Annie E. Casey Foundation Story Archives - West Virginia Public Broadcasting

Expert: W.Va.’s Drug Epidemic Is Holding Back Its Economy And Hurting Its Children

A senior policy advisor to the Legislature presented a sobering picture of West Virginia’s drug epidemic on Monday.

Despite the state’s billion dollar response, West Virginia has led the nation in overdose death rates since 2010, according to a senior policy advisor to the legislature.

Jeremiah Samples, former deputy secretary at the now reorganized Department of Health and Human Resources (DHHR) and current senior policy advisor to the Legislature, presented an analysis of the state’s substance use disorder (SUD) crisis to the Joint Committee on Health on Monday.

“The bottom line is that we have not made enough progress on this crisis,” Samples said. “We’re nowhere near where we need to be, and our data relative to other states, and even our own expectations, has fallen far short. We need to reassess all of our SUD strategies and expenditures through the prism of what is impacting real people in our society.”

A survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that 208,000 people in West Virginia used illicit drugs in the last month.

“That’s an average,” Samples said of the number. “It’s a gut-wrenching number to hear, but that’s where we stand.”

Samples also cited a West Virginia University Match Survey that found 359,880 West Virginians used drugs in the past year.

“We can’t sustain that as a society,” Samples said. “That is, it’s crippling to the state.”

In 2010, West Virginia’s fatal overdose death rate per 100,000 people was 28.2. Even after the state spent millions combating the problem, in 2022, West Virginia’s fatal overdose death rate had grown to 80.9 per 100,000 people.

“Our overdose death rate since 2010 has increased by 135 percent,” Samples told the committee. “West Virginia’s overdose death rate is 151 percent higher than the best state in the country, 85.6 percent higher than the national average and 36.4 percent higher than the next worst state (Tennessee).”

Samples cautioned against taking overdose death reports out of context.

“Any downturn is positive,” Samples said. “Those are real lives that people, that are not dying. However, the trend, we’ve had a couple blips where we’ve gone down in the past, but the trends are really what matter, and from a trend perspective, we have increased exponentially since we started leading the nation in overdose deaths.”

According to CDC data, the nation saw a 6.7 percent decrease in overdoses from January 2023 to January 2024. During that same period, West Virginia saw a 1.92 percent increase in overdoses.

“West Virginia is not keeping pace with the decrease in other states,” Samples said. “Before the pandemic, we were at a plateau of sorts. The pandemic hits and fentanyl issues become exponentially worse. Overdose death rates across the country explode. They increased in West Virginia, more so than most states. I think we were perhaps third, we saw the third biggest increase during the pandemic. But the bottom line is, we’re not decreasing at the same rate as some of these other states. So we’re not coming back down to that plateau. We need to get to that plateau and then continue to go down.”

The Current System

Samples explained that West Virginia’s state government response involves “over a dozen agencies,” led by the Governor’s Council on Substance Abuse, founded in 2018, and the Office of Drug Control Policy (ODCP), founded in 2017.

One of those agencies is the Bureau for Behavioral Health (BBH), the designated state mental health authority recognized by the federal government as the single state agency for substance abuse services.

The bureau receives federal block grant funding for substance abuse and prevention. It is responsible for SUD provider infrastructure and manages the state’s Crisis and Referral Line, 1-844-HELP4WV, contract.

“They (BBH) apply for these big federal grants,” Samples said. “They’re responsible for the infrastructure of the state for SUD and their annual budget is roughly $225 million.”

Samples said from 2017 to 2020, BBH was forced to send $34.2 million back to the federal government for funds that were not used from those grants.

“This came up in LOCHHRA (Legislative Oversight Commission on Health and Human Resources Accountability) last year,” Samples said. “We’re unclear from 2021 forward, how much money has been sent back, but it is something that the legislature and the state should explore and investigate.”

In 2023, legislation was passed directing the ODCP to report to the governor’s office. In the DHHR reorganization, the ODCP was placed administratively within the Department of Human Services.

