ERIC ED447921: Child Health USA, 2000.

83 Pages·2000·2.2 MB·English

by  ERIC

DOCUMENT RESUME
PS 029 018
ED 447 921
Child Health USA, 2000.
TITLE
Health Resources and Services Administration (DHHS/PHS),
INSTITUTION
Washington, DC. Maternal and Child Health Bureau.
2000-00-00
PUB DATE
83p.; For 1999 edition, see ED 438 063.
NOTE
U.S. Government Printing Office, Superintendent of
AVAILABLE FROM
Documents, Mail Stop: SSOP, Washington, DC 20402-9328.
Single copies also available from: National Maternal and
Child Health Clearinghouse, 2070 Chain Bridge Road, Suite
450, Vienna, VA 22182-2536; Tel: [phone]. For full
text: http://www.mchb.hrsa.gov.
Descriptive
-- Reports
Numerical/Quantitative Data (110)
PUB TYPE
(141)
MF01/PC04 Plus Postage.
EDRS PRICE
Adolescents; Birth Weight; *Child Health; Demography; Early
DESCRIPTORS
Parenthood; Employed Parents; Health Behavior; Health Care
Costs; *Health Needs; *Incidence; Infant Mortality; Infants;
Mortality Rate; Mothers; Municipalities; Poverty; Prenatal
Care; *Social Indicators; Tables (Data)
Healthy People 2010; *Indicators; Medicaid; Vaccination
IDENTIFIERS
ABSTRACT
Intended to inform policymaking in the public and private
sectors, this booklet compiles secondary data for 59 health status
indicators. The book provides both graphical and textual summaries of data
and addresses long-term trends where applicable. Data are presented for the
target populations of Title V funding: infants, children, adolescents,
women of childbearing age. In
children with special health care needs,
addition to health status, the book addresses health service2
;F:nd
population characteristics. Following the introduction, which discusses
trends and issues in children's health, the booklet has six sections:
(1)
"Population Characteristics," including children in poverty, maternal age,
"Health Status," discussing the
working mothers, and school dropouts;
(2)
"Health
health issues related to infants, children, and adolescents;
(3)
Services and Utilization," including health care financing, vaccination
coverage levels, physician visits, service utilization by children with
chronic conditions, hospital utilization, and prenatal care;
(4)
"State-Specific Data," including data tables on infant and neonatal
mortality, prenatal care, low birth weight, births to women under 18,
"City Data," focusing on
Medicaid information, and health insurance;
(5)
comparisons between cities with populations over 100,000 and national data on
"Healthy
infant mortality, low birth weight, and prenatal care; and (6)
People 2010 Objectives." (Contains 34 references.)
(EV)
Reproductions supplied by EDRS are the best that can be made
from the original document.
a
©1h
uom
CS
U.S. DEPARTMENT OF EDUCATION
Office of Educational Research and Improvement
EDUCATIONAL RESOURCES INFORMATION
CENTER (ERIC)
AThis document has been reproduced
as
received from the person or organization
originating it.
Minor changes have been made to
improve reproduction quality.
Points of view or opinions stated in this
document do not necessarily represent
Administration
erdlililltisoujces and
official OERI position or policy.
latemal and Child Health
Child Health USA 20
1
U.S. Department of Health and Human Services
Health Resources and Services Administration
Maternal and Child Health Bureau
3
3
founmwas
58
Hospital Utilization
32
Child Mortality
LETTER FROM DR. VAN DYCK ..
. .5
60
Prenatal Care
Childhood Deaths Due to Injury
33
Adolescents
6
INTRODUCTION
62
IV. STATE-SPECIFIC DATA
34
Physical Activity and Overweight
Prenatal Care, Low Birth Weight,
36
Sexual Activity and Condom Use
I. POPULATION
. .63
and Births to Women Under 18 .
37
10
Adolescent Childbearing
CHARACTERISTICS
.
