
Maternal and Child Health Library
This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html
October 23, 2009
1. New Edition of EPSDT Knowledge Path Available
2. Resource Provides Legal Professionals with Guidance on
Health Needs of Children in Foster Care
3. Brief Highlights Employer Strategies for Improving
Primary Care Services for Children
4. Authors Encourage Action in Addressing the Impact of
Environmental Toxicants on Women's and Children's Health
5. Report Summarizes Findings on the Availability of
Foods and Beverages with Lower Nutritional Quality in Schools
6. Article Assesses Progress in Meeting the Health
Insurance Needs of
Children with Special Health Care Needs
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1. NEW EDITION OF EPSDT KNOWLEDGE PATH AVAILABLE
The new edition of Knowledge Path: Early and Periodic Screening,
Diagnostic, and Treatment (EPSDT) Services is an electronic guide to
resources about providing and strengthening EPSDT services. The
knowledge path, produced by the Maternal and Child (MCH) Library at
Georgetown University, contains information on Web sites, publications,
distance learning resources, and databases. Guidelines for the
frequency, timing, and content of health-promotion and
disease-prevention services for infants, children, and adolescents are
provided. Separate sections present resources for professionals (health
professionals, program administrators, policymakers, and researchers)
and for families. A special topics area lists resources about oral
health services as part of the EPSDT benefit. The knowledge path is
available at http://www.mchlibrary.info/KnowledgePaths/kp_EPSDT.html
MCH Library knowledge paths on other maternal and child health topics
are available at http://www.mchlibrary.info/KnowledgePaths/index.html.
The MCH Library welcomes feedback on the usefulness and value of these
knowledge paths. A feedback form is available at http://www.mchlibrary.info/feedback/index.html
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2. RESOURCE PROVIDES LEGAL PROFESSIONALS WITH GUIDANCE ON HEALTH NEEDS
OF CHILDREN IN FOSTER CARE
Healthy Beginnings, Healthy Futures: A Judge’s Guide provides a source
of information about the health needs of very young children in foster
care within the context of permanency decision-making. The guide was
produced by the American Bar Association's Center on Children and the
Law, the National Council of Juvenile and Family Court Judges, and Zero
to Three's National Policy Center, with support from the Health
Resources and Services Administration's Maternal and Child Health
Bureau. The guide begins with descriptions of federal laws and grant
programs designed to support judges' efforts to meet the health needs
of very young children in foster care. Additional topics addressed
within the guide's five chapters include meeting the needs of very
young children in dependency court, promoting physical health,
addressing early mental health and developmental needs, achieving
permanency, and improving the court's response. The guide is available
at http://www.abanet.org/child/healthy_beginnings.pdf
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3. BRIEF HIGHLIGHTS EMPLOYER STRATEGIES FOR IMPROVING PRIMARY CARE
SERVICES FOR CHILDREN
Strengthening Health Care for Children: Primary Care and the Medical
Home examines the role of employers, as purchasers of health benefits,
in making changes that will improve the quality of children's health
care and expand access to it. The issue brief, published by the
National Business Group on Health's Center for Prevention and Health
Services with support from the Health Resources and Services
Administration's Maternal and Child Health Bureau, encourages employers
to work to ensure that all children have a usual source of continuous
and comprehensive care. Topics include current problems in health care
for children, the importance of primary care, and potential models for
improving health care services for children. The medical home and ways
that employers can support it, as well as other employer strategies for
improving primary care services for children, are discussed. The brief
is available at http://www.businessgrouphealth.org/pdfs/Medical%20home%20proof%20FINAL.pdf
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4. AUTHORS ENCOURAGES ACTION IN ADDRESSING THE IMPACT OF ENVIRONMENTAL
TOXICANTS ON WOMEN'S AND CHILDREN'S HEALTH
Environmental Toxicants and Maternal and Child Health: An Emerging
Public Health Challenge emphasizes the need to increase knowledge among
women and health professionals about environmental toxicants so they
can take steps to limit exposure before and during pregnancy. The brief
was prepared as an activity of the Johns Hopkins' Maternal and Child
Health (MCH) Leadership Training Program, with support from the Health
Resources and Services Administration's Maternal and Child Health
Bureau. The authors review environmental toxicants and federal public
policy response and discuss challenges in identifying and addressing
women's exposure to environmental toxicants. Tables present information
on specific toxicants and their sources as well as their potential
impact on fetal, infant, and child health. Legislation and regulations
relevant to exposure to environmental hazards, as well as selected
resources on prenatal exposure to environmental toxicants, are
provided. Figures display online sources of continuing education
specific to pregnancy and environmental hazards and locations of
Organization of Teratology Information Services and Pediatric
Environmental Health Specialty Units in the United States. The role of
MCH professionals in educating women and other health professionals
about managing exposure to environmental toxicants, as well as in
supporting surveillance efforts to monitor exposure to toxicants and
MCH outcomes, is also discussed. The brief is available at
http://www.jhsph.edu/wchpc/publications/Environ_Tox_MCH.pdf
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5. REPORT SUMMARIZES FINDINGS ON THE AVAILABILITY OF FOODS AND
BEVERAGES WITH LOWER NUTRITIONAL QUALITY IN SCHOOLS
"The findings in this report indicate that progress was made during
2002-2008 in increasing the percentage of secondary schools in which
students cannot purchase less nutritious foods and beverages from
vending machines at the school or from a school store, canteen, or
snack bar. This progress, however, has varied among states," according
to a report published in the October 9, 2009, issue of Morbidity and
Mortality Weekly Report. Foods and beverages offered or sold outside of
U.S. Department of Agriculture school meal programs are not subject to
federal nutrition standards and generally are of lower nutritional
quality than foods and beverages served in the meal programs. The
report summarizes the results of an analysis to estimate changes in the
percentage of schools in which students could not purchase less
nutritious foods and beverages.