Samples said it is hard to track SUD spending in West Virginia, but the state fiscal year 2025 budget for the ODCP is $2.3 million.

“You can directly attribute hundreds of millions again, in direct expenditures on SUD, just in West Virginia, annually,” Samples said. “And then there’s hundreds of millions more we know that we’re spending that are indirect, for example, child protective services, the child welfare crisis, there are hundreds of millions in indirect costs in just child welfare alone.”

A 2021 study that includes the economic impacts of the crisis by the West Virginia Center on Budget and Policy estimated that the drug crisis costs West Virginia $11.3 billion a year.

Samples also cited a Center for Disease Control and Prevention (CDC) report that found West Virginia experienced 1,335 known overdose deaths in 2022.

“Despite all the investment and expenditure, since 1999 we’ve seen a 1,680 percent increase in our overdose death rate,” Samples said. “Since 2010 which, again, 2010 is when we started leading the nation, [we’ve seen] a 135 percent increase. Since 2017, [we’ve seen] a 56 percent increase. So we have not been getting results. We’ve not been reversing the trend.”

According to Samples, Medicaid is the largest source of treatment funding for SUD in the state, serving approximately 50,000 members with an SUD diagnosis annually.

Medicaid is expected to spend about $140 million on SUD medical and behavioral health claims in West Virginia in 2025. In addition, Medicaid spends approximately $70 million on medication-assisted treatment (MAT) drugs.

“Medicaid’s annual expenditure, when you include MAT and the services, the claims are about $210 million,” Samples said. “Fatal overdoses have increased amongst the Medicaid population from 2018 to 2020, and so we’ve not seen appropriate progress there either.”

West Virginia Medicaid’s Substance Use Disorder Waiver

Since the launch of West Virginia’s Medicaid SUD Waiver, or 1115 Waiver, fatal overdose rates have continued to rise.

West Virginia Medicaid’s biggest SUD expenditure is the 1115 Waiver, which was developed to help increase the availability of SUD prevention and treatment services for Medicaid members.

The waiver was requested by the state and approved in 2017 by the federal government. It allows the state to provide additional services beyond what the federal government requires.

In 2018, the Bureau for Medical Services announced the expansion of services under the SUD Waiver, adding coverage of methadone as a withdrawal management strategy, a Naloxone distribution initiative, coverage of adult residential treatment, peer recovery support systems, withdrawal management services and the use of the Screening, Brief Intervention, and Referral to Treatment (SBIRT) tool to identify SUD treatment needs in the Medicaid community.

The SUD Waiver cost $12.2 million in 2019 and increased to $129.3 million by 2023. The Federal Reserve was responsible for $114 million of the 2023 total. West Virginia paid $15.3 million the same year.

Projected expenditures in 2027 are expected to grow to $161 million, according to Samples.

West Virginia Medicaid has proposed further expansion of the SUD waiver to the federal government. The application is under review with the expiration of the current waiver on September 30, 2024.

Proposed expansions include:

Expanding peer support to more settings
Sending quick response teams to clients who have overdosed or are experiencing a crisis
Providing Medicaid coverage to eligible individuals incarcerated in state prisons starting 30 days before their release
Offering involuntary secure withdrawal management and stabilization for individuals deemed to be a danger to themselves or others
Supporting a holistic and integrated approach to treatment
Education and outreach for Human Immunodeficiency Virus (HIV) and Hepatitis C (HCV) concerning substance use
Addressing social determinants of health to encourage self-reliance and support continued recovery housing offering clinical-level treatment services.
Supported house and supported employment
Offering the TRUST protocol for people with stimulant use disorders
Reimbursing short-term residential and inpatient treatment services in settings that qualify as an institution that treats mental diseases for Medicaid-eligible adults with serious mental illnesses.

West Virginia’s SUD Outcomes

Samples then shared some encouraging outcomes with the committee from this spending.

According to CDC provisional data, there was a decrease of 9.4 percent in overdose deaths nationally from March 2023 to March 2024. In West Virginia, that same data showed a decrease of 4.91 percent during the same time period.

