b'GREATER MONADNOCK COMMUNITY HEALTH IMPROVEMENT PLAN 2015-2018Children of Lower-Income According to estimates from the American Community Survey, children under 18 years represented 20.4% of the Regions population in 2013 but they comprised 26% of all people in poverty.Children of lower-income are disproportionately at risk for factors that threaten healthy development. Asearlyas 24months,childreninfamiliesoflower-incomehavebeenfoundtoshowlagsincognitiveandbehavioral developmentcomparedtotheirpeersinfamiliesofhigher-income.Childrenwhoexperiencepovertyandrelatedfactorssuchaspoor nutrition and lack of preventative health care are vulnerable to poor outcomesinsuchareasasschoolperformance,health,andmental health.These youth are often behind their more advantaged peers fromthestart,astheyoftenlacktheresourcesandopportunities found to lead to healthier outcomes.PHYSICAL ENVIRONMENTAccess to Goods, Services and Other DestinationsHavingsafe,convenient,andaffordableoptionsforaccessing employment, goods, services, and social and recreational activities is integral to maintaining a healthy, vibrant community and quality of life.In a rural area like the Monadnock Region, these options are extremely limited.Low population density, hilly terrain, far distances between servicecenters,andlimitedpublictransportationaresignificant challenges to getting around.For many living in the Region, the only safe or practical way to access destinations is by automobile.However, this travel option is not available to all residents.Within the Region, 4.9% of households do not have a vehicle available. Dependingonwhereyouliveandwhereyouneedtogo,non-motorizedtransportationoptionsintheRegionarealsolimited.Sidewalkslineapproximately5.5%(103miles)oftheRegions roadwaysandmostareconcentratedindowntownareasandsomeTop photo: Winter road conditions in the Region can make it difficult to get around; village centers.For even the most physically fit residents, bicycling canBottom photo: Volunteer drivers help transport residents of the Region to medical appointments and other destinations. 12'