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Spark NH

Spark NH. Vision “All New Hampshire children and their families are healthy, learning, and thriving now and in the future.” Mission

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Spark NH

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  1. Spark NH Vision • “All New Hampshire children and their families are healthy, learning, and thriving now and in the future.” Mission • “To provide leadership that promotes a comprehensive, coordinated, sustainable early childhood system that achieves positive outcomes for young children and families, investing in a solid future for the granite state.” Focus • Expectant parents and children from birth through grade 3 and their families.

  2. Indicators • Good Health • Strong Families • Positive Early Learning Experiences

  3. Our Goal Identify and catalog data sources • Focus on sources that are authoritative and current Describe young families and children in NH • Examination and summarization some of the resources Make recommendations • Recommendation concerning collection, maintenance, and use of these sources

  4. New Hampshire’s 135,894 Children Age 0 – 8 years • 10 counties • 15 public health regions • 170 school districts • 259 towns • 292 populated census tracts Source: 2006-2010 ACS

  5. Good Health: Social, Emotional, Behavioral Indicator #1: • All young children with social-emotional or behavioral issues and their families have access to trained professionals to assess, diagnose, and treat them.

  6. Good Health: Social, Emotional, Behavioral • Early childhood mental health is the social/emotional well-being of children ages birth to age six which promotes the capacity to: • Experience, manage and express emotions • Develop and sustain stable relationships with others (adults and peers) • Safely explore the environment to learn • Demonstrate developmentally appropriate behavior Source: Susan Covert, Endowment for Health, 2009

  7. Good Health: Social, Emotional, Behavioral • Infant and toddler social-emotional wellbeing is linked to • Social competence • Ability to maintain healthy relationships • Self-regulation • Characteristics combined with positive outcomes are related to a child’s health, development, and academic performance. Source: National Center for Children in Poverty, 2009

  8. Good Health: Social, Emotional, Behavioral Data Sources • National Survey of Children’s Health 2007 • Endowment for Health • NH Association for Infant Mental Health • Mental Health Services for New Hampshire’s Young Children and Their Families: Planning to Improve Access and Outcomes, 2009 • NH Center for Public Policy • Mental Health Services in New Hampshire Schools, 2009

  9. Good Health: Social, Emotional, Behavioral National Survey of Children’s Health (NSCH) • Examines the physical & emotional health of children 0-17 years of age • Special emphasis is placed on factors such as medical homes, family interactions, parental health, school and after-school experiences, and safe neighborhoods • Conducted every 4 years • Sponsored by Maternal and Child Health Bureau of the Health Resources and Services Administration

  10. Good Health: Social, Emotional, Behavioral National Survey of Children’s Health (NSCH) 2007 • Sample size • 91,642 completed child-level interviews • Sample frame • U.S. households with one or more resident children ages 0-17 years • Data collection period • April 2007- July 2008 • Data collection • State and Local Area Integrated Telephone Survey (SLAITS) • Random digit dial approach • Collected over landline phones

  11. Good Health: Social, Emotional, Behavioral National Survey of Children’s Health (NSCH) 2007 • NH population: ages 0-17 years • 298,439 • Race/Ethnicity • White- 89.8% (264,184) • Black- 0.7% (2,116) • Hispanic- 3.2% (9,365) • Multi-racial- 3.1% (8,979) • Other- 3.3% (9,583)

  12. The Mental and Emotional Well-Being of Children Source: Endowment for Health

  13. The Mental and Emotional Well-Being of Children Source: Endowment for Health

  14. Good Health: Social, Emotional, Behavioral National Survey of Children’s Health (NSCH) 2007 Emotional & Mental Health Indicators • 31.3% of children (ages 4 months to 5 years) have a physical, behavioral or social development issue that is of concern to their parents • White: 28.9% • Black: 76.7% • Hispanic: 58.7%