Samples also cited a decrease in new HIV cases from 153 in 2021 to 100 in 2023.

“This was a really big deal a couple of years ago, Kanawha County alone, which was one of the worst hit counties, saw a 66 percent decrease from 2021 to 2023,” he said. “The 2024 data, which is available online, it’s looking really good. It’s actually even more positive than that. So kudos to everyone that’s worked on that.”

According to a 2022 report from the CDC, 2,400 people were living with HIV in West Virginia.

“Other positives, Medicaid, managed care organizations, providers, recovery homes, they’re starting to make a lot of progress in better measuring our outcomes, better measuring what’s actually happening in the state, so we can pivot and actually make progress on this crisis,” Samples said.

Samples also said he is hopeful about the West Virginia First Foundation, the organization formed by an act of the legislature that is responsible for dispersing West Virginia’s opioid settlement funds.

“The first foundation, this is a new development and something that I think we should have hope for. The foundation stems from efforts by the Attorney General Patrick Morrissey, securing an opioid settlement of approximately $1 billion,” Samples said. “This is the number one per capita opioid settlement in the United States.”

Drugs And Economics

While there are some positive indicators for the future of West Virginia’s drug epidemic, Samples said the state has not had any significant successes but has seen plenty of failure.

“The failures have consequences, the economic impact of the drug crisis,” Samples said. “One study said $8.8 billion a year in impact. Another study said $11.3 billion a year in impact, just on the economy, a 12 percent economic drag on our GDP (Gross Domestic Product), annually.”

Samples said the drug crisis costs West Virginia at least one-eighth of the state’s total economy based on spending on health care, substance use treatment, criminal justice costs, the societal burden of fatal overdoses and lost worker productivity.

The “drag” on West Virginia’s GDP is more than double that of the next highest state, Maryland where substance use disorder-related costs consumed 5.4 percent of its GDP.

Then, Samples addressed West Virginia’s labor workforce participation rate (LFPR), or, the number of people in the labor force (working or looking for work) as a percentage of the total population 16 years and older. West Virginia’s LFPR is at 55.1 percent in July 2024, according to the St. Louis Federal Reserve.

“We’re no longer last, and I don’t say that in jest,” Samples said. “I mean, we were last place in labor force participation rate from 1976 to 2022, so progress is progress, and we are making some progress in that realm, but the drug crisis is holding us back.”

According to Samples, the economic impact of productivity loss for non-fatal substance use disorders has a reported cost of $316 million dollars and 1,206 jobs to the state, while the economic impact of productivity loss due to overdose fatalities carries an additional cost of $322 million and 5,905 jobs.

“When you look at the unemployment rate, which is at 4.2 percent right now, relative to our labor force participation rate, our labor force participation rate has pretty much been level, but our unemployment rate has gone down,” Samples said. “There’s just people not in the job market looking for work, and this is attributable to the drug crisis.”

West Virginia has the highest death rate for working-aged populations and the second lowest life expectancy in the U.S. at 72.8.

“Even going back to 1990 West Virginia has had a lower life expectancy than the national average, but there’s been a gap that’s built, and even as the national life expectancy has gone down, we’ve gone down more,” Samples said.

West Virginia’s Children Pay A Price

According to Samples’ report, 83 percent of child welfare removals were from homes with known drug use.

“West Virginia’s foster care rate grew 61 percent from 2010, to 2021,” Samples said. “It’s 23 percent higher than the next worst state, and 118 percent higher than the national average.”

Data from the Annie E. Casey Foundation shows that West Virginia leads the nation in its foster care entry rate.

“The difference between the entry rate and the foster care rate, entry foster care rate, is just kids in foster care,” Samples said. “The entry rate is kids coming in.”

Samples said West Virginia has led the nation in foster care entry rates since 2010.

“We are 131 percent worse than the national average, and 54.9 percent worse than the next worst state in foster care entry rates, and that’s Alaska,” Samples said.

In 2000, six out of every 1,000 West Virginia children entered foster care. In 2021, 13 out of every 1,000 West Virginia children entered foster care. West Virginia’s entry rate increased 117 percent from 2000 to 2021.

