2008: February | October | December
2007: January | February | April | May | June | August | October
2006: January | February | March | April | May | June | July | August
September | October | November | December
2005: September | October | November | December
Publications from 2008:
December:
It Is Time! Accelerating the Use of Child Health Information Systems to Improve Child Health
A new supplement to Pediatrics explores the state of the science and practice for child health information technology (HIT). This supplement was led and edited by faculty from CPRC and includes new data on the use of HIT in practices and hospitals, as well as commentaries on the opportunities for HIT applications to improve pediatric safety, quality, and outcomes. The table of contents and abstracts are available from the journal's website.
A new supplement to Pediatrics explores the state of the science and practice for child health information technology (HIT). This supplement was led and edited by faculty from CPRC and includes new data on the use of HIT in practices and hospitals, as well as commentaries on the opportunities for HIT applications to improve pediatric safety, quality, and outcomes. The table of contents and abstracts are available from the journal's website.
To read more download the PDF.
October:
What We Know About Prevention of Pre-Term Birth
The purpose of this Policy Brief is to summarize what is known about the contributors to preterm birth and present summaries of several recent national recommendations to address preterm birth. Today 13% of U.S. births occur before 37 weeks gestational age, often leading to a personal and financial tragedy for families and significant public policy implications, including alarmingly high health care expenditures and a significant loss of well-being and workforce productivity. The second issue of our policy brief series reviews what is known about the contributors to prematurity and its impact as well as recent national recommendations to reduce prematurity.
To read more, you can download an executive summary or the complete Policy Brief as PDF files.
February:
What We Know About the Effect of Insurance Expansions for Children
The purpose of this Policy Brief is to summarize what has been learned about the effects of SCHIP on children and to look more closely at the eligible but uninsured children. It is divided into three major sections. The first section summarizes the evidence on the effects of the SCHIP program on health care access and outcomes for the children that SCHIP did reach. The second section describes patterns of enrollment, explores insurance instability for eligible but uninsured children, and answers the question of whether (and to what degree) attention is focused on enrollment of new children vs. retention of children in the SCHIP program. The final section provides an overview of the current range of issues being considered or proposed to promote the quality of the program and the services it supports.
To learn more, you can download this Policy Brief as a PDF file.
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Publications from 2007:
October:
Infant Mortality Summit: Taking Action to Prevent Infant Death in Hamilton County
The 2007 Summit, “Taking Action to Prevent Infant Death in Hamilton County”, brings together leaders from social services, faith-based organizations, public-health, public-policy, and health services within Greater Cincinnati.
The 2007 Summit had three primary purposes:
• To convene stakeholders and community leaders
• To achieve a common understanding of infant mortality and its preventable causes and risk factors
• To develop an action agenda for reducing infant mortality in Hamilton County and greater Cincinnati
To learn more about the 2007 Infant mortality Summit you can download the PDF here.
August:
Reauthorizing SCHIP: Opportunities for Promoting Effective Health Coverage and High-Quality Care for Children and Adolescents
A new report from The Commonwealth Fund, Reauthorizing SCHIP: Opportunities for Promoting Effective Health Coverage and High-Quality Care for Children and Adolescents, says that Congress and the nation have a historic opportunity to build on these gains. The report, written by a team of noted child health policy experts, presents a framework for promoting effective health coverage and achieving high quality in both SCHIP and Medicaid, the other major public program that covers low-income children.
To learn more, you can download the full report as a 437K PDF file.
June:
Community Collaborative to Reduce Childhood Obesity
Eating Smart. Living Fit. These two straightforward messages are at the heart of a new collaborative in the Cincinnati region. The Collaborative has produced a comprehensive action plan targeted for many audiences. Families, children, schools, health care providers, recreation sites and the community at large all have a role in reducing childhood obesity.
For more information on the Collaborative, link to a copy of the action plan (292kb) in portable document format (.pdf).
May:
Transforming the US Child Health System
The system of care for child health in the Unites States is fragmented, expensive and ineffective. Neal Halfon and his colleagues present evidence to make the case for transformation. A long-term strategy for improving the child health system in our country focuses on multiple levels of integration, finance reform and solid measurement of child health outcomes. Read the entire Health Affairs article (154kb).
