Data in Action

“Our group presented your data to our county health managers and supervisors, and it provided the credibility and detailed info we needed to get some action.” – survey respondent

A warm thank-you to all who contributed to our survey. We loved learning about how members of the Kidsdata community, from program staff and county administrators to advocates and educators, are using data to take action.

Top Ways Kidsdata Is Driving Action

We are inspired by the ways you are using Kidsdata to ensure that all children are able to reach their maximum health potential. Check out the top ways Kidsdata is driving action:

1. Supporting the need for programs and initiatives through grant proposals
2. Promoting the importance of children’s health in presentations, research projects, and reports
3. Setting strategic goals and evaluating programmatic outcomes

Kidsdata aims to be a leading resource for those who work on behalf of children in California—that’s you!

Please continue to share how Kidsdata has made a difference for you. If you have additional suggestions on how Kidsdata can support your work, please contact us at kidsdata@lpfch.org.

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Promising Trends in Children’s Health Status

Kidsdata is excited to introduce its newest topic, Health Status. Check out self- and parent-reported data on whether a child’s health status is fair/poor, good, or excellent/very good. The data are available overall, by race/ethnicity, and by family income level for California and for counties.

Health status during childhood sets young people on a path toward good or poor health in adulthood. In California, children’s health status has improved overall and for each race/ethnicity for which we have data since 2001. Most notably, 68 percent of Hispanic/Latino children were in excellent or very good health in 2013-2014 compared with 55 percent in 2001. In addition, the gaps between racial/ethnic groups narrowed during this time period.

Explore our new topic »

Policy Implications

Healthy young people tend to become healthier and more educated adults who are better able to contribute to society than those who struggle with health problems, which means a stronger workforce and reduced strain on public service systems. Nurturing California’s children today may improve the state’s future social and economic well being.

Efforts to improve children’s health can be strengthened by recognizing the wide range of influences on children’s lives including social, economic, environmental, biological, and behavioral influences. Policies and programs that could improve children’s health include implementing cross-sector strategies that go beyond traditional health care and ensuring that every child has access to family-centered, culturally-competent, and coordinated health care within a “medical home.”

See additional policy implications »

We still need your input!

The Kidsdata team is devoted to providing the evidence you need to improve children’s health and well being. Tell us how we can better support your work! Complete a brief survey by September 1 and enter to win a $50 Amazon gift card.

Take the survey »

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Kidsdata Welcomes Alice Chiang

Alice_2017

The Lucile Packard Foundation for Children’s Health is pleased to welcome Alice Chiang, senior manager of communications and external relations, to the Kidsdata team. Alice is passionate about promoting communities of health for children. Prior to joining the Foundation, she was the communications manager for an organization in New York City focused on improving school food and healthy food access. As a Bay Area native, she is excited to be back in her home state and help make health care systems change for children across California.

Alice received her undergraduate degree in molecular and cell biology from University of California, Berkeley, and her master’s degree in food studies from New York University. Alice can be reached by email.

We still need your input!

The Kidsdata team is devoted to providing the evidence you need to improve children’s health and well being. Tell us how we can better support your work! Complete a brief survey by September 1 and enter to win a $50 Amazon gift card.

Take the survey »

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Kidsdata Needs Your Input

The Kidsdata team is devoted to providing the evidence you need to improve children’s health and well being. How can we better support your work? What would make the site more useful to you? Now’s your chance to tell us!

Please share your thoughts in a brief survey. In about 10 minutes, you can help shape the future of Kidsdata. The survey will close September 1.

After completing the survey, you can enter a drawing to win one of five $50 Amazon gift cards. You will also have the opportunity to join the inaugural Kidsdata Super User Group, whose members will provide additional feedback on proposed Kidsdata features.

Thank you for your input!

Take the survey »

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Disconnected Youth: Negative Personal, Social, and Economic Impact

Disconnected youth—teens who are neither enrolled in school nor working—may be more likely than their peers to experience poor health, lower incomes, and unemployment as adults. They are also more likely to become involved in illegal activity and become dependent on public aid. In 2013, disconnected youth cost U.S. taxpayers an estimated $27 billion in costs related to incarceration, public assistance, lost tax revenues, and lost earnings.

In 2011-2015, eight percent of California teens ages 16-19 were neither in school nor working. The percentage of disconnected youth in counties ranged from a low of three percent in Yolo County to a high of 14 percent in Mendocino County.

Trends in the rates of disconnected youth varied among counties, cities, school districts, and legislative districts, while the statewide trend saw little change.

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Cities Re-Connecting Their Youth

Daly City and Madera are among cities that have seen substantial improvement in re-engaging their youth since 2005-2009. Daly City has improved by five percentage points and Madera has improved by eight percentage points, both dropping below the California state average.