According to the U.S. Department of Health and Human Services Administration for Children and Families Administration on Children, Youth and Families Children’s Bureau, in 2020, West Virginia had the highest percentage of children nationally suffering from substantiated maltreatment with drug abuse by the caregiver.

2020 CDC data also showed West Virginia had the highest rate nationally of infants screened in by Child Protective Services (CPS) with prenatal substance exposure.

Also in 2020, there were 712 babies screened in by CPS in West Virginia with drug exposure, compared to 526 babies screened in California, which has a population of 39.5 million people. West Virginia has a population of 1.7 million people.

“We only have about 17,000 babies born in the state a year,” Samples said. “It’s not a lot. If you extrapolate from our birth score numbers, then you’re looking at and not just the difference between neonatal abstinence syndrome (NAS) and in uterine substance exposure. NAS is worse. The babies basically full-blown addicted, is kind of the simple way to say it. we’re looking at around 2,500 babies every year that are exposed to drugs in the womb.”

The Future

In his final address to the legislature, Samples told lawmakers West Virginia’s drug epidemic response needs to be reevaluated.

“The most important thing we need to do, in my opinion, is we need to measure what matters so that we can then pivot and organically improve our response to this crisis,” Samples said. “We need to measure every aspect of our substance use disorder policies and expenditures, and we need to tie it back to a core societal measure.”

Samples left lawmakers with a list of proposed policy solutions including:

Mandatory Treatment (Casey’s Law)
SUD Transparency Act: SUD Outcome and Expenditure Dashboard
Save Babies from Drugs Act
Improve CPS Management of Cases with Drug Addiction
Measure Outcomes of Recovery Homes
Analysis of syringe exchange outcomes and criminal penalties for illegal needle distribution
Enhanced drug testing and SUD services for those on government benefits
SUD Relocation Supports
Public Reporting on SUD expenditures and program outcomes
Expenditure and Opportunities Audit:
Ending Addiction Amongst Inmate Population
Expand Inmate SUD Services via RSAT and GOALS programs
Develop a ratio of law enforcement needs across communities and increase funding for more officers

“Our economy still struggling, I would propose that really we look at 10 core measures and that we use a smarter approach, which is really just an acronym for specific, measurable, attainable, relevant, time, evaluated and resourced,” Samples said.

Samples said he is “leaving the legislature next month,” but offered no further information after thanking legislative staff and lawmakers.

“It’s been an honor,” Samples said. “The President and the Speaker have been great to me. You all have been great to me. You know you’re wonderful people, and I’ll just always be available to you, should you need anything. I believe in this body, and I believe what you do, and I believe in your hearts.”

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Marshall Health.

Annual Report Shows Good News, Bad News In W.Va. Children’s Health

When it comes to several different measures of overall well-being, a new report shows West Virginia’s children rank 44th nationally. But there are some important improvements.

When it comes to several different measures of overall well-being, a new report shows West Virginia’s children rank 44th nationally.

But there are some important improvements, particularly in the health category where this year’s data shows the state ranks 35th. That’s up four places from last year’s report in the Kids Count Data Book, an annual 50-state report developed by the Annie E. Casey Foundation to analyze how children are doing in post-pandemic America.

The most recent data available is from 2022 and indicates improvements in the number of children covered by health insurance, considered obese and the number of deaths among children and teens.

The same assessment shows an increase in the number of low birth-weight babies.

Other categories included in the overall ranking are economic development, education, family and community.

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Marshall Health.

Black Children Most Likely To Live In Poverty In W.Va., New Report Finds

A report from the Annie E. Casey Foundation found Latino children are the least likely to live in poverty in West Virginia.

The Race for Results report, from the Annie E. Casey Foundation, standardizes scores across 12 indicators representing well-being milestones to measure aspects of health from the child’s infanthood to adulthood and converting them into a scale ranging from 0 to 1,000.

Latino children scored highest in West Virginia with a score of 568. West Virginia children of two or more races had a score of 513. White children came in third place with a score of 509. Black children came in last place with a score of 417 out of a possible 1,000.