Agenda for Southwest Ohio's Children
An Agenda for Southwest Ohio's Children (270kb) was published in January 2007 as Governor Ted Strickland was being sworn into office.
The Agenda is a product of a collaborative of child health and well-being organizations in SW Ohio, highlighting health, early care and education and economic security for our region's most vulnerable children. It implores state legislators to consider the evidence presented and pass a reasonable state budget that addresses children's needs.
April:
2004 Infant Mortality Data Available for City of Cincinnati and Hamilton County
Infant mortality rates for 2004 reveal that the infant mortality rate (deaths of infants before their first birthday) for Hamilton County and City of Cincinnati in 2004 are higher than any reported in the last 10 years. Many use the infant mortality rate as an indicator of the health of the population overall. This graph shows the infant mortality trend over the years for Cincinnati, Hamilton County and New York City as a comparison.
February:
New statistical profiles
The two new statistical profiles, describing Covington, Kentucky and the three Price Hill neighborhoods on Cincinnati's west side, are now available online.
The two reports combine basic population and socio-economic data from the 2000 Census with the latest indicators on maternal and infant health derived from state birth certificate files. Although 2000 Census data may be somewhat outdated at this point, it remains the most current source for detailed tabulations of demographic, social, and economic characteristics for small geographic areas such as city neighborhoods.
The selected indicators show, for instance, that child health and well-being is especially endangered in Cincinnati's Lower Price Hill neighborhood, with extremely high rates of poverty, failure to complete high school, and maternal smoking.
January:
How healthy are Butler County, Ohio, children?
The CPRC has published a report on the health and well-being of children living in Butler County. The report combines data from the Census, birth certificates, the Child Well Being Survey, and various health and wellness indicators to examine the overall well-being of children in this community. Also on the CPRC Research webpage, you will find Avondale, Price Hill and West Chester/Liberty Township community health profiles. In the future, be sure to locate the CPRC website for more well-being profiles of local neighborhoods/counties.
Reducing ER Visits for Asthma through Educational intervention
Approximately one million visits to the emergency department are made annually by children with asthma. Emergency care is not only more costly than primary care; it also has not traditionally focused on long-term aspects of care. Recently, the Managing Pediatric Asthma: Emergency Department Demonstration Program (EDDP), a national initiative funded by the Robert Wood Johnson Foundation, showed how the cycle of dependence on emergency care by child asthmatics can be reduced. Through early and consistent education, four U.S. test sites were able to reduce emergency department visits for childhood asthma.
Learn more about the educational interventions used by hospitals in the EDDP.
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Publications from 2006:
December:
The "Hidden Uninsured"
An article in the July 2005 New England Journal of Medicine shows that gaps in insurance status impact access to and use of ambulatory care visits among children in the US. In this study, authors explore in detail the effects of being the "hidden uninsured" or persons experiencing discontinuity in insurance coverage on health care. Data from two years of the National Health Interview Surveys was used to compare access to care among three groups, the fully insured, the part-time insured, and the fully uninsured. They find children with no insurance as well as children with gaps in coverage fare worse than their fully insured counterparts. Children with gaps in coverage were less likely to seek medical care such as preventive care visits and also were less likely to get needed prescriptions. Until recently, this subgroup of the uninsured had been ignored, especially among the child population. More studies are needed to assess the impact of discontinuity of health care insurance on the health and well-being of our children.
For more information about this recent research, the CPRC has provided a PDF file of this New England Journal of Medicine article on its web site.
November:
Infant Mortality Web Page
The CPRC has devoted an entire web page to infant mortality.
The page, which can be accessed from the left side navigation by selecting Infant Mortality --> Infant Vitality, includes reports on:
- population trends and child/infant death
- African American infant death in Hamilton County, Ohio
- the impact of infant mortality
- infant deaths in Hamilton County, 2004, and
- recommendations designed to reduce the infant mortality rate.
October:
Early Childhood Measures
Want to learn about the health of young children locally, in the state of Ohio, or nationally? Research on the health of this age group is now available at the CPRC website under the CPRC Research link. We provide data on various health measures for children ages 0 to 5 in the Tri-State area, Ohio, and the U.S. More health data on this age group is also available on the CPRC website under Child Well Being.
Look for the report prepared for the United Way of Greater Cincinnati, Success by Six. If you are interested in the health and well-being of older children (6 to 17), access the report prepared for the United Way of Greater Cincinnati, Thriving Children Vision Council.
