Maternal and Child Health Library
This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html.
September 8, 2006
1. New Web Feature Provides Easier Access to Information
and Materials on SIDS and Infant Death
2. Report Presents Innovative State Strategies for
Improving the Oral Health Delivery System
3. Issue Brief Focuses on Children with Special Health
Care Needs in SCHIP and Access to Care
4. Authors
Review National Data on the Health Status of Young Adults
5. Article Examines 1990s Decline in Fertility Among
Black Adolescents
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Special Notice: As the official webcaster for AIDS 2006,
kaisernetwork.org has made available webcasts and transcripts of each
day's sessions; audio podcasts and slide presentations, narrated video
conference highlights, news summaries from international media in the
Kaiser Daily HIV/AIDS Report, and interviews with newsmakers and
journalists to summarize conference developments. Archived webcasts and
reporting from the conference are available at http://www.kaisernetwork.org/aids2006.
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1. NEW WEB FEATURE PROVIDES EASIER ACCESS TO INFORMATION AND
MATERIALS ON SIDS AND INFANT DEATH
The National SIDS/Infant Death Resource Center has launched a new
feature on its Web site, providing access to electronic versions of
print publications (fact sheets, brochures, booklets, and posters) and
information on materials in other formats (CDs, DVDs, and videotapes).
The information was collected from national, state, and local
SIDS/infant death programs, as well as from perinatal, stillbirth,
maternal and child health, and bereavement organizations. Materials,
organized alphabetically by topic, are available at http://www.sidscenter.org/Topics.aspx?heading=TopicsA-Z.
Organizations wishing to participate in the project are encouraged to
submit links to electronic materials at http://www.sidscenter.org/biblio.
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2. REPORT PRESENTS INNOVATIVE STATE STRATEGIES FOR IMPROVING THE ORAL
HEALTH DELIVERY SYSTEM
Catalyzing Improvements in Oral Health Care Best Practices from the
State Action for Oral Health Access Initiative highlights the
successes, challenges, and results of six states (Arizona, Oregon,
Pennsylvania, Rhode Island, South Carolina, and Vermont) that developed
programs to reduce disparities and improve quality in oral health
services. The report, produced by the Center for Health Care Strategies
with support from the Robert Wood Johnson Foundation, is divided into
two main sections: (1) measuring oral health services performance and
(2) state action for oral health access strategies. The strategies
section discusses specific state efforts to improve the oral health
delivery system, such as developing value-based purchasing strategies,
broadening the provider network, expanding the dental safety net,
creating a dental home, and enhancing consumer and provider education.
A conclusion is also presented. The report is available at http://www.chcs.org/usr_doc/SAOHA_Report.pdf.
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3. ISSUE BRIEF FOCUSES ON CHILDREN WITH SPECIAL HEALTH CARE NEEDS IN
SCHIP AND ACCESS TO CARE
SCHIP Enrollees with Special Health Care Needs and Access to Care
summarizes findings from interviews with key stakeholders early in
State Children's Health Insurance Program (SCHIP) implementation to
determine whether children with special health care needs (CSHCN)
experienced problems in accessing health care in SCHIP programs with
limits and/or exclusions in coverage design. The issue brief is the
fifth in a series published by the Children's Research Initiative
(CHIRI) with support from the Agency for Healthcare Research and
Quality, The David and Lucile Packard Foundation, and the Health
Resources and Services Administration. Findings from surveys conducted
with state program officials, families of CSHCN with severe chronic
health conditions, advocates, and other key informants in five states
(Georgia, Kansas, Pennsylvania, Utah, and Virginia) with separate SCHIP
programs in 2000 are presented. The selected programs represent
different regions of the county and, compared with Medicaid, imposed
limits and/or exclusions on certain services or were ambiguous in
defining a standard of medical necessity. A conclusion and information
about the study methodology, policy implications, sources, and related
studies of interest are also included. The brief is available at
http://www.ahrq.gov/chiri/chiribrf5/chiribrf5.pdf.
More information on CHIRI projects is available at http://www.ahrq.gov/chiri.
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4. AUTHORS REVIEW NATIONAL DATA ON THE HEALTH STATUS OF YOUNG ADULTS
"These data show that young adult health issues merit attention," state
the authors of an article published in the September 2006 issue of the
Journal of Adolescent Health. Although the critical health issues of
young adulthood mirror those of adolescence, young adults fare worse
than adolescents in many areas. The article synthesizes national data
to present a health profile of young adults (ages 18-24). Gaps in
research, monitoring, and programmatic efforts are also identified.
The researchers conducted a comprehensive review of electronic
databases, articles, and reports since 2000 that used nationally
representative samples. Social indicators, mortality, morbidity, risk
behaviors, and health care access and utilization were examined, and
the most significant gender and racial and ethnic disparities were
identified.
