2025 Children's of Alabmama Community Health Needs Assessment

Survey alignment with external data is mixed.

Survey respondents’ top three issues were substance abuse of caregivers, screen time/social media, and suicide. The mean ranking of the first two was 5.9, and the third, suicide, was 6.1. Respondents were far more worried about adults’ substance abuse in the home than use by children and teens. External data justify that concern. While the state has seen a recent drop in opioid use and deaths from opioid overdose, the issue remains top of mind for many. National data find that of approximately 19 million children, 25% live with at least one parent with substance abuse issues. 34 Likewise, nationally, substance abuse is the second-leading cause of a child’s removal from home, accounting for 32% of cases, 35 and in 2023, 5,875 Alabama children were in foster care. 36

Jefferson County’s CHIP specifically calls out the need to address addiction as a community health issue. 37

Excessive screen time is correlated with data on sedentary behavior and mental health. Valid usage data is difficult to find, but the issue has received significant attention in the popular media, from publications such as Jonathan Haidt’s The Anxious Generation and the FOCUS Act passed by the Alabama Legislature in 2025, which severely reduces or prohibits students’ phone usage in school.

Phone/search policies (metal detectors, random sweeps, automatic suspensions) can undermine trust with adults students might otherwise confide in, while the “alwayson” social feed amplifies anxiety and suicide contagion.

Suicide is indeed a leading cause of adolescent death. In Alabama, suicide consistently ranks the second or third leading cause of death for ages 10–19. 38

The preventable teen death rate (which includes suicides) in Alabama is 52.9 per 100,000. 39

Alabama ranks 8 th nationally in the number of teen deaths from suicide. The rate of 9 per 100,000 is up from 7.9 in the 2012–14 period, but down from 11.5 in the 2018–20 period. 40

Sadly, 22% of Alabama high school students reported seriously considering suicide, and 10% reported attempting it. 41

Firearm-related harm to children is a real problem in Alabama. Firearms are a leading mechanism of injury death for youth (through both accidents and intentional violence). Jefferson County has seen a surge in gun violence in recent years; in 2022, the county’s child and teen homicide rate was part of an overall homicide rate of about 25 per 100k (many involving firearms). 42 Data from Children’s Hospital show numerous youth are treated for gunshot wounds each year in Birmingham, including 69 treated gunshot wounds in the Children’s Emergency Department in 2024.

______________________________________ 34 Millions of U.S. kids live with parents with substance use disorders.” National Institutes of Health. https://www.nih.gov/news-events/nih-research-matters/millions-us-kids live-parents-substance-use-disorders 35 The Adoption and Foster Care Analysis and Reporting System (AFCARS) Dashboard. U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. https://acf.gov/sites/default/files/documents/cb/2023-afcars-dashboard-printable.pdf 36 Alabama Profile” 2024 Kids Count Data Book. Voices for Alabama’s Children. https://alavoices.org/wp-content/uploads/2025/03/Alabama_Profile.pdf#:~:text= Children%20in%20Foster%20Care%20Base,2023%207%2C349%202%2C837 37 The Community Health Improvement Plan, 2020-2024. Jefferson County https://www.jcdh.org/SitePages/Misc/PdfViewer?AdminUploadId=2587#:~:text=match%20 at%20L1650%20Strategic%20Issue,Term%20Target 38 Youth Suicide ‘The Silent Epidemic’—Keeping More Than Dreams Alive.” Alabama State Department of Education. https://www.alabamaachieves.org/wp-content/ uploads/2021/02/Youth-Suicide-Training-for-Parents.pdf#:~:text=Among%20young%20people%20aged%2010,Suicide%20Statistics 39 Alabama Profile” 2024 Kids Count Data Book. Voices for Alabama’s Children. https://alavoices.org/wp-content/uploads/2025/03/Alabama_Profile.pdf#:~:text= Children%20in%20Foster%20Care%20Base,2023%207%2C349%202%2C837 40 “Teen Death in Alabama.” America’s Health Rankings https://www.americashealthrankings.org/explore/measures/teen_suicide/AL citing Data from U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, Multiple Cause of Death by Single Race Files via CDC WONDER Online Database, 2020–2022 41 The Secret Life of Children: Suicidal Ideation and the Need for Informed Intervention” Children’s Aid Society of Alabama. https://childrensaid.org/the-secret-life-of-children suicidal-ideation-and-the-need-for-informed-intervention/#:~:text=As%20of%20the%20latest%20reports%2C,LGBTQ%2B%20youth%20face 42 Alabama Profile” 2024 Kids Count Data Book. Voices for Alabama’s Children. https://alavoices.org/wp-content/uploads/2025/03/Alabama_Profile.pdf#:~:text= Children%20in%20Foster%20Care%20Base,2023%207%2C349%202%2C837

Children’s of Alabama, 2025 CHNA

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