COLUMBUS, Ohio -- With myriad public health and economic challenges looming, a new report offers local leaders in Ohio pre-pandemic data on child well-being to help guide the path forward.

New 2020 Kids Count County Profiles released yesterday by the Children's Defense Fund Ohio feature research on financial security, health, safety and education -- all of which is timely and relevant, said CDF Ohio Kids Count Project Director Kim Eckhart.

"It's a time when, more than ever, we need to focus on the needs of children and families in our communities," said Eckhart. "And setting these benchmarks really allows us to have child well-being as the key performance indicator of an economic recovery."

The report shows before COVID-19, Ohio showed slight progress in the areas of poverty, median income and unemployment.

Eckhart noted areas that need more work include child abuse and neglect and children in foster care - demonstrating the need to support programs that protect some of the state's most vulnerable residents.

In the area of health, babies born with low birthweight also continue to be a challenge for Ohio. Eckhart said mothers and infants could be better supported by extending pregnancy-related Medicaid coverage, from the current 60 days after delivery, to twelve months.

"A mother's health is so intimately related to a baby's health," said Eckhart. "And so, continuous eligibility for a year can tie into the measures of infant mortality and babies born with a low birth weight."

Eckhart said the county profiles can be used help to ensure kids are kept at the forefront of policy discussions. She added families are living with challenges they've never experienced before.

"Right now, housing is also an educational institution," said Eckhart. "And so, what are leaders' plans to prevent housing instability and to increase access to internet service? So, thinking about funding for utility assistance, funding for rental assistance."

Summit County was cited in the report as an example of local leaders elevating the needs of children. Eckhart said county leaders there are leveraging CARES Act funding to support rent and utility assistance, food banks and small business grants.

Roughly 200,000 children in the U.S. have lost a caregiver to COVID-19. In South Dakota, mental-health experts say these cases can have added complications as kids grieve, and a range of support is needed for a strong emotional recovery.

Nikki Eining is therapist with Avera Behavioral Health and board member for the Center for the Prevention of Child Maltreatment. She said loss of a biological parent falls under the scope of Adverse Childhood Experiences.

Eining explained it can affect the child's development, because they lost a relationship that's difficult to replace.

"I might not be receiving that nurturing piece from that caregiver anymore," said Eining, "when I've developed that bond to that caregiver as an infant or a toddler, or even an early elementary-aged youth."

With social-distancing requirements, the child may have not had a chance to say goodbye, and those rules may have kept their support system at bay during the mourning phase.

Eining said that's why it's important for adults in their lives to help build new trusted relationships that offer a sense of bonding. That involvement can come from outside the home, including neighbors, teachers and coaches.

Maureen Murray, director of mental health and prevention services with Youth and Family Services in Rapid City, said her office has responded to a handful of these cases.

She said in situations where a child has to suddenly adapt to a new environment, that can extend the grieving even longer.

"A move, a different school system, loss of friends," said Murray, "even if the surviving parent is struggling with their own grief and is not there emotionally for the child."

She said it's dangerous to assume all kids are resilient, noting some will not show how much they're struggling emotionally.

Murray said providing safe spaces for them to talk when they are ready is important, while adding therapy, such as individual sessions or grief camps can help.

The Moderna and Pfizer COVID-19 vaccines were cleared this weekend for use in children under age five by both the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC).

Parents likely have questions, and at Arkansas Children's Hospital, health professionals are gearing up to answer them.

The FDA has said both vaccines are likely to protect kids under age five against severe COVID illness, hospitalization and death. For the week ending June 9, children made up nearly 14% of reported weekly COVID cases.

Dr. Jessica Snowden, division chief for pediatric infectious disease at Arkansas Children's Hospital, thinks the expanded access could help keep cases down.

"There are a lot of kids who develop 'long COVID' syndrome that we are still trying to figure out how to treat and prevent," Snowden pointed out. "So far, the only thing we know that decreases your chance of getting that is being vaccinated. For a lot of parents, this is going to be an important step in protecting their kids as we move through the pandemic."

Parents are being advised to check with their child's pediatrician, and also to take other health precautions to prevent spreading any virus, from covering coughs and sneezes to 'masking up' if local guidelines suggest it. As of June 2, more than 400 deaths in children under age four were COVID-related, according to the CDC.

For parents deciding if the vaccine is a right move for their young children, Snowden pointed to her own experience as a parent and doctor, seeing children who have been in the Intensive Care Unit with long-term COVID symptoms.

"Particularly knowing that we don't have good treatments for this virus yet; this isn't like an ear infection, where I can give you antibiotics, and you'll get better," Snowden emphasized. "If your child gets sick, the things we can do to help them are limited. If I can help any family avoid that, vaccination is the best way to do that."

Pfizer's vaccine will be offered to children ages six months through four years, while Moderna's is for kids six months through five years of age.

North Dakota is seeing more diversity within its youth population, but researchers say they face a tougher road in securing a brighter future. A new report details these outcomes and how they were shaped.

According to Kids Count, a research arm of the Annie E. Casey Foundation, nearly one in four children in North Dakota is a person of color. However, because of discriminatory policies in such areas as housing, their families are less likely to achieve economic security.

Kids Count regional Coordinator Xanna Burg said these decisions, made decades ago, still have repercussions today.

"It made it harder for families of color to qualify for loans to purchase a home," she said, "and when we think about kind of the legacy that that racist policy had on today, we see disparities in home-ownership rates. "

North Dakota has the third-lowest rate of childhood poverty, but when measured by race, it has the highest poverty rates for Native American and Black children. The report authors recommended more energy investments in tribal areas to reduce utility costs, as well as boosting the minimum wage.

Burg acknowledged these aims might be hard with a conservative legislature, but said recent victories provide hope. She pointed to passage of a bill updating Native American history curriculum, and noted that having a more culturally relevant education helps Indigenous students succeed.

Burg said there are disparities in health outcomes as well, including access to prenatal care early in a pregnancy.

"We really see some of the lower rates for American Indian families," she said, "and when we think about some of the history, the federal government had this trust responsibility to provide health care. Unfortunately, the Indian Health Service is chronically underfunded."

The report recommended the federal government fund the Indian Health Service at the same per-person rate as Medicaid. It also called on the state to ensure all children eligible for Medicaid are enrolled. North Dakota is second-last in the nation for Medicaid participation among children, at 83%.