Medicaid Recipients, Expenditures
38
Adolescent STD s
Population of Children
11
64
and EPSDT Services
39
Abortion among Adolescents
12
Children in Poverty
65
SCHIP Enrollees
.40
Adolescent AIDS, by Race/Ethnicity
13
School Dropouts
66
Health Insurance Status
Adolescent AIDS, by Gender
41
14
Working Mothers/Child Care
67
Uninsured Children (Map)
.42
Young Adult AIDS, by Race/Ethnicity
16
Maternal Age
68
Infant and Neonatal Mortality
43
Violence
44
17
Cigarette Smoking
H. HEALTH STATUS
69
V. CITY DATA
45
Infants
Substance Abuse
70
Low and Very Low Birth Weight
46
Adolescent Mortality
18
Infant Feeding
71
Infant Mortality
Adolescent Deaths Due to Injury
47
20
Low Birth Weight
72
Prenatal Care
21
Very Low Birth Weight
III. HEALTH SERVICES
22
International Infant Mortality
48
VI. HEALTHY PEOPLE
23
UTILIZATION
Infant Mortality
73
2010 OBJECTIVES
49
.24
Health Care Financing
Neonatal and Postneonatal Mortality
76
References
50
25
Vaccination Coverage
Maternal Mortality
79
Contributors
51
Children
Immunization Schedule
52
27
Dental Health
Vaccine-Preventable Diseases
54
28
Physician Visits
Child Abuse and Neglect
55
29
Place of Physician Contact
Pediatric AIDS
Service Utilization by Children with
30
Hospitalization
56
Chronic Conditions
Hospital Discharge Trends
31
5
-
,
t
,
,
,
5
Please note that Child Health USA 2000 is
toward the goals set out in the MCHB's strate-
Dear Colleague:
not copyrighted. Readers are free to duplicate
gic planto eliminate barriers and health dis-
and use all or part of the information con-
parities, to assure quality of care, and to
The Health
and
Services
Resources
tained in this publication. The book is available
'improve the health infrastructure and system.
Administration's Maternal and Child Health
Single
online at http: / /www.mchb.hrsa.gov.
Child Health USA is published to provide
Bureau (MCHB) is pleased to present Child
copies of this publication are also available at
the most current data available for public
Health USA 2000, the eleventh annual report
no cost from the National Maternal and Child
health professionals and other individuals in
on the health status and service needs of
Health Clearinghouse, 2070 Chain Bridge
the private and public sectors. The book's suc-
To assess the Bureau's
America's children.
Road, Suite 450, Vienna, VA 22182-2536, tele-
cinct format is intended to facilitate the use of
progress toward achieving its vision for a
phone: [phone] or [phone].
the information as a snapshot of measures of
Nation where all individuals enjoy equal access
I hope the information provided in Child
children's health in the United States.
to quality health care in a supportive, culturally
Health USA 2000 is a valuable resource for
Population
The
first section,
competent, family and community setting,
your efforts to plan, implement, or expand pro-
Characteristics, presents statistics on factors
MCHB has compiled this book of secondary
grams that affect the health of children in the
that influence the well-being of children. The
data for 59 health status indicators. It provides
United States.
second section, entitled Health Status, contains
both graphical and textual summaries of data
vital statistics and health behavior information
and addresses long-term trends where applica-
for infants, children, adolescents, and women
Sincerely yours,
ble.
of childbearing age. The third section, Health
Data are presented for the target popula-
Services Utilization, contains data regarding
tions of Title V funding: infants, children, ado-
health care financing and newly implemented
lescents, children with special health care
health policies. The fourth and fifth sections
In
needs, and women of childbearing age.
contain information on selected indicators at
addition to population characteristics,
this
Peter C. van Dyck, M.D., M.P.H.
This edition also
the state and city levels.
book also addresses health status and health
Associate Administrator for Maternal and
includes a special section that lists the Healthy
Child Health USA 2000
services utilization.
Child Health
People 2010 Objectives for Maternal, Infant,
also provides insight into the Nation's progress
and Child Health.