The Centers for Disease Control and Prevention analyzed 2002-2008
survey data from its School Health Profiles, a confidential and
voluntary biennial survey of public secondary schools to assess school
health practices. A self-administered questionnaire was sent to
principals and lead health-education teachers to assess foods available
for purchase by students outside of the school meal programs in their
schools. The report includes data from 40 states that provided Profiles
data in 2008 and at least one other year during 2002-2006.
The authors found that
- From 2002 to 2008, the percentage of schools in which students
could not purchase candy or salty snacks increased in 37 of 40 states.
- Among the 34 states with weighted data for both 2006 and 2008,
the percentage of schools in which students could not purchase candy or
salty snacks varied widely (18.2 percent to 88.2 percent).
- Compared with 2006, in 2008 the percentage of secondary schools
in which students could not purchase soda pop was significantly higher
in all 34 states, and the percentage of schools in which students could
not purchase sports drinks was significantly higher in 23 states.
- Among the 34 states in 2008, the percentage of schools in which
students could not purchase soda pop (range: 25.6 percent to 92.8
percent) or sports drinks (range: 22.7 percent to 84.8 percent) also
varied widely.
Brener N, O'Toole T, Kann L, et al. 2009. Availability of less
nutritious snack foods and beverages in secondary schools -- Selected
states, 2002-2008. Morbidity and Mortality Weekly Report
58(39):1102-1104. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5839a4.htm?s_cid=mm5839a4_e
Readers: More information is available from the following MCH Library
resources:
- Nutrition in Children and Adolescents: Knowledge Path at
http://mchlibrary.info/KnowledgePaths/kp_childnutr.html
- Overweight and Obesity in Children and Adolescents: Knowledge Path at
http://mchlibrary.info/KnowledgePaths/kp_overweight.html
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6. ARTICLE ASSESSES PROGRESS IN MEETING THE HEALTH INSURANCE NEEDS OF
CHILDREN WITH SPECIAL HEALTH CARE NEEDS
"Even with improvement in the proportion of CSHCN [children with
special health care needs] who meet the health insurance core outcome,
significant challenges remain," write the authors of an article
published in Pediatrics (ahead of print) on October 12, 2009. In
recognition of the importance of adequate financing of care for CSHCN,
access to health insurance coverage is one of six core outcomes
established by the Maternal and Child Health Bureau for building a
system of services. The recently released 2005-2006 National Survey of
Children with Special Health Care Needs (NS-CSHCN), an update of the
2001 survey, provides a snapshot of health insurance coverage for
CSHCN. This article uses results from the new survey to assess progress
in meeting the health insurance core outcome, highlight insurance
trends among CSHCN, and discuss policy and program implications for
improving coverage.
For the study, the authors disaggregated the core outcome into its
essential components, related to presence, continuity, and adequacy of
coverage. These components were operationalized by using items
contained in the questionnaire for the 2005-2006 NS-CSHCN. The authors
then estimated the proportion of CSHCN who met the core outcome and
calculated a success rate. They conducted bivariate and multivariate
analyses to assess the degree of association between sociodemographic
factors and achievement of the core outcome and its components.
The authors found that
- Overall, the proportion of CSHCN who met the core outcome
increased from 59.6 percent to 62.0 percent from 2001 to 2005-2006.
- The likelihood of meeting the core outcome increased with income.
- Children in families whose primary language was not English were
much less likely to meet the core outcome than were children in
English-speaking families.
- The greater the reported impact of a child's condition, the less
likely the child was to meet the core outcome.
- Among insured children, those who were privately insured were
more likely than their publicly insured counterparts not to meet the
core outcome.
- Families whose children did not meet the core outcome were almost
three times more likely than other families to have at least one unmet
need, more than twice as likely to have problems obtaining a needed
referral, almost twice as likely to lack a usual source of care and a
personal doctor or nurse, and more than three times more likely to
experience financial problems. These differences remained significant
after adjusting for confounders.
- CSHCN were significantly less likely to meet the core outcome
than children without special health care needs.
The authors conclude that "given that substantial disparities remain,
eliminating them can be accomplished only through the concerted efforts
of private and public partners."
Honberg LE, Kogan MD, Allen D, et al. 2009. Progress in ensuring
adequate health insurance for children with special health care needs.
Pediatrics [published online ahead of print on October 12, 2009].
Abstract available at http://pediatrics.aappublications.org/cgi/content/abstract/peds.2009-0372v1
Readers: More information is available from the following MCH Library
resources:
- Children and Youth with Special Health Care Needs: Knowledge Path at
http://mchlibrary.info/KnowledgePaths/kp_CSHCN.html
- Health Insurance and Access to Care for Children and Adolescents:
Knowledge Path at
http://mchlibrary.info/KnowledgePaths/kp_insurance.html
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MCH Alert © 1998-2009 by National Center for Education in Maternal
and
Child Health and Georgetown University. MCH Alert is produced by
Maternal and Child Health Library at the National Center for Education
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MCH Alert
Maternal and Child Health Library
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