Health Report

This Plan for Health is an unusual undertaking in two respects. It is part of the Go To 2040 regional master plan along with other human services components that have, historically, been outside the purview of planners, who are usually more concerned with issues such as land use, transportation, and solid waste disposal. And the planning horizon covers three decades, providing a rare opportunity for health planners to engage in truly long range planning. Health is more than medical care: a variety of factors determine the health of individuals and a community. These "underlying determinants" include demographic composition, income and poverty, employment, social status, cultural beliefs and practices, level of educational attainment, environmental conditions, genetics, individual behaviors, and public health measures, in addition to the quality and utilization of health care services.Most planning efforts, which attempt to affect community health, deal only with public health and medical services delivery, even though the other factors are known to have a greater influence on community and individual health. This plan approaches the challenge differently; it focuses on the underlying determinants of health and moves beyond the narrower focus that health planners and public health officials traditionally take. This report identifies the connections that education, land use, transportation, food and hunger, civic engagement, workforce, and the economy have with health, and it focuses on strategies and interventions that can be pursued in these sectors to improve health throughout this region

Preparing the Future Workforce: Science, Technology, Engineering and Math (STEM) Policy in K12 Education in Wisconsin

Last December, the Science, Technology, Engineering, and Mathematics (STEM) Education Coalition - a national organization of more than 600 groups representing knowledge workers, educators, scientists, engineers, and technicians wrote to President-elect Obama urging him to "not lose sight of the critical role that STEM education plays in enabling the United States to remain the economic and technological leader of the 21st century global marketplace." While that imperative appears to have resonated in Washington, has it and should it resonate in Madison? This report attempts to answer that question by examining the extent to which STEM skills are a necessity for tomorrow's Wisconsin workforce, whether our schools are preparing students to be STEM-savvy workers, and where STEM falls in the state's list of educational priorities

A Study of Adolescent Depression Among Middle School Students

Adolescent depression and teenage suicide should not be neglected and underestimated. While mental health is one of the ten health indicators that Healthy People 20 I 0 is focused on, and there are goals for the health community to work on, statistics are showing that teenagers in a county in Northern California were at high risk for mental health problem. This study was an introductory screening of the depression level of 7th graders attending middle school, and explored sources of adolescent perceived stress and routes of assistance. Results of the study show that almost one in every five 7th graders has symptoms of depression, and Asian students have the highest prevalence and a higher level of depression. Although most students are aware of counseling services being offered at school, only a few students have used the service for personal reasons. School nurses can play an important role in assessment, intervention, and referrals for students at risk for mental health problems

Characteristics of Children Attending Asthma Camp in Nevada

The purpose of this study was to assess asthma trigger knowledge of camp attendees and the measure of agreement between physician and parent assessment of the children’s asthma severity. This study is based on cross-sectional data provided by the American Lung Association (ALA) and those children participating in summer asthma camps in Las Vegas and Reno, Nevada. Fifty-six children participated in the camp in August of 2008. The study results suggest a significant positive correlation between physician and parent assessment of asthma severity. With increasing asthma severity there was a relative increase in the number of school days missed among attendees. Trigger knowledge was low among 25.9% (n=7) of attendees, 40.7% (n= 11) had moderate trigger knowledge, and only 33% (n= 9) demonstrated adequate trigger knowledge. Asthma camp is an effective venue to improve asthma education among children and provide a clinical assessment of this condition among those that are without a current diagnosis

A Preliminary Look at Early Educational Results of the Opportunity NYC - Family Rewards Program: A Research Note for Funders

Targeted toward very low-income families in six high-poverty New York City communities, Family Rewards offers cash payments tied to efforts and achievements in children's education, family preventive health care practices, and parents' employment. This paper reviews data on participants' receipt of rewards and offers preliminary estimates of the program's impacts on selected educational outcomes during the first year

The Kids Are Not Alright: Leveraging Existing Health Law to Attack the Opioid Crisis Upstream

