This chart shows that the number of hospitalizations of California children ages 5-14 for mental health reasons has risen about 30% since 2007, even as the state’s child population has dipped slightly in that time period. In 2011, there were 11,687 hospitalizations for mental health issues among children ages 5-14 in California and 23,514 among youth ages 15-19. Mental health issues are the most common reason for hospital stays among California’s children.

At the same time, California cut its state mental health budget by about $750 million, or about 20%, between 2009 and 2012 according to a report by the National Alliance on Mental Illness. The result, the NAMI report suggests, is that California has seen a decrease in the availability of preventive and community-based mental health treatment options.

And as mental health services become harder for kids and teens to obtain amid budget cuts, the burden of mental health care shifts to hospital emergency departments, Dr. Mark Pearlmutter of the American College of Emergency Physicians said during a recent Congressional briefing sponsored by the National Association of State Mental Health Program Directors. Nationally, the demand for mental health services is rising at the same time that states continue to cut budgets.

According to a 2010 federal report on mental health in the United States, nearly half of children who met criteria for having any mental disorder did not get the treatment they needed.

Interested in learning more? Check out our other measures of California children’s mental and emotional health here.

Children’s Mental Health in the News

More U.S. Kids Diagnosed with Mental Health Disabilities, Study Finds
(U.S. News, 5/5/13, by Gordon)
http://health.usnews.com/health-news/news/articles/2013/05/05/more-kids-diagnosed-with-mental-health-disabilities-study-finds

Many Suicidal Children Have Access to Guns at Home, Study Finds
(USA Today, 5/6/13, by Szabo)
http://www.usatoday.com/story/news/nation/2013/05/06/suicidal-children-access-guns-home/2136931/?sf12472167=1

Prolonged Fatigue Linked to Mood and Anxiety Disorders in Teens, Study Finds
(Scope, 5/1/13, by Steakley)
http://scopeblog.stanford.edu/2013/05/01/prolonged-fatigue-and-mood-disorders-among-teens/

Abused Children Get Unique form of PTSD
(TIME, 4/30/13, by Szalavitz)
http://healthland.time.com/2013/04/30/abused-children-may-get-different-form-of-ptsd/

Approximately 6.2 million K-12 students were enrolled in public school in 2012, down about 2% since 2005, according to new data available from kidsdata.org.

Some counties have seen sharper declines, including Los Angeles County, where public school enrollment dipped 9% between 2005 and 2012. Some rural counties with small student populations shrank by as much as 32% during that period.

The data also show a striking shift in the racial/ethnic composition of public school students. The percentage of Latino students enrolled in California public schools continues to rise, with Latino students comprising 52% of all public school students in 2012.

In contrast, the proportion of white students continues to shrink: they made up 31% of public school children in 2005, compared to 26% in 2012. African American student enrollment also declined by nearly 20% between 2005 and 2012.

In general, as school enrollment decreases, so does average daily attendance (ADA). Declines in ADA result in decreased per pupil funding from the state.

This interactive motion chart highlights trends in public school enrollment across California. By default, the number of children in each racial/ethnic group is shown. Press play to see changes over time.

Hints:

- To follow the progression of a particular racial/ethnic group, hover over or click a bar.
- Change view from “number” to “percent” by clicking on the left axis.

For more information on public school enrollment, including county- and school district-level data, click here. For more information on the racial and ethnic composition of public school students, click here. For our complete data advisory on public school enrollment, click here.

Why is data so important for public health? Ever since British physician John Snow mapped the location of water pumps he thought might contribute to a cholera outbreak in the 1850s, the researchers and health professionals he inspired have used data to identify and prevent disease and ill health.

Here at kidsdata.org, we offer many indicators that provide insight into classic public health issues affecting children and adolescents, including lead contamination, immunizations, air quality, sexually transmitted diseases, smoking and drug and alcohol use. You can examine data statewide or at the local level. Here’s a sampling of key public health indicators affecting children and youth:

Air Quality

Alcohol Use in Past Month

Asthma

Cigarette Use in Past Month

Immunizations

Lead Poisoning

Injuries

Overweight/Obese Students

Sexually Transmitted Infections

We’re happy to help you use these data in your work. Contact Barbara.FederOstrov@lpfch.org for more information and resources.

This year’s rankings show that rates of premature deaths have dropped to their lowest level in two decades. Nevertheless, residents of the nation’s unhealthiest counties have premature death rates that are twice the rates of those in the healthiest counties. Violent crime has dropped 50 percent in the past 20 years, but one in five children live in poverty, imperiling their health.

Here’s how the RWJ Foundation describes the goals for its rankings:

We know that much of what influences our health happens outside of the doctor’s office—in our schools, workplaces and neighborhoods. County Health Rankings & Roadmaps help communities create solutions that make it easier for people to be healthy in their own communities, focusing on specific factors that we know affect health, such as education and income. Having health insurance and quality health care are important to our health, but we need leadership and action beyond health care.