7
6
T;.-,,JP5rvAlFqt*4zk
INTc., ODUCTION
months of pregnancy) went up for the ninth
of preventive health benefits for both mother
consecutive year, with nearly 83 percent of
and child. The benefits of breastfeeding
Early childhood is a critical time in chil-
women receiving care in the first trimester.
include prevention of diarrhea and infections
dren's physical, emotional, and intellectual
in infants, as well as long-term preventive
However, this percentage is significantly lower
development, a time when children's environ-
for minority women; only 73 percent of
effects for the mother, including earlier return
ment can have the greatest influence on their
African-American mothers and 74 percent of
to pre-pregnancy weight and reduced risk of
In addition to the effect of
future success.
Hispanic mothers received early care. African-
premenopausal breast cancer and osteoporosis.
positive relationships with parents and care-
In 1998, more than 64 percent of mothers
American and Hispanic women are also more
givers and the influence of early childhood
likely to begin care late in pregnancy or to
reported breastfeeding their babies right after
education on the social and intellectual devel-
delivery, the highest rate in recent years.
deliver with no prenatal care at all.
opment of children, many important steps
Young mothers are particularly likely to
However, rates of breastfeeding decline dra-
taken before and soon after birth can greatly
enter prenatal care late in pregnancy, and the
matically after the initial months of life, and
influence children's health and physical devel-
children of teenage mothers are more likely to
only 29 percent report that they are still breast-
opment. These include early and adequate pre-
face economic, health, and developmental chal-
feeding their infants at 6 months of age. These
natal care, breastfeeding, and immunization.
Another area in which we have seen
lenges.
the United
rates are even lower among African-American
Fortunately,
States has
seen
progress, is in the rate of births to adolescent
women and young mothers; 45 percent of
progress in recent years in many of these areas.
women. In 1998, the birth rate among adoles-
African-American women report breastfeeding
However, many threats to the lives and health
cents was 51 births per 1,000 women aged 15-
in the hospital, and only 19 percent breastfed at
of young children (as well as older children and
19, the lowest rate reported since 1987.
6 months.
adolescents) remain, and significant effort is
However, again, teen birth rates are much high-
An early indicator of the health of infants
still needed to assure the healthy development
er within minority groups:
for African-
is their birth weight. Babies born at low birth
of America's children.
Americans, the adolescent birth rate in 1998
weight (less than 2500 grams, or 5.5 pounds)
One of the earliest steps we can take for
was 85 births per 1,000 women 15-19, and for
are most susceptible to physical disabilities,
to assure that pregnant
children's health is
Hispanics, the rate was 94 births per 1,000
and infant
developmental
women have access to prenatal care early in
delays,
death.
women.
Despite improvements in the use of prental
pregnancy and that they receive appropriate
Breastfeeding is another important contrib-
care, the rate of low birth weight has actually
care throughout pregnancy. In 1998, the per-
utor to the health of young children, and rates
risen in recent years; the rate reported in 1998
centage of births to women who received early
of breastfeeding have also shown improve-
prenatal care (beginning in the first three
was 7.6 percent of all live births, which is sim-
ment in recent years. Breast milk has a number
ilar to the rates seen thirty years ago. However,
7
N'FIR 1)1
The major risks to children's health and
their
tance of putting infants down to sleep on
the causes of these rates of low birth weight
development, particularly after infancy, are
in
backs.
appear to be changing. The recent increases
largely preventable. The leading cause of death
As children grow, preventive health care is
the low birth weight rate, at least among white
is injury, including
for children over age
essential for monitoring their health and devel-
in the
1
women, can be attributed to increases
motor vehicle crashes, firearms (including
opment and assuring that they receive the rec-
rate of multiple births, as twins and triplets are
In 1998, injuries
homicides), and drowning.
ommended series of immunizations. The per-
at particular risk for being small at birth.
caused the deaths of 6,420 children under age
centage of 19- to 35-month-old children who
Another important risk factor for low birth
15. Other leading causes of death in childhood
had been fully immunized in 1998 was the
weight is smoking during pregnancy.
neoplasms, or
are birth defects and malignant
highest ever recorded, with 78 percent of chil-
Another sentinel indicator of the health of
dren receiving all recommended vaccines.
cancer.
young children is the rate of infant
mortality.