The opioid crisis is now a nationwide epidemic, ravaging both rural and urban communities. The public health and economic consequences are staggering; recent estimates suggest the epidemic has contracted the U.S. labor market by over one million jobs and cost the nation billions of dollars. To tackle the crisis, scholars and health policy initiatives have focused primarily on downstream solutions designed to help those who are already in the throes of addiction. For example, the major initiative announced by the U.S. Surgeon General promotes the dissemination of naloxone, which helps save lives during opioid overdoses. This Article argues that the urgency and gravity of the opioid crisis demand a very different approach. To stop the epidemic, interventions are needed long before people are on death’s doorstep. Rather, it must focus on upstream interventions that stop people from becoming addicted in the first place. To accomplish this, we should leverage an existing legal infrastructure that is already capable of such a preventive response. Although largely overlooked as a tool in tackling this epidemic, children’s Medicaid, known as the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit, provides a mechanism to identify at-risk children and the treatment necessary to shift their life trajectories off of the road to addiction. This Article lays out a blueprint for the ways in which EPSDT, the largest provider of children’s health insurance in the country, facilitates best practices in substance abuse prevention through (1) regular mental health and substance abuse screening in the doctor’s office and (2) the provision of medically necessary treatment for children at risk for and engaged in opioid and other substance abuse. This upstream approach is consistent with Lifecourse Health Development theory, which emphasizes strategies that address risk factors and burgeoning health conditions in childhood before they become debilitating. Indeed, through the Medicaid statute and its legislative history, executive branch guidance, and judicial precedent, all three branches of the federal government have endorsed the power of Medicaid EPSDT to address health conditions early and preventively. This Article argues that this existing infrastructure should be leveraged so that at-risk children can access mental health and substance abuse services before a next generation falls victim to the greatest public health crisis of our time

Toward Reduced Poverty Across Generations: Early Findings from New York City's Conditional Cash Transfer Program

In 2007, New York City launched Opportunity NYC -- Family Rewards, an experimental, privately funded, conditional cash transfer (CCT) program to help families break the cycle of intergenerational poverty. CCT programs offer cash assistance to reduce immediate hardship and poverty but condition this assistance -- or cash transfers -- on families' efforts to improve their "human capital" (typically, children's educational achievement and family health) in the hope of reducing their poverty over the longer term. Such programs have grown rapidly across lower- and middle-income countries, and evaluations have found some important successes. Family Rewards is the first comprehensive CCT program in a developed country.Aimed at low-income families in six of New York City's highest-poverty communities, Family Rewards ties cash rewards to a pre-specified set of activities and outcomes in the areas of children's education, family preventive health care, and parents' employment. The program is available to 2,400 families for three years. Inspired by Mexico's pioneering Oportunidades program, Family Rewards' program effects are being measured via a randomized control trial.The Family Rewards demonstration is one of 40 initiatives sponsored by New York City's Center for Economic Opportunity (CEO), a unit within the Office of Mayor Michael R. Bloomberg that is responsible for testing innovative strategies to reduce the number of New Yorkers who are living in poverty. Two national, New York-based nonprofit organizations -- MDRC, a nonpartisan social policy research firm, and Seedco, a workforce and economic development organization -- worked in close partnership with CEO to design the demonstration. Seedco, together with a small network of local community-based organizations, is operating Family Rewards, and MDRC is conducting the evaluation and managing the overall demonstration. A consortium of private funders is supporting the project.1This report presents the initial findings from an ongoing and comprehensive evaluation of Family Rewards. It examines the program's implementation in the field and families' responses to it during the first two of its three years of operations. This evaluation period, beginning in September 2007 and ending in August 2009, encompasses a start-up phase as well as a stage when the program was beginning to mature. The report also presents early findings on the program's effects, or "impacts," on a wide range of outcome measures. For some measures, the results cover only the first program year, while for others they also cover part or all of the second year. No data are available yet on the third year. The evaluation findings are based on analyses of a wide variety of administrative records data, responses to a survey of parents that was administered about 18 months after random assignment, and qualitative in-depth interviews with program staff and families.Overall, this study shows that, despite an extraordinarily rapid start-up and early challenges, the program was operating largely as intended by its second year. Although many families struggled with the complexity of the program, most were substantially engaged with it and received a large amount of money for meeting the conditions it established. During the period covered by the report, Family Rewards reduced current poverty (its main short-term goal) and produced a range of effects on a variety of outcomes across all three program domains (children's education, family health care, and parents' work and training)