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Cities with Increasing Rates of Disconnected Youth

West Covina and Yuba City are among cities that have seen an increase in percentages of disconnected youth since 2005-2009. West Covina has increased by five percentage points and Yuba City has increased by six percentage points, both near or above the California state average.

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Policy Implications

Policy solutions range from those that prevent youth from becoming disconnected in the first place to those that re-engage disconnected youth with school and work.

Since teen engagement is related to early school achievement and positive early learning experiences, effective solutions include home-visiting programs for struggling families, quality preschool, and safe and supportive K-12 schools to ensure children have access to quality education and stable, caring environments. To engage older youth, their participation in youth advisory councils, volunteer or community projects, and service learning allows them to become active decision-makers, take on leadership roles, and contribute to the community. Help in creating such opportunities can come from improved statewide coordination and cross-sector community collaboration, both of which can foster integrated approaches to support at-risk and disconnected youth.

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A Smarter System: Addressing Social Determinants of Health as a Cost-Saving Measure

by Edward Schor, MD, Senior Vice President at the Lucile Packard Foundation for Children’s Health

The importance of social factors in determining individuals’ health status and their use of health care services has been receiving increasing attention. A recent report from the Bipartisan Policy Center suggests that opportunities to control health care costs reside primarily in addressing patients’ social and behavioral care needs. The report lays out the arguments for integrating social and medical services and, ideally, their funding, to better serve vulnerable patients with complex care needs.

To date, most of the experimentation within the health care system to address underlying social determinants of health has occurred within the framework offered by Medicare. Such interventions have focused on home-based, patient-centered care, supportive housing, in-home meal delivery, and community-based assistive services. They have yielded improvements in the health of the individuals served and some reductions of health care use. Some states have used Medicaid waivers to allow provision of certain community-based services. Within child health there have been experiments offering similar service options, such as intensive, comprehensive case management to patients and families, housing assistance, and referral for social and legal services.

With a very few, notable exceptions, all of these early efforts to address social determinants of health were built on a medical model, i.e., identifying and treating specific factors contributing to the individual’s poor health. Our existing service delivery systems, which are designed to hew to this traditional model, have had some success but at unsustainable costs.

A public health approach to better serve populations as opposed to individuals would be more efficient and effective. Implementing broad changes in social programs can reduce potentially adverse circumstances that contribute to poor health and harmful health behaviors. Fee-for-service payment schemes perpetuate an individual-based approach to solving health problems. Adopting a capitated model in which all costs are covered by a single advance payment, such as those used by accountable care organizations, can encourage but does not necessarily assure that population-based, integrated approaches will be adopted.

Some health care systems, guided by their own cost-benefit analyses, are addressing social determinants of health, not as their mission but rather as cost-saving strategies for individual or targeted groups of high-risk patients, under the rubric of value-based purchasing. This is a step toward, but still a long way from, adopting the changes in social policy that are necessary to improve the standard of living and quality of life of Americans. Until such changes occur, health care costs will continue to rise and the health of the nation will remain poor in contrast to the rest of the developed world.

 

Data on Social Determinants of Health

There is substantial evidence that children’s health is directly correlated with income and inequities in access to resources and services. The American Academy of Pediatrics has called for an effort to reduce childhood poverty and to mitigate the adverse outcomes of challenging social circumstances in order to obtain and maintain good health.

Many indicators on kidsdata.org describe social determinants of health, the family and community factors that affect individuals’ health and well being. Social determinants can help make individuals’ health better or worse. Examples include economic well being, housing stability, community connectedness, and parents’ physical and mental health.

 

Helpful Links

Healthy People 2020—Social Determinants of Health

Poverty and Child Health

Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity

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Black youth experience highest felony arrest rate in California

The felony arrest rate among African American/black youth in 2015 was substantially higher than other racial and ethnic groups in California. At 24 arrests per 1,000 youth, the rate among this group is about 8 times higher than the felony arrest rate among white youth.

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Encouragingly, nearly all of the 21 counties with data have seen improvements in felony arrest rates for African American/black youth over the past 17 years. Since 1998, San Francisco County saw a particularly sharp, though volatile, decrease, while San Joaquin County experienced the second largest rate drop since that year.

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Policy Implications

Youth who have contact with the juvenile justice system are at increased risk for a number of negative long-term outcomes when compared with the general youth population. For example, an estimated 30 percent of the youth who enter California’s juvenile justice system have mental health issues and those who have been held in detention have higher rates of attempted suicide and psychiatric disorders than youth who have not been detained. Additional long-term outcomes include injury, substance use and dependency, dropping out of school, and early pregnancy.

Policymakers within the justice, education, and social services systems can play a role in improving the way we address juvenile crime. Policy options include redirecting young offenders toward rehabilitative programs instead of the juvenile justice system and conducting case-specific assessments of an individual’s circumstances.

Currently, there is not a minimum age for entering the juvenile court system in California. If passed, Senate Bill 439, under review by the legislature, would establish 12 years of age as the minimum age over which the juvenile court has jurisdiction in California.

