By Kate Howe, MPH
Program Manager, Child Health, AMCHP
Caroline Stampfel, MPH
Senior Epidemiologist, AMCHP
In preparation for this issue on Child Health, we sent a brief survey to Pulse readers asking: “What is a top child health priority in your state?” Within one week, we had over 570 responses! The responses covered a wide range of topics, though overwhelmingly people mentioned child obesity and overweight as a top priority. The breadth of responses gave us a quick glimpse into what people are doing and thinking around child health. A brief summary of the top 10 responses is below:
- Obesity and Overweight (24.3 percent): Nearly one fourth of respondents named addressing and preventing obesity and overweight as a top priority for children’s health. Responses focused on healthy weight, active living, healthy eating, nutrition, physical activity and early prevention.
- Dental care / Oral health (12.3 percent): Oral health and dental care for children was the second most cited priority (12.3 percent). Responses focused on access to and adequate insurance coverage (particularly Medicaid/state health insurance) for dental care. Preventive care and dental caries were specifically mentioned by several respondents, as were beginning dental care early on and continuing dental care throughout the lifespan.
- Access to care (12.1 percent): Access to comprehensive care (including medical, dental, mental health, primary care, specialty care, etc.) was also a popular priority. Not having insurance and lack of affordable care were mentioned as top barriers to access. Racial disparities in access and barriers related to access rural locales were also mentioned in several responses.
- Insurance, coverage, Medicaid, SCHIP (9.8 percent): Health insurance coverage, particularly coverage for all children, and affordable coverage were top themes within this category. Other recurring themes within this category included Medicaid reimbursement rates and funding, CHIP, program eligibilities and coverage that meet children’s “physical, mental, developmental and oral health needs.”
- Injury and Violence (6.5 percent): Responses in this category included those related to unintentional and intentional injuries, and violence, including exposure to violence in the home. Specific examples of injury and violence were motor vehicle accidents, traumatic brain injury and bullying.
- Mental health (6.3 percent): The majority of responses focused on increasing access to and the affordability of mental health care and services. Others included mental health promotion and increasing services and provider training for early childhood mental health services.
- Maltreatment, abuse, neglect (4.0 percent): Prevention of child abuse, maltreatment and neglect was recognized as a priority, including child exploitation and prevention of adverse and traumatic experiences. While some responses overlapped with Injury & Violence, most cited maltreatment, abuse and neglect separately as public health issues.
- Immunizations and vaccines (3.9 percent): Improving immunization and vaccines rates, and expanding coverage rates, were listed as important preventive public health priorities for children.
- Nutrition, hunger, and food security (3.3 percent): Several respondents listed proper nutrition as a separate top priority. Responses addressed food security, hunger and poverty as barriers to good nutrition and healthy eating.
- Substance use or abuse (3.0 percent): This includes health issues due to substance use, as well as those due to parental substance use/abuse (such as neglect and child abuse) and exposure to substances, such as second-hand smoke.
Click here to view quick statistics of the top responses to our poll.
So what does this tell us?
The survey results provide a snapshot of the health burdens that children in our nation face every day, and are telling of the larger problems that impact children’s overall health. The common bond that ties these results is how these health outcomes are deeply rooted to social, biological, economic and environmental factors that are often compounded together. It is hard to pick just one child health priority – in fact, many responders stated two, three or even four issues as top priorities.
For example, a family with no health insurance does not have the incentive, financial means and support to take a child to the doctor for annual physical exams, routine preventive care, vaccines and dental check-ups. A child without access to healthy foods, safe places to live and play, and a supportive home environment is at risk for poorer physical and mental health. A comprehensive approach helps ensure that children do not fall through the cracks of our health system. This issue of Pulse contains several examples of how states are doing just that – addressing child health issues while taking into account how other health, environmental, social and system factors affect outcomes and working to build collaborations that increase capacity to improve children’s health across the lifespan.
For other reactions to this survey, read the Member to Member column for perspectives from the states.