public school programs. It does include certified family homes, licensed child care providers, certified child care group homes, participants in the Child and Adult Care Food Program, and unregulated homes registered with the Child Care Resource and Referral agencies. Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B15002 *Note: Data presented in tables are a compilation of 4 counties: Apache, Coconino, Navajo, and Yavapai. Building Bright Futures 2013 | 51 Gila Demographic Change Households with young children (0-5) Population of children under age six (as of April 1, 2010) Total number of households 3,800 Households with one or more children under 6 years 3,772 3,780 22,000 3,760 Percent of households with children under 6 years 3,740 3,720 3,700 2,488 11% Source: 2010 U.S. Census, Summary File 1, P20 3,680 3,657 3,660 Living arrangements for young children (0-5) 3,640 3,620 2% 3,600 1% Living with two married parents or step-parents 3,580 Census 2000 Census 2010 Living with one unmarried parent or step-parent Increase or decrease from 2000 to 2010 - 3% 45% 52% Source: 2000 and 2010 U.S. Census , Table P14 Living with relative(s), but not with parent(s) and/or step parent(s) Living with unrelated person(s)/other living arrangements Population of children under age six, by ethnicity Source: US Census, American Community Survey, 5-year estimates (2007-2011), Tables B05009, B09001, B17006 Young children with grandparent householders 2% 28% 28% Hispanic or Latino White, not Hispanic Black or African American, not Hispanic < 1% American Indian, not Hispanic 42% Other (including children of two or more races), not Hispanic Source: 2010 US Census, Tables PCT12H, PCT12I, PCT12J, PCT12K, PCT12L, PCT12M, PCT12N, PCT12O Number of children 0-5 living in the household of their grandparent 28% Source: 2010 US Census, Tables P14 and P41 Young children with one or both foreign-born parents Number of children 0-5 living with foreign-born parent(s) 223 Percent of all children 0-5, who live with foreign-born parent(s) 6% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B05009 52 | First Things First Gila Economic Change Rates of unemployment, annual averages Employment status of parents of young children 19% 23% Children living with two parents, both in labor force Children living with two parents, one in labor force and one not Children living with two parents, neither in labor force 28% 27% 3% Children living with one parent, in labor force Children living with one parent, not in labor force 14.0% 11.3% 12.0% 11.8% 10.5% 10.0% 8.0% 6.0% 9.4% 6.3% 5.1% 4.0% 4.1% 2.0% 0.0% 2006 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B23008 2008 2009 2010 2011 2012 Unemployment Rate Source: Arizona Office of Employment and Population Statistics, Local Area Unemployment Statistics (LAUS), in cooperation with the U.S. Dept of Labor, Bureau of Labor Statistics. May 2013. Note: Rates are not seasonally adjusted. Median income of families with their own children (0-17), by family type For Married-couple families, with at least one child under 18 2007 Foreclosures, as of May 2013 $53,300 For families with at least one child under 18, headed by a single male * For families with at least one child under 18, headed by a single female $21,900 May 2012 May 2013 1.8 0.8 Number of foreclosures per 1,000 housing units Source: Realty Trac (www.realtytrac.com/statsandtrends/foreclosuretrends/az) Children (0-17) receiving food assistance Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B19126, 2011 inflation-adjusted dollars, rounded to the nearest hundred. * Sample too small to produce stable estimate Young children in poverty Number of children (0-5) living in poverty 1,563 Percent of children (0-5) living in poverty 40% Households with one or more children (0-17), estimated 4,731 Households with children (0-17), receiving food stamps 1,590 Percent of households with children (0-17) receiving food stamps 34% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B22002 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B17001. Building Bright Futures 2013 | 53 Gila Child Health Number of children enrolled (0-19) in KidsCare Births by year, by mother’s county of residence 720 680 697 694 700 300 670 667 250 660 640 200 620 620 609 600 150 173 107 100 580 50 560 2006 2007 2008 2009 2010 2011 2012 Births by year, by mother's county of residence 609 Mother unmarried 62% Mother 19 years or younger 14% Mother had fewer than 9 prenatal visits 34% Baby had low birth weight (less than 5.5 pounds) 6% Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Births by payor, 2012 0% AHCCS Indian Health Service (IHS) Private Insurance 18% 61% Self-pay Unknown Source: ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T12-T27 | First Things First August 2013 Young children without health insurance Total number of births, 2012 1% August 2012 Source: AHCCCS Population Statistics, September 2013; www.azahcccs.gov/reporting/ Downloads/KidsCareEnrollment/2013/Aug/KidsCareEnrollmentbyCounty.pdf Note: August 2013 data show children enrolled in KidsCare and KidsCare II. Characteristics of births and women giving birth, 2012 20% 0 August 2011 Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 54 332 350 704 Number of children 0-5 without health insurance Percent of children 0-5 who have no health insurance 1,093 30% Source: US Census, American Community Survey, 3-year estimates (2009-2011), Table B27001 Gila Education Estimated number of children served by child care providers on an average day Centers Percent of third-grade students passing Arizona’s Instrument to Measure Standards (AIMS), reading and math 2,813 Certified Group Homes 130 Approved Family Homes 443 Reading 80% 70% 60% Source: Arizona DES, Child Care Market Rate Survey, 2012. * 74% 64% 59% 58% 60% 2012 2013 52% 52% 51% 2011 2012 2013 50% 40% 30% Estimated median daily charges by licensed child care providers 20% 10% 0% Median charge for infants under 1 year old Centers Certified Group Homes Approved Family Homes $40 $30 $25 Median charge for children ages 1 or 2 $37 Median charge for children ages 3 to 5 $30 Median charge for children ages 6 and up $30 $26 2009 2010 2011 Math 70% 60% $25 64% 57% 50% $25 40% $25 30% $25 20% $25 10% 0% 2009 Source: Arizona DES, Child Care Market Rate Survey, 2012. * 2010 Source: Arizona Dept of Education, www.azed.gov/researchpolicy/aimsresults Estimated child care capacity, according to providers’ approved numbers of children (all ages) Educational Attainment 16% Estimated capacity in licensed centers 4,434 Estimated capacity in certified group homes 155 Estimated capacity in approved family homes Less than a high-school education High school or GED 51% 538 33% More than a high-school education Source: Arizona DES, Child Care Market Rate Survey, (2012)* These data are for early care and education providers that charge for their services, therefore, it does not include many Head Start and public school programs. It does include certified family homes, licensed child care providers, certified child care group homes, participants in the Child and Adult Care Food Program, and unregulated homes registered with the Child Care Resource and Referral agencies. Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B15002 *Note: Data presented in tables are a compilation of 2 counties: Gila and Pinal. Building Bright Futures 2013 | 55 Graham Demographic Change Households with young children (0-5) Population of children under age six (as of April 1, 2010) Total number of households Households with one or more children under 6 years 4,500 3,830 4,000 3,500 11,120 Percent of households with children under 6 years 3,112 3,000 2,448 22% Source: 2010 U.S. Census, Summary File 1, P20 2,500 2,000 Living arrangements for young children (0-5) 1,500 1,000 3% 1% 500 Living with two married parents or step-parents Census 2000 Census 2010 Increase or decrease from 2000 to 2010 Living with relative(s), but not with parent(s) and/or step parent(s) + 23% 64% Source: 2000 and 2010 U.S. Census , Table P14 Population of children under age six, by ethnicity Living with unrelated person(s)/other living arrangements Source: US Census, American Community Survey, 5-year estimates (2007-2011), Tables B05009, B09001, B17006 Young children with grandparent householders 3% 18% Living with one unmarried parent or step-parent 32% Hispanic or Latino 34% White, not Hispanic 1% 44% Number of children 0-5 living in the household of their grandparent Black or African American, not Hispanic Source: 2010 US Census, Tables P14 and P41 American Indian, not Hispanic Young children with one or both foreign-born parents Other (including children of two or more races), not Hispanic Source: 2010 US Census, Tables PCT12H, PCT12I, PCT12J, PCT12K, PCT12L, PCT12M, PCT12N, PCT12O 22% Number of children 0-5 living with foreign-born parent(s) 239 Percent of all children 0-5, who live with foreign-born parent(s) 7% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B05009 56 | First Things First Graham Economic Change Rates of unemployment, annual averages Employment status of parents of young children 14% Children living with two parents, both in labor force Children living with two parents, neither in labor force Children living with one parent, in labor force 0% 42% 14.0% 14.2% 12.0% Children living with two parents, one in labor force and one not 19% 15.0% 16.0% 25% Children living with one parent, not in labor force 10.4% 10.0% 8.9% 8.0% 6.0% 6.8% 5.0% 4.0% 4.1% 2.0% 0.0% 2006 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B23008 2008 2009 2010 2011 2012 Unemployment Rate Median income of families with their own children (0-17), by family type Source: Arizona Office of Employment and Population Statistics, Local Area Unemployment Statistics (LAUS), in cooperation with the U.S. Dept of Labor, Bureau of Labor Statistics. May 2013. Note: Rates are not seasonally adjusted. For Married-couple families, with at least one child under 18 $67,000 For families with at least one child under 18, headed by a single male $44,300 For families with at least one child under 18, headed by a single female * Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B19126, 2011 inflation-adjusted dollars, rounded to the nearest hundred. * Sample too small to produce stable estimate Young children in poverty Number of children (0-5) living in poverty 969 Percent of children (0-5) living in poverty 27% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B17001. 