texas kids count: our border, our future frances deviney, ph.d. texas kids count director may 15,...

46
Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Upload: grace-mason

Post on 23-Dec-2015

216 views

Category:

Documents


3 download

TRANSCRIPT

Page 1: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Texas KIDS COUNT:Our Border, Our Future

Frances Deviney, Ph.D. Texas KIDS COUNT Director

May 15, 2009South Texas College

McAllen, TX

Page 2: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Our Sponsors

Page 3: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

El Paso

Hud

spet

h

Jeff Davis

Pre

sidi

o

BrewsterVal Verde

Culberson

Kinney

Maverick

Zavala

Dimmitt Webb

ZapataStarr

Jim Hogg

HidalgoCameron

Willacy

Brooks

Terrell

TX Counties Along the Border with Mexico

Page 4: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

One of Every Nine Kids Lives in Border Counties

Rural Non-border 701,099 (10%)

Urban Border 710,995 (10%)

Rural Border 88,405 (1%)

Urban Non-border

5,305,704 (79%)

Source: Children ages 0-17, 2007 Population Estimates, Texas State Data Center; Urban designations from Texas Department of State Health Services, based on 2004 U.S. Office of Management and Budget definitions.

Page 5: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Hidalgo County’s Child Population Growth Skyrockets from 2000 to 2007

81

,94

7

60

1,5

82

20

1,0

02

83

,58

7

67

3,6

42

24

4,0

82

Hidalgo County Urban Border Rural Border

2000

2007

21%

12%

2%

Source: Children ages 0-17, 2007 Population Estimates, Texas State Data Center; Urban designations from Texas Department of State Health Services, based on 2004 U.S. Office of Management and Budget definitions. Urban Border includes Hidalgo County.

Page 6: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Over Half of Hidalgo County Children Live in an Immigrant Family; Virtually All Are Citizens

Source: CPPP analysis of the citizenship and foreign-born data for 117 counties available in 2005-2007 three-year American Community Survey Data. Border includes Hidalgo County.

Page 7: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Median Household Income in Urban Border Counties Lower than Even Rural Non-border Counties

Source: CPPP analysis of 2007 Median Household Income from Small Area Income and Poverty Estimates & Households from Census 2000 Summary File 3. Border includes Hidalgo County.

Page 8: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Hidalgo Co. Experiences Purchasing Power Plateau

Source: CPPP analysis using 2007 Median Household Income from Small Area Income and Poverty Estimates. Purchasing Power = Median Income adjusted for inflation to year 2000 dollars.

Page 9: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Although Better than in 2000, Border Unemployment Still Much Higher Than Rest of State

Source: CPPP of Texas Workforce Commission unemployment and labor market data. Border includes Hidalgo County.

Page 10: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Child Poverty in Texas Heavily Concentrated Along the Border;Nearly One of Every Two Hidalgo County Children Live in Poverty

Hidalgo County (43.9%)

Source: 2007 Small Area Income and Poverty Estimates, U.S. Census Bureau

Page 11: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Kids Living on Border More Than Twice as Likely to Live in Poverty

Source: Small Area Income and Poverty Estimates, U.S. Census Bureau. Border includes Hidalgo County.

Page 12: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Children in Immigrant Families on Border Much More Likely to Live in Poverty

Source: CPPP analysis of poverty and foreign-born data for 117 counties available in 2005-2007 three-year American Community Survey data. Border includes Hidalgo County.

Page 13: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Condition of Family Economic Security along the Border

• Lower median income than state• Wages not keeping pace with inflation• Unemployment higher than state and

on the rise• Highest child poverty concentration in

state and U.S.• Poverty particularly high for children

in immigrant families on the border

Page 14: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Infant Health

Page 15: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

One of Every Seven Texas Babies is Born in a Border County

Border 51,419 (13%)

Non-border 334,118 (87%)

Source: Texas Department of State Health Services 2005 birth data

Page 16: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Infant Mortality Program Review/Planning Tool

Age at Death

Fetal Neonatal (< 28 days old)

Post Neonatal(>= 28 days old)

Birthweight < 2500g Maternal Health and Prematurity

>= 2500 g

Maternal Care

Newborn Care

Infant Health and Safety

Source: Adapted from presentation on March 27, 2009 by Brian Castrucci, Director of the Office of Program Decision Support at the Division of Family and Community Health Services with the Department of State Health Services.

Page 17: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Border Counties’ Infant Mortality Rates Lower Than Rest of State, but Show the Same Pattern

2.6 2.7

3.9

1.61.9

2.3

Hidalgo County Border Non-border

Infa

nt D

eath

s pe

r 1,

000

Live

Bir

ths

Less than 28 days old 28+ days old

Source: CPPP analysis of Texas Department of State Health Services 2005 death and birth data. Border includes Hidalgo County.