In West Virginia, American Indian, Alaska Native, Asian and Pacific Islander races results were suppressed. This means the data pool was so small, that releasing it would identify the participants.

Leslie Boissiere, the vice president of external affairs at the foundation, said West Virginia’s high school graduation rates are above the national average, but other indicators are below the national average.

“There are some some areas where West Virginia has done well,” Boissiere said. “But in the area, beyond high school, as well as looking at the rate of poverty for all kids of all racial and ethnic groups. It’s an area where the state is underperforming compared to the nation as a whole.”

According to Boissiere, a child tax credit could help the poverty rate in West Virginia.

“We know that based on the data and the evidence, it is an effective way,” Boissiere said. “Medicaid expansion is another way that we know is effective, allowing kids to remain in foster care beyond the age of 18 to ensure that those kids have a higher likelihood of graduating from high school on time, and also earning a post-secondary degree and being financially stable. So we have evidence of some programs that have been effective in lifting kids out of poverty, and those should be effective for the state legislature to consider as well.”

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.

W.Va. Kids Count Tallies Data On State Of Children

West Virginia ranked 42nd in the latest Kids Count Databook produced by the Annie E. Casey Foundation. The databook tracks hard data on the challenges facing kids around the nation. This latest report has a particular focus on mental health and anxiety challenges facing kids after the pandemic.

News Director Eric Douglas spoke with Tricia Kingery, the executive director of West Virginia Kids Count to learn more about the program and how to improve the lives of West Virginia children.

The organization plans to release a county by county breakdown of the information in October.

Douglas: What is West Virginia Kids Count?

Courtesy image.

Tricia Kingery, executive director, WV Kids Count.

Kingery: West Virginia Kids Count is a private, nonprofit organization. We are one of the state’s oldest child advocacy organizations and we pride ourselves on providing the most trusted data about the well being of West Virginia’s children and we encourage others to use data to drive decisions that help kids have a better life.

Douglas: Rather than just saying, “Well, this is what I believe, you actually have the receipts to prove it.”

Kingery: The foundation of everything we do is data. And I think that’s what makes us a little bit different than other child advocacy organizations. We’ve got a 34 year track record on producing an annual data book on child well being. It is essentially the go to for all things children so that we can see how our children are faring. We recently released the national data book in partnership with the Annie E. Casey Foundation. I think it’s interesting to always point out that Kids Count is a network that’s throughout the country, and every state has their own Kids Count. And I’m honored to represent West Virginia Kids Count at a state level, but also at a national level. The Casey Foundation makes that possible. We’re part of a national network and a national movement to help advocate for what kids need most.

Douglas: The organization has been doing this for 34 years producing these kids count data books.

Kingery: Interestingly enough, during the Gaston Caperton administration, he established a task force of business leaders to get involved in child advocacy work. And that was the first Kids Count in the country. West Virginia is leading the way and counting our kids and making them important. His legacy continues with a business driven board of directors. And that’s why we’re a little bit different. We’re all about the data and making sure that we use data to drive decisions, just like a business would do.

Douglas: So this is a nationwide program, but it started right here in West Virginia?

Kingery: It did. It was called a task force. This one, thankfully, turned into West Virginia kids count.

Douglas: What are some of the things you track within the data book?

Kingery: The Casey Foundation reports on a national ranking. And so we’re compared to other states in terms of how our kids are faring. So this year, the report identified West Virginia as 42. So, we are 42nd overall in child well being in comparison to other states throughout the country, which is a slight improvement. We went from 44 to 42. We typically hover around the 40’s, but that’s why data is even more important. So we can use data to drive decisions and help kids.

Douglas: What are some of the things you track?

Kingery: There’s overall child well being but what makes that up is the whole child. There’s four of what we call domains, and those four domains are education, health, family and community, and economic well being. So there’s four buckets of data and each of those buckets have indicators in it.

