WIC Improves Child Health and School Readiness

New research by Children's HealthWatch demonstrates that young children who participate in the Special Supplemental Nutrition program for Women, Infants, and Children (WIC) are more likely to be in excellent or good health and have a reduced risk of developmental delay. Investing in WIC supports the nutritional and health needs of young children during a critical window of brain and body growth.Progam improvements that decrease access barriers, provide the full amount of fruits and vegetables recommended by the Institute of Medicine, and accommodate working parents' schedules will help young children reach their full potential

Energy Insecurity is a Major Threat to Child Health

With the recession and this winter's harsh weather, many families are facing a choice between eating and heating. Research by Children's HealthWatch shows that young children whose families struggle to pay their utility bills ('energy insecure' families) are more likely to suffer a host of problems including food insecurity, poor health, hospitalizations and developmental delays.The Low Income Home Energy Assistance Program (LIHEAP), which provides low-income households with assistance in paying their utility bills, is effective at shielding young children from the harmful effects of energy insecurity.According to research by Children's HealthWatch, young children whose families received LIHEAP were less likely to be at risk for growth problems and had healthier weights for their age.By appropriating the maximum authorized funding for LIHEAP and ensuring that climate change legislation buffers vulnerable families and children from the harmful effects of higher energy prices, Congress will be taking important steps to protect children's health

Too Many Hurdles: Barriers to Receiving SNAP Put Childrens Health at Risk

Summary of Findings

Child Care Feeding Programs Support Young Children's Healthy Development

New research by Children's HealthWatch shows that toddlers from low-income families who receive meals from their child care provider - those likely to be receiving CACFP - are in better health, have decreased risk for hospitalization, and are at healthier heights and weights for their age than those whose have to bring meals from home. As the nation's only nutrition program for young children in child care, CACFP is a critical component of a comprehensive approach to child nutrition.Changes to CACFP that expand access, reduce barriers and ensure that child care providers have the resources they need to provide healthy meals are beneficial for young children's health, growth and development

LIHEAP Stabilizes Family Housing and Protects Children's Health

The heating and cooling season presents special challenges for our nation's low-income families. With limited resources, many are challenged to manage the seasonal spike in utility expenses, facing decisions about whether to pay the rent, keep the lights and heat on, or buy enough groceries to get through the end of the month. We know that each of these decisions will have significant implications for the health of their youngest children. Unfortunately, these tough choices are all too common this winter as the nation experiences increases in energy prices, unusually cold weather, and continued high unemployment

Boost to SNAP Benefits Protected Young Children's Health

The Great Recession has taken a significant toll on America's children. In 2010, 25 percent of children under age six were living in poverty, up from 21 percent in 2007

Overcrowding and Frequent Moves Undermine Children's Health

Children need stability in their lives -- whether it is in their daily routines, the adults that care for them, or their housing. Recent economic conditions are putting families at risk, not just of outright homelessness but of being housing insecure (frequent moves, overcrowding, or doubling up with another family for economic reasons)

Earning More, Receiving Less: Loss of Benefits and Child Hunger

New research from Children's HealthWatch shows that increases in income that trigger loss of public assistance benefits can leave young children without enough food to eat. Families hat have been cut off from SNAP or TANF when their income exceeds eligibility limits are more likely to experience levels of food insecurity that require reducing the size or frequency of children's meals compared to those currently receiving benefits. Previous research has demonstrated that both SNAP and TANF reduce the likelihood of food insecurity. Income eligibility guidelines should be re-examined to ensure that a modest increase in income does not disqulaify a family from the benefits they need to keep their children healthy and well-fed. Families that successfully increase their earnings should not find themselves worse off due to a resulting loss of benefits

Household food insecurity positively associated with increased hospital charges for infants

Objective: To test whether household food insecurity (HFI) was associated with total annual hospitalization charges, annual days hospitalized, and charges per day, among low-income infants (months) with any non-neonatal hospital stays. Methods: Administrative inpatient hospital charge data were matched to survey data from infants\u27 caregivers interviewed 1998-2005 in emergency departments in Boston and Little Rock. All study infants had been hospitalized at least once since birth; infants whose diagnoses were not plausibly related to nutrition were excluded from both groups. Log-transformed hospitalization charges were analyzed, controlling for site fixed effects. Results: 24% of infants from food-insecure households and 16% from food-secure households were hospitalized \u3e2 times (P=0.02). Mean annual inpatient hospital charges ($6,707 vs$5,735; P Conclusion: HFI was positively associated with annual inpatient charges among hospitalized low income infants. Average annual inpatient charges were almost $2,000 higher (inflation adjusted) for infants living in food-insecure households. Reducing or eliminating food insecurity could reduce health services utilization and expenditures for infants in low-income families, most of whom are covered by public health insurance

