Children Are HealthyGood health provides an important foundation for children and youth, helping them to focus on school and other activities and nurturing their development. Access to health insurance, either private or, like Medi-Cal, publicly funded, is perhaps the most important indicator of the healthfulness of a community's youth and children. Although precise numbers are impossible to obtain for this measurement at the County level, the UCLA California Health Interview Survey, (CHIS), reports that more children and youth in Yolo County have access to health insurance than does the average Californian aged 0-21. (Note that the survey sample for Yolo County is relatively small and may therefore under or overstate the true number of insured county residents. Given the importance of access to health insurance, the community may wish to more thoroughly study this issue in Yolo County.) The need for regular healthcare for children begins with the first trimester of pregnancy. In spite of the importance of early prenatal care, only 65% of mothers in Yolo County receive what is considered to be adequate prenatal care. Nevertheless, fewer babies in Yolo County are born with low birth weight. Low birth weight is associated with health risks and problems for children. Two current health concerns for children are asthma and obesity. Asthma is an increasingly prevalent disease in children that affects the respiratory system, but regular access to health care and treatment can help control the symptoms and reduce the need for hospitalization. Higher numbers of children and youth with health insurance may be related to the relatively low levels of hospitalization for children and youth with asthma in Yolo County. Children and youth in Yolo County appear to have fewer problems with their weight than children across the state, but the percentage of obese children is still far higher than the national goal of 5% or less of the child and adolescent population. According to the California Healthy Kids Survey, over 10% of children in grades 7-11 can be considered obese by their score on the body mass index. Being obese or overweight is strongly correlated with the occurrence of other health risks and diseases. Preventative health care is considered preferable to disease treatment, and required immunizations have greatly improved children's health. Immunization levels in Yolo County are close to the state averages, and in some cases higher. Kindergarteners have much higher immunization rates than 7th graders in 2002, which may indicate that immunization rates among children have been rising over time. Teenagers often pose the greatest risk to their own health by engaging in risky behaviors like unprotected sexual activity, drinking alcohol, or smoking. Although Yolo County teens report they are aware of the risks of smoking cigarettes, this has apparently not completely ended teen smoking and almost 30% of 11th graders report having smoked a cigarette at least once in their lives. However, few Yolo County teens report smoking on a regular basis. Yolo County teens also have a much lower incidence of sexually transmitted diseases such as chlamydia and gonorrhea relative to the state average. We know that children's mental health is as important as physical health in affecting their well being. While Yolo County children and youth do not report higher levels of depression than their peers statewide, the number of students reporting sad or hopeless feelings for a period of at least two weeks apparently increases as students move up from grade 7 to grade 11. Children with health and dental insurance coverageWhy is this important?Because of the high cost, access to health care is heavily influenced by health insurance coverage. Because individuals with health insurance coverage are more likely to receive preventative care, such as routine checkups, than are people without health insurance, increased health insurance coverage in a community can lead to improved quality of life and lower overall healthcare costs. |
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How is Yolo County doing?Nearly 93% of Yolo County children and youth ages 0-21 are covered by some form of health insurance, compared to the state average of 88%. Of those children with health insurance, the majority are covered by private or employer based health insurance, and a smaller percent are covered by public health insurance. Health insurance coverage information comes from the UCLA California Health Interview Survey, which estimated that around four thousand children and youth do not have health insurance in Yolo County. (Note) |
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Although less likely to have
dental
insurance than health insurance, Yolo County youth are more likely to
have dental insurance than the average child in California. Again,
coverage rates are higher for whites than other ethnicities and decline
as a child ages.
Children receiving immunizationsWhy is this important?Immunizations reduce the spread of contagious diseases and can improve the overall healthfulness of the population. Mass immunization has nearly eradicated many diseases that once were leading causes of childhood illness or death, including polio, measles and diphtheria. The cost of disease prevention through immunization is markedly lower than the costs of direct medical care and disease outbreak control. |
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The Immunization Branch of
the
California Department of Health Services oversees a statewide network
of local immunization registries, which are responsible for ensuing
that children receive immunizations. Yolo County is served by the Shots
for Tots Regional Coalition, a liaison between providers,
public agencies and parents. Children can be exempted from receiving
required immunizations for medical concerns, or personal or religious
beliefs; these exemptions are a small percentage of total missed
immunizations, but are increasing, particularly among children in
private school, according to the California Department of Health
Services.