Racial Gap in Childhood Vaccination Rates Closed
In 2005, for the first time, the overall vaccination rates among children ages 19 months to 35 months did not vary by race or ethnicity in the U.S., according to the CDC. Improvements have been occurring over the past five or six years and finally in 2005, the vaccination rates for U.S. Black children caught up with the rates for children in other racial and ethnic groups. The CDC warns data could change next year; therefore, efforts must continue to maintain this progress.
September:
Disparities in Health Insurance Coverage among Working-age Adults
"Health Care Disconnect: Gaps in Coverage and Care for Minority Adults: Findings from the Commonwealth Fund Biennial Health Insurance Survey," a report by The Commonwealth Fund, finds that nearly two-thirds (62%) of working-age Hispanics and one-third (33%) of African Americans were uninsured at some point during 2005, compared with 20 percent of working-age white adults.
Read the full report.
Children Living in Homes with Insufficient Food
In a recent Social Science & Medicine article, researchers examine the relationship between family food insufficiency and being overweight among children. The study finds that infants, birth to 1 ½ years, who lived in homes with insufficient food were 3 times more likely to be obese at age 4 ½. Read more about this research.
August:
Health Insurance Coverage Among Children
The percent of children without health insurance has declined in recent years in the U.S., Ohio, and Greater Cincinnati.
The State of Kids' Coverage, a national report commissioned by the Robert Wood Johnson Foundation, details insurance coverage patterns at the national and state level among children in 2003/2004 and 1997/1998. Locally, the 2000 and 2005 Child Well Being Survey provides health insurance data on children living in the Tri-State region. View a comparison table of data on child health insurance coverage and a brief description of the national report's findings compared to an analysis of local data.
July:
Practical Health Strategies to Help Childhood Obesity
Childhood obesity in the U.S. has reached epidemic proportions. More than 9 million children and adolescents suffer from obesity. Recently the American Academy of Pediatrics (AAP) released practical strategies geared toward parents to help alleviate this growing health problem among children. Sandra Hassink, editor of the book, titled Parents Guide to Childhood Obesity: A Road Map to Health by the AAP, encourages parents to work closely with pediatricians, family members, and schools to monitor their children's health. Parents are urged to be role models of healthy eating habits for their children. The guide provides techniques on preparing nutritious foods and increasing physical activity among family members. Most importantly, this guide provides evidence-based research on the physical and emotional challenges associated with childhood obesity.
The AAP also recently directed a new policy at physicians and health care professionals that addresses the public health concern of childhood obesity. The AAP policy encourages providers, in turn, to work closely with families and communities to improve nutrition and exercise, especially through in-school programs.
Please visit the American Academy of Pediatrics web site to view practical strategies for healthcare providers and parents to improve childhood obesity.
Child Well Being Survey (CWB) 2005
Analysis and reporting of data from the Child Well Being Survey (CWB) 2005 are underway at the Child Policy Research Center (CPRC). The CWB is a joint project of the CPRC at Cincinnati Children's Hospital Medical Center, The Health Foundation of Greater Cincinnati, and United Way of Greater Cincinnati.
A total of 1,559 randomly selected caregivers (primarily parents) of children under the age of 18 residing in 5 geographic regions in the tri-state were interviewed by telephone in 2005. The survey provides data on the well-being of children who live in the tri-state area. Health measures include access to care, physical and social-emotional health, child care arrangements, food security questions, middle adolescent behaviors, and parents' perceptions of child substance abuse.
Results from the survey provide policy makers, decision makers, public agencies, and academicians with population-based information to describe and monitor the health and well-being of children in the area. Data from the CWB survey can be used to guide and implement change in policy to improve the outcomes of our children.
Summary data and interpretation of the CWB 2005 will be available in PDF format at the CPRC's web site, or at the University of Cincinnati web-based on-line statistical tool — http://www.oasis.uc.edu. The CPRC will also produce fee-based custom data reports. Please send requests via email to cprc@cchmc.org or call the CPRC at (513) 636-0180.
Attached is a summary of the survey content and an example of a report based on child health insurance data from the CWB.
Read the editorial from the Sunday, June 18, 2006 issue of the Cincinnati Enquirer.
