Texas KIDS COUNT:Our Border, Our Future

May 8, 2009La Fe Cultural & Technology

CenterEl Paso, TX

Our Sponsors

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

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.

El Paso’s Child Population Growth Stagnant Since 2000

81,9

47

4,51

5,62

9

687,

601

658,

449

601,

582

217,

423

5,02

3,06

6

83,5

87673,

642

219,

674

El PasoCounty

Urban Border Rural Border Urban Non-border

Rural Non-border

2000

2007

1%12%

2%

11%

-4%

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. Border includes El Paso County.

Nearly One of Every Three El Paso Children Lives 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 El Paso County.

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 El Paso County.

El Paso also 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.

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 El Paso County.

Child Poverty in Texas Heavily Concentrated Along the Border;More Than One of Every Three El Paso Children Live in Poverty

El Paso County (37.9%)

Source: 2006 Small Area Income and Poverty Estimates, U.S. Census Bureau

2009 Federal Poverty Guidelines

Persons in family Poverty guideline

1 $10,830

2 14,570

3 18,310

4 22,050

5 25,790

Source: U.S. Department of Health and Human Services

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 El Paso County.

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 El Paso County.

Infant Health

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

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.

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

3.9

2.72.5

2.31.91.9

El Paso 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 El Paso County.

Largest Number of El Paso County’s Infant Mortalities Occurring within First Month with Very

Low Birthweight Babies

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

Reducing El Paso 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.

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

42.9%

34.1%

41.2%37.4%37.5%

Border Non-border

Per

cent

age

of A

ll Li

ve B

irths

El Paso County Urban Rural

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

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

55.2%

42.0% 35.7% 28.8%

29.9%

24.8%

52.5%

36.5% 29.1%

25.9%

22.2%

20.0%

49.1%

37.7% 29.5% 21.5%

16.0%

14.7%

Less thanHigh

School

HighSchool

Graduateor GED

SomeCollege,but NoDegree

AssociateDegree

BachelorsDegree

GraduateDegree

El Paso County Border Non-Border

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

One of Every Three Births in El Paso County to Mother with Less than High School Degree

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

The Percentage of Low Birthweight Babies (< 2500g) Born in Border Counties Slightly Lower

than Rest of State; El Paso Slightly Higher

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

Majority of Low Birthweight Births are Linked to Preterm Deliveries

4.4%

59.8%

25.9%

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)

El Paso County Border Non-border

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

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

El Paso County Border Non-border

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

Of the More Than 2,300 Births to Teens in El Paso, One in Five were to Teens Who Were Already Mothers

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

Health Care

Coverage and

Access

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.

El Paso County (25.4%)

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

El Paso County (39.3%)

The Number of El Paso Children on Medicaid Increased After Instituting Six-Month Continuous Enrollment in 2002; Later

Decline Due to Eligibility System Breakdown Beginning in 2006

87,932(Apr '09)

86,145

91,25993,068

97,887

93,190

89,541

80,803

68,558

65,135

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

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

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.

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.

Texas Voice for Health ReformEl Paso, TXMay 8, 2009

Kymberlie Quong Charles, Coordinator

quongcharles@cppp.org

Texas Voice for Health Reform

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%

“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

Texas Voice for Health Reform Principles

AffordabilityAccessibility

Quality

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.

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

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

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

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© CPPP

Center for Public Policy Priorities900 Lydia StreetAustin, TX 78702

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

Contact InformationContact InformationFrances Deviney, PhD

Texas KIDS COUNT Director deviney@cppp.org

(512) 320-0222 ext. 106

Kymberlie Quong CharlesTexas Voice for Health Reform

quongcharles@cppp.org(512) 320-0222 ext. 115