As we focus our attention on the health and
However, approximately 1 million children still
In 1998, the infant mortality rate remained
developmental needs of young children, we
need one or more of the recommended doses
steady at 7.2 deaths per 1,000 live births, the
crit-
must not forget that adolescence is another
of vaccine to be fully protected.
lowest rate ever recorded in the U.S. However,
Lifetime health
ical period in children's lives.
Children are more likely to have access to
this rate still ranks 26th among the industrial-
habits, both positive and negative, are formed
both preventive and acute health care, in infan-
ized nations of the world. In addition, the mor-
during the teenage years, and the groundwork is
adolescence,
cy and throughout childhood and
tality rate among African-American infants is
laid for the health of the next generation.
if they have a source of comprehensive health
still more than twice that of whites. The lead-
While most adolescents are generally healthy,
In 1998, nearly 16 percent of chil-
coverage.
ing causes of neonatal mortality, or death in the
significant threats to adolescent health remain.
dren, or over 11 million children, were unin-
first 28 days of life, are birth defects and disor-
One of the greatest of these threats is cigarette
sured, a proportion that was unchanged from
ders related to short gestation (preterm deliv-
smoking, which, when begun in the teen years,
1997. This proportion varies across the coun-
Neonatal deaths
ery) and low birth weight.
1999,
can have lifelong health consequences. In
in
try, from 6 percent in Nebraska to 26 percent
make up two-thirds of all infant deaths. The
the percentage of eighth-graders who smoke
Arizona and Texas. However, the implementa-
leading causes of postneonatal mortality, or
decreased to 18 percent, while the percentage
tion of the State Children's Health Insurance
death between 28 days and 1 year of age, are
of tenth- and twelfth-graders who smoke
Program in all 50 states has improved access to
Sudden Infant Death Syndrome, or SIDS, and
remained steady at 26 and 35 percent, respec-
health insurance for low-income children, and
birth defects. The rate of SIDS has dropped
tively. The prevalence of smoking among teens
by the end of 1999 these programs had
dramatically in the past five years, as parents
has increased substantially since 1991.
enrolled two million children.
and caregivers have learned about the impor-
9
8
ONTR OLT= I%
Other important threats to the lives and
tary, and professional organizations, in 28 focus
health of adolescents include injury, particular-
The 23 objectives in the Maternal,
areas.
ly motor vehicle crashes, the leading cause of
Infant, and Child Health focus area are includ-
death among teens aged 15-19; sexually trans-
ed here. Although the methods used to calcu-
mitted diseases; substance abuse; and violence.
late the specific statistics in this book may not
Motor vehicle crashes caused the deaths of
precisely coincide with the way these national
5,213 15- to 19-year-olds in 1998, and firearms
and state-level objectives are measured, the
were the cause of death for another 3,593 ado-
:;-;information presented here will provide readers
lescents. The number of AIDS cases reported
with timely and accurate data that allows for an
in adolescents and young adults has declined in
overview of the current status of child health.
recent years, and rates of other reportable sex-
ually transmitted diseases, including chlamydia,
gonorrhea, and syphilis, appear to be decreasing
as well. However, STDs still affect thousands
of adolescents and young adults each year and
can have lasting health effects if not adequately
treated.
The statistics presented here paint a picture
of continuing progress toward the goal of
healthy children and families, but we still have a
long way to go in many areas. On the National
level, the U.S. Department of Health and
Human Services has launched Healthy People
2010, a revised set of health objectives for the
Nation that focuses on two major goals:
increasing the quality and years of healthy life
and eliminating health disparities. These goals
10
are reflected in 467 specific objectives, devel-
oped by a consortium of government, volun-
9
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