Page 18: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Largest Number of Hidalgo County’s Infant Mortalities Occurring within First Month with Low

Birthweight Babies

Source: 2005 death data, Texas Department of State Health Services

Page 19: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Reducing Hidalgo County’s Infant Mortality Rate Will Require Increased Attention to

Maternal Health and Prematurity

Age at Death

Fetal Neonatal (< 28 days old)

Post Neonatal(>= 28 days old)

Birthweight < 2500g Maternal Health and Prematurity

>= 2500 g

Maternal Care

Newborn Care

Infant Health and Safety

Source: Adapted from presentation on March 27, 2009 by Brian Castrucci, Director of the Office of Program Decision Support at the Division of Family and Community Health Services with the Department of State Health Services.

Page 20: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Women Living in the Urban Border Counties More Likely to Have Inadequate Prenatal Care

39.3%

34.1%

41.2%

37.4%37.5%

Border Non-border

Per

cent

age

of A

ll Li

ve B

irths

Hidalgo County Urban Rural

Source: Texas Department of State Health Services. Border includes Hidalgo County. Inadequate Prenatal Care = No prenatal care or care that begins after first trimester.

Page 21: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

At Most Education Levels, Women Along the Border More Likely to Receive Inadequate Prenatal Care

16.4%

52.2%

29.7% 21.0%

27.2%

13.9%

25.9%

29.1%

36.5%

52.5%

22.2%

20.0%

49.1%

37.7% 29.5% 21.5% 14.7%

16.0%

Less thanHigh

School

HighSchool

Graduateor GED

SomeCollege,but NoDegree

AssociateDegree

BachelorsDegree

GraduateDegree

Hidalgo County Border Non-Border

Source: CPPP analysis of Texas Department of State Health Services 2005 birth data. Border includes Hidalgo County. Inadequate Prenatal Care = No parental care or care that begins after first trimester.

Page 22: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

One of Every Two Births in Hidalgo County to Mother with Less than High School Degree

Less than High School (52.8%)

High School Graduate or GED

(24.0%)

Some College, but No Degree (13.2%)

Associates Degree (2.4%)

Bachelors Degree (5.8%)

Graduate Degree (1.7%)

Source: CPPP analysis of Texas Department of State Health Services 2005 birth data.

Page 23: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

The Percentage of Low Birthweight Babies (< 2500g) Born in Border Counties Slightly Lower than Rest of State; Even

Better in Hidalgo Co.

Source: CPPP analysis of Texas Department of State Health Services 2005 birth data. Urban Border data includes Hidalgo County.

Page 24: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Majority of Low Birthweight Births are Linked to Preterm Deliveries

1.6%

57.3%

31.4%

2.9%

25.7%

59.6%

32.6%

63.0%

11.9%

LBW to Mothers WhoSmoked

LBW & Preterm (< 37weeks gestation)

LBW to Mothers withMaternal Risk Factors

Pe

rce

nta

ge

of

All

Lo

w B

irth

we

igh

t B

irth

s (

LB

W)

Hidalgo County Border Non-border

Source: CPPP analysis of Texas Department of State Health Services 2005 birth data. Urban Border data includes Hidalgo County.

Page 25: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

One in Five Babies Born in Rural Border Counties is to a Teen Mom Ages 13-19

16.3% 16.7%

19.9%

12.4%

17.1%

Urban Rural

Per

cen

tag

e o

f A

ll L

ive

Bir

ths

Hidalgo County Border Non-border

Source: CPPP analysis of Texas Department of State Health Services 2005 birth data. Urban Border data includes Hidalgo County.

Page 26: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Of the More Than 2,700 Births to Teens in Hidalgo Co., One in Four Were to Teens Who Were Already Mothers

Source: CPPP analysis of Texas Department of State Health Services 2005 birth data.

Page 27: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Infant Health Along the Border• Infant mortality rates better than

state, but still have room for improvement

• Largest number of infant mortalities occur with LBW babies in first month

• Too many pregnant women not getting adequate prenatal care

• LBW linked to preterm deliveries• Higher rate of births to teens

Page 28: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Health Care

Coverage and

Access

Page 29: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Higher Child Medicaid Enrollment Along Border

Percentage of Children on Medicaid

Source: CPPP analysis of Texas Health and Human Services Commission data: All Children ages 0-18 enrolled in Medicaid in August 2007 as a percentage of total 2007 child population 0-18

Hidalgo County (49.6%)

Page 30: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

The Number of Hidalgo Co. Children on Medicaid Increased After Instituting Six-Month Continuous Enrollment in 2002; Later Plateau

Likely Due to Eligibility System Breakdown Beginning in 2006

128,573(Apr '09)