  15. Good Health: Social, Emotional, Behavioral National Survey of Children’s Health (NSCH) 2007 Emotional & Mental Health Indicators • 6% of children (ages 4 months to 5 years) are at high risk for developmental, behavioral or social delay • White: 3.2% • Hispanic: 33.4%

  16. Good Health: Social, Emotional, Behavioral National Survey of Children’s Health (NSCH) 2007 Emotional & Mental Health Indicators • 27.1% children (ages 1-5) play with other children their age every day • White: 25.8% • Hispanic: 68.6%

  17. Good Health: Social, Emotional, Behavioral National Survey of Children’s Health (NSCH) 2007 Health Care Access & Quality Indicator • 18.1% of children (ages 10 months to 5 years) had received a developmental screening • Received health care in the past 12 months • White: 18.5% • Black: 10.4% • Hispanic: 23.1%

  18. Good Health: Social, Emotional, Behavioral NH Association for Infant Mental Health (NHAIMH) • Study on the availability, accessibility, and quality of early childhood mental health supports and services for New Hampshire’s youngest children (aged birth to six) and their families • Methodology – family and provider specific surveys and focus groups with families and key stakeholders • Survey respondents: • 178 families • 119 early care and education providers • 72 health care providers • 57 mental health providers

  19. Good Health: Social, Emotional, Behavioral NH Association for Infant Mental Health (NHAIMH) Challenges • State does not have adequate mental health services to meet the needs of young children and their families • Early childhood mental health screening and evaluations are not consistently provided • There is no approved process for determining eligibility for children 0 to 4 years • Over 50% of the early care and education providers reported that there are not enough mental health services to which they can refer young children Source: NHAIMH, 2009

  20. Good Health: Social, Emotional, Behavioral NH Association for Infant Mental Health (NHAIMH) Findings • 1 in 38 children were identified as needing early childhood mental health services (out of 119 early care & education programs surveyed) • Of 173 families surveyed, 46.2% were worried that their child (under age 6) might have a social emotional or behavioral disorder • Nearly half of the family respondents said that mental health screening was not part of their child’s annual physical • Most common reason for children needed mental health services was for external social emotional behavior Source: NHAIMH, 2009

  21. Good Health: Social, Emotional, Behavioral NH Association for Infant Mental Health (NHAIMH) Ability to Access Services • 80% of families said they had sufficient time to take their children • Services were not too far way • Transportation was not a barrier • They were eligible for all services needed • However, 28% of respondents indicated that they did not know where to get services • 30% reported they did not even know what services were available

  22. Good Health: Social, Emotional, Behavioral Mental Health Services in Schools • 75-80% of all children who receive mental services get them at school • Lack of communication and/or formal agreements between school personnel and mental health providers • Despite being funded by the same program • NH Center for Public Policy reports • 80% of schools provide mental health assessments and referrals • 50% of school provide family support services • Schools have inadequate mental health resources • No school-wide screening for behavioral or emotional problems • No formal training for staff to identify mental health issues • Third of schools do not collect any data on services being provided

  23. Good Health: Social, Emotional, Behavioral Resources • New Hampshire Early Supports and Services • 10 regional agencies contract with the NH Bureau of Developmental Services • Community Mental Health Centers (CMHC) • Located in 10 regions of the states • Contracted with DHHS and Bureau of Behavioral Health to provide publicly funded mental health services to individuals and families • Watch Me Grow • Developmental screening & referral system

  24. Good Health: Social, Emotional, Behavioral Resources • Child development clinics • Private practices • Preschool special education • Early head start/head start • Primary care physicians • Community home visiting programs • Private non-profit mental health • Preschool Technical Assistance Network (PTAN) • Division of children, youth, and families

  25. Good Health: Social, Emotional, Behavioral Improving Access & Availability of Services Emphasis placed on: • Increasing public awareness • Increasing training programs in early childhood mental health • More trained professionals in the field • Effective coordination & integration of services Source: NHAIMH, 2009