The authors found that
- Like the adolescent population, the young adult population is
more racially and ethnically diverse than the overall population. White
non-Hispanics comprised 61.7% of the young adult population in 2000;
Hispanics, 17.3%; Black non-Hispanics, 13.6%; Asian/Pacific Islander
non-Hispanics, 4.2%; and American Indian/Alaskan Native non-Hispanics,
.9%.
- Over 96% of young adults report being in excellent, very good, or
good health, with little variance by gender or race and ethnicity.
- Young adults have over twice the mortality rate of adolescents
ages 12-17; the higher rate for young adults is largely attributable to
the male mortality rate, which is three times the female rate.
- Unintentional injury (UI) is the leading cause of mortality for
young adults; about 70% of young adults' UI mortality is due to motor
vehicle accidents.
- Homicide rates peak in young adulthood (16.1 per 100,000) and
then decline throughout the lifespan; male young adults are about six
times more likely to die from homicide than same-age females, with the
rate for black non-Hispanic males (62.1 per 100,000) being extremely
high.
- Cigarette smoking peaks in young adulthood; young adults'
cigarette use is higher among males than among females and among
American Indian/Alaskan Native non-Hispanics than among other racial
and ethnic groups.
- Recent binge drinking, heavy alcohol use, and recent illicit drug
use peak in young adulthood; rates of dependence on or abuse of any
illicit drug or alcohol are highest in young adulthood and are higher
among males than among females.
- Young adults have triple the suicide rate of adolescents ages
12-17; young adult males have six times the suicide rate of young adult
females.
- Young adults have the lowest insurance rate of any age group
(from birth through age 64).
The authors state that "based on our review, we conclude that young
adulthood is an important, unique period of the lifespan and recommend
the development of a national young adult health agenda to address the
needs of this population."
Park MJ, Mulye TP, Adams SH, et al. 2006. The health status of young
adults in the United States. Journal of Adolescent Health
39(3):305-317. Full text available at http://www.jahonline.org/article/PIIS1054139X06001431/fulltext.
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5. ARTICLE EXAMINES 1990S DECLINE IN FERTILITY AMONG BLACK ADOLESCENTS
"By 1997, the adolescent fertility rate had declined by 77% in the
first 3 high schools selected for [school-based health] centers, a
decline significantly greater than the decline that occurred in schools
without centers," state the authors of an article published in the
September 2006 issue of the American Journal of Public Health.
Colorado's black adolescent fertility rate dropped from a high of
83.7/1,000 in 1991 to 45.3/1,000 in 1997, the steepest decline of any
state in the nation for this period. Colorado's decline was driven by
Denver, where the rate drop was substantially greater than it was in
the rest of the state (50% vs. 36%). The article examines the decline
in black adolescent fertility that occurred in Denver, CO, between the
early 1990s and 1997 and explores the decline's association with the
Denver schools hosting of school-based health centers (SBHCs).
Beginning in 1989, Denver schools began establishing SBHCs. Schools
selected to host SBHCs were generally determined to have the highest
enrollment of "at-risk" adolescents. Of Denver's 10
high-school-attendance areas, 3 hosted SBHCs continuously during the
1990s; 4 areas did not have centers during the period. SBHC services
included health maintenance exams, immunizations, diagnosis and
treatment of acute illnesses and injuries, acute management of chronic
conditions, pregnancy testing, abstinence and birth control counseling,
gynecologic exams, diagnosis and treatment of sexually transmitted
infections, and mental health and substance abuse services. Students
needing contraceptive supplies were referred to the city's neighborhood
health centers.
Data for the study were drawn from the birth certificates of 932
infants born between 1991 and 1997 to black adolescents ages 15-17 who
were residents of Denver. Each birth was assigned to its corresponding
high-school-attendance area. Fertility rates (births per 1,000 female
students) were calculated for each year for each of the
high-school-attendance areas. Fertility rates among black female
students in the three areas with SBHCs were aggregated and compared
with fertility rates among black female students in the four areas
without SBHCs.
The authors found that
- Between 1992 and 1997, the black adolescent fertility rates in
the three high-school-attendance areas with SBHCs fell by 77% (vs. 56%
for the four areas without SBHCs).
- In 1992, the adolescent fertility rate for areas with SBHCs was
significantly lower than that for areas without SBHCs (165 vs. 86). In
1997, the rate for both types of areas was 38.
The authors conclude that "clinicians and policymakers interested in
reducing the adolescent birth rates should consider expanding the
numbers of SBHCs."
Ricketts SA, Guernsey BP. 2006. School-based health centers and the
decline in black teen fertility during the 1990s in Denver, Colorado.
American Journal of Public Health 96(9): 1588-1592. Abstract available
at http://www.ajph.org/cgi/content/abstract/96/9/1588?etoc.
Readers: More information is available from the MCH Library's knowledge
path, Adolescent Pregnancy Prevention, at http://www.mchlibrary.info/KnowledgePaths/kp_adolpreg.html
and from the bibliography, School Health Services, at http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_schlthserv.html&-MaxRecords=all&-DoScript=auto_search_schlthserv&-search.
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and
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