Nashville Community Health Needs forChildren and Youth, 0-24Nashville Community Health Needs forChildren and Youth, 0-24
GOAL 5Children and Youth arePhysically Healthy
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Children and Youth are Physically Healthymeans…Children and Youth are Physically Healthymeans…
•Children and youth are reaching their optimal level ofphysical health.
•Children and youth illness or health conditions aredealt with immediately to assure minimal long-rangeimpact.
•Children and youth receive regular preventive care(med/oral) and counseling, assuring physical progressand identifying problems needing referral.
•Children receive services for special medical and oralhealth needs as soon as possible and on as regular abasis as needed.
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There are many current issues that preventchildren from being physically healthy.There are many current issues that preventchildren from being physically healthy.
•Many children and youth are without insurance tocover care. Particular groups affected are:
Children who do not have citizenship status.
Youth over 18 years old.
•Many children and youth are living in poverty andaccess is not easy in their neighborhoods. Particulargroups affected are:
African-American and Hispanic children and youth.
•Families are often not fluent in English.
•Medical and oral health services are centrallyorganized on traditional hours, creating difficultaccess, long waits and parental hardship.
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Numbers help tell the story…Numbers help tell the story…
•At least 10% of children and youth have no insurance – thisfigure is increasing.
•40.1% of children and youth 21 and under receive TennCare.The percentage and number has fallen from 66,791 and43.7% in 2001 to 62,357.
•Nationally, the largest growing groups of uninsured arechildren and youth who are not citizens and youth over 18.
•LEP growing to 7% of children in schools, from 3,000to 5,000.
•19.8% of children live below poverty
41.1% of these children live below 200% of poverty level.
61% of these children are African American.
•Economically Disadvantaged populations in schools aregrowing, increasing from 45.3% to 60.8%.
* Data from various 2005 statistics.
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Numbers help tell the story…Numbers help tell the story…
•Half of children on TennCare do not use available services duringthe year.
20% of those 0-9 do not receive screening.
60% of those 10 and up do not receive screening.
This would likely be greater for those without insurance.
•36% of children K-8 have untreated oral disease.
•12.6% of students in Metro Nashville Public Schools (MNPS) havedisabilities.
•Disparities tell another story: One example
Asthma is the leading chronic condition leading to Emergency Department use,hospitalization and school absence among children.
Prevalence of asthma may be as high as 15%; the percentage is higher amongAfrican American and poor children.
711 children with asthma identified in Metro schools, but number may be ashigh as 10,000.
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Currently, a number of programs in thecommunity address these needs.Currently, a number of programs in thecommunity address these needs.
•Metro Nashville Health Department
Mobile Pediatric Assessment Clinic providing health screening andreferral serving up to 21 with TennCare.
School-based Oral Disease Prevention Program.
Dental clinic in East Nashville.
School nurse program: 45 nurses in 128 Metro schools.
•United Neighborhood Health Services
5 neighborhood clinics (1 with dental) (3 Se Habla Espanol).
3 school clinics (2 Se Habla Espanol).
Mobile clinic.
3 clinics with Saturday hours 1 clinic with extended hours.
•Mercy Health Services
Medical & social services for children, particularly specialneeds children.
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Currently, a number of programs in thecommunity address these needs.Currently, a number of programs in thecommunity address these needs.
•Vanderbilt Nursing School
School nurse program with 1 nurse covering 2 schools.
Vine Hill Clinic.
•Matthew Walker Comprehensive Health Center
Provides medical and dental services at one location .
Se Habla Espanol.
Saturday hours.
•St. Thomas Health Clinics
Two locations.
Se Habla Espanol.
•Siloam Health Center
International and refugee services.
Many languages.
•Faith Family Clinic
•Inter-Faith Dental
Non-traditional evening hours.
NOTE: This slide provides only a few examples of programs; it is not intended to be a comprehensive list.
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There are many gaps in today’s programsand services.There are many gaps in today’s programsand services.
•There is no MNPS central health plan to coordinatedevelopment of school health & dental services.
•School health services are not comprehensive orequitably distributed.
All schools don’t receive services.
All schools aren’t served equally.
•Some school services are only for TennCare childrenand do serve uninsured.
•Language competency is not present in all schoolhealth programs.
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There are many gaps in today’s programsand services.There are many gaps in today’s programsand services.
•Some high need neighborhoods are without alocal health center.
Cumberland View, Bordeaux, Buena Vista,Charlotte Park
•Many more neighborhoods do not have oralhealth services.
•Many centers do not have non-traditional hours(Saturdays and evenings).
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In the next 2-5 years a number of changesare expected.In the next 2-5 years a number of changesare expected.
•Number of uninsured children withoutcitizenship will grow.
•Number of uninsured youth 19-24will grow.
•CoverKids will expand insurance to thosechildren who are citizens and in poverty 0-18.
•Public resources for uninsured are not expectedto grow.
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ReferencesReferences
•Kids Count
•Metropolitan Department of Health
•Metro Nashville Public Schools
•Tennessee Department of Health
•CDC: Center for Disease Control
•Health Resources Services Administration
•BlueCare Insurance
•Bureau of TennCare
•Health Affairs
•Diversitydata.org (Harvard University)