  26. Good Health: Social, Emotional, Behavioral Family Feedback: Paper Survey • Target population • Families • Target Locations • Schools, early head start/head start facilities, early childcare providers and educators, community mental health centers, doctor’s office • Sample Questions: Focus on child welfare, service availability & accessibility • Are you worried that your child might have a social, emotional, or behavioral issue? • Do you know what types of early childhood mental health services are available to your family? • Do you know where to get screening or information about screening? • Are services too far or located in an inconvenient area? • Do you think your primary care physician is knowledgeable childhood mental health?

  27. Good Health: Immunizations Indicator #2: • All children receive immunizations appropriate to their age, development, and mental status. 

  28. Good Health: Immunizations • Vaccination is the most effective way to prevent the spread of many of infectious diseases. • New Hampshire is committed to universal immunization coverage of all children 18 years of age and younger regardless of insurance status and provides vaccines, funded by health insurers and the federal and state governments, to every child in the State. • NH School Immunization Requirements*: • 4+ DTP/DT/DTaP • 3+ polio vaccine • 1+ MMR • 3+ hepatitis B vaccine • 1+ varicella vaccine • 4+ HIB vaccine required for preschool students 3-5 years old * Source: http://www.dhhs.nh.gov/dphs/immunization/documents/school12-13.pdf

  29. Good Health: Immunizations Data Sources: • National Immunization Survey (NIS) • Conducted annually by the National Immunization Program and the National Center for Health Statistics, Centers for Disease Control and Prevention. • Random digit dialing (RDD) telephone survey, with immunization provider record check (PRC) verification. • Assess immunization coverage among children aged 19-35 months in the United States and monitor the need for immunization in geographically defined areas. Source: http://www.cdc.gov/nchs/nis.htm

  30. Good Health: Immunizations Data Sources (continued): • New Hampshire Immunization Data 2011   • A collection of data from various sources including the NIS, BRFSS and NH School Vaccination Survey mostly in the time period between 2006 and 2009 • National Immunization Survey 2002-2006 Combined Data- NH • Combined data from the NIS between 2002-2006 to access vaccination coverage in NH • School Immunization Survey • This survey focused on Kindergarteners and 7th graders

  31. Good Health: Immunizations NIS estimated vaccine coverage among children aged 19-35 months in NH 2007-2010 * Vaccine series include 4+ DTP/DT/DTaP, 3+ polio vaccine, 1+ MMR, 3+ hepatitis B vaccine, and 1+ varicella vaccine

  32. Good Health: Immunizations NIS estimated coverage of vaccinations among children aged 19-35 months in NH 2007-2010 Source: NIS 2010; and the New Hampshire Immunization Data 2011

  33. Good Health: Immunizations NH School Immunization Survey 2010-11 and 2011-12 Source: Dionne-Odom J. State of the State. NH Immunization Conference, March 2012

  34. Good Health: Immunizations Estimated vaccine series coverage by selected characteristics for NH- 2002-2006 Source: NIS 2002-2006 Combined Data-New Hampshire  

  35. Good Health: Immunizations • Disparities: (2002-2006 data) • Children with parents speaking English at interview had higher coverage (74.9%) than children with parents speaking Spanish (66.5%).   • Non-Hispanic white had higher coverage (74.9%) than Non-Hispanic black (65.1%). • Children living in Manchester and Nashua cities had higher vaccine coverage 80.7-81.5%) than children living in Non-MSA areas (72.0%).  