2007 Foreclosures, as of May 2013 May 2012 May 2013 1.7 1.2 Number of foreclosures per 1,000 housing units Source: Realty Trac (www.realtytrac.com/statsandtrends/foreclosuretrends/az) Children (0-17) receiving food assistance Households with one or more children (0-17), estimated 4,601 Households with children (0-17), receiving food stamps 1,490 Percent of households with children (0-17) receiving food stamps 32% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B22002 Building Bright Futures 2013 | 57 Graham Child Health Number of children enrolled (0-19) in KidsCare Births by year, by mother’s county of residence 700 600 644 645 582 540 530 238 250 606 525 500 400 200 150 300 100 200 100 100 75 50 0 2006 2007 2008 2009 2010 2011 2012 Characteristics of births and women giving birth, 2012 525 Mother unmarried 46% Mother 19 years or younger 14% Mother had fewer than 9 prenatal visits 44% Baby had low birth weight (less than 5.5 pounds) 8% Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Births by payor, 2012 0% AHCCS Indian Health Service (IHS) 48% Private Insurance Self-pay Unknown 13% Source: ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T12-T27 58 | First Things First August 2013 Young children without health insurance Total number of births, 2012 37% August 2012 Source: AHCCCS Population Statistics, September 2013; www.azahcccs.gov/reporting/ Downloads/KidsCareEnrollment/2013/Aug/KidsCareEnrollmentbyCounty.pdf Note: August 2013 data show children enrolled in KidsCare and KidsCare II. Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 2% 0 August 2011 Births by year, by mother's county of residence Number of children 0-5 without health insurance Percent of children 0-5 who have no health insurance 677 18% Source: US Census, American Community Survey, 3-year estimates (2009-2011), Table B27001 Graham Education Estimated number of children served by child care providers on an average day Centers Percent of third-grade students passing Arizona’s Instrument to Measure Standards (AIMS), reading and math 1,732 Certified Group Homes Approved Family Homes Reading 74 82% 664 81% 81% 80% 80% 79% Source: Arizona DES, Child Care Market Rate Survey, 2012.* 78% 77% Estimated median daily charges by licensed child care providers 78% 77% 76% 76% 75% 74% 73% Median charge for infants under 1 year old Centers Certified Group Homes Approved Family Homes $32 $26 $24 2009 $31 Median charge for children ages 3 to 5 $28 Median charge for children ages 6 and up $22 $25 $24 $22 2012 2013 73% 72% 72% 71% 71% $24 $22 2011 Math 74% 73% Median charge for children ages 1 or 2 2010 70% 70% 69% 69% $24 68% 67% 2009 Source: Arizona DES, Child Care Market Rate Survey, 2012.* 2010 2011 2012 2013 Source: Arizona Dept of Education, www.azed.gov/researchpolicy/aimsresults Estimated child care capacity, according to providers’ approved numbers of children (all ages) Educational Attainment Estimated capacity in licensed centers 2,673 Estimated capacity in certified group homes 80 Estimated capacity in approved family homes 785 17% Less than a high-school education High school or GED 51% 32% More than a high-school education Source: Arizona DES, Child Care Market Rate Survey, (2012)* These data are for early care and education providers that charge for their services, therefore, it does not include many Head Start and public school programs. It does include certified family homes, licensed child care providers, certified child care group homes, participants in the Child and Adult Care Food Program, and unregulated homes registered with the Child Care Resource and Referral agencies. Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B15002 *Note: Data presented in tables are a compilation of 4 counties: Cochise, Graham, Greenlee, and Santa Cruz. Building Bright Futures 2013 | 59 Greenlee Demographic Change Households with young children (0-5) Population of children under age six (as of April 1, 2010) Total number of households 880 3,188 Households with one or more children under 6 years 869 860 Percent of households with children under 6 years 840 820 566 18% Source: 2010 U.S. Census, Summary File 1, P20 794 800 Living arrangements for young children (0-5) 780 760 3% 4% Living with two married parents or step-parents 740 Census 2000 Census 2010 46% Increase or decrease from 2000 to 2010 - 9% 47% Population of children under age six, by ethnicity 2% Living with relative(s), but not with parent(s) and/or step parent(s) Living with unrelated person(s)/other living arrangements Source: 2000 and 2010 U.S. Census , Table P14 1% Living with one unmarried parent or step-parent Source: US Census, American Community Survey, 5-year estimates (2007-2011), Tables B05009, B09001, B17006 Young children with grandparent householders 2% Hispanic or Latino White, not Hispanic 40% 55% Number of children 0-5 living in the household of their grandparent Black or African American, not Hispanic Source: 2010 US Census, Tables P14 and P41 American Indian, not Hispanic Young children with one or both foreign-born parents Other (including children of two or more races), not Hispanic Source: 2010 US Census, Tables PCT12H, PCT12I, PCT12J, PCT12K, PCT12L, PCT12M, PCT12N, PCT12O Number of children 0-5 living with foreign-born parent(s) Percent of all children 0-5, who live with foreign-born parent(s) 19% 75 11% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B05009 60 | First Things First Greenlee Economic Change Rates of unemployment, annual averages Employment status of parents of young children 11% 18.9% 20.0% 20% Children living with two parents, both in labor force 40% 29% 0% 18.0% 16.0% Children living with two parents, one in labor force and one not 14.0% Children living with two parents, neither in labor force 10.0% Children living with one parent, in labor force 6.0% Children living with one parent, not in labor force 2.0% 11.4% 12.0% 8.2% 8.0% 4.0% 3.1% 2006 2007 0.0% 2008 2009 2010 2011 2012 Unemployment Rate Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B23008 Source: Arizona Office of Employment and Population Statistics, Local Area Unemployment Statistics (LAUS), in cooperation with the U.S. Dept of Labor, Bureau of Labor Statistics. May 2013. Note: Rates are not seasonally adjusted. Median income of families with their own children (0-17), by family type For Married-couple families, with at least one child under 18 6.0% 5.1% 3.7% Foreclosures, as of May 2013 $65,400 For families with at least one child under 18, headed by a single male $52,300 For families with at least one child under 18, headed by a single female * May 2012 May 2013 0.2 0.5 Number of foreclosures per 1,000 housing units Source: Realty Trac (www.realtytrac.com/statsandtrends/foreclosuretrends/az) Children (0-17) receiving food assistance Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B19126, 2011 inflation-adjusted dollars, rounded to the nearest hundred. * Sample too small to produce a stable estimate Young children in poverty Number of children (0-5) living in poverty 115 Percent of children (0-5) living in poverty 16% Households with one or more children (0-17), estimated 1,396 Households with children (0-17), receiving food stamps 148 Percent of households with children (0-17) receiving food stamps 11% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B22002 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B17001. Building Bright Futures 2013 | 61 Greenlee Child Health Number of children enrolled (0-19) in KidsCare Births by year, by mother’s county of residence 160 138 140 120 131 45 130 110 119 105 40 40 114 35 100 30 80 25 60 20 40 15 20 15 15 August 2011 August 2012 10 0 2006 2007 2008 2009 2010 2011 2012 0 Births by year, by mother's county of residence Characteristics of births and women giving birth, 2012 Young children without health insurance Total number of births, 2012 114 37% Mother 19 years or younger 8% Mother had fewer than 9 prenatal visits 35% Baby had low birth weight (less than 5.5 pounds) 5% Number of children 0-5 without health insurance – Percent of children 0-5 who have no health insurance – Source: US Census, American Community Survey, 3-year estimates (2009-2011), Table B27001 Note: Data for Greenlee County were not available Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Births by payor, 2012 0% 0% AHCCS 36% Indian Health Service (IHS) Private Insurance 64% Self-pay 0% Unknown Source: ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T12-T27 62 | First Things First August 2013 Source: AHCCCS Population Statistics, September 2013; www.azahcccs.gov/reporting/ Downloads/KidsCareEnrollment/2013/Aug/KidsCareEnrollmentbyCounty.pdf Note: August 2013 data show children enrolled in KidsCare and KidsCare II. Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Mother unmarried 5 Greenlee Education Estimated number of children served by child care providers on an average day Centers Percent of third-grade students passing Arizona’s Instrument to Measure Standards (AIMS), reading and math 1,732 Certified Group Homes Reading 74 Approved Family Homes 90% 664 Source: Arizona DES, Child Care Market Rate Survey, 2012.* 80% 87% 85% 85% 79% 76% 74% 75% Estimated median daily charges by licensed child care providers 70% 65% Median charge for infants under 1 year old Centers Certified Group Homes Approved Family Homes $32 $26 $24 Median charge for children ages 1 or 2 $31 $25 $24 Median charge for children ages 3 to 5 $28 $22 $24 Median charge for children ages 6 and up $22 $22 $24 2009 2010 82% 85% 2011 2012 2013 Math 90% 81% 80% 64% 70% 68% 60% 50% 40% 30% 20% 10% Source: Arizona DES, Child Care Market Rate Survey, 2012.* 0% 2009 2010 2011 2012 2013 Source: Arizona Dept of Education, www.azed.gov/researchpolicy/aimsresults Estimated child care capacity, according to providers’ approved numbers of children (all ages) Educational Attainment Estimated capacity in licensed centers 2,673 Estimated capacity in certified group homes 80 Estimated capacity in approved family homes 785 14% Less than a high-school education High school or GED 50% 36% More than a high-school education Source: Arizona DES, Child Care Market Rate Survey, (2012)* These data are for early care and education providers that charge for their services, therefore, it does not include many Head Start and public school programs. It does include certified family homes, licensed child care providers, certified child care group homes, participants in the Child and Adult Care Food Program, and unregulated homes registered with the Child Care Resource and Referral agencies. Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B15002 *Note: Data presented in tables are a compilation of 4 counties: Cochise, Graham, Greenlee, and Santa Cruz. Building Bright Futures 2013 | 63 La Paz Demographic Change Households with young children (0-5) Population of children under age six (as of April 1, 2010) Total number of households 1,227 1,230 1,220 1,210 9,198 Households with one or more children under 6 years 822 Percent of households with children under 6 years 9% Source: 2010 U.S. Census, Summary File 1, P20 1,200 1,195 Living arrangements for young children (0-5) 1,190 5% < 1% 1,180 32% 1,170 Census 2000 Living with one unmarried parent or step-parent Census 2010 Increase or decrease from 2000 to 2010 Living with two married parents or step-parents Living with relative(s), but not with parent(s) and/or step parent(s) + 3% Source: 2000 and 2010 U.S. Census , Table P14 63% Population of children under age six, by ethnicity Living with unrelated person(s)/other living arrangements Source: US Census, American Community Survey, 5-year estimates (2007-2011), Tables B05009, B09001, B17006 Young children with grandparent householders 4% Hispanic or Latino 50% 21% White, not Hispanic Black or African American, not Hispanic 1% American Indian, not Hispanic 24% Other (including children of two or more races), not Hispanic Source: 2010 US Census, Tables PCT12H, PCT12I, PCT12J, PCT12K, PCT12L, PCT12M, PCT12N, PCT12O Number of children 0-5 living in the household of their grandparent 16% Source: 2010 US Census, Tables P14 and P41 Young children with one or both foreign-born parents Number of children 0-5 living with foreign-born parent(s) Percent of all children 0-5, who live with foreign-born parent(s) 361 31% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B05009 64 | First Things First La Paz Economic Change Rates of unemployment, annual averages Employment status of parents of young children 16% 13% 12.0% 21% Children living with two parents, both in labor force 10.0% Children living with two parents, one in labor force and one not 8.0% Children living with two parents, neither in labor force 0% 50% 6.0% 9.8% 10.1% 9.2% 7.5% 5.6% 4.9% 4.0% Children living with one parent, in labor force 2.0% Children living with one parent, not in labor force 0.0% 2006 2007 2008 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B23008 Median income of families with their own children (0-17), by family type 10.6% 2009 2010 2011 2012 Unemployment Rate Source: Arizona Office of Employment and Population Statistics, Local Area Unemployment Statistics (LAUS), in cooperation with the U.S. Dept of Labor, Bureau of Labor Statistics. May 2013. Note: Rates are not seasonally adjusted. Foreclosures, as of May 2013 For Married-couple families, with at least one child under 18 For families with at least one child under 18, headed by a single male For families with at least one child under 18, headed by a single female $48,300 $26,600 May 2012 May 2013 0.6 0.2 Number of foreclosures per 1,000 housing units Source: Realty Trac (www.realtytrac.com/statsandtrends/foreclosuretrends/az) $25,400 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B19126, 2011 inflation-adjusted dollars, rounded to the nearest hundred. Young children in poverty Number of children (0-5) living in poverty 472 Percent of children (0-5) living in poverty 39% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B17001. Children (0-17) receiving food assistance Households with one or more children (0-17), estimated 2,598 Households with children (0-17), receiving food stamps 767 Percent of households with children (0-17) receiving food stamps 30% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B22002 Building Bright Futures 2013 | 65 La Paz Child Health Number of children enrolled (0-19) in KidsCare Births by year, by mother’s county of residence 300 250 160 229 246 230 204 200 200 174 172 120 100 150 80 100 60 50 40 61 49 20 0 2006 2007 2008 2009 2010 2011 2012 Characteristics of births and women giving birth, 2012 204 Mother unmarried 67% Mother 19 years or younger 12% Mother had fewer than 9 prenatal visits 29% Baby had low birth weight (less than 5.5 pounds) 6% Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Births by payor, 2012 0% AHCCS Indian Health Service (IHS) 25% 60% Private Insurance Self-pay Unknown Source: ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T12-T27 | First Things First August 2013 Young children without health insurance Total number of births, 2012 0% August 2012 Source: AHCCCS Population Statistics, September 2013; www.azahcccs.gov/reporting/ Downloads/KidsCareEnrollment/2013/Aug/KidsCareEnrollmentbyCounty.pdf Note: August 2013 data show children enrolled in KidsCare and KidsCare II. Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 15% 0 August 2011 Births by year, by mother's county of residence 66 140 140 Number of children 0-5 without health insurance Percent of children 0-5 who have no health insurance 63 5% Source: US Census, American Community Survey, 3-year estimates (2009-2011), Table B27001 La Paz Education Estimated number of children served by child care providers on an average day Centers Percent of third-grade students passing Arizona’s Instrument to Measure Standards (AIMS), reading and math Reading 4,017 Certified Group Homes 233 80% Approved Family Homes 632 70% 69% 61% 60% 59% 65% 53% 50% Source: Arizona DES, Child Care Market Rate Survey, 2012.* 40% 30% Estimated median daily charges by licensed child care providers 20% 10% 0% Median charge for infants under 1 year old Centers Certified Group Homes Approved Family Homes $28 $24 $20 Median charge for children ages 1 or 2 $24 Median charge for children ages 3 to 5 $22 Median charge for children ages 6 and up $22 $22 2009 2010 2012 2013 Math 80% 70% $20 71% 60% 51% 50% $22 2011 $20 48% 52% 58% 40% 30% $22 20% $20 10% 0% 2009 Source: Arizona DES, Child Care Market Rate Survey, 2012.* 2010 2011 2012 2013 Source: Arizona Dept of Education, www.azed.gov/researchpolicy/aimsresults Estimated child care capacity, according to providers’ approved numbers of children (all ages) Educational Attainment Estimated capacity in licensed centers 5,943 Estimated capacity in certified group homes 290 Estimated capacity in approved family homes 25% Less than a high-school education 44% High school or GED 787 Source: Arizona DES, Child Care Market Rate Survey, (2012)* These data are for early care and education providers that charge for their services, therefore, it does not include many Head Start and public school programs. It does include certified family homes, licensed child care providers, certified child care group homes, participants in the Child and Adult Care Food Program, and unregulated homes registered with the Child Care Resource and Referral agencies. More than a high-school education 31% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B15002 *Note: Data presented in tables are a compilation of 3 counties: La Paz, Mohave, and Yuma. Building Bright Futures 2013 | 67 Maricopa Demographic Change Households with young children (0-5) Population of children under age six (as of April 1, 2010) Total number of households 350,000 Households with one or more children under 6 years 339,217 340,000 1,411,583 238,955 Percent of households with children under 6 years 330,000 320,000 17% Source: 2010 U.S. Census, Summary File 1, P20 310,000 300,000 289,759 290,000 Living arrangements for young children (0-5) 280,000 2% 270,000 2% Living with two married parents or step-parents 260,000 Census 2000 Census 2010 Increase or decrease from 2000 to 2010 Living with one unmarried parent or step-parent 34% + 17% Living with relative(s), but not with parent(s) and/or step parent(s) 62% Source: 2000 and 2010 U.S. Census , Table P14 Population of children under age six, by ethnicity Living with unrelated person(s)/other living arrangements Source: US Census, American Community Survey, 5-year estimates (2007-2011), Tables B05009, B09001, B17006 Young children with grandparent householders 2% 8% Hispanic or Latino 5% 45% White, not Hispanic Black or African American, not Hispanic American Indian, not Hispanic 40% Other (including children of two or more races), not Hispanic Source: 2010 US Census, Tables PCT12H, PCT12I, PCT12J, PCT12K, PCT12L, PCT12M, PCT12N, PCT12O Number of children 0-5 living in the household of their grandparent 12% Source: 2010 US Census, Tables P14 and P41 Young children with one or both foreign-born parents Number of children 0-5 living with foreign-born parent(s) Percent of all children 0-5, who live with foreign-born parent(s) 114,024 34% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B05009 68 | First Things First Maricopa Economic Change Rates of unemployment, annual averages Employment status of parents of young children 9% 12.0% 33% 26% 1% 31% Children living with two parents, both in labor force 10.0% Children living with two parents, one in labor force and one not 8.0% Children living with two parents, neither in labor force 6.0% Children living with one parent, in labor force 4.0% Children living with one parent, not in labor force 2.0% 9.6% 9.1% 8.4% 7.1% 5.2% 3.5% 3.1% 0.0% 2006 2007 2008 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B23008 Median income of families with their own children (0-17), by family type 2009 2010 2011 2012 Unemployment Rate Source: Arizona Office of Employment and Population Statistics, Local Area Unemployment Statistics (LAUS), in cooperation with the U.S. Dept of Labor, Bureau of Labor Statistics. May 2013. Note: Rates are not seasonally adjusted. Foreclosures, as of May 2013 For Married-couple families, with at least one child under 18 $79,300 For families with at least one child under 18, headed by a single male $39,900 For families with at least one child under 18, headed by a single female May 2012 May 2013 4.0 1.5 Number of foreclosures per 1,000 housing units Source: Realty Trac (www.realtytrac.com/statsandtrends/foreclosuretrends/az) $29,200 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B19126, 2011 inflation-adjusted dollars, rounded to the nearest hundred. Young children in poverty Children (0-17) receiving food assistance Households with one or more children (0-17), estimated Households with children (0-17), receiving food stamps Number of children (0-5) living in poverty 82,535 Percent of children (0-5) living in poverty 24% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B17001. Percent of households with children (0-17) receiving food stamps 488,983 81,338 17% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B22002 Building Bright Futures 2013 | 69 Maricopa Child Health Number of children enrolled (0-19) in KidsCare Births by year, by mother’s county of residence 70,000 66,160 65,931 62,667 60,000 30,000 57,663 54,236 53,361 54,475 27,613 25,000 50,000 20,000 40,000 13,526 15,000 30,000 20,000 10,000 10,381 10,000 5,000 0 2006 2007 2008 2009 2010 2011 2012 Births by year, by mother's county of residence August 2011 Characteristics of births and women giving birth, 2012 54,475 44% Mother 19 years or younger 9% Mother had fewer than 9 prenatal visits 15% Baby had low birth weight (less than 5.5 pounds) 7% Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Births by payor, 2012 3% < 1% AHCCS Indian Health Service (IHS) 52% Private Insurance Self-pay Unknown < 1% Source: ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T12-T27 70 | First Things First August 2013 Young children without health insurance Mother unmarried 44% August 2012 Source: AHCCCS Population Statistics, September 2013; www.azahcccs.gov/reporting/ Downloads/KidsCareEnrollment/2013/Aug/KidsCareEnrollmentbyCounty.pdf Note: August 2013 data show children enrolled in KidsCare and KidsCare II. Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Total number of births, 2012 0 Number of children 0-5 without health insurance Percent of children 0-5 who have no health insurance 33,815 10% Source: US Census, American Community Survey, 3-year estimates (2009-2011), Table B27001 Maricopa Education Estimated number of children served by child care providers on an average day Centers Percent of third-grade students passing Arizona’s Instrument to Measure Standards (AIMS), reading and math 71,579 Certified Group Homes 1,097 Approved Family Homes 2,952 Reading 79% 78% 78% 77% 77% 77% 2012 2013 76% Source: Arizona DES, Child Care Market Rate Survey, 2012. 75% 74% Estimated median daily charges by licensed child care providers 73% 74% 73% 72% 71% 70% Centers Certified Group Homes Approved Family Homes Median charge for infants under 1 year old $43 $30 $20 Median charge for children ages 1 or 2 $39 Median charge for children ages 3 to 5 $34 $23 $20 Median charge for children ages 6 and up $30 $23 $16 2009 $20 75% 74% 72% 70% 70% 71% 70% 67% 68% 66% 64% 62% Source: Arizona DES, Child Care Market Rate Survey, 2012. 2009 2010 2011 2012 2013 Source: Arizona Dept of Education, www.azed.gov/researchpolicy/aimsresults Estimated child care capacity, according to providers’ approved numbers of children (all ages) Educational Attainment Estimated capacity in licensed centers 125,233 Estimated capacity in certified group homes 1,293 Estimated capacity in approved family homes 2011 Math 76% $26 2010 14% Less than a high-school education 24% 3,608 High school or GED More than a high-school education Source: Arizona DES, Child Care Market Rate Survey, 2012 These data are for early care and education providers that charge for their services, therefore, it does not include many Head Start and public school programs. It does include certified family homes, licensed child care providers, certified child care group homes, participants in the Child and Adult Care Food Program, and unregulated homes registered with the Child Care Resource and Referral agencies. 62% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B15002 Building Bright Futures 2013 | 71 Mohave Demographic Change Households with young children (0-5) Population of children under age six (as of April 1, 2010) Total number of households 13,500 82,539 Households with one or more children under 6 years 13,218 13,000 Percent of households with children under 6 years 12,500 8,981 11% Source: 2010 U.S. Census, Summary File 1, P20 12,000 Living arrangements for young children (0-5) 11,454 11,500 11,000 4% 1% Living with two married parents or step-parents 10,500 Census 2000 Census 2010 Increase or decrease from 2000 to 2010 + 15% Population of children under age six, by ethnicity 4% 1% Hispanic or Latino Living with unrelated person(s)/other living arrangements Source: US Census, American Community Survey, 5-year estimates (2007-2011), Tables B05009, B09001, B17006 Young children with grandparent householders 27% White, not Hispanic Black or African American, not Hispanic American Indian, not Hispanic 65% Living with relative(s), but not with parent(s) and/or step parent(s) 62% Source: 2000 and 2010 U.S. Census , Table P14 3% Living with one unmarried parent or step-parent 33% Other (including children of two or more races), not Hispanic Source: 2010 US Census, Tables PCT12H, PCT12I, PCT12J, PCT12K, PCT12L, PCT12M, PCT12N, PCT12O Number of children 0-5 living in the household of their grandparent 14% Source: 2010 US Census, Tables P14 and P41 Young children with one or both foreign-born parents Number of children 0-5 living with foreign-born parent(s) Percent of all children 0-5, who live with foreign-born parent(s) 1,953 15% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B05009 72 | First Things First Mohave Economic Change Rates of unemployment, annual averages Employment status of parents of young children 7% 14.0% 36% 28% Children living with two parents, both in labor force 0% 8.0% Children living with two parents, neither in labor force 6.0% 29% Children living with one parent, not in labor force Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B23008 Median income of families with their own children (0-17), by family type For Married-couple families, with at least one child under 18 $59,500 For families with at least one child under 18, headed by a single male $30,600 For families with at least one child under 18, headed by a single female $20,200 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B19126, 2011 inflation-adjusted dollars, rounded to the nearest hundred. 11.9% 11.0% 10.0% Children living with two parents, one in labor force and one not Children living with one parent, in labor force 11.4% 12.0% 4.0% 9.9% 7.4% 4.2% 4.5% 2006 2007 2.0% 0.0% 2008 2009 2010 2011 2012 Unemployment Rate Source: Arizona Office of Employment and Population Statistics, Local Area Unemployment Statistics (LAUS), in cooperation with the U.S. Dept of Labor, Bureau of Labor Statistics. May 2013. Note: Rates are not seasonally adjusted. Foreclosures, as of May 2013 May 2012 May 2013 2.2 1.4 Number of foreclosures per 1,000 housing units Source: Realty Trac (www.realtytrac.com/statsandtrends/foreclosuretrends/az) Children (0-17) receiving food assistance Households with one or more children (0-17), estimated 19,220 Young children in poverty Households with children (0-17), receiving food stamps 5,504 Number of children (0-5) living in poverty 4,194 Percent of households with children (0-17) receiving food stamps 29% Percent of children (0-5) living in poverty 31% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B22002 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B17001. Building Bright Futures 2013 | 73 Mohave Child Health Number of children enrolled (0-19) in KidsCare Births by year, by mother’s county of residence 3,000 2,500 2,468 1400 2,439 2,301 2,220 2,000 2,022 1,962 1,736 1000 1,500 800 1,000 600 500 400 0 2006 2007 2008 2009 2010 1,237 1200 2011 2012 625 382 200 0 Births by year, by mother's county of residence August 2011 Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 August 2012 August 2013 Source: AHCCCS Population Statistics, September 2013; www.azahcccs.gov/reporting/ Downloads/KidsCareEnrollment/2013/Aug/KidsCareEnrollmentbyCounty.pdf Note: August 2013 data show children enrolled in KidsCare and KidsCare II. Characteristics of births and women giving birth, 2012 Young children without health insurance Total number of births, 2012 1,736 Mother unmarried 56% Mother 19 years or younger 12% Mother had fewer than 9 prenatal visits 19% Baby had low birth weight (less than 5.5 pounds) 6% Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Births by payor, 2012 5% 0% AHCCS 30% Indian Health Service (IHS) Private Insurance 64% 1% Self-pay Unknown Source: ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T12-T27 74 | First Things First Number of children 0-5 without health insurance Percent of children 0-5 who have no health insurance 1,771 13% Source: US Census, American Community Survey, 3-year estimates (2009-2011), Table B27001 Mohave Education Estimated number of children served by child care providers on an average day Centers Percent of third-grade students passing Arizona’s Instrument to Measure Standards (AIMS), reading and math 4,017 Certified Group Homes 233 Approved Family Homes 632 Reading 80% 79% 78% 77% 76% 75% 74% 73% 72% 71% 70% Source: Arizona DES, Child Care Market Rate Survey, 2012.* Estimated median daily charges by licensed child care providers Median charge for infants under 1 year old Median charge for children ages 1 or 2 Centers Certified Group Homes Approved Family Homes $28 $24 $20 $24 $22 $22 $22 $20 Median charge for children ages 6 and up $22 $22 $20 77% 75% 73% 2009 2010 2011 2012 2013 Math 76% 74% 72% 70% 68% 66% 64% 62% 60% 58% 56% $20 Median charge for children ages 3 to 5 79% 78% Source: Arizona DES, Child Care Market Rate Survey, 2012.* 74% 72% 68% 69% 63% 2009 2010 2011 2012 2013 Source: Arizona Dept of Education, www.azed.gov/researchpolicy/aimsresults Estimated child care capacity, according to providers’ approved numbers of children (all ages) Educational Attainment Estimated capacity in licensed centers 5,943 Estimated capacity in certified group homes 290 Estimated capacity in approved family homes 787 16% Less than a high-school education High school or GED 50% 34% More than a high-school education Source: Arizona DES, Child Care Market Rate Survey, (2012)* These data are for early care and education providers that charge for their services, therefore, it does not include many Head Start and public school programs. It does include certified family homes, licensed child care providers, certified child care group homes, participants in the Child and Adult Care Food Program, and unregulated homes registered with the Child Care Resource and Referral agencies. Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B15002 *Note: Data presented in tables are a compilation of 3 counties: La Paz, Mohave, and Yuma. Building Bright Futures 2013 | 75 Navajo Demographic Change Households with young children (0-5) Population of children under age six (as of April 1, 2010) Total number of households 10,600 10,550 35,658 Households with one or more children under 6 years 10,500 Percent of households with children under 6 years 10,400 10,300 7,011 20% Source: 2010 U.S. Census, Summary File 1, P20 10,200 10,068 10,100 Living arrangements for young children (0-5) 10,000 9,900 5% 3% Living with two married parents or step-parents 9,800 Census 2000 Census 2010 Increase or decrease from 2000 to 2010 + 5% 46% Source: 2000 and 2010 U.S. Census , Table P14 46% Living with one unmarried parent or step-parent Living with relative(s), but not with parent(s) and/or step parent(s) Living with unrelated person(s)/other living arrangements Population of children under age six, by ethnicity 4% 15% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Tables B05009, B09001, B17006 Hispanic or Latino Young children with grandparent householders White, not Hispanic Black or African American, not Hispanic 49% American Indian, not Hispanic Number of children 0-5 living in the household of their grandparent 27% Source: 2010 US Census, Tables P14 and P41 32% < 1% Other (including children of two or more races), not Hispanic Source: 2010 US Census, Tables PCT12H, PCT12I, PCT12J, PCT12K, PCT12L, PCT12M, PCT12N, PCT12O Young children with one or both foreign-born parents Number of children 0-5 living with foreign-born parent(s) 554 Percent of all children 0-5, who live with foreign-born parent(s) 6% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B05009 76 | First Things First Navajo Economic Change Rates of unemployment, annual averages Employment status of parents of young children 18.0% 20% 20% Children living with two parents, both in labor force 28% 30% 2% 12.0% Children living with two parents, neither in labor force 8.0% Children living with one parent, in labor force 4.0% Median income of families with their own children (0-17), by family type For Married-couple families, with at least one child under 18 $54,800 For families with at least one child under 18, headed by a single male $30,300 For families with at least one child under 18, headed by a single female $20,700 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B19126, 2011 inflation-adjusted dollars, rounded to the nearest hundred. 