Policy Information Center Library Blog

http://www.mchb.hrsa.gov/chusa_06/pages/pdf/c06.pdf

U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau

"The Health Resources and Services Administration’s Maternal and Child Health Bureau (MCHB) is pleased to present Child Health USA 2006, the 17th annual report on the health status and service needs of America’s children. The Bureau’s vision is that of a future nation in which the right to grow to one’s full potential is universally assured through attention to the comprehensive physical, psychological, and social needs of the maternal and child population. To assess the Bureau’s progress toward achieving this vision, MCHB has compiled this book of secondary data for more than 50 health status and health care indicators. It provides both graphical and textual summaries of relevant data, and addresses longterm trends where applicable and feasible.
All of the data discussed within the text of these pages is from the same sources as the information in the corresponding graphs (unless otherwise noted). Data are presented for the target populations of Title V funding: infants, children, adolescents, children with special health care needs, and women of childbearing age. Child Health USA 2006 addresses health status and health services utilization, as well as insight into the nation’s progress toward the goals set out in the MCHB’s strategic plan—to assure quality of care, eliminate barriers and health disparities, and improve the health infrastructure and systems of care."

Labels: Child Health

http://www.cdc.gov/pcd/issues/2007/jul/pdf/06_0094.pdf

Preventing Chronic Disease

"Results
We estimated that 46.4% of older Americans engaged in no leisure-time aerobic activity; that 26.1% were regularly active (participated in light- to moderate-intensity aerobic activities at least 5 days per week for at least 30 minutes or vigorous-intensity activities at least 3 days per week for at least 20 minutes); that 16.2% participated in vigorous-intensity aerobic activities at least 3 days per week for at least 20 minutes; that 13.7% participated in strength-training activities at least 2 days per week; and that 24.5% participated in flexibility activities at least 1 day per week. Among the 26.1% of older Americans who were regularly active, 30.5% engaged in strengthen-training activities at least 2 days per week. Overall, only 8.2% of older Americans met the criteria for both aerobic and strength-training activity.

Conclusion
As of 2001, the percentage of older Americans who met recommended activity levels of physical activity were well below the goals for U.S. adults in Healthy People 2010. Further efforts are needed to encourage older Americans to engage in aerobic activities and in strengthening and flexibility activities."

Labels: Elderly, Exercise

http://www.kidscount.org/sld/db_07pdf/databook.pdf

Annie E. Casey Foundation

"About 11% of U.S. children lack health insurance, according to the 18th annual "Kids Count" reports. The report measured the progress of each state since 2000 in 10 areas -- infant mortality rates, teenage birth and mortality rates, child mortality rates, rates of low-birthweight infants, and child poverty rates -- based on Census Bureau data from 2004 or 2005, the most recent information available.

The report found that Minnesota, New Hampshire and Connecticut ranked the highest overall and that Alabama, Louisiana and Mississippi ranked the lowest. According to the report, the national infant mortality rate decreased to 6.8 per 1,000 live births in 2004 from 6.9 per 1,000 in 2000. The report also found that the national birth rate among teens ages 15 to 19 decreased to 41 per 1,000 in 2004 from 48 per 1,000 in 2000 and that the mortality rate among teens ages 15 to 19 decreased to 66 per 100,000 in 2004 from 67 per 100,000 in 2000."

Labels: Children, statistics

http://www.urban.org/UploadedPDF/411475_low_income.pdf

Urban Institute

"This paper for the Charles Stewart Mott Foundation conceptualizes a framework for a new safety net for low-income working families that is rooted in their most essential needs. It is organized around five key goals:

1. enabling parents to meet their family’s needs while working in lower-wage jobs,
2. helping families weather gaps in parental employment,
3. supporting parents’ job advancement,
4. helping parents combine work and child-rearing, and
5. improving children’s well-being and development.

The paper describes these families’ circumstances, discusses gaps in current safety-net programs, and explores possible alternative approaches to meeting families’ most pressing needs."

