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Child and Adolescent Health

Child and Adolescent Health. Cheryl Duncan De Pinto, M.D., M.P.H. Medical Director, Child, Adolescent, and School Health Center for Maternal and Child Health. Children and Adolescents in Maryland. Family Structure and Living Arrangements.

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Child and Adolescent Health

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  1. Child and Adolescent Health Cheryl Duncan De Pinto, M.D., M.P.H. Medical Director, Child, Adolescent, and School HealthCenter for Maternal and Child Health

  2. Children and Adolescents in Maryland

  3. Family Structure and Living Arrangements • 33% (nearly 500,000) of Maryland children under 18 live in a single parent home. • In December 2009, 8,429 children were in out-of-home placement through the MD Department of Human Resources. • 11.8% were in group homes • 76.9% were in family foster homes • In 2009, 4,968 youth were admitted to secure detention facilities Source: Kids Count Data Center; MD Department of Juvenile Services

  4. Health Insurance Coverage • 10% of Maryland youth, birth-18 years, are uninsured. Source: MD Health Care Commission, Health Insurance Coverage in Maryland Through 2007

  5. The American Academy of Pediatrics' description of a "medical home" lists seven defining components: Accessible Continuous Comprehensive Family-centered Coordinated Compassionate Culturally effective 41.4% of Maryland children do not meet the AAP criteria for having a medical home. However, 93.9% of Maryland children have a usual place for sick and well care. Source: 2007 National Survey of Children’s Health Medical Home

  6. Immunizations

  7. Vaccination Coverage Among Adolescents

  8. Lead Poisoning

  9. Oral Health: Status • 31% of school children in Kindergarten and Grade 3 had at least one tooth with dental caries. • 27% of school children in Kindergarten and Grade 3 had at least one tooth with a dental sealant. Oral Health: Disparities • Children more likely to have dental caries and less likely to have dental sealants: • Black, non-Hispanic children • Children receiving free or reduced price meals • Children residing on the Eastern Shore (both sealants and caries) or in Central Baltimore (sealants only) • Children covered by Medicaid rather than private insurance (sealants) • Children with either Medicaid or no insurance coverage (caries) Source: Survey of the Oral Health Status of Maryland School Children, 2005-2006

  10. Dentist visit in the past 12 months: Yes: 83.1 % No: 15.6 % Unknown: 1.3 % Dental care service availability: Yes: 90.3 % No: 8.1 % Unknown: 1.6 % Source: 2005-2006 Survey of the Oral Health Status of Maryland Children, University of Maryland School of Dentistry Oral Health: Access to Care

  11. Mortality • In 2007, there were 366 deaths to children ages 1-17 in Maryland and the child death rate was 28.6 deaths per 100,000 population. • Highest child death rates (2005-2007): • Black, non-Hispanic youth: 33.4 per 100,000 • Older youth (15-17 years): 51.1 per 100.000 Source: MD DHMH, Vital Statistics Administration

  12. Mortality: Unintentional Injuries Source: MD DHMH, Vital Statistics Administration

  13. Injury-related deaths Source: MD DHMH, Vital Statistics Administration

  14. Hospitalizations Other Leading Causes of Hospitalizations: Young children (1-4 years) : Common childhood infections Middle children (5-9 years): Injuries Older children (10-14 years): Injuries Source: HSCRC Hospital Inpatient Data, 2007

  15. Mental Health: Hospitalizations Source: HSCRC Hospital Inpatient Data, 2007 *Not a Top 10 Reason for Hospitalization for this Age Group

  16. Mental Health: Early Childhood • 1,094 of 30,094 children, ages 0-5 years cared for in child care sites* were identified as having a mental health concern • Of those, 414 children with more serious mental health concerns have been referred to other services. *Child care centers, family child care homes, Head Start centers, preschools, and unregistered sites Source: MSDE, Early Childhood Mental Health Project

  17. School Readiness: The Seven Domains • Personal and Social Development • Language and literacy • Mathematical thinking • Scientific thinking • Social studies • The arts • Physical development Source: MSDE Report, Children Entering School Ready to Learn: School Readiness Information for School Year 2008-2009

  18. School Readiness

  19. Source: Maryland State Department of Education Health of School-aged ChildrenSchool Health Services Annual Survey SY 2006-2007

  20. Source: Maryland, BRFSS, 2001-2007 *Survey question changed in 2005. Childhood Asthma

  21. Childhood Asthma Source: Maryland, BRFSS, 2001-2007 *Survey question changed in 2005.

  22. Childhood Asthma Sources: HSCRC ambulatory care data, 2007; HSCRC hospital discharge data, Maryland Health Care Commission, West Virginia Health Care Authority, Pennsylvania Health Care Cost Containment Council, and Delaware Department of Health, 2005-2007.

  23. Childhood Asthma Sources: HSCRC ambulatory care data, 2007; HSCRC hospital discharge data, Maryland Health Care Commission, West Virginia Health Care Authority, Pennsylvania Health Care Cost Containment Council, and Delaware Department of Health, 2005-2007.

  24. Childhood Obesity

  25. Childhood Obesity

  26. Mental Health: Depression and SuicideYRBS, Maryland 2007 • Source: MD Youth Risk Behavior Survey, 2007

  27. Substance Use-Related Risk BehaviorsYRBS, Maryland 2007 • Source: MD Youth Risk Behavior Survey, 2007

  28. Violence and BullyingYRBS, Maryland 2007 Source: MD Youth Risk Behavior Survey, 2007

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