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Public Health In the Southwest: Children’s Health Issues

Public Health In the Southwest: Children’s Health Issues. Mary E. Rimsza, M.D. Arizona State University 480-965-1622 Mary.Rimsza@asu.edu. Southwestern Child Health. Ethnic Diversity Urban, Rural, and Frontier Regions Border States with undocumented children Uninsured and Underinsured

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Public Health In the Southwest: Children’s Health Issues

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  1. Public Health In the Southwest: Children’s Health Issues Mary E. Rimsza, M.D. Arizona State University 480-965-1622 Mary.Rimsza@asu.edu

  2. Southwestern Child Health • Ethnic Diversity • Urban, Rural, and Frontier Regions • Border States with undocumented children • Uninsured and Underinsured • Antigovernment Culture

  3. Arizona Child Fatality Program • Provides an ongoing multidisciplinary review of all child deaths • Determines which deaths were preventable. • Develops data driven recommendations for prevention statewide. • Local teams develop community specific prevention strategies.

  4. Child Fatality Review Program: Mission • To reduce preventable child fatalities by reviewing child deaths and making data-driven recommendations for community-based prevention, education, legislation, and public policy.

  5. Preventable Deaths A child’s death is considered preventable if an individual or the community could reasonably have done something that would have changed the circumstances that led to the death.

  6. Death certificate sent to team Team requests records Multidisciplinary local team reviews records Standardized data form is completed The data is entered into a state database State team produces annual report Child Fatality Review process

  7. The Attorney General’s Office The Department of Health Services The Department of Economic Security The Governor’s Office for Children The Arizona Supreme Court The Department of Youth Treatment and Rehabilitation The Arizona Chapter of the American Academy of Pediatrics A medical examiner/ forensic pathologist A maternal and child health specialist involved with the treatment of Native Americans Composition of the State Child Fatality Review Team

  8. Inter-Tribal Council of Arizona The Navajo Nation The United States Military Family Advocacy Program The Arizona Sudden Infant Death Advisory Council Prosecuting Attorneys advisory council Law enforcement officers advisory council Association of county health officers A child advocate not employed by the state A public member Composition of the State Child Fatality Review Team cont.

  9. Southwestern Child Health • Ethnic Diversity • Urban, Rural, and Frontier Regions • Border States with undocumented children • Uninsured and Underinsured • Antigovernment Culture

  10. Ethnic Disparities in Total Death Rate Ethnicity Death Rate Black 86.5/100,000 Hispanic 81.6/100,000 American Indian 70.8/100,000 White,non-Hispanic 51.8/100,000

  11. Preventable Deaths: 1995-1999 • 4,800 child deaths reviewed (95% of total) • 1,400 preventable (29%) • 5% of neonates-preventable • 26% of infants 28 days to 1 year-preventable • 33% of deaths in children 1 to 9-preventable • 56% of children over 9-preventable

  12. Preventability ofLeading Categories of Deaths (1995-1999)

  13. Ethnic Disparities in Preventable Deaths EthnicityPreventable Death Rate American Indian 33.6/100,000 Black 25.8/100,000 Hispanic 23.4/100,000 White 14.2/100,000

  14. American Indian Children • Highest Preventable Motor Vehicle Crash Deaths (18.6/100,000) • Highest Preventable Intentional Injury Deaths (8.4/100,000) • Average Preventable Medical Condition Deaths (4.7/100,000) • Lowest Infant Mortality (446.3/100,000)

  15. Hispanic Children • 2nd Highest Preventable Motor Vehicle Crash Death (15.2/100,000) • Lowest Preventable Medical Deaths (2.3/100,000) • Highest Total Adolescent Deaths (98.3/100,000)

  16. Black Children • Highest Infant Mortality (1,083/100,000) • Highest Preventable Medical Deaths (7.4/100,000)

  17. Southwestern Child Health • Ethnic Diversity • Urban, Rural, and Frontier Regions • Border States with undocumented children • Uninsured and Underinsured • Antigovernment Culture

  18. Rural Public Health Issues • Tribal Governance and Public Health • Limited Health Resources for everyone • Injury-Prone Play Environments • Reliance on Automobiles • Access to Guns

  19. Guns and the Old West

  20. Urban Public Health Issues • Limited Health Resources for uninsured • Backyard Swimming Pools • Reliance on Automobiles • Access to Guns

  21. Southwestern Child Health • Ethnic Diversity • Urban, Rural, and Frontier Regions • Border States with undocumented children • Uninsured and Underinsured • Antigovernment Culture

  22. Border Issues • Lack of Health Care Resources for undocumented • Border Crossing Deaths (7 deaths in 2002) • Unwillingness to cooperate with Public Health surveillance if undocumented • Transporting Infectious Diseases across borders

  23. Additional Information Mary Ellen Rimsza MD School of Health Administration & Policy W. P. Carey School of Business Arizona State University mrimsza@asu.edu 480-965-1622

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