Arthroplasties for hip fracture in adults: Review

Background Hip fractures are a major healthcare problem, presenting a huge challenge and burden to individuals and healthcare systems. The number of hip fractures globally is rising rapidly. The majority of hip fractures are treated surgically. This review evaluates evidence for types of arthroplasty: hemiarthroplasties (HAs), which replace part of the hip joint; and total hip arthroplasties (THAs), which replace all of it. Objectives To determine the effects of different designs, articulations, and fixation techniques of arthroplasties for treating hip fractures in adults. Search methods We searched CENTRAL, MEDLINE, Embase, seven other databases and one trials register in July 2020. Selection criteria We included randomised controlled trials (RCTs) and quasi‐RCTs comparing different arthroplasties for treating fragility intracapsular hip fractures in older adults. We included THAs and HAs inserted with or without cement, and comparisons between different articulations, sizes, and types of prostheses. We excluded studies of people with specific pathologies other than osteoporosis and with hip fractures resulting from high‐energy trauma. Data collection and analysis We used standard methodological procedures expected by Cochrane. We collected data for seven outcomes: activities of daily living, functional status, health‐related quality of life, mobility (all early: within four months of surgery), early mortality and at 12 months after surgery, delirium, and unplanned return to theatre at the end of follow‐up. Main results We included 58 studies (50 RCTs, 8 quasi‐RCTs) with 10,654 participants with 10,662 fractures. All studies reported intracapsular fractures, except one study of extracapsular fractures. The mean age of participants in the studies ranged from 63 years to 87 years, and 71% were women. We report here the findings of three comparisons that represent the most substantial body of evidence in the review. Other comparisons were also reported, but with many fewer participants. All studies had unclear risks of bias in at least one domain and were at high risk of detection bias. We downgraded the certainty of many outcomes for imprecision, and for risks of bias where sensitivity analysis indicated that bias sometimes influenced the size or direction of the effect estimate. HA: cemented versus uncemented (17 studies, 3644 participants) There was moderate‐certainty evidence of a benefit with cemented HA consistent with clinically small to large differences in health‐related quality of life (HRQoL) (standardised mean difference (SMD) 0.20, 95% CI 0.07 to 0.34; 3 studies, 1122 participants), and reduction in the risk of mortality at 12 months (RR 0.86, 95% CI 0.78 to 0.96; 15 studies, 3727 participants). We found moderate‐certainty evidence of little or no difference in performance of activities of daily living (ADL) (SMD ‐0.03, 95% CI ‐0.21 to 0.16; 4 studies, 1275 participants), and independent mobility (RR 1.04, 95% CI 0.95 to 1.14; 3 studies, 980 participants). We found low‐certainty evidence of little or no difference in delirium (RR 1.06, 95% CI 0.55 to 2.06; 2 studies, 800 participants), early mortality (RR 0.95, 95% CI 0.80 to 1.13; 12 studies, 3136 participants) or unplanned return to theatre (RR 0.70, 95% CI 0.45 to 1.10; 6 studies, 2336 participants). For functional status, there was very low‐certainty evidence showing no clinically important differences. The risks of most adverse events were similar. However, cemented HAs led to less periprosthetic fractures intraoperatively (RR 0.20, 95% CI 0.08 to 0.46; 7 studies, 1669 participants) and postoperatively (RR 0.29, 95% CI 0.14 to 0.57; 6 studies, 2819 participants), but had a higher risk of pulmonary embolus (RR 3.56, 95% CI 1.26 to 10.11, 6 studies, 2499 participants). Bipolar HA versus unipolar HA (13 studies, 1499 participants) We found low‐certainty evidence of little or no difference between bipolar and unipolar HAs in early mortality (RR 0.94, 95% CI 0.54 to 1.64; 4 studies, 573 participants) and 12‐month mortality (RR 1.17, 95% CI 0.89 to 1.53; 8 studies, 839 participants). We are unsure of the effect for delirium, HRQoL, and unplanned return to theatre, which all indicated little or no difference between articulation, because the certainty of the evidence was very low. No studies reported on early ADL, functional status and mobility. The overall risk of adverse events was similar. The absolute risk of dislocation was low (approximately 1.6%) and there was no evidence of any difference between treatments. THA versus HA (17 studies, 3232 participants) The difference in the risk of mortality at 12 months was consistent with clinically relevant benefits and harms (RR 1.00, 95% CI 0.83 to 1.22; 11 studies, 2667 participants; moderate‐certainty evidence). There was no evidence of a difference in unplanned return to theatre, but this effect estimate includes clinically relevant benefits of THA (RR 0.63, 95% CI 0.37 to 1.07, favours THA; 10 studies, 2594 participants; low‐certainty evidence). We found low‐certainty evidence of little or no difference between THA and HA in delirium (RR 1.41, 95% CI 0.60 to 3.33; 2 studies, 357 participants), and mobility (MD ‐0.40, 95% CI ‐0.96 to 0.16, favours THA; 1 study, 83 participants). We are unsure of the effect for early functional status, ADL, HRQoL, and mortality, which indicated little or no difference between interventions, because the certainty of the evidence was very low. The overall risks of adverse events were similar. There was an increased risk of dislocation with THA (RR 1.96, 95% CI 1.17 to 3.27; 12 studies, 2719 participants) and no evidence of a difference in deep infection. Authors' conclusions For people undergoing HA for intracapsular hip fracture, it is likely that a cemented prosthesis will yield an improved global outcome, particularly in terms of HRQoL and mortality. There is no evidence to suggest a bipolar HA is superior to a unipolar prosthesis. Any benefit of THA compared with hemiarthroplasty is likely to be small and not clinically appreciable. We encourage researchers to focus on alternative implants in current clinical practice, such as dual‐mobility bearings, for which there is limited available evidence