15.8% 2010 2011 15.2% 9.8% 10.0% 7.2% 6.0% 6.2% 2.0% 0.0% 2006 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B23008 15.9% 14.0% Children living with two parents, one in labor force and one not Children living with one parent, not in labor force 15.2% 16.0% 2007 2008 2009 2012 Unemployment Source: Arizona Office of Employment and Population Statistics, Local Area Unemployment Statistics (LAUS), in cooperation with the U.S. Dept of Labor, Bureau of Labor Statistics. May 2013. Note: Rates are not seasonally adjusted. Foreclosures, as of May 2013 May 2012 May 2013 1.8 0.8 Number of foreclosures per 1,000 housing units Source: Realty Trac (www.realtytrac.com/statsandtrends/foreclosuretrends/az) Children (0-17) receiving food assistance Households with one or more children (0-17), estimated 13,443 Young children in poverty Households with children (0-17), receiving food stamps 4,753 Number of children (0-5) living in poverty 4,312 Percent of households with children (0-17) receiving food stamps 35% Percent of children (0-5) living in poverty 42% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B22002 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B17001. Building Bright Futures 2013 | 77 Navajo Child Health Number of children enrolled (0-19) in KidsCare Births by year, by mother’s county of residence 2,500 2,000 1400 1,877 2,012 1,944 1,893 1,737 1,147 1200 1,642 1,633 1,500 1000 800 1,000 600 500 400 0 2007 2008 2009 2010 2011 2012 Births by year, by mother's county of residence 1,633 61% Mother 19 years or younger 15% Mother had fewer than 9 prenatal visits 33% Baby had low birth weight (less than 5.5 pounds) 8% Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Births by payor, 2012 1% 1% AHCCS Indian Health Service (IHS) Private Insurance 68% Self-pay Unknown Source: ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T12-T27 | First Things First August 2013 Young children without health insurance Mother unmarried 12% August 2012 Source: AHCCCS Population Statistics, September 2013; www.azahcccs.gov/reporting/ Downloads/KidsCareEnrollment/2013/Aug/KidsCareEnrollmentbyCounty.pdf Note: August 2013 data show children enrolled in KidsCare and KidsCare II. Characteristics of births and women giving birth, 2012 Total number of births, 2012 0 August 2011 Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 78 450 200 2006 18% 365 Number of children 0-5 without health insurance 978 Percent of children 0-5 who have no health insurance 9% Source: US Census, American Community Survey, 3-year estimates (2009-2011), Table B27001 Navajo Education Estimated number of children served by child care providers on an average day Centers Percent of third-grade students passing Arizona’s Instrument to Measure Standards (AIMS), reading and math 7,043 Certified Group Homes 117 Approved Family Homes 430 Reading 74% 72% 72% 70% 68% 67% 68% Source: Arizona DES, Child Care Market Rate Survey, 2012.* 67% 66% 64% Estimated median daily charges by licensed child care providers 62% 62% 60% 58% 56% Centers Certified Group Homes Approved Family Homes Median charge for infants under 1 year old $30 $27 $22 Median charge for children ages 1 or 2 $25 $25 $20 Median charge for children ages 3 to 5 $25 $22 $20 Median charge for children ages 6 and up $21 $22 $20 2009 2010 2011 2012 2013 Math 64% 62% 60% 62% 60% 59% 57% 58% 55% 56% 54% 52% 50% Source: Arizona DES, Child Care Market Rate Survey, 2012.* 2009 2010 2011 2012 2013 Source: Arizona Dept of Education, www.azed.gov/researchpolicy/aimsresults Estimated child care capacity, according to providers’ approved numbers of children (all ages) Educational Attainment Estimated capacity in licensed centers 8,542 Estimated capacity in certified group homes 411 Estimated capacity in approved family homes 537 20% Less than a high-school education High school or GED 52% 28% More than a high-school education Source: Arizona DES, Child Care Market Rate Survey, (2012)* These data are for early care and education providers that charge for their services, therefore, it does not include many Head Start and public school programs. It does include certified family homes, licensed child care providers, certified child care group homes, participants in the Child and Adult Care Food Program, and unregulated homes registered with the Child Care Resource and Referral agencies. Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B15002 *Note: Data presented in tables are a compilation of 4 counties: Apache, Coconino, Navajo, and Yavapai. Building Bright Futures 2013 | 79 Pima Demographic Change Households with young children (0-5) Population of children under age six (as of April 1, 2010) Total number of households 76,000 Households with one or more children under 6 years 74,796 74,000 53,862 Percent of households with children under 6 years 72,000 14% Source: 2010 U.S. Census, Summary File 1, P20 70,000 68,000 388,660 67,159 Living arrangements for young children (0-5) 66,000 3% 64,000 1% Living with two married parents or step-parents 62,000 Census 2000 Census 2010 Living with one unmarried parent or step-parent 39% Increase or decrease from 2000 to 2010 + 11% 57% Source: 2000 and 2010 U.S. Census , Table P14 Living with unrelated person(s)/other living arrangements Population of children under age six, by ethnicity 3% Living with relative(s), but not with parent(s) and/or step parent(s) 6% Hispanic or Latino Source: US Census, American Community Survey, 5-year estimates (2007-2011), Tables B05009, B09001, B17006 Young children with grandparent householders 3% White, not Hispanic Black or African American, not Hispanic Number of children 0-5 living in the household of their grandparent 14% Source: 2010 US Census, Tables P14 and P41 American Indian, not Hispanic 35% 53% Other (including children of two or more races), not Hispanic Source: 2010 US Census, Tables PCT12H, PCT12I, PCT12J, PCT12K, PCT12L, PCT12M, PCT12N, PCT12O Young children with one or both foreign-born parents Number of children 0-5 living with foreign-born parent(s) Percent of all children 0-5, who live with foreign-born parent(s) 18,361 26% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B05009 80 | First Things First Pima Economic Change Rates of unemployment, annual averages Employment status of parents of young children 9% 10.0% 31% Children living with two parents, both in labor force Children living with two parents, one in labor force and one not 32% Children living with two parents, neither in labor force 1% 27% 9.4% 9.0% 9.0% 8.3% 8.0% 7.3% 7.0% 5.6% 6.0% 5.0% 4.0% Children living with one parent, in labor force 3.0% Children living with one parent, not in labor force 1.0% 3.9% 3.6% 2006 2007 2.0% 0.0% 2008 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B23008 2009 2010 2011 2012 Unemployment Rate Source: Arizona Office of Employment and Population Statistics, Local Area Unemployment Statistics (LAUS), in cooperation with the U.S. Dept of Labor, Bureau of Labor Statistics. May 2013. Note: Rates are not seasonally adjusted. Median income of families with their own children (0-17), by family type For Married-couple families, with at least one child under 18 Foreclosures, as of May 2013 $70,900 For families with at least one child under 18, headed by a single male $34,700 For families with at least one child under 18, headed by a single female $24,400 May 2012 May 2013 1.7 0.9 Number of foreclosures per 1,000 housing units Source: Realty Trac (www.realtytrac.com/statsandtrends/foreclosuretrends/az) Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B19126, 2011 inflation-adjusted dollars, rounded to the nearest hundred. Children (0-17) receiving food assistance Households with one or more children (0-17), estimated Households with children (0-17), receiving food stamps Young children in poverty Number of children (0-5) living in poverty 19,941 Percent of children (0-5) living in poverty 27% Percent of households with children (0-17) receiving food stamps 113,323 26,112 23% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B22002 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B17001. Building Bright Futures 2013 | 81 Pima Child Health Number of children enrolled (0-19) in KidsCare Births by year, by mother’s county of residence 14,500 14,000 7,000 13,929 13,798 13,500 5,000 12,840 13,000 12,500 12,169 12,000 4,000 11,874 11,876 11,500 3,000 3,009 2,297 2,000 11,000 1,000 10,500 2006 2007 2008 2009 2010 2011 2012 Characteristics of births and women giving birth, 2012 45% Mother 19 years or younger 9% Mother had fewer than 9 prenatal visits 26% Baby had low birth weight (less than 5.5 pounds) 7% Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Births by payor, 2012 3% < 1% AHCCS Indian Health Service (IHS) 44% 52% Private Insurance Self-pay Unknown 1% Source: Arizona Department of Health Services, Section of Health Status and Vital Statistics | First Things First August 2013 Young children without health insurance 11,876 Mother unmarried August 2012 Source: AHCCCS Population Statistics, September 2013; www.azahcccs.gov/reporting/ Downloads/KidsCareEnrollment/2013/Aug/KidsCareEnrollmentbyCounty.pdf Note: August 2013 data show children enrolled in KidsCare and KidsCare II. Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Total number of births, 2012 0 August 2011 Births by year, by mother's county of residence 82 5,943 6,000 13,503 Number of children 0-5 without health insurance Percent of children 0-5 who have no health insurance 6,049 8% Source: US Census, American Community Survey, 3-year estimates (2009-2011), Table B27001 Pima Education Estimated number of children served by child care providers on an average day Centers Percent of third-grade students passing Arizona’s Instrument to Measure Standards (AIMS), reading and math 16,408 Certified Group Homes Reading 791 Approved Family Homes 76% 1,523 75% 75% 74% Source: Arizona DES, Child Care Market Rate Survey, 2012. 72% 71% 74% 2011 2012 73% 73% Estimated median daily charges by licensed child care providers 74% 71% 70% 69% Centers Certified Group Homes Approved Family Homes Median charge for infants under 1 year old $38 $25 $25 Median charge for children ages 1 or 2 $33 $25 $24 Median charge for children ages 3 to 5 $31 $25 $23 Median charge for children ages 6 and up $28 $25 2009 2010 2013 Math 74% 72% 72% 70% 67% 68% 67% 65% 66% $22 68% 64% 62% Source: Arizona DES, Child Care Market Rate Survey, 2012. 60% 2009 2011 2012 2013 Source: Arizona Dept of Education, www.azed.gov/researchpolicy/aimsresults Estimated child care capacity, according to providers’ approved numbers of children (all ages) Educational Attainment Estimated capacity in licensed centers 28,062 Estimated capacity in certified group homes 1,029 Estimated capacity in approved family homes 2010 13% Less than a high-school education 23% 1,773 High school or GED More than a high-school education Source: Arizona DES, Child Care Market Rate Survey, 2012 These data are for early care and education providers that charge for their services, therefore, it does not include many Head Start and public school programs. It does include certified family homes, licensed child care providers, certified child care group homes, participants in the Child and Adult Care Food Program, and unregulated homes registered with the Child Care Resource and Referral agencies. 64% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B15002 Building Bright Futures 2013 | 83 Pinal Demographic Change Households with young children (0-5) Population of children under age six (as of April 1, 2010) Total number of households 40,000 125,590 Households with one or more children under 6 years 36,181 35,000 24,750 Percent of households with children under 6 years 30,000 25,000 20% Source: 2010 U.S. Census, Summary File 1, P20 20,000 15,000 14,552 Living arrangements for young children (0-5) 10,000 1% 5,000 - Living with two married parents or step-parents 29% Census 2000 Census 2010 Increase or decrease from 2000 to 2010 Living with one unmarried parent or step-parent + 149% Source: 2000 and 2010 U.S. Census , Table P14 Living with relative(s), but not with parent(s) and/or step parent(s) 68% Population of children under age six, by ethnicity 5% 2% 5% Hispanic or Latino Living with unrelated person(s)/other living arrangements Source: US Census, American Community Survey, 5-year estimates (2007-2011), Tables B05009, B09001, B17006 Young children with grandparent householders 3% 38% White, not Hispanic Black or African American, not Hispanic Number of children 0-5 living in the household of their grandparent 13% Source: 2010 US Census, Tables P14 and P41 American Indian, not Hispanic 49% Other (including children of two or more races), not Hispanic Source: 2010 US Census, Tables PCT12H, PCT12I, PCT12J, PCT12K, PCT12L, PCT12M, PCT12N, PCT12O Young children with one or both foreign-born parents Number of children 0-5 living with foreign-born parent(s) Percent of all children 0-5, who live with foreign-born parent(s) 6,170 19% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B05009 84 | First Things First Pinal Economic Change Rates of unemployment, annual averages Employment status of parents of young children 8% 14.0% 32% 22% Children living with two parents, both in labor force 12.0% Children living with two parents, one in labor force and one not 10.0% Children living with two parents, neither in labor force 1% 37% 12.2% 10.3% 8.9% 7.2% 8.0% 6.0% Children living with one parent, in labor force 4.0% Children living with one parent, not in labor force 2.0% 11.6% 4.9% 4.4% 0.0% 2006 2007 2008 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B23008 2009 2010 2011 2012 Unemployment Rate Source: Arizona Office of Employment and Population Statistics, Local Area Unemployment Statistics (LAUS), in cooperation with the U.S. Dept of Labor, Bureau of Labor Statistics. May 2013. Note: Rates are not seasonally adjusted. Median income of families with their own children (0-17), by family type For Married-couple families, with at least one child under 18 Foreclosures, as of May 2013 $66,600 For families with at least one child under 18, headed by a single male $37,800 For families with at least one child under 18, headed by a single female $23,300 May 2012 May 2013 4.9 1.4 Number of foreclosures per 1,000 housing units Source: Realty Trac (www.realtytrac.com/statsandtrends/foreclosuretrends/az) Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B19126, 2011 inflation-adjusted dollars, rounded to the nearest hundred. Young children in poverty Number of children (0-5) living in poverty 6,636 Percent of children (0-5) living in poverty 20% Children (0-17) receiving food assistance Households with one or more children (0-17), estimated 44,447 Households with children (0-17), receiving food stamps 8,688 Percent of households with children (0-17) receiving food stamps 20% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B22002 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B17001. Building Bright Futures 2013 | 85 Pinal Child Health Number of children enrolled (0-19) in KidsCare Births by year, by mother’s county of residence 2000 7,000 6,000 5,000 5,285 5,731 5,309 4,467 4,990 4,607 4,656 1600 1400 4,000 1200 3,000 1000 800 2,000 600 1,000 800 617 400 0 2006 2007 2008 2009 2010 2011 2012 Characteristics of births and women giving birth, 2012 4,656 44% Mother 19 years or younger 10% Mother had fewer than 9 prenatal visits 16% Baby had low birth weight (less than 5.5 pounds) 7% Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Births by payor, 2012 < 1% AHCCS 50% 44% Indian Health Service (IHS) Private Insurance Self-pay Unknown 2% Source: ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T12-T27 | First Things First August 2012 August 2013 Young children without health insurance Mother unmarried 4% 0 Source: AHCCCS Population Statistics, September 2013; www.azahcccs.gov/reporting/ Downloads/KidsCareEnrollment/2013/Aug/KidsCareEnrollmentbyCounty.pdf Note: August 2013 data show children enrolled in KidsCare and KidsCare II. Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Total number of births, 2012 200 August 2011 Births by year, by mother's county of residence 86 1,733 1800 Number of children 0-5 without health insurance Percent of children 0-5 who have no health insurance 4,179 12% Source: US Census, American Community Survey, 3-year estimates (2009-2011), Table B27001 Pinal Education Estimated number of children served by child care providers on an average day Centers Percent of third-grade students passing Arizona’s Instrument to Measure Standards (AIMS), reading and math 2,813 Certified Group Homes 130 Approved Family Homes 443 Reading 74% 73% 72% 71% 70% 69% 68% 67% 66% 65% 64% Source: Arizona DES, Child Care Market Rate Survey, 2012. * Estimated median daily charges by licensed child care providers Median charge for infants under 1 year old Centers Certified Group Homes Approved Family Homes $40 $30 $25 71% 70% 67% 2009 2010 2011 $37 $26 $25 Median charge for children ages 3 to 5 $30 $25 $25 2012 2013 Math 70% Median charge for children ages 1 or 2 Median charge for children ages 6 and up 73% 72% 68% 68% 67% 66% $30 $25 63% 64% $25 63% 61% 62% 60% 58% 56% Source: Arizona DES, Child Care Market Rate Survey, 2012. * 2009 2010 2011 2012 2013 Source: Arizona Dept of Education, www.azed.gov/researchpolicy/aimsresults Estimated child care capacity, according to providers’ approved numbers of children (all ages) Educational Attainment Estimated capacity in licensed centers 4,434 Estimated capacity in certified group homes 155 Estimated capacity in approved family homes 538 15% Less than a high-school education High school or GED 55% 30% More than a high-school education Source: Arizona DES, Child Care Market Rate Survey, (2012)* These data are for early care and education providers that charge for their services, therefore, it does not include many Head Start and public school programs. It does include certified family homes, licensed child care providers, certified child care group homes, participants in the Child and Adult Care Food Program, and unregulated homes registered with the Child Care Resource and Referral agencies. Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B15002 *Note: Data presented in tables are a compilation of 2 counties: Gila and Pinal. Building Bright Futures 2013 | 87 Santa Cruz Demographic Change Households with young children (0-5) Population of children under age six (as of April 1, 2010) Total number of households 4,500 4,435 15,437 Households with one or more children under 6 years 4,400 Percent of households with children under 6 years 4,300 4,200 3,231 21% Source: 2010 U.S. Census, Summary File 1, P20 4,100 4,027 Living arrangements for young children (0-5) 4,000 3,900 3% 3,800 Census 2000 1% Living with two married parents or step-parents Census 2010 Increase or decrease from 2000 to 2010 + 10% Living with one unmarried parent or step-parent 38% Source: 2000 and 2010 U.S. Census , Table P14 58% Living with relative(s), but not with parent(s) and/or step parent(s) Living with unrelated person(s)/other living arrangements Population of children under age six, by ethnicity 6% < 1% < 1% < 1% Hispanic or Latino White, not Hispanic Black or African American, not Hispanic American Indian, not Hispanic 94% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Tables B05009, B09001, B17006 Other (including children of two or more races), not Hispanic Source: 2010 US Census, Tables PCT12H, PCT12I, PCT12J, PCT12K, PCT12L, PCT12M, PCT12N, PCT12O Young children with grandparent householders Number of children 0-5 living in the household of their grandparent 22% Source: 2010 US Census, Tables P14 and P41 Young children with one or both foreign-born parents Number of children 0-5 living with foreign-born parent(s) Percent of all children 0-5, who live with foreign-born parent(s) 2,117 49% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B05009 88 | First Things First Santa Cruz Economic Change Rates of unemployment, annual averages Employment status of parents of young children 7% 20.0% 23% 32% 2% 36% Children living with two parents, both in labor force 18.0% Children living with two parents, one in labor force and one not 