Here at kidsdata.org, we applaud the RWJ Foundation and its research partner, the University of Wisconsin Population Health Institute, for drawing national attention to the complex economic, environmental, behavioral and social factors that influence Americans’ health.

Kidsdata.org has additional information on California children’s and adolescents’ health – not included in the County Health Rankings – that nonprofit organizations, children’s advocates and policymakers can use in their work, including:

* Statewide data on children with special health care needs: demographics, conditions, quality of care and more.

* Children’s emotional and behavioral health data, including tobacco and alcohol use, suicide rates, school connectedness, and other measures available for counties and local school districts.

* Child safety and welfare statistics, including bullying, child abuse and neglect, and foster care at the local level.

We invite you to explore our data and welcome your questions and comments!

We’re also offering a free, in-person training session on how to use kidsdata.org in San Francisco on April 9, 2013. For more information, click here.

Please contact Barbara Feder Ostrov, communications officer, at Barbara.FederOstrov@lpfch.org or 650-721-6044 or share in the comments section below.

Image credit: Calsidyrose via Flickr

In Shasta County, a public education campaign encouraged reversal of waning immunization rates among children. A Fresno report highlighted the importance of collecting data for Asian subgroups to demystify the “model minority.” Santa Barbara County residents received newspaper inserts describing the state of children’s health in their county, emphasizing the impact of poverty on kids. Fact sheets went out statewide documenting the health status of Latino youth in rural counties. Nonprofits, residents, and local government in the City of Stockton used data to develop a community action plan to address the most pressing youth health issues.

These creative projects and others were funded in 2011 by grants from the Lucile Packard Foundation for Children’s Health, which issued a request for proposals that would use data to promote positive change in children’s health in California. Grant applicants were asked to use kidsdata.org, the Foundation’s flagship website that tracks indicators of child health and well being, along with data from other sources. More than 40 organizations submitted proposals.

“We were impressed by the range of innovative ideas proposed for using data to improve child health,” said JoAnna Caywood, senior director of programs and partnerships at the Foundation. “We hope that these examples will inspire organizations to use the local data available on kidsdata.org to target specific concerns in their communities.”

Here are some project highlights:

The California Pan-Ethnic Health Network expanded the Multicultural Health Web Portal to include more data on children and youth of color. The organization also produced nine county fact sheets highlighting factors that influence the health of children of color.

The Central California Children’s Institute at California State University-Fresno produced the report, “Demystifying the model minority: The importance of disaggregating subgroup data to promote success for Southeast Asian youth.” The report spotlights the need for Asian ethnic subgroup information and shares data collection approaches that can be replicated in other regions.

The Public Health Institute’s California Adolescent Health Collaborative produced three issue briefs on the health status of rural Latino youth in California. The briefs describe trends and inequities in rural Latino youth health outcomes and factors that can promote their health. The series has been disseminated statewide and featured in a national public health newsletter.

The San Joaquin Community Data Co-op led a series of community convenings to increase understanding of the issues affecting children’s health in Stockton and to create a guide for action. The guide outlines the needs facing children, existing services to meet those needs, and areas in which additional services are needed.

See a complete list of the grant results to date and links to each organization.

Photo credit: Enrico Strocchi via Flickr

They shouldn’t, Dr. Edward Schor argues in a recent article in the journal Pediatrics.

Pediatricians, like other specialists, are facing new pressures to account for the quality and cost of care they provide to their small charges. That’s especially true for physicians treating chronically ill children, whose increasingly complex care is contributing to rising medical costs.

Dr. Schor, a pediatrician and senior vice president for programs and partnerships at the Lucile Packard Foundation for Children’s Health, highlights six ways health providers can help transform the care they provide to children and their families. The goal, he writes, is to achieve the Institute for Healthcare Improvement’s “Triple Aim” framework: reduce health care costs, improve patients’ experiences of care, and improve the health of populations.

1. Family Centered Medical Homes: Child health providers are being asked to create “medical homes” that better coordinate their patients’ care, but incentives for them to do so remain lacking.

2. Practice Redesign: Advanced access appointment systems and telehealth initiatives are among pediatric practice transformations that are improving patient satisfaction.

3. Care Plans and Care Planning: Physicians can work with patients to create individualized “accountable care plans” that address acute, preventive and chronic care, and spells out who is responsible for each part of the care plan.

4. Supporting Self-Management: Pediatricians can better involve patients and caregivers by emphasizing problem-solving approaches and self-monitoring.

5. Organized Health Care Systems: Because participation in large, integrated health networks can improve quality and control costs, increasingly, insurers and other payers are offering incentives for pediatricians to join these networks.