Labels: low-income, Working Parents

http://www.chcf.org/documents/insurance/EmployerHICostsUS.pdf

California Healthcare Foundation

"Key findings include:
• While wages and salaries increased by 39 percent between 1996 and 2005, health insurance costs to employers rose 97 percent.
• At offering businesses, the share of total compensation paid as health insurance rose from 6 to 8 percent from 1996 to 2005. As health insurance costs increased, the share of compensation paid as wages fell.
• Of those businesses that offered insurance, costs relative to payroll increased 34 percent between 1996 and 2005.
• Premium contributions as a share of payroll were highest for unionized businesses, businesses with a high share of full-time workers, and low-wage businesses.
• Although the increase in health insurance costs was similar across businesses, increases were highest for low-wage businesses. This may be due in part to the fact that compensation for high-wage businesses has increased substantially, while for low-wage businesses it has been stagnant."

Labels: health insurance costs

http://www.ahrq.gov/prep/nursinghomes/nhomerep.pdf

Agency for Healthcare Research and Quality, HHS

"To date, most health care preparedness planning efforts have been focused on hospital and first responder preparedness. Nevertheless, the elderly are particularly vulnerable to bioterrorism and other public health emergencies due to their complex physical, medical, and psychological needs. The potential role and question of preparedness on the part of nursing homes has emerged in local and national preparedness discussions. However, little is known about the extent to which nursing homes have planned for and/or been incorporated into regional planning efforts
To address this issue, a series of focus groups was conducted to collect information about disaster- and bioterrorism-related planning activities among nursing homes in five States—North Carolina, Oregon, Pennsylvania, Washington, and Utah—and southern California. The aims of the focus groups were to:
--Determine if nursing home administrators have prepared and trained staff on disaster plans, including bioterrorism response.
--Assess the special needs of the elderly population in nursing home settings during a public health emergency.
--Determine if nursing homes are able to accommodate patient flows from acute care hospitals or provide other resources.
--Assess the impact of State regulations on the ability of nursing homes to offer support and/or surge capacity.
Findings from this report can provide important insight into current nursing home preparedness activities as well as the potential role of nursing homes in larger local or regional preparedness efforts and the special needs of the nursing home population. "

Labels: nursing homes, public health emergencies

http://content.nejm.org/cgi/content/full/357/1/70

New England Journal of Medicine


"The United States relies on voluntary, employer-sponsored health insurance as its preferred way of providing employees and their dependents with financial protection against illness. In 2005, 68.2% of all workers were covered by private insurance, 59.5% of which was employer-sponsored. Of the total U.S. population with coverage of any type, 27.5% relied on government-sponsored insurance. As private insurance has become less affordable and fewer businesses even offer it, the number of employees with such coverage has declined over the past 5 years. A record 46.6 million people were uninsured in 2005 — 15.9% of the population — about two thirds of whom were adults with incomes below 200% of the federal poverty level, which in 2007 is $20,650 for a family of four. Children lost private coverage, too, but most of these losses were offset by expansions in public insurance. Because Democrats and Republicans remain divided over how best to expand coverage, there is no expectation that the new groundswell of interest will translate quickly into the enactment of major reforms. But politicians vying to succeed President Bush already recognize that to be viable, a candidate must propose ways to address what has become a major concern among an increasing number of Americans: the availability of affordable insurance.
Although broader efforts at reform will await the results of the 2008 election, there is strong bipartisan sentiment — reinforced by the need for Congress to reauthorize the State Children’s Health Insurance Program (SCHIP) — that legislation designed to expand coverage should focus on children this year. In this report, I discuss the evolution and track record of SCHIP and the future prospects for extending the program, the legal mandate of which expires on September 30, 2007."

Labels: Children, health insurance

http://www.americanprogress.org/issues/2007/05/pdf/health_it.pdf

Center for American Progress

"The problems are clear: a complex, fractured system of individual and institutional providers, limited ability to share clinical information, and suboptimal care processes has lead to administrative inefficiency and reduced value for our nation’s health care spending. As the report notes, the United States spends more per capita on health care than any other nation on the planet, yet experiences poorer health outcomes, higher levels of preventable illness and disability, and overall lower health status compared to other wealthy nations. Health IT, one of the fundamental building blocks of a reformed health care system, offers the potential to improve health care delivery and patient safety, while creating the information base necessary to identify and implement best practices in health care."