The percent of Yolo County
kindergarten entrants and children in childcare with all required
immunizations is essentially equal to the state average, around 92%.
However, this still falls slightly short of the national Healthy People
2010 goal of 95% of children in childcare or kindergarten/first grade.
Immunization levels for 7th graders
were much lower than those for kindergarteners in 2002. As the
immunization requirements for 7th graders are not much higher than for
kindergartners, this may indicate a cohort of children in the 1990s
that did not receive all necessary immunizations, and thus current
higher immunization levels may be the result of recent improvements in
immunizing kindergarteners. A retrospective study of Yolo County two
years olds in 1994 revealed that only 60% were up to date in their
immunizations. Those two year olds are now just a few years younger
than the 7th graders in the 2002 data, only 80% of whom have received
all required immunizations.Prenatal careWhy is this important?The level of prenatal care
received is an important predictor of the future health of a
child. Adequate prenatal care is defined as care initiated by the
fourth month of pregnancy, followed by the mother receiving 80% or more
of the prenatal care visits recommended by the American College of
Obstetricians and Gynecologists.
Low birth-weight babies and infant
mortality rates
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Why is this important?The proportion of children
with low birth weight (5.8 lbs or less) is generally considered a
predictor of future health problems including infant mortality, and
increased special education usage. |
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How is Yolo County doing?During the past 12 years (1990-2002), fewer Yolo County children were born with low birth weights relative to the state average, although the county’s rate of low-weight births is still somewhat higher than the national public health goal of 5%.Yolo County’s rate of infant mortality has been somewhat lower than the state average during the past 5 years, although during the two most recent years, 2000 and 2001, infant mortality rates have been somewhat above the state average. |
Rates of asthma
Why is this important?
Asthma, a chronic inflammatory lung disease, is the most common chronic disease among children, and one of the leading causes of hospitalization and death among children. The exact causes are unknown, but both genetics and environmental triggers contribute to the development of asthma. Asthma symptoms range from mild to severe, and although the disease cannot be cured, it can be treated and controlled through proactive effort. These efforts to control the disease in children can reduce risk of hospitalization or death and lower later costs of treating the disease. Without ready access to healthcare, children with asthma are more likely to be hospitalized for the disease.
How is Yolo County doing?There is no definitive
source of data regarding asthma prevalence in California, however the
California Department of Health Services reports asthma affects between
8% and 12% of the population. Yolo County has a higher rate of
lifetime asthma diagnosis compared with the state as a whole, according
to the California Healthy Kids Survey. |
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Incidence of obesity
Why is this important?Childhood obesity is a top concern with health officials, families and communities across the country. The increase in childhood obesity is often associated with an increase in other adverse health conditions, such as type II diabetes and hypertension.How is Yolo County doing?Obesity is determined as a
body mass index (BMI, the ratio of weight to height per age and gender
standards) above the 95th percentile. Individuals measured above
the 85th percentile are considered at risk of being overweight. (Note)
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The Healthy People 2010 goal is for no more than 5% of the child and adolescent population to score above the 95th percentile in the body mass index. Yolo County has not achieved that goal, with 12-13% of surveyed students scoring above the 95th percentile.