14.0% Children living with two parents, neither in labor force 10.0% Children living with one parent, in labor force 6.0% Children living with one parent, not in labor force 2.0% 12.0% 8.0% 17.1% 17.0% 17.2% 2010 2011 2012 10.7% 7.4% 7.1% 2006 2007 4.0% 0.0% 2008 2009 Unemployment Rate Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B23008 Source: Arizona Office of Employment and Population Statistics, Local Area Unemployment Statistics (LAUS), in cooperation with the U.S. Dept of Labor, Bureau of Labor Statistics. May 2013. Note: Rates are not seasonally adjusted. Median income of families with their own children (0-17), by family type For Married-couple families, with at least one child under 18 15.7% 16.0% Foreclosures, as of May 2013 $51,800 For families with at least one child under 18, headed by a single male * For families with at least one child under 18, headed by a single female $17,700 May 2012 May 2013 3.4 1.8 Number of foreclosures per 1,000 housing units Source: Realty Trac (www.realtytrac.com/statsandtrends/foreclosuretrends/az) Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B19126, 2011 inflation-adjusted dollars, rounded to the nearest hundred. * Sample too small to produce stable results Young children in poverty Number of children (0-5) living in poverty 1,631 Percent of children (0-5) living in poverty 37% Children (0-17) receiving food assistance Households with one or more children (0-17), estimated 5,739 Households with children (0-17), receiving food stamps 1,717 Percent of households with children (0-17) receiving food stamps 30% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B22002 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B17001. Building Bright Futures 2013 | 89 Santa Cruz Child Health Number of children enrolled (0-19) in KidsCare Births by year, by mother’s county of residence 820 800 780 760 740 720 700 680 660 640 620 600 600 796 766 753 400 693 694 300 671 275 244 200 100 2006 2007 2008 2009 2010 2011 2012 Characteristics of births and women giving birth, 2012 671 Mother unmarried 52% Mother 19 years or younger 17% Mother had fewer than 9 prenatal visits 49% Baby had low birth weight (less than 5.5 pounds) 8% Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Births by payor, 2012 1% AHCCS Indian Health Service (IHS) Private Insurance 0% 69% Self-pay Unknown Source: ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T12-T27 | First Things First August 2013 Young children without health insurance Total number of births, 2012 21% August 2012 Source: AHCCCS Population Statistics, September 2013; www.azahcccs.gov/reporting/ Downloads/KidsCareEnrollment/2013/Aug/KidsCareEnrollmentbyCounty.pdf Note: August 2013 data show children enrolled in KidsCare and KidsCare II. Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 9% 0 August 2011 Births by year, by mother's county of residence 90 486 500 761 Number of children 0-5 without health insurance Percent of children 0-5 who have no health insurance 540 12% Source: US Census, American Community Survey, 3-year estimates (2009-2011), Table B27001 Santa Cruz Education Estimated number of children served by child care providers on an average day Centers Percent of third-grade students passing Arizona’s Instrument to Measure Standards (AIMS), reading and math 1,732 Certified Group Homes Approved Family Homes Reading 74 78% 664 76% 76% 74% 74% Source: Arizona DES, Child Care Market Rate Survey, 2012.* 74% 72% 70% Estimated median daily charges by licensed child care providers 68% 68% 68% 2009 2010 66% 64% Centers Certified Group Homes Approved Family Homes Median charge for infants under 1 year old $32 $26 $24 Median charge for children ages 1 or 2 $31 $25 $24 Median charge for children ages 3 to 5 $28 $22 $24 Median charge for children ages 6 and up $22 $22 2012 2013 Math 72% 70% 68% 66% 64% 62% 60% 58% 56% 54% 52% $24 Source: Arizona DES, Child Care Market Rate Survey, 2012.* 70% 68% 66% 65% 59% 2009 2010 2011 2012 2013 Source: Arizona Dept of Education, www.azed.gov/researchpolicy/aimsresults Estimated child care capacity, according to providers’ approved numbers of children (all ages) Educational Attainment Estimated capacity in licensed centers 2,673 Estimated capacity in certified group homes 80 Estimated capacity in approved family homes 2011 29% Less than a high-school education 42% High school or GED 785 Source: Arizona DES, Child Care Market Rate Survey, (2012)* These data are for early care and education providers that charge for their services, therefore, it does not include many Head Start and public school programs. It does include certified family homes, licensed child care providers, certified child care group homes, participants in the Child and Adult Care Food Program, and unregulated homes registered with the Child Care Resource and Referral agencies. More than a high-school education 29% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B15002 *Note: Data presented in tables are a compilation of 4 counties: Cochise, Graham, Greenlee, and Santa Cruz. Building Bright Futures 2013 | 91 Yavapai Demographic Change Households with young children (0-5) Population of children under age six (as of April 1, 2010) Total number of households 14,000 Households with one or more children under 6 years 12,583 12,000 90,903 10,392 Percent of households with children under 6 years 10,000 8,854 10% Source: 2010 U.S. Census, Summary File 1, P20 8,000 6,000 Living arrangements for young children (0-5) 4,000 3% 2,000 2% Living with two married parents or step-parents Census 2000 Census 2010 Living with one unmarried parent or step-parent 34% Increase or decrease from 2000 to 2010 61% Source: 2000 and 2010 U.S. Census , Table P14 Population of children under age six, by ethnicity 2% < 1% Living with relative(s), but not with parent(s) and/or step parent(s) + 21% 4% Hispanic or Latino 30% White, not Hispanic Black or African American, not Hispanic Living with unrelated person(s)/other living arrangements Source: US Census, American Community Survey, 5-year estimates (2007-2011), Tables B05009, B09001, B17006 Young children with grandparent householders Number of children 0-5 living in the household of their grandparent 13% Source: 2010 US Census, Tables P14 and P41 American Indian, not Hispanic 64% Other (including children of two or more races), not Hispanic Source: 2010 US Census, Tables PCT12H, PCT12I, PCT12J, PCT12K, PCT12L, PCT12M, PCT12N, PCT12O Young children with one or both foreign-born parents Number of children 0-5 living with foreign-born parent(s) Percent of all children 0-5, who live with foreign-born parent(s) 2,033 17% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B05009 92 | First Things First Yavapai Economic Change Rates of unemployment, annual averages Employment status of parents of young children 10% 12.0% 32% 26% Children living with two parents, both in labor force 10.0% Children living with two parents, one in labor force and one not 8.0% Children living with two parents, neither in labor force 6.0% Children living with one parent, in labor force 2% 30% Children living with one parent, not in labor force 4.0% 10.4% 9.7% 8.6% 6.0% 3.9% 3.6% 2006 2007 2.0% 0.0% 2008 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B23008 Median income of families with their own children (0-17), by family type 10.9% 2009 2010 2011 2012 Unemployment Rate Source: Arizona Office of Employment and Population Statistics, Local Area Unemployment Statistics (LAUS), in cooperation with the U.S. Dept of Labor, Bureau of Labor Statistics. May 2013. Note: Rates are not seasonally adjusted. Foreclosures, as of May 2013 For Married-couple families, with at least one child under 18 For families with at least one child under 18, headed by a single male For families with at least one child under 18, headed by a single female $66,400 $41,800 May 2012 May 2013 3.0 1.6 Number of foreclosures per 1,000 housing units Source: Realty Trac (www.realtytrac.com/statsandtrends/foreclosuretrends/az) $22,900 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B19126, 2011 inflation-adjusted dollars, rounded to the nearest hundred. Young children in poverty Number of children (0-5) living in poverty 3,434 Percent of children (0-5) living in poverty 28% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B17001. Children (0-17) receiving food assistance Households with one or more children (0-17), estimated 20,033 Households with children (0-17), receiving food stamps 4,494 Percent of households with children (0-17) receiving food stamps 22% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B22002 Building Bright Futures 2013 | 93 Yavapai Child Health Number of children enrolled (0-19) in KidsCare Births by year, by mother’s county of residence 1600 3,000 2,500 2,380 2,411 2,216 2,000 1,817 1,829 1,782 1,500 1200 1000 731 800 1,000 600 500 400 571 200 0 2006 2007 2008 2009 2010 2011 2012 Characteristics of births and women giving birth, 2012 1,782 44% Mother 19 years or younger 10% Mother had fewer than 9 prenatal visits 16% Baby had low birth weight (less than 5.5 pounds) 8% Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Births by payor, 2012 3% < 1% AHCCS Indian Health Service (IHS) Private Insurance 64% < 1% Self-pay Unknown Source: ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T12-T27 | First Things First August 2013 Young children without health insurance Mother unmarried 32% August 2012 Source: AHCCCS Population Statistics, September 2013; www.azahcccs.gov/reporting/ Downloads/KidsCareEnrollment/2013/Aug/KidsCareEnrollmentbyCounty.pdf Note: August 2013 data show children enrolled in KidsCare and KidsCare II. Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Total number of births, 2012 0 August 2011 Births by year, by mother's county of residence 94 1,350 1400 2,061 Number of children 0-5 without health insurance Percent of children 0-5 who have no health insurance 1,240 10% Source: US Census, American Community Survey, 3-year estimates (2009-2011), Table B27001 Yavapai Education Estimated number of children served by child care providers on an average day Centers Percent of third-grade students passing Arizona’s Instrument to Measure Standards (AIMS), reading and math 7,043 Certified Group Homes 117 Approved Family Homes 430 Reading 81% 80% Source: Arizona DES, Child Care Market Rate Survey, 2012.* 79% 77% 76% 80% 2012 2013 78% 78% Estimated median daily charges by licensed child care providers 80% 77% 76% 75% Median charge for infants under 1 year old Centers Certified Group Homes Approved Family Homes $30 $27 $22 Median charge for children ages 1 or 2 $25 $25 $20 Median charge for children ages 3 to 5 $25 $22 $20 Median charge for children ages 6 and up $21 74% 2009 2010 2011 Math 78% 76% 76% 74% 71% 72% 70% $22 $20 68% 67% 67% 2010 2011 70% 66% 64% 62% Source: Arizona DES, Child Care Market Rate Survey, 2012.