Labels: Health Care, health information technology

http://www.mit.edu/~jjdoyle/doyle_fosterlt_march07_aer.pdf

American Economic Review

"The child welfare system investigates over 2 million children each year for parental abuse or neglect, yet little is known about the effects of removing children from home and placing them in foster care. Long-term outcomes are rarely observed, and children placed in foster care likely differ from those not placed, making comparisons difficult. This paper uses the removal tendency of investigators as an instrumental variable to identify causal effects of foster care placement on a range of outcomes for school-age children and youth. A rotational assignment process effectively randomizes families to these investigators. The results suggest that children assigned to investigators with higher removal rates are more likely to be placed in foster care themselves, and they have higher delinquency rates, teen birth rates, and lower earnings. Large marginal treatment effect estimates suggest caution in the interpretation, but the results suggest that children on the margin of placement tend to have better outcomes when they remain at home, especially for older children."

Labels: Children, foster care

http://www.urban.org/UploadedPDF/311495_Work_Supports.pdf

Urban Institute

"Low-income families in Alaska, Connecticut, Maine, Maryland, Minnesota, New York, Rhode Island, and Vermont received more than $4,000 in work supports per person in 2005, more than double what their counterparts in Idaho, Nevada, and Utah received, an Urban Institute analysis of data for 44 states reveals.
Nationally, federal and state governments spent $3,264 per person on the core work-support programs, which help nonworking parents get jobs and stay employed: Medicaid and the State Children’s Health Insurance Program (SCHIP), Food Stamps, child-care subsidies, and the federal and state earned income tax credits (EITC). Medicaid, SCHIP, and food stamps are available to low-income families regardless of work status; child-care subsidies and the EITC specifically help working families."

Labels: food stamps, Medicaid, SCHIP, work-support

http://childstats.gov/pdf/ac2007/ac_07.pdf

Federal Interagency Forum on Child and Family Statistics

"Compared to national statistics for the previous year, there has been an increase in the percentage of children living with at least one working parent and the percentage of children living in households classified as food insecure has declined. High school students were more likely to have taken advanced academic courses and the percentage of young adults who completed high school has increased. The adolescent birth rate has dropped to a record low.
Increasing were: the percentage of children served by community water systems that did not meet all applicable standards for healthy drinking water, and the percentage of children living in physically inadequate or crowded housing or housing that cost more than 30 percent of household income. The percentage of low birthweight infants also increased, as did the percentage of births to unmarried women. The rate at which youth were perpetrators of serious violent crime increased slightly.
These findings are described in detail in America’s Children: Key National Indicators of Well-Being, 2007, the U.S. government’s annual report that monitors the well-being of the Nation’s children and youth. The report is a compendium of the most recently released federal statistics on the nation’s children, issued by the Federal Interagency Forum on Child and Family Statistics. It presents a comprehensive look at critical areas of child well-being. These encompass family and social environment, economic circumstances, health care, physical environment and safety, behavior, education, and health."

Labels: Children

http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/

National Heart Lung and Blood Institute, NIH

"We Can! or "Ways to Enhance Children's Activity & Nutrition" is a national program designed for families and communities to help children maintain a healthy weight. The program focuses on three important behaviors: improved food choices, increased physical activity and reduced screen time. Read more about the program."

Labels: Childhood Obesity, Children

http://assets.aarp.org/rgcenter/health/fs7r_ltc.pdf

AARP Public Policy Institute

"Relatively few older persons have private insurance that covers the cost of long-term care. Many common long-term care needs (e.g., bathing, dressing, and household chores) do not require skilled help and therefore are not generally covered by private health insurance policies or Medicare.
But without private insurance or public program coverage, the high cost of long-term care is unaffordable for most Americans. The average cost of a nursing home stay is more than $67,000 per year and exceeds $100,000 in some urban areas. The base rate for assisted living facilities is over $35,000 per year. Hourly home care agency rates average $37 for a licensed practical nurse and $19 for a home health aide.
As an alternative to public program coverage and direct payments for services, a market for private long-term care insurance (LTCI) has developed in recent years. However, its overall role is still limited: private insurance currently pays for about 7 percent of all long-term care costs."

Labels: long term care insurance

http://www.gwumc.edu/sphhs/healthpolicy/chsrp/downloads/health_literacy_062207.pdf

George Washington University Medical Center School of Public Health and Health Services

"The policy brief examines the link between children's health insurance status, appropriate use of care and parents' health literacy. The report makes recommendations for SCHIP and Medicaid policies to help improve family health literacy "

Labels: Children's Health Care, health insurance, health literacy

http://www.kff.org/uninsured/upload/7662.pdf

Kaiser Family Foundation

"Providing health coverage for the entire family can both help to increase coverage of children and assist low-income families in obtaining more affordable health care services. This brief uses data from the 2005 Kaiser Low-Income Coverage and Access Survey to examine health coverage, access and the financial impacts of health care for low-income parents and their families."