Measuring the Public's Health
Traditional measures of public health have been centered around the burden of disease, measuring rates of death (mortality), occurrence of disease (morbidity) and effects of disease or conditions (disability). These fall short of measuring the broader definition of health because they focus on negative outcomes of death ,disease and injury. Essential activities of the public health system such as emergency preparedness, surveillance and monitoring and immunizations are also difficult to quantify.
The Center for Disease Control (CDC) has defined specific goals for improving the health of the population. Looking at outcome measures by developmental stage (infant/toddler, adolescent, young adult, older adult), including the impact of social relationships and protective factors will aid in achieving improved health status of the American people.
For more information please see the attached PDF article, Thacker et al in Public Health Reports, Vol 121, No.1: pp. 14-22 [Adobe PDF, 82k].
Bolstering Community Strengths to Reduce Health Disparities
In the December 2005 issue of American Journal of Public Health, Davis et al. describe a community resilience assessment tool named THRIVE, a Toolkit for Health and Resilience in Vulnerable Environments. The purpose of THRIVE is to provide practical ways to improve the health of minority communities in order to reduce well-documented disparities in health and health care. THRIVE concentrates on four areas to improve community health. The factors include community environment (e.g., Safe places to play, housing, transportation, clean air), social capital (e.g., Community engagement, voting, behavior norms), services and institutions (e.g., Availability of public and community based services), and structural factors (e.g., Racial relations, economic opportunities).
Learn more about the pilot study funded to implement THRIVE in three communities.
Living Arrangements of Children
A recent report from the U.S. Census Bureau presents data on the many living arrangement variations of children in the United States. The source for the estimates is the Survey of Income and Program Participation (SIPP), collected in 2001. The survey collects detailed information, from a nationally representative sample of households, on each household member's relationship to every other person in the household. This multi-layered approach permits the identification of many different kinds of parent-child and sibling relationships such as those found in blended families, going far beyond the somewhat limited household and family types reported in the 2000 Census and other periodic surveys.
The diversity of children's living arrangements in the U.S. grows out of the marriage, divorce, remarriage, and cohabitation patterns of their parents. Adding to the fragmentation is the fact that out-of-wedlock childbearing now accounts for one third of all American births.
The report provides tabulations by race / ethnicity and poverty status. A few notable points:
- More than 51 million children, or 71% of all children under 18 living in households, lived with two parents. Among children in two-parent households, 88% lived with their biological mother and father.
- Fifteen percent of children lived in blended families, which are characterized by the presence of a stepparent, stepsibling, or half-sibling.
- Three out of five children (60%) live with both biological parents, who are married. Among black children, this share is only 29%.
- One third of children living with an unmarried parent were in families below the poverty level. In contrast, only one tenth of children living with married parents were below poverty level.
For more information, including the complete report in PDF along with supplemental tables, visit www.census.gov/population/www/socdemo/children.html.
February:
On the Preservation of Health
Chronic diseases and conditions impact the quality of life for most Americans. Many chronic health conditions have their roots in childhood and adolescence.
A life course approach to address and mediate factors and behaviors that influence health and well-being is suggested by the author of the attached article [Adobe PDF, 55k] as a way to preserve and maximize one's health throughout the lifespan.
The Child Well-Being Survey 05/06
The 2003 National Survey of Children's Health (NSCH) provides state and national data on various measures of child health and well-being. In an online resource database, state profiles of NSCH survey data can be compared to national estimates to track the health of area children. View Ohio's NSCH data profile.
During the fall/winter of 2005, the CPRC conducted the Child Well-Being Survey to gather data on similar child health and well-being measures. The telephone survey was administered to randomly selected families in the designated multi-county region in southern Ohio and northern Kentucky. Analysts at the Child Policy Research Center will analyze and report on the collected data by Spring 2006.
January:
Neighborhood Safety and Childhood Overweight Status
Do parents' perceptions of neighborhood safety limit outdoor physical activity? Are these perceptions of neighborhood safety associated with overweight status in children? In the most recent issue of Archives of Pediatric and Adolescent Medicine, researchers found that parental perceptions of unsafe neighborhoods were associated with an increased risk of being an overweight child at age seven years. Maternal marital status, education, and depressive symptoms, child race/ethnicity, participation in structured after-school activities, measurement of the home environment scores, and neighborhood social cohesiveness did not alter this association.
