Introducing EnRICH CA

An initiative to end racial inequalities in children’s health

By Children Now Health Team

July 15, 2021

Did You Know?

  • Chronic health conditions affect around 2.2 million kids (around 25%) in California, and they take a financial and emotional toll on a child’s family.
  • There are at least five major chronic diseases affecting children in California with known racial disparities: asthma, diabetes, depression, dental caries, and vaping-related diseases.
  • Families of color are 1.5 to 2 times more likely than white families to suffer from major chronic diseases.
  • Black children are twice as likely to be hospitalized for asthma and have a twofold increased risk of diabetes death compared with white kids.

End Racial Inequities in Children’s Health California or EnRICH CA is a new initiative, spearheaded by Children Now, that is focused on eliminating racial disparities in childhood chronic illnesses by 2030. These illnesses, which include asthma, diabetes, depression, dental caries, and vaping-related diseases, limit what kids can do in everyday life. Kids with chronic illnesses can miss school and playtime, have difficulty concentrating when in class, and struggle to grow up without pain. In short, these conditions can keep them from simply being a kid.

According to Alondra, a 15-year-old living with asthma, “Asthma keeps me from running, it’s very hard.

I have two brothers and I don’t get to play with them often; it can be very frustrating at times when it’s hard to breathe.” She goes on, “On days when my asthma is really bad, it’s impacted me at school and affected my concentration. It makes it harder to experience new things.”

Lillian, mother to four-year-old Jeremiah, who had to go under general anesthesia to have 10 cavities filled, explains the burden of childhood dental caries, “It was an experience that was scary for both of us, and his recovery was very hard. I could tell that he was in pain every time he ate.”

Unfortunately, California children of color are not only more likely to have chronic conditions, but they are more likely to suffer and die from preventable and/or manageable chronic illness than their white peers. For example, both asthma and diabetes are far deadlier for Black kids than white kids. And these disparities extend beyond childhood, creating an unjust cycle that eventually leads to shorter, less healthy lives for Black and brown adults.

Scientific evidence tells us that these significant disparities are not a result of biology, but rather social determinants of health (SDOH) – the conditions in which children are born, grow, and live which include access to healthy foods, investments in safe neighborhoods and physical environments, healthy and stable housing, economic stability, educational access and quality, including early learning and child care, and transportation availability. Systemic racism is the primary driver of SDOH, which are strongly linked to the development and management of chronic illnesses. Racial inequities in housing, income, education, and other systems reflect systemic racism and impact children’s social determinants of health and, ultimately, their health outcomes.

Maria, a mother of five children, all of whom have been diagnosed with asthma, said “When I had my first child, I used to work out in the field [in Madera] and was surrounded by chemicals and pesticides, I think that’s where my asthma came from.”

Alondra also mentions environmental impacts, “Our apartment has a lot of mold and the apartment manager does not give us much to clean the mold with. Mom is constantly cleaning it and some of the harsh chemicals might also be making my asthma worse.”

State leaders have indicated that racial equity in health care is a priority, but now we need action. Since the impacts of these illnesses are far reaching and persistent, if we don’t address the root causes of these conditions now, with the explicit intention of reducing the racial disparities within these chronic childhood diseases, they will negatively impact the health and economic well-being of our communities of color for generations. EnRICH CA will provide the roadmap that sets Black and brown children on the path to thrive and grow up to become healthy adults.

The State can achieve the ambitious goals of EnRICH CA by developing and executing on a comprehensive plan, which begins with Senate Bill 682. Children Now is a proud sponsor of SB 682, and the bill is co-sponsored by Public Health Advocates and the California Children’s Hospital Association. SB 682 will require the California Health and Human Services Agency to develop a plan to reach racial disparities reduction targets in five childhood chronic diseases by 2030. The bill is moving through the state legislative process unopposed.

While there is no single solution for eliminating racial disparities in children’s chronic illnesses, SB 682 and EnRICH CA are the first of many steps. The State must bring together a cross-section of departments including the Department of Education, Department of Housing and Community Development, the Mental Health Services Oversight and Accountability Commission, and others, to address the root causes of systemic racism and hold systems accountable in the move towards achieving true equity in health. In California, our diversity is our richest asset – it’s time to EnRICH CA and guarantee the health and well-being of all kids of color in our state.