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Kids Count! State's youngsters move forward in well-being index

Published on Wednesday, March 27, 2019

By: Kate Royals, kroyals2@umc.edu

Mississippi's children have a long history of well-being.

After years of coming in 50th, the latest Kids Count report by the Annie E. Casey Foundation shows the state moved to 48th in children's overall well-being, providing child care, childhood immunization, immunization coverage, prenatal care, childhood obesity and preventive care. The report also looked at the differences in statistics.

Portrait of Dr. Bettina Beech
Beech

Dr. Bettina Beech, professor of population health science and dean of the John D. Bower School of Population Health at the University of Mississippi Medical Center, said the improvement in Mississippi's ranking should be applauded.

"When you're comparing large numbers across states, moving up in rankings can be difficult, so let's applaud the efforts that got Mississippi moving into the right direction," Beech said. "I do not think that should be understated.

"Let's just keep going in the right direction."

MS-KIDS-COUNT-Logo.jpgThe report shows "mixed results" on the measurements of children's health. While the numbers are improved, when the data is disaggregated by race, it shows African-American families and children experiencing less positive outcomes.

According to the report, "We find that these families are less optimistic about their children 's lives than their parents, and that they are more likely to be in poor health. Black mothers are less likely than white mothers to receive prenatal care, and vaccination rates for young children. "

In Mississippi, 91.5 percent of white parents describe their children as "in excellent or very good health," while only 83.5 percent of black parents said the same about their children. Overall, 88.1 percent of all parents in Mississippi describe their children in excellent or very good health.

Vaccinations rates for Mississippi children from 19-35 months were higher than most other countries, and in some cases higher than the national rate. However, immunization rates are higher than those of the national average, but they are higher than the national average.

Portrait of Dr. April Palmer
Palmer

However, the report also noted vaccination coverage for completion of the seven vaccines by age 3 is lower in Mississippi than the national average. Dr. April Palmer, UMMC Professor of Pediatric Infectious Diseases, said that it was a recent change in the world.

Previously only the state of the art could approve these (medical) exemptions, usually based on known contraindications for vaccines, "she said. "Now any certified physician in Mississippi can give a medical exemption."

While the number of exemptions has not yet increased significantly, Palmer said it remains to be seen "if problems occur with exemptions being given to patients being seen and / or for unclear medical indications."

She said if this happens, it could threaten Mississippi's good track record.

"In addition, poor access to care, poor immunization and vaccination can all hinder vaccination," Palmer said.

The report also reads about prenatal care, revealing that 80.2 percent of white women in their first trimester of pregnancy while 70.6 percent of black women did the same. Lastly, the report revealed that while they were 56.5 percent of children in Mississippi, they were reported by their parents, 13.1 percent were overweight and 26.1 percent were obese, defined as a Body Mass Index at or above the 95th percentile.

Portrait of Whitney Herring
Herring

Dr. Whitney Herring, UMMC associate professor of pediatric gastroenterology, said other data she has seen paints a worse picture. And like the data in the Kids Count report, there are disparities based on race and even gender.

"Maybe we're not even realizing how big the problem is," she said, noting that it was intended.

For example, after sodas were removed from vending machines, they were often replaced with sports drinks. Healthier lunch options, lunch, lunch and dinner

Survey data, like the one used in the report Count, is not "traditionally a reliable indicator for weight status," Herring said. She works at UMMC 's Pediatric Weight and Wellness Clinic, where she has overweight children, a dietitian and a psychologist, if needed.

Herring said there are physical and emotional repercussions of being overweight or obese.

"There's poor self-esteem, depression - they often get a lot of bullied," she said. "And then in terms of the physical side - they can have hypertension, diabetes, early cardiovascular disease, bone and joint problems, fatty liver disease, cholesterol problems. . . It's a lot.

"What they are most concerned about, they are already in the severely obese category, and we know that it is increasing in the United States."

She said it was often difficult to make a positive difference.

Beech said the reason for the state's health problems is simple: poverty. She said until citizens "deal with poverty in a serious manner," Mississippi will continue to languish at the bottom of such lists.

“We need to start recognizing that health is beyond health care. Health begins in our homes, in our communities, in our families, in our environment,” Beech said. She said studies show clinical care accounts for 20 percent of health and health outcomes, while 60 percent is health behaviors and environment, or social determinants outside the health care system.

“Under this move of practicing population health in a clinical environment, we (UMMC) are beginning to pay attention to those issues.”

EversCare, a social program of UMMC’s Myrlie Evers-Williams Institute for the Elimination of Health Disparities, helps Medical Center patients who struggle with food insecurity, housing and transportation, health literacy, personal safety, and education by connecting them with community resources.

Llocated at the Jackson Medical Mall Thad Cochran Center, EversCare opened a food pantry in February in partnership with the Mississippi Urban League and the Mississippi Food Network. Patients considered “food insecure” and referred by their medical team can visit the pantry to receive healthy non-perishable foods.

“If you don’t have a regular source of nutrition, how will you get well?” Beech asked. “If we can keep people well and keep them out of the ED for things that are preventable, then we can allocate time and resources to people that really do need to be here.

"It improves the quality of life of patients as well as providers."