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Tobacco use among youth
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Why is this important?Smoking is associated with increased rates of serious diseases, such as lung cancer, high blood pressure, and heart disease. It is one of the leading causes of death among Californians. According to the Campaign for Tobacco-Free Kids, 90% of adult smokers started smoking at age 18 or younger. In fact, most tobacco users begin smoking at age 13. Thus, efforts aimed at lowering or eliminating teen smoking are crucial to reducing rates of smoking as today’s youth become tomorrow’s adults.How is Yolo County doing?Yolo County has programs
to help teens quit smoking at Davis High School, River City High
School, and in Woodland schools. Peer education groups are one
effective way to help students fight nicotine addiction. High
levels of students (94-97%) reported knowing that frequent cigarette
use is dangerous. |
Youths with sexually transmitted diseases
Why is this important?
| Teens are at greater risk of contracting sexually transmitted diseases (STDs) than other age groups for a variety of reasons: more sexual partners, less use of condoms, lack of knowledge about diseases, difficulty accessing confidential health care services, or difficulty obtaining contraceptives. Teens are much more likely to contract either chlamydia or gonorrhea than older sexually active adults, and girls are at an even greater risk of contracting an STD due to the nature of their physiology. |  |
Because many sexually transmitted diseases do not produce symptoms in infected individuals, they can go unnoticed for a long time, with significant health effects. STDs can harm the reproductive system of the infected person, affect fetal health, and cause cancer or even death.
How is Yolo County doing?
Fewer Yolo County youth have contracted the STDs chlamydia and gonorrhea compared to the state average, although gonorrhea rates increased somewhat in the late 1990’s before subsiding in 2001. The number of teens with chlamydia has stayed fairly constant since 1997. Yolo County has not reached the Healthy People 2010 goal of only 19 new cases of gonorrhea per 100,000 people, although the county is well under the national goal of 3,000 cases per 100,000 adolescents and young adults (ages 15-24) infected with chlamydia.
The mental health of children and youth
Why is this important?
The Healthy People 2010 goal is to increase the proportion of children with mental health problems who receive treatment. The Surgeon General's report and extensive research, including projects sponsored by the National Institute of Mental Health (NIMH), have demonstrated that anxiety and mood disorders, ADHD, and conduct disorders interfere with children's normal development and contribute to impaired learning, high rate of suicide among youth, violence, and pose a risk for adult psychopathology. A recent national survey revealed that while more than 10% of children in California have serious behavioral problems, only a fraction of those children actually receive mental health services and that California lags behind the rest of the nation in the percentage of those children who do receive needed mental health services.How is Yolo County doing?
For the past 5 years, a higher percentage of children and youth in Yolo County have been served by County Mental Health Services compared with the state. Historically, across the state and in Yolo County, Children's Mental Health was a minor division in the overall mental health area. However, since 1997 resources such as entitlements for Early Periodic Screening Diagnosis and Treatment (EPSDT), grants, mandates and new state allocations have increased mental health funding for children, thus substantially increasing the number of children served by County Mental Health Services. In collaboration with community based partners and other Yolo County departments serving children, the Children's System of Care (CSOC) Division has increased access and provides better continuity of care to eligible children and their families. In addition, services have moved beyond the clinics, and staff are integrated into the community in agencies like the schools, Child Welfare, Probation, Juvenile Hall, Unified Family Court and Family Resource Centers so families have access to a mental health practitioner at the same time as they are engaged with other service systems. CSOC serves mostly Medi-Cal beneficiaries who meet "Medical Necessity" criteria including foster children, children with special health care needs, and children eligible for benefits under the Americans with Disabilities Act (ADA). Children included under a variety of other mandates, or who fit the target population, are also served. No data is available for the number of Yolo County children needing services, or for those children receiving mental health services privately.
Adolescence is an emotionally volatile time for most young people, making them particularly susceptible to depressive illness, which causes them to withdraw from the activities of daily life - such as school and sports - increases the risk of self-injury - including suicide - and increases susceptibility to substance abuse. However, Yolo County youth do not report higher than average levels of mental illness, according to the California Healthy Kids Survey which asked students in grades 7, 9 and 11: "During the past 12 months, did you ever feel so sad and hopeless almost everyday for two weeks or more that you stopped doing some usual activities?" As in the case of the State, the number of Yolo County youth reporting sad or hopeless feelings, that may be interpreted as symptoms of depression, increased by age.
