Transcript Texas KIDS COUNT: Our Border, Our Future

Texas KIDS COUNT:
Our Border, Our Future
May 8, 2009
La Fe Cultural & Technology Center
El Paso, TX
Our Sponsors
TX Counties Along the Border with Mexico
Jeff Davis
Presidio
El Paso
Hudspeth
Culberson
Terrell
Brewster
Val Verde
Kinney
Maverick
Zavala
Dimmitt
Webb
Brooks
Zapata
Jim Hogg
Starr
Willacy
Hidalgo
Cameron
One of Every Nine Kids Lives in
Border Counties
Rural Border
88,405 (1%)
Urban Border
710,995 (10%)
Urban Nonborder
5,305,704 (79%)
Rural Non-border
701,099 (10%)
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
2000
2007
5,023,066
4,515,629
11%
1%
El Paso
County
687,601
83,587
81,947
673,642
601,582
219,674
217,423
2%
Urban Border Rural Border
Urban Nonborder
658,449
-4%
12%
Rural Nonborder
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
90.6%
95.1% 93.7% 95.2%
88.2%
83.0%
El Paso County
Border
Non-border
31.8%
19.6%
11.2%
% of all kids who are in % kids in immigrant % all kids < 18 who are
immigrant families
families who are U.S. U.S. citizens (native or
born
naturalized)
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
$50,958
El Paso
Border
Non-border
$35,116
$38,352
$32,421
$28,037
Urban
Rural
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
$35,116
$32,046
$31,086
$29,840
$29,465
$32,354
$31,340
$29,831
$28,650 $28,554
$29,164
$29,092 $29,212
$27,633 $27,635
Median Income
Purchasing Power
2000
2001
2002
2003
2004
2005
2006
2007
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
14.0%
12.0%
El Paso County
Border
12.0%
Non-border
10.7%
10.6%
9.2%
10.0%
8.5%
8.9%
8.0%
8.2%
8.2%
7.8%
6.0%
5.9%
6.4%
5.9%
5.7%
4.0%
4.1%
3.7%
2.0%
0.0%
2000
2001
2002
2003
2004
2005
2006
2007
2008
Feb '09
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
50.0%
45.4%
42.9%
45.0%
40.0%
35.0%
30.0%
40.6%
38.4%
37.9%
37.1%
34.4%
33.9%
25.0%
20.0%
15.0%
19.1%
21.5%
21.2%
19.5%
Border
10.0%
El Paso County
Non-border
5.0%
0.0%
2000
2001
2002
2003
2004
2005
Source: Small Area Income and Poverty Estimates, U.S. Census Bureau. Border includes El Paso County.
2006
Children in Immigrant Families on Border
Much More Likely to Live in Poverty
Border
53.2%
El Paso County
Non-Border
47.3%
33.0%
26.7%
30.0%
13.1%
% of kids in immigrant families living
in poverty
% of kids with native parents who
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
Birthweight
< 2500g
>= 2500 g
Neonatal
(< 28 days old)
Post Neonatal
(>= 28 days old)
Maternal Health and Prematurity
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
Infant Deaths per 1,000 Live Births
Less than 28 days old
28+ days old
3.9
2.7
2.5
2.3
1.9
El Paso County
1.9
Border
Non-border
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
Infant death count
22
18
Weight < 1500g
1500-2499g
2500+g
8
6
Less than 28 days old
Source: 2005 death data, Texas Department of State Health Services
5
4
28+ days old
Reducing El Paso County’s Infant Mortality
Rate Will Require Increased Attention to
Maternal Health and Prematurity
Age at Death
Fetal
Birthweight
< 2500g
>= 2500 g
Neonatal
(< 28 days old)
Post Neonatal
(>= 28 days old)
Maternal Health and Prematurity
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
El Paso County
42.9%
Urban
Rural
41.2%
37.5%
37.4%
Percentage of All Live Births
34.1%
Border
Non-border
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
14.7%
20.0%
24.8%
Non-Border
16.0%
22.2%
29.9%
Some
College,
but No
Degree
Border
21.5%
25.9%
28.8%
Less than
High
High
School
School
Graduate
or GED
29.5%
29.1%
35.7%
37.7%
36.5%
42.0%
49.1%
52.5%
55.2%
El Paso County
Associate Bachelors Graduate
Degree
Degree
Degree
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
El Paso County
Border
Non-border
8.8%
