Nashville Community Health Needs for Children and Youth, 024

1
Nashville Community Health Needs for Children and
Youth, 0-24

• GOAL 5 Children and Youth are Physically Healthy

2
Children and Youth are Physically Healthy means

• Children and youth are reaching their optimal
  level of physical health.
• Children and youth illness or health conditions
  are dealt with immediately to assure minimal
  long-range impact.
• Children and youth receive regular preventive
  care (med/oral) and counseling, assuring physical
  progress and identifying problems needing
  referral.
• Children receive services for special medical and
  oral health needs as soon as possible and on as
  regular a basis as needed.

3
There are many current issues that prevent
children from being physically healthy.

• Many children and youth are without insurance to
  cover 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 and
  access is not easy in their neighborhoods.
  Particular groups affected are
• African-American and Hispanic children and youth.
• Families are often not fluent in English.
• Medical and oral health services are centrally
  organized on traditional hours, creating
  difficult access, long waits and parental
  hardship.

4
Numbers help tell the story

• At least 10 of children and youth have no
  insurance this figure is increasing.
• 40.1 of children and youth 21 and under receive
  TennCare. The percentage and number has fallen
  from 66,791 and 43.7 in 2001 to 62,357.
• Nationally, the largest growing groups of
  uninsured are children and youth who are not
  citizens and youth over 18.
• LEP growing to 7 of children in schools, from
  3,000 to 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
  are growing, increasing from 45.3 to 60.8.

Data from various 2005 statistics.
5
Numbers help tell the story

• Half of children on TennCare do not use available
  services during the 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) have disabilities.
• 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 among African American and
  poor children.
• 711 children with asthma identified in Metro
  schools, but number may be as high as 10,000.

6
Currently, a number of programs in the community
address these needs.

• Metro Nashville Health Department
• Mobile Pediatric Assessment Clinic providing
  health screening and referral 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 special needs children.

7
Currently, a number of programs in the community
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.
8
There are many gaps in todays programs and
services.

• There is no MNPS central health plan to
  coordinate development of school health dental
  services.
• School health services are not comprehensive or
  equitably distributed.
• All schools dont receive services.
• All schools arent served equally.
• Some school services are only for TennCare
  children and do serve uninsured.
• Language competency is not present in all school
  health programs.

9
There are many gaps in todays programs and
services.

• Some high need neighborhoods are without a local
  health center.
• Cumberland View, Bordeaux, Buena Vista,
  Charlotte Park
• Many more neighborhoods do not have oral health
  services.
• Many centers do not have non-traditional hours
  (Saturdays and evenings).

10
In the next 2-5 years a number of changes are
expected.

• Number of uninsured children without citizenship
  will grow.
• Number of uninsured youth 19-24 will grow.
• CoverKids will expand insurance to those children
  who are citizens and in poverty 0-18.
• Public resources for uninsured are not expected
  to grow.

11
References

• 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)