6. Sharing Resources: Large health networks aren’t the only option for pediatricians who want to benefit from partnerships while retaining their autonomy. Community-based systems of care coordination, after-hours call centers and other initiatives involve pooling resources from local health providers for mutual benefit.

See the Pediatrics Perspectives article here (paywall). For a full-text copy of this publication, contact Barbara Feder Ostrov at Barbara.FederOstrov@lpfch.org.

Today is International Childhood Cancer Day, hosted by the International Confederation of Childhood Cancer Parent Organizations (ICCPO) which is represented by the American Childhood Cancer Organization in the United States. ICCPO describes the day as one in which “the strength, courage and resiliency of children with cancer and their families are celebrated.”

Advances in the treatment of childhood cancers during the past 50 years have led to remarkable improvements in survival rates. Despite these advances, more children from birth to age 14 die of cancer than any other disease. Only accidents account for a larger number of childhood deaths. It’s estimated that more than 1,100 children under age 15 are diagnosed with cancer each year in California. Approximately one of every 340 children in California will develop some form of cancer before they reach 20 years old.

From 2005-2009, 9,101 children ages 0-19 in California were diagnosed with cancer, a rate of 17.4 diagnoses per 100,000 children/youth, according to kidsdata.org. The rate of cancer diagnoses increased from 16.4 in 2000-2004 to 17.4 in 2005-2009. Youth ages 15-19 generally have higher rates of cancer diagnoses than children ages 0-14. In California, white children also tend to have the highest rate of cancer diagnoses among all ethnic groups with available data, although Latino children have the greatest number of diagnoses.

Find out more about childhood cancer in California and the U.S. by checking out these resources:

• California Cancer Facts and Figures, 2012, California Cancer Registry & American Cancer Society
• Outcomes for Children and Adolescents with Cancer: Challenges for the 21st Century, 05/20/2010, Journal of Clinical Oncology, Smith et al.
• National Cancer Institute: Childhood Cancers, U.S. National Institutes of Health

First the good news from the EPA report, America’s Children and the Environment: the levels of toxins such as lead and cotinine (a marker of second-hand smoke exposure) in kids’ bodies have declined significantly since the 1970s. Kids increasingly are breathing less-polluted air in many communities as well.

Still – and this remains a mystery to scientists – despite nationwide improvements in air quality, asthma rates have risen slightly in U.S. children, particularly children of color.

Here are some highlights of kidsdata’s new environmental health data, which focus on conditions for California’s children:

Air Quality

• In 2010, the annual average level of “fine particulate matter,” or soot, in the air exceeded the concentration considered potentially harmful in only two California counties (out of 30 with available data): Kern and Riverside.

• That same year, San Bernardino County had the most recorded days (103) with ozone levels above the regulatory standard, among counties with available data, followed by Riverside (93), Tehama (78), Kern (69), and Los Angeles (69). The state as a whole averaged 15 days in which ozone concentrations exceeded regulations in 2010.

• Measures of air quality on kidsdata.org also indicate improvements in some areas. For example, the recorded number of days with high ozone levels in Fresno County decreased by 99 days in the past decade. In 2001, the county had 145 documented days in which ozone levels were above regulatory standards. In 2010, that number decreased to 46 days.

Lead Exposure

• In 2010, almost one-third (30%) of California children and youth identified with elevated blood levels resided in Los Angeles County.  The vast majority of children screened for lead poisoning are under age 6 because Medicaid and state regulations require that every child covered by a government-funded health program be preventively screened for lead poisoning twice, once at 12 months old and again at age 2 (or at the next opportunity up until age 6).

Water Contamination

• California had 1,730 violations indicating that contaminant levels in drinking water exceeded public health limits in 2009. Nearly two-thirds of these violations occurred in seven counties: Fresno (254 violations), Tulare (208), Kern (198), Madera (132), San Joaquin (110), Monterey (101), and Sonoma (100).

For more information and a deeper data dive, click here.

Following are some recent news highlights about children and families, along with related data from kidsdata.org:

Alcohol & Tobacco Use (see related data)

Living in Caring Community May Help Curb Teen Alcohol Use, Research Finds
(PsychCentral, 1/13/13, by Wood)

CDC: Binge Drinking Important Health Issue for Girls and Young Women
(CNN, 1/8/13, by Curley)

Rate of Youth Smokers Decreases as Use of Smokeless Tobacco Increases, Report Finds
(California Healthline, 12/14/12)

Children’s Mental Health (see related data)

GAO Report: Improvements Needed in Mental Health Care for Children
(Huffington Post, 1/10/13, by Resmovits) 

About Half of Suicidal Teens Have Access to Therapy Prior to Ideation and Attempt, Research Finds
(NY Times, 1/8/13, by Carey)

Children Special Health Care Needs (see related data)

California Ranks Low Nationally in Providing Health Care and Social Services to Children with Special Health Care Needs
(LA Times, 1/17/13, by Gorman)

