In 2024, North Carolina’s leading child health and welfare advocates hope to build on some of last year’s successes and tackle other threats to children in the state.
The Child Fatality Task Force, which is made up of volunteer experts in child health and safety, state agency leaders, community leaders and state legislators, has been working since 1991 to prevent child death and promote child well-being.
Last year, task force members saw success with several of their recommendations to state legislators. The biggest success — the creation of the Office of Child Fatality Prevention — came after years of lobbying.
The group’s focus areas for 2024 so far include supporting legislation to address addictive algorithms on social media and encouraging the General Assembly to provide recurring funding to increase the numbers of certain school health personnel and to continue the new N.C. SAFE campaign that is geared toward educating people about securing firearms.
The task force will meet on Feb. 29 to finalize its 2024 action agenda, the recommendations that it includes in an annual report to the governor and General Assembly.
Addictive algorithms
The percentage of teens age 13-17 who said they are online constantly has risen from 24% in 2014-15 to 46% last year, according to a survey by the Pew Research Center.
Last May, U.S. Surgeon General Vivek Murthy issued a warningabout the role social media use may be playing in a widening mental health crisis among youth.
Sam Hiner, a UNC Chapel Hill junior, says he knows all too well how social media can send young people into a dangerous spiral. Hovering too long over content about dieting, for instance, can lead to a person’s feed being inundated with unusual diet techniques and pictures of unrealistic body standards, he said.
“What ends up happening to a lot of these teens is their feeds become full of really harmful content. And that's all they see anymore because of the way the algorithm works,” Hiner told Child Fatality Task Force members during a November meeting.
Hiner is executive director of the Young People’s Alliance, which he started while in high school after seeing how young people were underrepresented in politics generally. He feels the mental health crisis among his generation isn’t being addressed by policymakers.
Finding ways to protect young people is important because of how much they use social media and because that use comes at a critical time in their development, Eva Telzer, a professor of psychology and neuroscience at UNC Chapel Hill, told task force members at that November committee meeting.
Social media has really “transformed what it means to be an adolescent today,” Telzer said.
“This increase in social media use is happening at a really important developmental period when the adolescent brain is also going through really dramatic changes,” she said. “It's becoming very sensitive to the social world. It thrives and connects on having peer interactions. The adolescent brain is rewiring in a way that makes it very sensitive to social rewards to avoiding social punishment.”
She said social media can be both a positive and negative force, depending on how it is used.
For example, children can find supportive communities online that they might not have otherwise. They might be able to find greater diversity in online interactions. They can get involved in civic engagement and activism. However, social media can also reinforce negative feelings. It can become addictive. It can interfere with sleep.
Hiner told task force members that changing the algorithms social media companies use to determine when and where to place ads could protect young people.
He said it is important to target the algorithms by cutting off the data supply of information coming from children who are online so that the algorithms don't know what kind of content will keep children online for as long as possible.
“Then it won't be able to send them down certain rabbit holes,” he said. “So, instead, you'll be left with a more balanced feed that's reflective of everything that's happening online, rather than just a feed full of content that's all about your specific insecurity that this platform is exploiting to keep you online.”
Hiner’s nonprofit has been working to get state and federal legislation passed to address the algorithms used in social media.
House Bill 644, bipartisan legislation also known as the Social Media Algorithmic Control in IT Act, stalled in committee last year. Hiner said they plan to reintroduce it in the General Assembly and expect a federal version of the bill to be ready by March.
Task force members agreed to throw the weight of their endorsement behind such bills.
Increasing school health workers
As teen suicides and mental health diagnoses increase, North Carolina’s schools remain woefully understaffed to address these issues with youth.
Though the school nurse-to-student ratio has improved slightly since 2018, it remains a far cry from the 750 students per nurse recommended by the Centers for Disease Control and Prevention.
The American School Counselor Association recommends one school counselor for every 250 students. With 316counselors per student, North Carolina fares better than the national average of 408, but it still falls short.
The situation is even more dire when it comes to school psychologists. North Carolina has one psychologist for every 1,902 students. That’s nowhere near the one for every 500 that the National Association of School Psychologists recommends, and staffing lags well behind the national average of one professional per 1,127 students.
State legislators included money in the budget approved last September to hire an additional 120 people in school health positions. However, that money is from federal COVID-19 aid, which means it is temporary funding, said Ellen Essick, section chief for the N.C. Department of Public Instruction’s Healthy Schools and Specialized Instructional Support Office of Academic Standards.
She told task force members that educators are worried about what some of the ratios, which are still well below recommended levels, will look like once COVID money runs out.
The task force voted to support recurring funding to increase the number of school nurses, social workers, counselors and psychologists and to move the state closer to the nationally recommended ratios for those positions.
Support NC SAFE funding
Firearms are now the leading cause of injury-related death — homicides and suicides — for the state’s youth, surpassing vehicle crashes.
The Child Fatality Task Force’s top action item for 2023 was to get the state to launch and fund a new statewide firearm safety initiative.
Lawmakers did approve a two-year firearm safe storage education initiative as part of a new law; that same law also ended the pistol permitting requirement and expanded the ability to carry a concealed weapon in some situations.
No funding for the education initiative was included in Senate Bill 41, which became law in late March 2023 after lawmakers overrode the governor’s veto.
The first year of the campaign is funded by state money that wasn’t spent in the previous budget year. Federal funding is covering a second year, so advocates worry that any gains would be short-lived.
There’s a lot of literature about how public health campaigns have been able to shift people’s behavior, which is what NC S.A.F.E. is aiming to do, said Kimberly Quintus, director of analysis, research and external affairs in the Division of Juvenile Justice and Delinquency Prevention for the North Carolina Department of Public Safety.
NC S.A.F.E., which urges people to “secure all firearms effectively,” includes an educational component and free gun locks.
Quintus said the state can’t rely on spotty federal financial support to continue the program. That’s why the task force members are again recommending that legislators set up recurring funding for the program.
The task force had included a firearm storage initiative in its recommendations to lawmakers for five years before at least part of what they were requesting was granted last year.
“That’s how change happens,” said task force member Alan Dellapenna Jr., former Branch Head of the Injury and Violence Prevention Branch, North Carolina Division of Public Health. “You work on it a long time.”
The next N.C. Child Fatality Task Force meeting will be Feb. 29 from 1-4 p.m. A link to watch will be provided at https://sites.ncleg.gov/nccftf/
The agenda isn’t available yet, but two items that didn’t get discussed at the December meeting will be part of the February agenda. The task force will discuss paid family leave insurance and a recommendation to support recurring funding for the new Office of Violence Prevention.
This article first appeared on North Carolina Health News and is republished here under a Creative Commons license.
North Carolina Health News is an independent, non-partisan, not-for-profit, statewide news organization dedicated to covering all things health care in North Carolina. Visit NCHN at northcarolinahealthnews.org.