* 2009 Estimated child care capacity, according to providers’ approved numbers of children (all ages) 2013 Source: Arizona Dept of Education, www.azed.gov/researchpolicy/aimsresults Educational Attainment Estimated capacity in licensed centers 8,542 Estimated capacity in certified group homes 411 Estimated capacity in approved family homes 2012 10% Less than a high-school education 27% 537 Source: Arizona DES, Child Care Market Rate Survey, (2012)* These data are for early care and education providers that charge for their services, therefore, it does not include many Head Start and public school programs. It does include certified family homes, licensed child care providers, certified child care group homes, participants in the Child and Adult Care Food Program, and unregulated homes registered with the Child Care Resource and Referral agencies. High school or GED More than a high-school education 63% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B15002 *Note: Data presented in tables are a compilation of 4 counties: Apache, Coconino, Navajo, and Yavapai. Building Bright Futures 2013 | 95 Yuma Demographic Change Households with young children (0-5) Population of children under age six (as of April 1, 2010) 18,500 18,048 18,000 17,500 Total number of households 64,767 Households with one or more children under 6 years 12,998 Percent of households with children under 6 years 17,000 16,500 20% Source: 2010 U.S. Census, Summary File 1, P20 16,000 15,441 15,500 Living arrangements for young children (0-5) 15,000 14,500 1% 1% Living with two married parents or step-parents 14,000 Census 2000 Census 2010 Increase or decrease from 2000 to 2010 + 17% Living with one unmarried parent or step-parent 41% Living with relative(s), but not with parent(s) and/or step parent(s) Source: 2000 and 2010 U.S. Census , Table P14 57% Population of children under age six, by ethnicity 19% 1% 1% 3% Living with unrelated person(s)/other living arrangements Source: US Census, American Community Survey, 5-year estimates (2007-2011), Tables B05009, B09001, B17006 Hispanic or Latino White, not Hispanic Black or African American, not Hispanic American Indian, not Hispanic 76% Other (including children of two or more races), not Hispanic Source: 2010 US Census, Tables PCT12H, PCT12I, PCT12J, PCT12K, PCT12L, PCT12M, PCT12N, PCT12O Young children with grandparent householders Number of children 0-5 living in the household of their grandparent 19% Source: 2010 US Census, Tables P14 and P41 Young children with one or both foreign-born parents Number of children 0-5 living with foreign-born parent(s) Percent of all children 0-5, who live with foreign-born parent(s) 7,865 45% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B05009 96 | First Things First Yuma Economic Change Rates of unemployment, annual averages Employment status of parents of young children 9% 30.0% 31% 32% 1% 27% Children living with two parents, both in labor force 25.0% Children living with two parents, one in labor force and one not 20.0% Children living with two parents, neither in labor force 15.0% Children living with one parent, in labor force 10.0% Children living with one parent, not in labor force Median income of families with their own children (0-17), by family type For Married-couple families, with at least one child under 18 $33,400 For families with at least one child under 18, headed by a single female $20,100 27.5% 2010 2011 2012 13.5% 5.0% 0.0% 2007 2008 2009 Unemployment Rate Source: Arizona Office of Employment and Population Statistics, Local Area Unemployment Statistics (LAUS), in cooperation with the U.S. Dept of Labor, Bureau of Labor Statistics. May 2013. Note: Rates are not seasonally adjusted. Foreclosures, as of May 2013 $52,600 For families with at least one child under 18, headed by a single male 26.8% 17.9% 14.6% 2006 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B23008 26.2% 22.9% May 2012 May 2013 2.2 1.3 Number of foreclosures per 1,000 housing units Source: Realty Trac (www.realtytrac.com/statsandtrends/foreclosuretrends/az) Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B19126, 2011 inflation-adjusted dollars, rounded to the nearest hundred. Young children in poverty Number of children (0-5) living in poverty 4,997 Percent of children (0-5) living in poverty 28% Children (0-17) receiving food assistance Households with one or more children (0-17), estimated 30,223 Households with children (0-17), receiving food stamps 9,128 Percent of households with children (0-17) receiving food stamps 30% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B22002 Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B17001. Building Bright Futures 2013 | 97 Yuma Child Health Number of children enrolled (0-19) in KidsCare Births by year, by mother’s county of residence 3,400 3,350 2500 3,362 3,354 1,933 2000 3,300 3,252 3,250 3,234 3,229 3,200 1500 3,198 3,150 3,121 1000 3,100 1,032 719 500 3,050 3,000 2006 2007 2008 2009 2010 2011 2012 Characteristics of births and women giving birth, 2012 3,121 47% Mother 19 years or younger 14% Mother had fewer than 9 prenatal visits 33% Baby had low birth weight (less than 5.5 pounds) 6% Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Births by payor, 2012 < 1% AHCCS 32% Indian Health Service (IHS) Private Insurance 62% Self-pay Unknown 0% Source: ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T12-T27 98 | First Things First August 2013 Young children without health insurance Mother unmarried 6% August 2012 Source: AHCCCS Population Statistics, September 2013; www.azahcccs.gov/reporting/ Downloads/KidsCareEnrollment/2013/Aug/KidsCareEnrollmentbyCounty.pdf Note: August 2013 data show children enrolled in KidsCare and KidsCare II. Source: ADHS “Arizona Health Status and Vital Statistics 2011, “ Table 5B-3, ADHS “Advance Vital Statistics by County of Residence, 2012,” Tables T1, T2, T3,T12-T27 Total number of births, 2012 0 August 2011 Births by year, by mother's county of residence Number of children 0-5 without health insurance Percent of children 0-5 who have no health insurance 2,215 12% Source: US Census, American Community Survey, 3-year estimates (2009-2011), Table B27001 Yuma Education Estimated number of children served by child care providers on an average day Centers Percent of third-grade students passing Arizona’s Instrument to Measure Standards (AIMS), reading and math 4,017 Reading Certified Group Homes 233 70% Approved Family Homes 632 69% 69% 68% 68% Source: Arizona DES, Child Care Market Rate Survey, 2012.* 67% 67% 66% Estimated median daily charges by licensed child care providers 65% 65% 65% 2009 2010 64% 63% Median charge for infants under 1 year old Centers Certified Group Homes Approved Family Homes $28 $24 $20 Median charge for children ages 1 or 2 $24 $22 $20 Median charge for children ages 3 to 5 $22 $22 $20 Median charge for children ages 6 and up $22 $22 $20 2011 2012 2013 Math 66% 65% 63% 64% 64% 65% 62% 60% 58% 55% 56% 54% 52% 50% Source: Arizona DES, Child Care Market Rate Survey, 2012.* 2009 2010 2011 2012 2013 Source: Arizona Dept of Education, www.azed.gov/researchpolicy/aimsresults Estimated child care capacity, according to providers’ approved numbers of children (all ages) Educational Attainment Estimated capacity in licensed centers 5,943 Estimated capacity in certified group homes 290 Estimated capacity in approved family homes 787 28% Less than a high-school education 46% Source: Arizona DES, Child Care Market Rate Survey, (2012)* These data are for early care and education providers that charge for their services, therefore, it does not include many Head Start and public school programs. It does include certified family homes, licensed child care providers, certified child care group homes, participants in the Child and Adult Care Food Program, and unregulated homes registered with the Child Care Resource and Referral agencies. High school or GED More than a high-school education 26% Source: US Census, American Community Survey, 5-year estimates (2007-2011), Table B15002 *Note: Data presented in tables are a compilation of 3 counties: La Paz, Mohave, and Yuma. Building Bright Futures 2013 | 99 ACKNOWLEDGEMENTS First Things First (FTF) would like to acknowledge the contributions of the following organizations and individuals, without whom this publication would not have been possible. Building Bright Futures was assembled and produced under the general direction of Dr. Roopa Iyer, FTF Senior Director for Research and Evaluation. The data used in this publication were provided by various state agency partners, including the Arizona Department of Administration, the Arizona Department of Economic Security, the Arizona Department of Education, the Arizona Department of Health Services and the Arizona Health Care Cost Containment System. Additional data were obtained from the U.S. Census, the American Community Survey and RealtyTrac. Collection and initial analysis of data contained in Building Bright Futures were completed by Dr. John Daws and Dr. Michele Walsh from the Norton School of Family and Consumer Sciences at the University of Arizona. Additional information and support were provided by Karen Woodhouse, FTF Chief Program Officer, and Dr. Iyer, Dr. Karen Peifer and Dr. Christine Stein of the FTF Program Division. 100 | First Things First We offer special thanks to the individuals whose writing talents translated the numbers and painted a picture of what the data mean for young children in Arizona. They include Dr. Iyer, Dr. Stein and Liz Barker Alvarez of FTF. We gratefully acknowledge the many hours contributed by Dr. Lisa Colling and Meena Shahi in checking and re-checking the information presented herein, and the talents of Windy Jones and Rey Verdugo in the final layout and design of this publication. Building Bright Futures is produced and submitted in accordance with A.R.S. §8-1192 and is distributed in accordance with section 41-4153. © 2013 First Things First 4000 North Central Avenue, Suite 800 Phoenix, AZ 85012 www.azftf.gov Permission to copy, disseminate or otherwise use the information in this publication is granted, as long as appropriate acknowledgement is given. Building Bright Futures is produced and submitted in accordance with A.R.S. §8-1192 and is distributed in accordance with section 41-4153. © 2013 Arizona Early Childhood Development and Health Board (First Things First) 4000 North Central Avenue, Suite 800 Phoenix, AZ 85012 www.azftf.gov Permission to copy, disseminate or otherwise use the information in this publication is granted, as long as appropriate acknowledgement is given.