1. Nashville Community Health Needs for Children and Youth, 0-24 GOAL 5 Children and Youth are Physically Healthy

2. 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. 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. 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. 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. 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. 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. 8 There are many gaps in today’s 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 don’t receive services.  All schools aren’t 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. 9 There are many gaps in today’s 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. 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. 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)