Let me talk about economic wellbeing for a moment. That’s actually where we struggled the most. If you ask me what’s the biggest foundational concern or challenge for children, it’s poverty. This economic well being indicator, we actually ranked 47th in the country. In terms of overall economic well being, and that’s data points, such as children in poverty, children whose parents lack secure employment, children living in households with the high cost of housing, and teens not in school and not working.

Douglas: There were a couple of things that were up slightly, a couple things that were down slightly.

Kingery: Unfortunately, we do hover in those 40s; 42 is probably the best we’ve been in the last 10 years. So we are making progress. What I want to do is use that data and identify specifically what indicators could push that number down. I mean, let’s be 30 next year, and then 20, and then 10, and then one. Sometimes it’s low hanging fruit. What can we do that can make a big difference? And then sometimes identifying long term change requires step one, step two, step three to do this.

It’s all about using the data, getting the right people to use the data. Our other partner is the legislature. We want them to have access to this guidebook when they’re making decisions and voting, so that they make informed decisions. What the Casey Foundation does is produce the national data book that has West Virginia level data. And then in October, West Virginia Kids Count will publish the state data book which takes those same indicators and breaks them down by county. That allows the media and legislators to understand what’s happening in our own backyard.

Douglas: Give me an example of low hanging fruit; something simple that we could change that would improve the lives of our kids.

Kingery: The focus of this entire data book is on mental health. I think that’s where we can start in terms of low hanging fruit. In fact, the U.S. Surgeon General has recognized us as being in a youth mental health pandemic. Kids are struggling with anxiety and depression, which affects school absenteeism and academic success, and so many other things. Throw a COVID pandemic into the world of which our youth are living and they’re really struggling.

So we can’t ignore the mental health fallout, or what they call an echo pandemic. It does take shape in the form of anxiety and depression for many of our youth. In 2016, West Virginia children were struggling with anxiety and depression at a percentage of 11.7. And then in 2020, that number jumped to 14.6, which is a 24.8 percent increase. That number is the low hanging fruit because that’s the number of children that need mental health resources and support. That’s where we have to start; mental health awareness. We’ve come a long way even in the past 10 years, but it’s still something that folks don’t talk about. We have to make sure our schools are trauma informed, which means they understand that things that are happening at home, affect a child at school, and to make sure there’s acceptance of mental health issues, that there’s environments where kids feel comfortable talking about what’s going on, and then also the resources and support to give them.

Douglas: Does that run across all socioeconomic classes? Is it related to lower socio-economic children?

Kingery: It affects all kids, but research tells us that children living in poverty, and, or, children of various races, it does affect them more so. So children of color and poverty, really have a disadvantage right out of the box. So those are the kids that we really need to be watching out for a little bit more than the others, actually a lot more than the others, and making sure that they even have a level playing field, which they don’t.

I’m a firm believer that poverty is at the foundation, the root cause of all of all of our challenges in West Virginia. And that’s why we have to address the whole child and have to look at education, economics, their family situation, what resources are available in the community. Do you have a bed to sleep in at night? Do you have electricity in your home? Do you feel safe in the home? Do you have access to services and resources? Transportation is a huge issue. But that underlying issue is still economic well being and poverty.

Douglas: What would you like to see the legislature do to improve the mental health and overall health and well being of children in West Virginia?

Kingery: Year before last, we advocated for the passing of what we call the Adverse Childhood Experiences (ACE) bill. And it did pass without funding, but it did create an exploratory task force that looks at the impact of trauma on kids. Recently there’s been a report submitted from that task force to the legislature. We want to make sure that the ACEs movement, that people understand what adverse childhood experiences are. And we want to make sure that we help children who are experiencing those events, overcome those issues, and most importantly, to prevent them from happening in the first place.

I’m hoping the legislature looks at the results of the report and advances the adverse childhood experiences effort. And what that means is funding schools to be trauma informed, making sure there’s access to mental health services in the community. It’s funding anything that puts resources in the hands of kids and families at a local level. We really support schools being the center of a community. So making sure schools have the resources.

Douglas: What’s the takeaway message from this?