Study: Children with Chronic Conditions Regularly Treated with Alternative Therapies
(Huffington Post, 1/14/13, by Pearson)

Report: U.S. Child Cancer Death Rates Drop
(WebMD, 1/7/13, by Mann)

Children with Complex Chronic Diseases Taking Up Increasing Amount of Pediatric Hospital Resources
(HealthDay, 1/2/13, by Mozes)

Report: Federal Funding to California for Special Education Falling Short
(SF Chronicle, 1/3/13, by Tucker)

Study: Some Children Diagnosed with Autism as Young Children Lose Symptoms as They Age
(Disability Scoop, 1/15/13, by Heasley)

Demographics (see related data)

Shrinking California Child Population Signals Major Changes for State
(Wall Street Journal, 1/8/13, by Jordan)

Dental Health (see related data)

Report Finds State Facing Dental Crisis for Medi-Cal Children
(California Healthline, 1/18/13)

Affordable Care Act Offers Expanded Dental Coverage for Some Children
(Kaiser Health News, 1/14/13, by Andrews)
Also See: http://www.npr.org/blogs/health/2013/01/15/169419717/law-expands-kids-dental-coverage-but-few-dentists-will-treat-them

California Gets “C” in Report on Basic Preventive Dental Procedure for Kids
(California Healthline, 1/8/13, by Gorn)

Exercise and Physical Fitness (see related data)

Reducing Kids’ Screen Time Alone May Not Promote Exercise, Study Suggests
(SJ Mercury, 1/10/13, by Pittman)

Study: 3 Out of 5 Elementary Schoolers Do Not Meet Physical Activity Goals
(MedPage Today, 1/7/13, by Neale)

Academic, Social, and Physical Benefits of Recess Make it ‘Crucial’ for School Kids, Pediatricians Say
(LA Times, 12/31/12, by Brown)

Infant and Maternal Mortality (see related data)

Disparities in Infant Mortality Require Deep, Complex Solutions
(HealthyCal.org, 1/14/13, by Gilligan)

Report: Racial Disparities in Maternal Mortality Persist; Overall Rate Increases
(Healthycal.org, 1/9/13, by Fulton)

San Francisco Works to Combat Black Infant Mortality Rate, Which Is Six Times That of White Infants
(SF Chronicle, 12/29/12, by Gonzales)

School Health Centers (see related data)

More than $14 Million in Funding to Go to California School Health Centers Under ACA
(California Healthline, 1/7/13)

American Academy of Pediatrics Urges Having Doctors for Every School District, Nurse in Every School
(Reuters Health, 12/31/12, by Seaman)

School Health Centers Partner with Existing Community Organizations to Increase Access to Health Services
(Reporting on Health, 1/15/13, by Plevin)

Weight (see related data)

Study: Parents Who Harshly Criticize Their Overweight Teens Do More Harm than Good
(NY Times, 1/9/13, by Brown)

Obesity Rates Decline Among Young, Low-Income Children, According to Study
(Reuters, 12/25/12, by Pittman)

Our new study, Children with Special Health Care Needs in California: A Profile of Key Issues, analyzes the most recent data from a survey of parents by the U.S. Maternal and Child Health Bureau. California ranks in the bottom six of states on key health measures such as access to pediatric specialists and coordination of care.  Data from the study are available at http://www.kidsdata.org/cshcn/.

Among the key findings:

• An estimated one in 10 – approximately one million – California children under age 18 has a special health care need, ranging from mild to life-threatening.
More than four in five children with special health care needs in California do not receive care that meets federal minimum quality standards.
• Among the estimated 270,000 children with special health care needs in California with Medi-Cal or other public insurance coverage, only 6 percent receive health care that meets the federal quality standards. California ranks last in the nation on this measure, tied with Nevada.
  

Children are considered to have special health care needs if they have a chronic health problem and use more health care services than typical children.  These children may have asthma or diabetes, conditions that can be controlled with medication and lifestyle changes, or be dependent on sophisticated medical equipment to get through each day. They account for more than 40 percent of all health care costs among children nationwide, despite making up only about 16 percent of the U.S. child population.

Low-income families and families of children with the most complex needs usually have the most difficulty in finding medical and dental care, child care, transportation, educational assistance, medical equipment, consistent health insurance, and a range of other services.

We can and must do better by our children. Here are some possible solutions:

• Strengthen and expand care coordination efforts
• Facilitate access to community-based therapeutic and family support services.
• Improve availability, comprehensiveness, and affordability of insurance
• Improve access to specialist care
• Emphasize family-centered care

To that end, we have established the California Advocacy Network for Children with Special Health Care Needs, which brings together individuals and organizations to press for policy changes to improve the system. More than 450 individuals are Network members, representing families, young adults, care providers, insurers, advocates, researchers, and more. To find out more about the Network or join, click here.