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Learn more about SB 439 »

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Racial and ethnic gaps persist in child cancer survival rates

In California, gaps persist in net five-year survival rates among children and youth ages 0-19 diagnosed with cancer between 2003 and 2013. The survival rate among white children is 85 percent, compared to 80 percent for Hispanic/Latino children, 79 percent for Asian/Pacific Islander youth, and 76 percent for African American/black children.

Data at the county level are limited, however variation in gaps across counties is wide. A few counties, such as Sacramento and Contra Costa, show less than a five percentage point gap in cancer survival rates across racial/ethnic groups, but most counties show wider gaps.

The figures below show a selection of counties with data that had a gap wider than 10 percentage points for three race/ethnic groups in California.

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Survival Rate Gap: Hispanic/Latino

The gap in cancer survival rates between white and Hispanic/Latino children is four percentage points at the state level. Counties with gaps greater than 10 percentage points include Napa, Placer, and Tulare.

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Survival Rate Gap: Asian/Pacific Islander

The gap in cancer survival rates between white and Asian/Pacific Islander children is six percentage points at the state level. Counties with gaps greater than 10 percentage points include Riverside, San Joaquin, and Los Angeles.

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Survival Rate Gap: African American/Black

The gap in cancer survival rates between white and African American/black children is nine percentage points at the state level. Counties with gaps greater than 10 percentage points include San Diego, Alameda, Solano, and San Francisco.

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Policy Implications

Early identification of affected children and ready access to pediatric specialty centers for diagnosis and ongoing care are key to cancer survival. Public policy ensuring that all children with cancer have adequate health insurance is essential to providing them with access to equitable, appropriate, and affordable care.

The Affordable Care Act (ACA) addresses cancer and other chronic illnesses by requiring regular, comprehensive preventive care without copayments and by eliminating lifetime caps on care and denials of coverage based on pre-existing conditions. Additional policies could assure that all pediatric cancer patients, regardless of race/ethnicity or family income, have consistent access to affordable health care that is evidence-based, well-coordinated, family-centered, and provided in the context of a medical home. Access to care coordination services is especially important as these children and their families need to navigate and align an array of services.

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Protecting water and air protects children’s health

Children are at greater risk of developing health problems due to pollutants compared to mature adults. Their small body size and developing organs make them more vulnerable to environmental contaminants.

In 2015, California had 1,533 Maximum Contaminant Level (MCL) violations, meaning contamination of drinking water supplies exceeded public health limits. Four Central Valley counties (Fresno, Kern, Madera, and Tulare) were issued 40% of all such violations.

Exposure to contaminants in drinking water can result in numerous adverse health effects for children, such as gastrointestinal disorders, damage to developing organs (particularly the liver, kidneys, and brain), and cancer.

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Five Central Valley counties (Fresno, Kings, Plumas, Tulare, and Kern) averaged particulate matter concentrations that are considered to be potentially harmful, among counties with data in 2014.

Long-term exposure to high levels of particulate matter, commonly found in diesel exhaust, may be related to heart and respiratory disease, along with adverse reproductive or pregnancy outcomes, among other health problems.

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Policy Implications

To protect children’s health, federal and state environmental laws and regulations that limit harmful waste and byproducts of agricultural, industrial, and other practices should be enforced and strengthened. Environmental safeguards can be bolstered by maintaining funding for national, state, and local agencies; increasing collaboration across agencies; and requiring reporting of environmental data to the public. The Environmental Protection Agency has a leadership role in ensuring that we are all protected from environmental risks.

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Learn more about the Environmental Protection Agency »

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Over 14,000 CA foster youth facing end to critical services

For more than 14,000 California foster youth between the ages of 16 and 20—nearly a quarter of all those in care in 2015—the transition to adulthood is especially challenging. At age 21, if they had not been reunified with their families or adopted, youth "age out" of the state’s foster care system, and services often end abruptly. Without effective transition planning, these young adults are at increased risk for negative outcomes including unstable housing, low educational and career attainment, early parenthood, substance abuse, physical and mental health problems, and involvement with the criminal justice system.

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Policy Implications

Policies that could enable youth aging out of the foster care system to thrive as adults include ensuring effective implementation of the Federal Affordable Care Act, which extends Medicaid coverage to foster youth until age 26, and the California Fostering Connections to Success Act, which extends foster care services to age 21. In addition, strengthened educational and workforce supports, including support to pursue secondary education, can improve outcomes for youth transitioning out of care.

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May Is National Foster Care Month

National Foster Care Month is a time to acknowledge the foster parents, family members, volunteers, mentors, policymakers, child welfare professionals, and other members of the community who help children and youth in foster care find permanent homes and connections. It is also a time to focus on ways to create a bright future for the more than 400,000 children and youth in foster care in the US.

See resources from the US Department of Health & Human Services »

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