Maternal and Child Health Library

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February 9, 2007

1. REPORT HIGHLIGHTS RACIAL AND ETHNIC DISPARITIES IN OPPORTUNITY IN U.S. METROPOLITAN AREAS

Children Left Behind: How Metropolitan Areas Are Failing America's Children profiles the 100 U.S. metropolitan areas with the largest child populations and reflects a picture of disparities across many dimensions of well-being. The report is the first in a series of reports derived from diversitydata.org, a new Web site developed by the Harvard School of Public Health in conjunction with the Center for the Advancement of Health, and with support from the W. K. Kellogg Foundation. The Web site uses data from multiple sources to bring together a range of indicators on many dimensions of well-being including housing, neighborhood conditions, residential integration, education, and health. The report presents findings on indicators of child well-being for four racial and ethnic groups focusing first on families, then on neighborhood environment, and finally on school environment. Then, for each racial and ethnic group, the report shows rankings of metropolitan areas for a subset of indicators of neighborhood environment. The metro areas with the largest disparities are also shown. The report concludes with a discussion of the policy implications, a brief overview of the levers that might be employed to improve prospects for children, and a detailed description of several promising models for action. The report is available at http://diversitydata.sph.harvard.edu/children_left_behind_final_report.pdf. A chartbook with additional graphs is also available at http://diversitydata.sph.harvard.edu/children_left_behind_chartbook.pdf.

• Inclusive Planning -- Planning should involve all significant stakeholders and should begin with a policy review.
• Collaborative Relationships -- Ideally, a memorandum of agreement should be established between schools and collaborating community agencies and supported by state systems.
• Logistics -- The optimal time to conduct screenings must be determined, based on the adequacy of resources necessary to provide needed follow-up services after screenings.
• Training, Supervision, and Support -- Staff will require adequate training and supervision to coordinate a screening program; select age-appropriate and culturally sensitive measurement tools; manage associated technology for administering, scoring, and interpreting data; and establish and sustain relationships with the school and the community. Professional development will also be required to raise awareness about and increase knowledge of child and adolescent mental health needs, factors that promote healthy development and those that contribute to mental health problems, specific signs of mental health problems, and strategies to assist children and adolescents with mental health problems in obtaining help.
• Integration -- Mental health screening should be one aspect of a complete continuum of effective mental health programs and services in schools that includes a full partnership between families, schools, and child-serving systems; quality assessment and improvement; empirically supported practice; and outcome evaluations.

• The children and their families were characteristic of county mental health populations in California: culturally diverse and largely low income with multiple child, family, and environmental risk factors.
• At posttest, MHST and risk-assessment scores were significantly lower.
• At posttest, global assessment of function scores and parent support were significantly higher.
• Most parents reported high levels of satisfaction with the quality of service and the help they received.