Kingery: I think most of us who grew up in West Virginia chose to stay here or came back home. We want to make sure that West Virginia is a great place to be a kid and for all kids, not just our own. So that means honestly looking out for the kids in your life, and not just the ones under your roof. But making sure that you keep an eye out in our community because they need us. The problems are so big and so massive and so complex: COVID-19, depression, the opioid crisis, foster care, grandparents raising grandchildren. We have so many issues we have to come together, place mental health as a priority, talk about it, invest in it, make resources and services accessible to all and that’s it’s going to take all of us to make sure West Virginia is a great place to be a kid and for all kids.

Numbers Of Children In Concentrated Poverty Increasing In West Virginia

West Virginia is one of ten states where the number of children living in areas of concentrated poverty is increasing. That’s according to the Annie E. Casey Foundation’s “Data Snapshot on High-Poverty Communities.”

Concentrated poverty is an area where 30 percent of the population lives below the poverty line.

“In the United States, eight and a half million kids or 12 percent of the kids population in the United States are living in neighborhoods of concentrated poverty,” said Scot Spencer, Associate Director for Advocacy and Influence at the Annie E. Casey Foundation. “That is an improvement from our first snapshot. But it still means that there are too many kids living in neighborhoods of concentrated poverty.”

The Data Snapshot underscores that living in neighborhoods of concentrated poverty undermines a child’s well-being. Nationwide, the number of people living in concentrated poverty is falling, but remains high. West Virginia is lower than the national average, but the numbers are rising.

Between the Casey Foundation’s last report in 2012 and the latest report using 2017 numbers, the number of children in West Virginia living in poverty rose from 30,000 to 38,000.

“Any kids living in neighborhoods of concentrated poverty should be an unacceptable number for us. Because what it means for the long run is that their ability to succeed in life is truncated by living in these types of neighborhoods,” Spencer said.

West Virginia and Delaware are the only two states where poverty levels rose last year, according to U.S. Census data. The Mountain State’s overall poverty rate climbed to 19.1 percent last year, making it one of four states with a poverty rate above 18 percent.

“It doesn’t matter whether you’re in an urban environment or suburban environment or a rural environment. There are parts of the economy that have left places,” Spencer said. “And so just by the fact that the jobs that were once family sustaining jobs are no longer there. People then fall into poverty and pockets of neighborhoods fall into poverty.”

Spencer didn’t have detailed information on specific locations in West Virginia. But indicators exist that point to which regions are struggling.

According to the US Department of Agriculture, 22 percent of the households in the 3rd Congressional District — which includes the southern coal fields — use the Supplemental Nutrition Assistance Program, or SNAP, benefits.

Spencer also noted a lack of access to hospitals and the presence of food deserts in these areas can compound the problems.

“There may just not be places for kids to be kids and to play and to grow up and to do well. There’s a lack of access to quality education, the lack of access to quality housing, the lack of access to jobs,” he said.

Finding solutions to problems like concentrated poverty will involve federal, state and local governments working with the business sector and community groups, according to Spencer.

“How do we focus industry or sector specific job training and opportunities in neighborhoods of concentrated poverty so that people can actually make families sustaining wages? In places where there are large industries, how do they hire and contract locally? How does local government think about how they let their services or hire their contracts, so that they are actually hiring from the communities that they are in?” Spencer asked.

Spencer also notes that financial hardships can cause chronic stress linked to diabetes, heart disease and stroke — all major health problems in West Virginia.

West Virginia Improves 4 Spots on Child Well-Being Rankings

West Virginia has improved from 43rd to 39th among all states in a foundation’s rankings for overall child well-being.

The group West Virginia KIDS COUNT announced the change in the Annie E. Casey Foundation’s 2016 national rankings of child well-being.

West Virginia KIDS COUNT says the Mountain State tied with five other states for the second-largest improvement since the 2015 marks.

The group says West Virginia ties for third for percentage of children covered by health insurance.

The foundation measures well-being through four metrics.

West Virginia ranked 31st in economic well-being, 46th in education, 41st in health and 33rd in family and community.