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Think Tank: Problem Solving Barriers to Children’s Health. Nevada Early Childhood Health & Immunization Summit Presented by: Denise Tanata Ashby. Children’s Health in Nevada. Overall – State Rankings: 42nd – United Health Foundation, America’s Health Rankings, 2008
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Think Tank: Problem Solving Barriers to Children’s Health Nevada Early Childhood Health & Immunization Summit Presented by: Denise Tanata Ashby
Children’s Health in Nevada Overall – State Rankings: • 42nd – United Health Foundation, America’s Health Rankings, 2008 • 43rd – Overall Child Well-Being, Every Child Matters Education Fund, 2008 • 45th – Commonwealth Fund, Child Health System Performance, 2008 • Weak – Overall Health Care Quality, Agency for Healthcare Research & Quality, 2008
Children’s Health in Nevada • Insurance Coverage • Immunizations • Oral Health • Mental Health • Obesity and Physical Activity • Prenatal Care • Infant Mortality and Child Deaths • Chronic Disease • Preventive Care/Medical Homes
Children’s Health in Nevada Insurance Coverage • 18.4% (nearly 500,000) of Nevadans are without health insurance1 • 16.8% (115,000) of Nevada’s children are uninsured2 • About 35% of Latinos and 18% of Blacks in NV are uninsured, compared with 15% of Caucasians3 1 United Health Foundation, 2008 2 Kaiser Family Foundation, 2007 3 Kaiser Family Foundation, 2009
Children’s Health in Nevada Insurance Coverage, cont’d. • 38% of children live in households with incomes at or below 200% FPL1 • Over 35,000 children of school age are uninsured & meet the income guidelines of NV Medicaid or Check Up2 • 51st for the percentage of eligible children enrolled in Medicaid3 1 U.S. Census Bureau, Current Population Survey, 2006-08 2 Nevada Covering Kids and Families, 2009 3 Nevada Academy of Health, National Health Scorecard, 2009
Children’s Health in Nevada Immunizations • 51st in 2006 and 2007 for schedule completion rates among children 19 to 35 months1 • 2006 – 59.5% (4:3:1:3:3:1) • 2007 – 63.1% (4:3:1:3:3:1) • 48th in 2008 for schedule completion rates among children 19 to 35 months1 • 2008 – 67.8% (4:3:1:3:3:1) • Healthy People 2010 goal: 80% • Nearly 6% of kindergarten parents indicated that they would not have their child immunized if it were not required by law2 1 National Immunization Survey, 4:3:1:3:3 and 4:3:1:3:3:1 2 NICRP Kindergarten Health Survey, 2008
Children’s Health in Nevada Oral Health • 73.1% of parents reported that their children received preventive dental care in the past 12 months (78.4% nationally) 1 • 32.5% of kindergarteners have not seen a dentist within the past 12 months2 1National Survey of Children’s Health, 2007 2 NICRP Kindergarten Health Survey, 2008
Children’s Health in Nevada Mental Health • Nevada has the 6th highest suicide rate in the nation for youth ages 11 to 181 • In Clark County there were 12 youth suicides in 2007, an increase from 9 in 20062 • 3.4% of kindergarten parents reported that they had tried to access mental health services for their child 2 • One-third of those reported having trouble accessing services 1 National Survey on Drug Use and Health Promotion, 2007 2Clark County Child Death Review Annual Report, 2007 2 NICRP Kindergarten Health Survey, 2008
Children’s Health in Nevada Obesity/Physical Activity • 25.5% of Nevada students (grades 6 to 12) are overweight or obese1 • 46% of Nevada students (grades 6 to 12) are physically active for at least 60 min. per day1 • 36% of kindergarteners in NV are overweight or at risk of overweight2 • African American and Native American/Alaska Native children are disproportionately represented in the overweight category at 38.9% and 30.8%, respectively • Nevada is one of only 20 states that has NO statewide approach to address childhood obesity at the legislative level3 1 Nevada Youth Risk Behavior Survey, 2007 2 NICRP Kindergarten Health Survey, 2008 3 Kaiser Family Foundation, State Health Facts, 2009
Children’s Health in Nevada Prenatal Care1 • Only 69% of mothers in NV begin prenatal care in the first trimester (78% nationally) • 58% for Hispanic women • 62% for Black women • 14% of births in NV are pre-term (13% nationally) 1 Nevada Maternal and Child Health Issue Brief: Access to Prenatal Care, 2009
Children’s Health in Nevada Infant Mortality and Child Deaths • The 2005 infant mortality rate (per 1,000 live births) was 6.1 (US Median, 7.1)1 • There were 480 child and adolescents deaths in NV in 20062 • 58.5% were children under age 1 • Leading Causes/Manners: Natural (<1), MVA’s, non-MVA Accidents, Homicide, Suicide 1 Commonwealth Fund, Child Health System Performance, 2008 2Nevada DCFS, Statewide Child Death Report, 2006
Children’s Health in Nevada Chronic Disease & Special Health Care Needs • 12% of kindergartners have a medical condition that requires special treatment (ie: asthma, diabetes, cancer, ADD/ADHD, seizures, glasses, etc.)1 • Asthma – the rate of childhood lifetime asthma in NV for 2006 was 11.8%, approximately 78,000 children age 0-172 • NV is 9th worst in the nation for pediatric asthma hospital admissions at 141.7 per 100,000 children age 0-173 1NICRP Kindergarten Health Study, 2008 2 Yang, et al., Childhood Asthma Prevalence Report for NV, 2006 3 Commonwealth Fund, Child Health System Performance, 2008
Children’s Health in Nevada Preventive Care and Medical Homes • 50th for the percent of children (0-17) with both a medical and dental preventive care visit in the past year • Only 45% of children receive care within a “medical home” (compared to 57.5% nationally) • Over 17% of kindergarteners have not had a routine medical check up within the 12 months prior to starting school • 21% of kindergarteners do not have a primary care provider (66% uninsured, compared to 10% with insurance) 1 Commonwealth Fund, Child Health System Performance, 2008 2 National Survey of Children’s Health, 2007 3 NICRP Kindergarten Health Survey, 2008
Children’s Health in Nevada What are the barriers to improving children’s health in Nevada?
Children’s Health in Nevada What are the barriers to improving children’s health in Nevada? What are some potential solutions for improving children’s health?
Children’s Health in Nevada What are the barriers to improving children’s health in Nevada? Identify 3 barriers What are some potential solutions for improving children’s health? Identify at least 1 solution
Contact Information Denise Tanata Ashby, J.D. Nevada Institute for Children’s Research & Policy University of Nevada, Las Vegas (702) 895-1040 Denise.tanata@unlv.edu http://nic.unlv.edu