128,213127,742

120,851119,864119,020

112,814

101,161

86,621

80,969

Aug '00 Aug '01 Aug '02 Aug '03 Aug '04 Aug '05 Aug '06 Aug'07 Aug '08 Apr '09

Ch

ildre

n A

ge

s 0

-18

En

rolle

d in

Me

dic

aid

Simplified

Enrollment

Begins

Source: Texas Health and Human Services Commission

Page 31: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Majority of Doctors Serving Children and Families have Medicaid Clients

Source: CPPP analysis of Texas Health and Human Services Commission 2007 Medicaid claim data and 2008 Physician Licensure Data

Page 32: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Texas Border Counties Have Fewer Doctors to Serve Children and Families Than the Rest of the State

Source: CPPP analysis of Texas Department of State Health Services 2008 data. Border includes Hidalgo County.

Page 33: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Physician Acceptance of New Medicaid Patients in Texas, 2008

52%

30%

42%

42%

21%

15%

38%

39%

27%

54%

20%

19%

0% 20% 40% 60% 80% 100%

Surgical

Family Medicine

Pediatrics

OB-GYN

Accept All New Limit New Accept No New

Source: Texas Medical Association based on TMA Physician Survey 2008. Prepared by TMA, 2008.

Page 34: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

TX Border Counties Projected to Have Some of the Highest Rates of Uninsured Children in 2010

Percentage of Uninsured Children

Source: Texas State Data Center, Uninsured projections for children 0-17 in 2010.

Hidalgo County (23.8%)

Page 35: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Health Access Along the Border

• Although there are high participation rates in public insurance programs, also a high concentration of uninsured children

• Not enough doctors to meet the need; even fewer willing to take new patients without insurance or with public health insurance coverage

Page 36: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Texas Voice for Health Reform

A project of the Center for Public Policy PrioritiesMade possible with generous funds from the Robert Wood Johnson Foundation

McAllen, TXMay 15, 2009

Kymberlie Quong Charles, Coordinator

Page 37: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Texas Voice for Health Reform

Page 38: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

The Government and the American People Agree…

"The status quo is the one option

that is not on the table," he said. "And those who

seek to block any reform at any cost will not

prevail this time around."

-- President Barak Obama, Christian Science Monitor, March 6, 2009

Does our health care system need complete overhaul,

major reform, minor reform or no reform at all?

Voter attitudes on Health System Change Reforms: Findings from a Survey

of 800 Likely Voters Nationwide, Lake Research Partners, April 20, 2009

69%

Page 39: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

“The crucial and weighty step needed is the decision as a country to ensure

access to health care as a public good, just as we do education, roads, military, fire, and police protection.”

-- Anne Dunkelberg, Associate Director, Center for Public Policy Priorities

Page 40: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Texas Voice for Health Reform Principles

AffordabilityAccessibility

Quality

Page 41: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Affordable access to good healthcare must be available for all Americans. It should:

• Cover all who want it

• Be affordable for people at all income levels

• Remain available and affordable when family and economic circumstances change

• Establish both a responsibility for the public to contribute and an assurance of cost containment for individuals and families

• Eliminate health costs as the number one cause of bankruptcy in the United States.

Page 42: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

A decent standard of comprehensive care must be established. It should:

• Keep people healthy and treat them when they’re ill

• Cover the whole person

• Not be lost or reduced based on pre-existing conditions or pregnancy

Page 43: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Additionally, in order to be effective, sustainable, equitable, and balanced with our other important priorities as a nation,

national health reform should also address:

• Safe and high quality care

• Costs and Cost-Effectiveness of Healthcare

• Consumer Choice

• Eliminating barriers to and disparities in care

Page 44: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Get Involved

• Join our email list

• Communicate with us about your healthcare

priorities

• How do our principles fit with your priorities?

• Contribute to our Story Bank project

• Engage in citizen advocacy using our online

resources

Page 45: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Contact InformationContact InformationFrances Deviney, PhD

Texas KIDS COUNT Director [email protected]

(512) 320-0222 ext. 106

Kymberlie Quong CharlesTexas Voice for Health Reform

[email protected](512) 320-0222 ext. 115

Page 46: Texas KIDS COUNT: Our Border, Our Future Frances Deviney, Ph.D. Texas KIDS COUNT Director May 15, 2009 South Texas College McAllen, TX

Use of This PresentationThe Center for Public Policy Priorities encourages you to reproduce

and distribute these slides, which were developed for use in making public presentations.

If you reproduce these slides, please give appropriate credit to CPPP.

The data presented here may become outdated.

For the most recent information or to sign up for our free E-Mail Updates, visit www.cppp.org.

© CPPP

Center for Public Policy Priorities900 Lydia StreetAustin, TX 78702

P 512/320-0222 F 512/320-0227