We asked the Co-Chairs of AMCHP’s Emerging Issues Committee to respond to the following question:
Looking at the results of the “Crowd Scan” on top Child Health priorities, is there anything that particularly stands out or resonates with you and your state?
Judy Ganser, MD, MPH
Maternal & Child Health Division
Children’s Special Health Care Services
Indiana State Department of Health
In Indiana, we can certainly relate to the main issues reported in the Child Health Priorities Poll. We know childhood obesity is a problem in Indiana, but do not have a comprehensive surveillance system to show the extent of the crisis. Our data for young children come from the CDC Pediatric Nutrition and Surveillance System, which for Indiana only includes children ages 2-5 on the WIC program. In 2009, 17 percent were overweight and 14 percent were considered obese. According to the 2007 National Survey of Children’s Health (NSCH), approximately 30 percent of Indiana’s children ages 10-17 years are overweight or obese. Because of the lack of overall data for young children, the Division of Maternal and Child Health decided to concentrate on working to decrease the percentage of high school students who are obese. The 2009 Youth Risk Behavior Survey showed that almost 16 percent of Indiana high school students are obese and the rate has been increasing since 2002.
This year, to date, requests for dental providers, mainly for children on Medicaid, is the second highest need of callers to the Indiana Family Helpline (our Title V 1-800 Helpline). The third highest need expressed is for Health and Medical services. The highest number of calls has been for help accessing transportation for medical or dental services. From my perspective the above are all access issues. In addition, we are seeing an increase in calls for Spanish Services, financial assistance and help with food and clothing. The poor economic situation is having an impact on the population who seek information from our Helpline. More and more we are realizing, as my colleague, Indiana’s MCH Director Mary Weber reminds me, “that these problems are related from a life course perspective – with poverty being an underlying cause of lack of access to health care providers, lack of transportation and minimal access to fresh fruits and vegetables, as well as safe streets/sidewalks/parks for exercise.”
Marilyn Kacica, MD, MPH
Division of Family Health
New York State Department of Health
The top four “child health priorities” are consistent with current New York state efforts. The major effort in NY revolves around “Redesigning the Medicaid Program.” Significant reforms include:
· A major expansion of patient-centered medical homes
· Better control of home health care services
· Care management for individuals with complex and continuing health care needs
We will be looking to provide improved care management of Children and Youth with Special Health Care Needs (CYSHCN) within a medical home. Obesity and Overweight will need to be better managed, as well as other chronic diseases such as asthma and diabetes. The issues of access to care, including dental care and insurance coverage, will be highlighted in the implementation of the Affordable Care Act. There will be critical discussions on Preventive Care Guidelines and Health Insurance benefit packages.
It is important to note that all our work includes a focus on reducing child health disparities.