Labels: uninsured

http://www.kff.org/medicaid/upload/7663.pdf

Kaiser Family Foundation

Some of the reports findings include:

--The number of elderly long-stay nursing home residents (90 days or longer) declined from 1.21 million to 1.06 million between 1999 and 2004, while the demographic profile of these residents changed little during the time period;

--Disease prevalence was higher and multiple conditions were more common among elderly nursing home residents in 2004 compared to 1999 indicating an increasingly sicker population; and

--Medicaid is the main payer for elderly long-stay residents, accounting for 68% of these residents in 2004.

Labels: nursing home residents

http://www.cbo.gov/ftpdocs/82xx/doc8268/06-28-Medicare_Advantage.pdf

Congressional Budget Office

"Medicare provides federal health insurance for 43 million people who are aged or disabled or who have end-stage renal disease. Most receive services through the traditional fee-for-service (FFS) part of the program, which pays providers a set fee for each covered service (or bundle of services). Participants can choose their providers and are not required to obtain prior authorization for any covered service.
Medicare beneficiaries have the option of enrolling in Medicare Advantage–the program through which private plans participate in Medicare–rather than receiving their care through the FFS program.1 They may choose to do so because such plans provide additional benefits beyond those available within traditional Medicare, including coverage for services not covered by FFS Medi- care (for instance, dental services) and cash rebates of premiums or reduced cost-sharing. As of June 2007, about 18 percent of beneficiaries are enrolled in Medicare Advantage plans.2 This brief describes how those private plans function, how they are paid, how their costs com- pare with the costs of traditional Medicare, and how those costs vary by geographic area."

Labels: Medicare Advantage

http://pewresearch.org/assets/social/pdf/Marriage.pdf

Pew Research Center

"--A Generation Gap in Behaviors and Values. Younger adults attach far less moral stigma than do their elders to out-of-wedlock births and cohabitation without marriage. They engage in these behaviors at rates unprecedented in U.S. history. Nearly four-in-ten (36.8%) births in this country are to an unmarried woman. Nearly half (47%) of adults in their 30s and 40s have spent a portion of their lives in a cohabiting relationship.

--Public Concern over the Delinking of Marriage and Parenthood. Adults of all ages consider unwed parenting to be a big problem for society. At the same time, however, just four-in-ten (41%) say that children are very important to a successful marriage, compared with 65% of the public who felt this way as recently as 1990.

--Marriage Remains an Ideal, Albeit a More Elusive One. Even though a decreasing percentage of the adult population is married, most unmarried adults say they want to marry. Married adults are more satisfied with their lives than are unmarried adults.

--Children Still Vital to Adult Happiness. Children may be perceived as less central to marriage, but they are as important as ever to their parents. As a source of adult happiness and fulfillment, children occupy a pedestal matched only by spouses and situated well above that of jobs, career, friends, hobbies and other relatives.

--Cohabitation Becomes More Prevalent. With marriage exerting less influence over how adults organize their lives and bear their children, cohabitation is filling some of the vacuum. Today about a half of all nonmarital births are to a cohabiting couple; 15 years ago, only about a third were. Cohabiters are ambivalent about marriage – just under half (44%) say they to want marry; a nearly equal portion (41%) say they aren’t sure.

--Divorce Seen as Preferable to an Unhappy Marriage. Americans by lopsided margins endorse the mom-and-dad home as the best setting in which to raise children. But by equally lopsided margins, they believe that if married parents are very unhappy with one another, divorce is the best option, both for them and for their children.

--Racial Patterns are Complex. Blacks are much less likely than whites to marry and much more likely to have children outside of marriage. However, an equal percentage of both whites and blacks (46% and 44%, respectively) consider it morally wrong to have a child out of wedlock. Hispanics, meantime, place greater importance than either whites or blacks do on children as a key to a successful marriage – even though they have a higher nonmarital birth rate than do whites.

--Survey Sample and Methods. These findings are from a telephone survey conducted from February 16 through March 14, 2007 among a randomly-selected, nationally representative sample of 2,020 adults."

Labels: marriage, parenting