7.8%
8.5%
Percentage of All Live Births
7.9% 8.3%
Urban
Rural
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
Percentage of All Low Birthweight Births (LBW)
El Paso County
Border
Non-border
63.0%
59.8% 59.6%
32.6%
25.9% 25.7%
11.9%
4.4% 2.9%
LBW to Mothers Who
Smoked
LBW & Preterm (< 37
weeks gestation)
LBW to Mothers with
Maternal Risk Factors
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
Percentage of All Live Births
El Paso County
Border
Non-border
19.9%
17.1%
16.3% 16.7%
12.4%
Urban
Rural
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
4
First
Births
535
483
28
First
Births
106
First
Births
276
First
Births
24
Previous
Births
386
Number of Births to Teens
First Birth
Had Previous Birth
4
Previous
0
Births
1
Previous
Previous
Births
Birth
13
14
15
277
144
77
16
17
Source: CPPP analysis of Texas Department of State Health Services 2005 birth data.
18
19
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
El Paso County
(25.4%)
Source: Texas State Data Center, Uninsured projections for children 0-17 in 2010.
Higher Child Medicaid Enrollment Along Border
Percentage of Children
on Medicaid
El Paso County
(39.3%)
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
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
97,887
Children Ages 0-18 Enrolled in Medicaid
Simplified
93,190
Enrollment
89,541
Begins
93,068
91,259
86,145
87,932
(Apr '09)
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
Source: Texas Health and Human Services Commission
Percentage of Drs with at least one Medicaid claim
Majority of Doctors Serving Children and Families
have Medicaid Clients
OB-GYN
Pediatrician
100%
General/Family Practice
100%
92%
83%
79%
83%
79% 82%
72%
El Paso County
Border
Non-border
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
Rate per 100,000 in Relevant Population
OB-GYN (women 15-44)
Pediatrician (ages 0-18)
General/Family Practice (all ages)
45.1 44.8
36.2
34.7 33.5
32.4
27.7
17.6
13.9
El Paso County
Border
Source: CPPP analysis of Texas Department of State Health Services 2008 data.
Non-border
Physician Acceptance of New
Medicaid Patients in Texas, 2008
Accept All New
Limit New
Accept No New
OB-GYN
42%
39%
19%
Pediatrics
42%
38%
20%
Family Medicine
30%
Surgical
15%
52%
0%
20%
54%
21%
40%
60%
27%
80%
Source: Texas Medical Association based on TMA Physician Survey 2008. Prepared by TMA, 2008.
100%
Texas Voice for Health Reform
El Paso, TX
May 8, 2009
Kymberlie Quong Charles, Coordinator
[email protected]
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."
Does our health care system need
complete overhaul, major
reform, minor reform or no
reform at all?
69%
-- President Barak Obama, Christian Science Monitor, March 6,
2009
Voter attitudes on Health System Change Reforms: Findings from a Survey
of 800 Likely Voters Nationwide, Lake Research Partners, April 20, 2009
“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
Affordability
Accessibility
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
Use of This Presentation
The Center for Public Policy Priorities encourages you to reproduce and distribute these slides,
which were developed for use in making public presentations.
If you reproduce these slides, please give appropriate credit to CPPP.
The data presented here may become outdated.
For the most recent information or to sign up for
our free E-Mail Updates, visit www.cppp.org.
© CPPP
Center for Public Policy Priorities
900 Lydia Street
Austin, TX 78702
P 512/320-0222 F 512/320-0227
Contact Information
Frances Deviney, PhD
Texas KIDS COUNT Director
[email protected]
(512) 320-0222 ext. 106
Kymberlie Quong Charles
Texas Voice for Health Reform
[email protected]
(512) 320-0222 ext. 115