Download a PDF with a more detailed description of this study's findings and policy implications.Back to top
Publications from 2005:
December:
Health Insurance Coverage Estimates
In July, the U.S. Census Bureau released experimental estimates of health insurance coverage for all counties in the United States. The reference year for the estimates is 2000. Previous estimates of the uninsured population have been made only for larger geographic areas such as states and the nation, but this ambitious project covers all 3,140 counties across the 50 states and District of Columbia. There is no other source of county-level data on health insurance, since neither the decennial census nor the American Community Survey includes questions on the topic.
Because health insurance coverage estimates have never been attempted before at the county level, these estimates are considered experimental. The new program, named Small Area Health Insurance Estimates (SAHIE), uses survey data along with population estimates and administrative records to model health insurance coverage. Inputs to the model are drawn from the following sources:
- the Annual Social and Economic Supplement (ASEC) of the Current Population Survey (CPS);
- population estimates;
- aggregated federal tax returns;
- food stamp participation records; and
- Medicaid participation records.
Estimates are provided for the child population as well as the total population. Click here to view maps and download data files
http://www.census.gov/hhes/www/sahie/data.html.
New Trends in U.S. Births and Fertility Rates
In October 2005, Child Trends, a nonprofit research organization dedicated to improving the lives of children, released a report documenting changes in birth and fertility rates. According to Child Trends, in 2003, teen birth rates declined to the lowest rate ever reported in the U.S. (41.6 per 1,000). However, the U.S. witnessed a dramatic increase in the percentage of births to unmarried women. Specifically, in 1960, 5.3% of births were to unmarried women. In 2003, this percentage has dramatically risen to 34.6%. Large racial and ethnic differences in unmarried births are documented. Non-Hispanic black women are the most likely to have a child while unmarried (68.5% of black births are to unmarried women). Also, age differences exist in trends of unmarried births. Younger women are more likely to give birth while unmarried. Research shows a relationship between high unmarried birth percentages and an increase in cohabitation and giving birth within a cohabiting relationship.
For a more detailed description of the 2003 trends in birth and fertility rates, PDF versions of three Child Trend reports are provided below. Follow the link, http://www.childtrends.org/index.cfm, to access more information on Child Trends and research on improving the lives of children.
October:
Real-World Solutions to Eliminating Racial and Ethnic Gaps in Health Care
In early October 2005, a $23 million dollar commitment was made by the Robert Wood Johnson Foundation (RWJF) to move beyond documenting racial and ethnic disparities in health care to developing and testing solutions to the problem.
Teams at The George Washington University, Harvard University, and the University of Chicago will head the initiatives. The three programs concentrate on measuring and enhancing the quality of cardiac care, awarding and managing grants to organizations implementing solutions through quality improvement agendas, and synthesizing and disseminating the results through technical assistance and leadership.
For a complete description of the three RWJF initiatives, visit the Robert Wood Johnson Foundation site.
A Useful Community-Based Approach to Improving Maternal and Child Health
The RAND Corporation and the University of Pittsburgh, in partnership with Allegheny County's Department of Health and Department of Human Services, developed a community-based approach to improving the health and well-being of mothers, infants, and young children in the Pittsburgh region.
This approach may be applicable to improving maternal and child health in our own community. Similar to efforts in Pittsburgh, our community has a need to improve the health of mothers and children. The Pittsburgh example offers insight in designing a community-based collaborative approach that incorporates best practices, barriers experienced by consumers and stakeholders, and potential solutions.
Below is a PDF document of the report. This full report and a summary are also available at http://www.rand.org/publications/MG/MG225/
September:
Selected highlights from the July/August issue of Public Health Reports, covering child health disparities.
Edward Donovan, MD, and Barbara Rose of the Child Policy Research Center served as guest editors of the July/August 2005 issue of Public Health Reports, the journal of the U.S. Public Health Service. This special issue was devoted to disparities in children's health and health care.
A new supplement to Pediatrics explores the state of the science and practice for child health information technology (HIT). This supplement was led and edited by faculty from CPRC and includes new data on the use of HIT in practices and hospitals, as well as commentaries on the opportunities for HIT applications to improve pediatric safety, quality, and outcomes. The table of contents and abstracts are available from the journal's website.
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