  36. Good Health: Immunizations NIS estimated coverage of vaccinations among children aged 19-35 months by selected characteristics in NH 2010 Source: NIS 2010 data  

  37. Good Health: Immunizations • Areas with Incomplete Data and Recommendations: • Information about Religious Exemption is incomplete. Although parents or guardians are not required to name a religion or provide religion related information, the public health professionals could include religious related questions in the NH School Survey. Parents or guardians can provide such information voluntarily. • NH Immunization Data 2011 is a comprehensive report. But it does not include information about vaccination coverage by social economic characteristics. We recommend to include these data in the future updates of combined NH vaccination coverage.   • Implementation of the immunization information system (IIS)

  38. Strong Families: Multiple risk factors Indicator #3: • All families with young children who face multiple-risk factors (such as very low income, homelessness, and family violence) can access programs and services that work together to support them.

  39. Strong Families: Multiple risk factors Data Sources: • American Community Survey (ACS) • 2010 Census • 211 New Hampshire Characteristics: • Credible • State wide, preferable town level data • Reliable yearly up-date of key sources & reports

  40. Strong Families: Multiple risk factors Data Sources: American Community Survey (ACS) • Continuous survey by US Census Bureau of about 10,000 NH households per year since 2006. Earlier surveys had a smaller sample size. The survey contains about 78 questions some answered for each person in the household. The responses are compiled into over 1600 tables in 29 subject areas. • Data is reported annually with estimates based on 1yr, 3yr, and 5yr aggregated data. Estimates from the 5yr summary are available at the census tract level of geographic resolution. • Identifying vulnerable communities: 6 domains; 28 measures

  41. Strong Families: Multiple risk factors Disparities: New Hampshire Examples

  42. Family Strength • Screening for communities with multiple risk factors. • For each measure flag 10% of the census tracts with the highest need.

  43. Strong Families: Multiple risk factors Household family relationship: % population age 8 and younger % single parent families, children age 0-5 % Teen births % Large families, 5 or more children % Foster children % Living with grandparent, children age 0-10 Income security: Median household income, householder 25-44 % Children receiving public assistance income % Young children age 0-5 in poverty % Elementary school children 6-11 in poverty % Families with young children age 0-4 below 184% of poverty % new mothers below 200% of poverty % mothers unemployed, looking for work with children 0-5 % of families with children, parents not employed % uninsured: under 6, 6-17, 24-34

  44. Strong Families: Multiple risk factors Education: % new mothers with less than high school degree or GED % preschool children 3-4 in school % elementary school children 5-9 in school Housing: % Children in subfamilies % Households with children under 0-5 that rent Disability: % Children 0-4 with a disability % Children 5-17 with a disability Minority/Language: % Children in households with limited English % Children 0-9 of race other than white alone % population Hispanic or Latino race % children 0-17 that are foreign born

  45. Strong Families: Multiple risk factors Caveats: • This analysis is an exercise to explore the usefulness of population characteristics. • These results should not be used to infer conclusions about a community. • These measures are selected because they may be useful in understanding, reaching, and supporting young families. • This screening is best used as the starting point for discussion. • These measures are not a substitute for qualitative experts especially those familiar with local areas and populations.

  46. Manchester: Center city Manchester 14/28 Measures Flagged > 90th percentile Vulnerabilities Poverty Unemployment Single parents Mothers without high school Low English proficiency Minority, Foreign born Low home ownership Children 5-17 with disability Source: 2006-2010 , 2008-2010 ACS

  47. Winchester: Winchester 11/28 Measures Flagged > 90th percentile Vulnerabilities Poverty Unemployment Mothers without high school Grandparent householder Children in subfamilies Source: 2006-2010 , 2008-2010 ACS

  48. Claremont: Smallest of 3 tracts in Claremont 8/28 Measures Flagged > 90th percentile Vulnerabilities Poverty % population age 8 and younger Teen births High uninsured Source: 2006-2010 , 2008-2010 ACS

  49. Berlin: Smallest of 3 tracts in Berlin 13/28 Measures Flagged > 90th percentile Vulnerabilities Poverty Unemployment Single parents Teen births Mothers without high school Large families Children 6-17 uninsured Grandparent householder Children with disability Source: 2006-2010 , 2008-2010 ACS

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